Physical performance tests have excellent reliability in frail and non-frail patients with prostate cancer

PURPOSE

Our aim was to investigate the test-retest reliability of the 2-min walk test (2MWT), timed up and go test (TUG), and five times sit-to-stand test (FTSST) in prostate cancer (PC) patients.

METHODS

This study was conducted with 73 patients who were classified into two groups as frail and non-frail determined by the Geriatric-8 questionnaire. Patients performed the 2MWT, TUG, and FTSST tests for two times. The test-retest reliability of the 2MWT, TUG, and FTSST was assessed by calculating the intraclass correlation coefficient (ICC). The standard error of measurement (SEM95) and minimal detectable change (MDC95) values were calculated.

RESULTS

All tests showed excellent test-retest reliability for both groups (ICC(2.1) > 0.90). The SEM95 and MDC95 values of 2MWT were 3.09, 8.57, and 3.15 m, 8.73 m for frail and non-frail groups. The SEM95 and MDC95 values of TUG for the frail group were 0.6 and 1.66 and 0.43 and 1.19 for the non-frail group, respectively. The SEM95 and MDC95 values of FTST for the frail group were 0.68 and 1.88 and for the non-frail group 0.86 and 2.38.

CONCLUSIONS

The 2MWT, TUG, and FTSST showed excellent reliability in frail and non-frail older adults with PC which can be used to assess physical performance.

Performance of myotonometer in the assessment of skin involvement in systemic sclerosis

OBJECTIVES

A clinically practical tool to assess skin biomechanical properties rapidly and accurately is still lacking. Our aim was to examine the intra- and inter-observer reproducibility of a myotonometer for objective skin property assessment in systemic sclerosis (SSc), comparing it with the modified Rodnan skin score (mRSS), and distinguishing patients from healthy controls.

METHOD

Thirty-four patients (21 limited and 13 diffuse SSc), and 31 age and gender-matched healthy controls were enrolled. Skin tone and stiffness were measured at four different anatomical sites (the forearm, hand, leg, and foot) using a myotonometer. The correlation between the mRSS and skin properties was assessed. Also, hand functionality was evaluated for possible correlations between the variables. The differences in skin properties between dcSSc and lcSSc patients, and healthy controls were assessed using variance analysis.

RESULTS

Intra- and inter-examiner reproducibility were excellent (ICC = 0.70 to 0.98) for tone and stiffness except for non-dominant hand tone, which showed good reliability (ICC = 0.64 to 0.74). Stiffness and tone values of the hands, forearms, and feet significantly correlated with mRSS total score (r = 0.40 to 0.71, p < 0.05). Additionally, tone and stiffness of the hands and forearms moderately correlated with hand function (p < 0.05). Tone and stiffness values increased in patients with dcSSc compared to healthy controls, or patients with lcSSc, at the hands, forearms, and legs (p < 0.05).

CONCLUSIONS

Our findings emphasize the potential utility of the myotonometer for assessing skin properties and differentiating SSc patients from controls, demonstrating its promise as a valuable clinical evaluation tool in this context. Key Points •The myotonometer displayed excellent intra- and inter-examiner reproducibility for assessing skin properties. •Skin tone and stiffness parameters well correlated with the mRSS scores. •The myotonometer can distinguish patients with diffuse cutaneous SSc from healthy controls.

Investigation of factors affecting physical activity level in patients with primary Sjögren's syndrome

OBJECTIVES

This study aimed to determine physical activity levels and understand the factors influencing an active lifestyle among patients with primary Sjögren's syndrome (pSS).

METHODS

Ninety-seven patients participated in this multicentric study. Physical activity levels were assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The Inflammatory Arthritis Facilitators and Barriers (IFAB) questionnaire was used to evaluate perceived barriers and facilitators to physical activity.

RESULTS

Forty-six patients were physically inactive and the rest of them were moderately active. Commonly identified barriers included a lack of motivation, fatigue, and pain. Conversely, knowledge of the health and mood benefits for physical activity emerged as a key motivator. Patients with better scores on facilitators and lower scores on barriers exhibited higher physical activity levels (p < 0.05). Notably, a high level of perceived facilitators of physical activity (odds ratio [OR]: 1.02; 95% confidence interval [CI], 1.00 – 1.05) and reduced pain (OR: 0.81; 95% CI: 0.69 – 0.95) were linked to an active lifestyle.

CONCLUSIONS

This study emphasizes the role of motivation and awareness of the benefits of physical activity for health and mood in driving physical activity for patients with primary Sjögren’s syndrome. Tailored physical activity programs that address psychological aspects and disease-related pain, and fatigue should be designed to counter sedentary lifestyles in pSS patients.

Perceived complexity of total hip arthroplasty: results of a survey of orthopedic surgeons

OBJECTIVE

No analysis of the perception of the complexity of total hip arthroplasty (THA) has been performed so far. This study aimed to evaluate the perceived complexity of the disorders faced by orthopedic surgeons in the evaluation process prior to THA.

SUBJECTS AND METHODS

A three-part online survey was administered to orthopedic surgeons. In the first part, the participants were asked questions about demographic and academic knowledge, as well as their experiences with THA. In the second part, it was asked to rate the complexity of certain disorders, such as soft tissue abnormalities, ankylosis/arthrodesis, dysplastic hip, high dislocated hip, post-traumatic arthrosis, protrusio acetabuli, etc., on a scale of one to five. Perceived complexity was classified as mild if the calculated mean score was <1.67, moderate if it was between 1.67 and 3.34, and complex if it was >3.34. In the last section, the effects of perceived complexity on surgical preferences were investigated.

RESULTS

THA administered for femoral neck fracture was graded as the least complex surgical challenge (mean score of 1.85±0.99), while high dislocated hip (Crowe III-IV) was scored with the highest mean score of 4.10±0.99. None of the disorders were evaluated as easy by orthopedic surgeons. Disorders of the high dislocated hip (Crowe III-IV) and protrusio acetabuli were identified as the most complicated cases by surgeons.

CONCLUSIONS

Perception of complexity affected preference for surgical approach. Besides, the level of education after participating in a course related to THA may affect the preferences of orthopedic surgeons when planning an operation.

Video-Based Information About Plantar Fasciitis Reflects Current Treatment Guidelines

BACKGROUND

Online health-related information has become increasingly popular. Social media platforms have great potential to support and change patients' perspective. Plantar fasciitis (PF) is a common disease that is one of the most frequently researched subjects among foot problems. This study aimed to assess the content, quality, and reliability of YouTube videos related to PF and to evaluate whether they reflect current PF treatment guidelines.

METHODS

The descriptive cross-sectional study analyzed the most viewed 79 YouTube videos retrieved by using the keyword "plantar fasciitis." The quality, reliability, and content of the videos were analyzed using Global Quality Scale (GQS), the modified DISCERN instrument, the Journal of the American Medical Association instrument, and a content scoring system by two independent physiotherapists. The analyzed videos were divided into three groups according to their GQS score as high, intermediate, and low quality. Also, video parameters were compared between the useful and misleading groups.

RESULTS

Of the 79 analyzed videos, 26 (32.9%) were of low quality, 29 (36.7%) were of intermediate quality, and 24 were of (30.3%) high quality. Most high-quality videos were uploaded by allied health professionals (39.4%). The view ratio and video power index scores were highest in patients. There were significant differences between useful and misleading videos in terms of DISCERN, GQS, and Journal of the American Medical Association scores (P = .000, P = .000, and P = .020, respectively). Almost all of the evaluated videos contain at least one treatment approach.

CONCLUSIONS

This study demonstrates that the vast of majority of YouTube videos on PF are useful and comprehensive; also, our results may lead us to propose that the vast majority of the videos reflect current treatment guidelines. Video-based information about PF may provide valuable insight to patients, especially in the absence of direct access to health care by stakeholders.

Exploring non-equilibrium processes and spatio-temporal scaling laws in heated egg yolk using coherent X-rays

The soft-grainy microstructure of cooked egg yolk is the result of a series of out-of-equilibrium processes of its protein-lipid contents; however, it is unclear how egg yolk constituents contribute to these processes to create the desired microstructure. By employing X-ray photon correlation spectroscopy, we investigate the functional contribution of egg yolk constituents: proteins, low-density lipoproteins (LDLs), and yolk-granules to the development of grainy-gel microstructure and microscopic dynamics during cooking. We find that the viscosity of the heated egg yolk is solely determined by the degree of protein gelation, whereas the grainy-gel microstructure is controlled by the extent of LDL aggregation. Overall, protein denaturation-aggregation-gelation and LDL-aggregation follows Arrhenius-type time-temperature superposition (TTS), indicating an identical mechanism with a temperature-dependent reaction rate. However, above 75 °C TTS breaks down and temperature-independent gelation dynamics is observed, demonstrating that the temperature can no longer accelerate certain non-equilibrium processes above a threshold value.

Is Morton's neuroma in a pes planus or pes cavus foot lead to differences in pressure distribution and gait parameters?

Morton's neuroma (MN) is a compressive neuropathy of the common digital plantar nerve causing forefoot pain. Foot posture and altered plantar pressure distribution have been identified as predispoing factors, however no studies have compared individuls with different foot postures with MN. Thus, we aimed to compare the effect of MN on spatiotemporal gait parameters and foot-pressure distribution in individuals with pes planus and pes cavus. Thirty-eight patients with unilateral MN were evaluated between June and August 2021. Nineteen patients with bilateral pes planus and 19 age and gender-matched patients with pes cavus who had no prior surgery were recruited. A Zebris FDM-THM-S treadmill system (Zebris Medical GmbH, Germany) was used to evaluate step length, stride length, step width, step time, stride time, cadence, velocity, foot-pressure distribution, force and whole stance phase, loading response, mid stance, pre-swing and swing phase percentages. There were no significant differences between the groups in spatiotemporal gait parameters (p > 0.05). Patients with pes planus displayed the following results for step length (49.36 ± 8.38), step width (9.05 ± 2.12), stance phase percentage (65.92 ± 2.11), swing phase percentage (34.08 ± 2.12), gait speed (2.96 ± 0.55), and cadence (100.57 ± 8.84). In contrast, patients with pes cavus displayed the following results for step length (49.06 ± 8.37), step width (8.10 ± 2.46), stance phase percentage (64.96 ± 1.61), swing phase percentage (34.79 ± 1.60), gait speed (2.95 ± 0.65), and cadence (99.73 ± 13.81). Foot-pressure distribution values showed no differences were detected in force, forefoot, and rearfoot pressure distribution, except for midfoot force (p < 0.05). The forefoot, midfoot, and rearfoot pressure values for the pronated group were 32.14 ± 10.90, 13.80 ± 3.03, and 22.78 ± 5.10, and for the supinated group were 33.50 ± 11.49, 14.23 ± 3.11 and 24.93 ± 6.52. MN does not significantly affect spatiotemporal gait parameters or foot-pressure distribution in patients with pes cavus or pes planus.

X-ray driven and intrinsic dynamics in protein gels

We use X-ray photon correlation spectroscopy to investigate how structure and dynamics of egg white protein gels are affected by X-ray dose and dose rate. We find that both, changes in structure and beam-induced dynamics, depend on the viscoelastic properties of the gels with soft gels prepared at low temperatures being more sensitive to beam-induced effects. Soft gels can be fluidized by X-ray doses of a few kGy with a crossover from stress relaxation dynamics (Kohlrausch-Williams-Watts exponents [Formula: see text] to 2) to typical dynamical heterogeneous behavior ([Formula: see text]1) while the high temperature egg white gels are radiation-stable up to doses of 15 kGy with [Formula: see text]. For all gel samples we observe a crossover from equilibrium dynamics to beam induced motion upon increasing X-ray fluence and determine the resulting fluence threshold values [Formula: see text]. Surprisingly small threshold values of [Formula: see text] s[Formula: see text] nm[Formula: see text] can drive the dynamics in the soft gels while for stronger gels this threshold is increased to [Formula: see text] s[Formula: see text] nm[Formula: see text]. We explain our observations with the viscoelastic properties of the materials and can connect the threshold dose for structural beam damage with the dynamic properties of beam-induced motion. Our results suggest that soft viscoelastic materials can display pronounced X-ray driven motion even for low X-ray fluences. This induced motion is not detectable by static scattering as it appears at dose values well below the static damage threshold. We show that intrinsic sample dynamics can be separated from X-ray driven motion by measuring the fluence dependence of the dynamical properties.

Identifying frailty and its associated factors in patients with axial spondyloarthritis

BACKGROUND AND AIM

Frailty is an elderly people phenomenon; however, younger adults with comorbidities may show a higher trajectory of frailty toward older age. The frailty status of middle-aged patients with axial spondyloarthritis (axSpA) remains little researched. We aimed to identify frailty status and to investigate the association of clinical, sociodemographic, and psychosocial factors with frailty.

METHODS

This study included 114 patients aged between 40 and 65 years. The patients were classified as frail, pre-frail, and robust according to Fried's phenotype and the Kihon Checklist (KCL). Physical function, quality of life, depression, anxiety, and disease-related factors were assessed. Between-group comparisons and multinomial logistic regression analysis were performed.

RESULTS

Frailty and pre-frailty prevalences were 20.2% and 49.1% for Fried's phenotype and 36.0% and 33.3% for the KCL. Frail adults had impaired physical function and increased disease activity compared to pre-frail and robust patients. Adjusted multinomial logistic regression analysis revealed that disease activity (odds ratio [OR] = 1.62, 95% CI = 1.12-2.34) and Short Physical Performance Battery (OR = 0.32, 95% CI = 0.18-0.56) were associated with Fried's phenotype-determined frailty. Disease activity (OR = 1.91, 95% CI = 1.11-3.26), Bath Ankylosing Spondylitis Functional Index (OR = 2.70, 95% CI = 1.56-4.67), and depression (OR = 1.55, 95% CI = 1.18-2.02) were associated with the KCL determined frailty.

CONCLUSION

Frailty and pre-frailty are commonly detected in middle-aged individuals with axSpA. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged axSpA patients.

Cross-cultural adaptation and validation of Diabetes Quality of Life Brief Clinical Inventory in Turkish patients with type 2 diabetes mellitus

PURPOSE

To translate and culturally adapt the Diabetes Quality of Life Brief Clinical Inventory (DQoL-BCI) into Turkish and assess the psychometric properties of the translated version.

METHODS

A forward-backward translation process was conducted in conformity with international guidelines. A total of 150 patients with type 2 diabetes mellitus (T2DM) completed the Turkish version of DQoL-BCI (DQoL-BCI-Tr). The factor structure, test-retest reliability, and construct validity were evaluated.

RESULTS

In the DQoL-BCI-Tr, the three-factor structure was found optimal and explained 68.7% of the variance. The DQoL-BCI-Tr showed excellent internal consistency (Cronbach's alpha = 0.90) and test-retest reliability (ICC = 0.98). Cronbach's alpha values ranged from 0.85 to 0.91 for subscales (satisfaction, worry, impact). A negative correlation was found between the total scores of the DQoL-BCI-Tr and the EuroQoL-5 dimensions (EQ-5D) indexes (r= -0.22, p < 0.01). The DQoL-BCI-Tr total score and satisfaction and worry subscale scores differentiated between groups defined by glycated hemoglobin (HbA1c>9%) and the use of insulin.

CONCLUSIONS

The study results showed that the DQoL-BCI-Tr can be served as a reliable and valid instrument to obtain information from Turkish patients with T2DM diagnosis, including satisfaction with treatment, the impact of the disease, and worry about the social/vocational issues.Implications for rehabilitationThe Turkish version of the Diabetes Quality of Life Brief Clinical Inventory (DQoL-BCI) is a valid and reliable instrument.The DQoL-BCI Questionnaire in Turkish (DQoL-BCI-Tr) is an easy and quick way to determine satisfaction with treatment, impact of disease, and worry about the social/vocational issues.The DQoL-BCI-Tr is a reliable instrument for assessing disease-specific effects, emotional loads, and satisfaction of Turkish patients with type 2 diabetes in clinical and research settings.

Physical literacy as a determinant of physical activity level among late adolescents

BACKGROUND/OBJECTIVES

This study aimed to investigate the level of physical literacy among late adolescents according to the current physical activity level and to examine the relationship between current physical activity, barriers to engaging in physical activity, and enjoyment of physical activity and physical literacy.

METHODS

A total of 568 university students (405 women) aged from 18 to 20 were involved in this study. The physical literacy, physical activity level, enjoyment from activity, and barriers to physical activity were assessed with the Perceived Physical Literacy Instrument (PPLI), the International Physical Activity Questionnaire-Short Form (IPAQ-SF), Physical Activity Enjoyment Scale (PACES), and the Physical Activity Barriers Questionnaire (PABQ), respectively. Multinomial and binary logistic regression analyses were employed to explore the association between physical literacy and physical activity level.

RESULTS

Highly physically active adolescents had better scores on the PPLI, PACES, and PABQ than moderately active and inactive participants. The PPLI total score was significantly moderately correlated with PACES total, positive, and negative scores and the PABQ score. There were significant poor correlations between the IPAQ-MET value and the PPLI scores. Adjusted logistic regression analysis revealed the PPLI total score and the PACES positive sub-scale scores, and gender (men) were associated with being highly active relative to moderately active.

CONCLUSIONS

The findings highlight the evidence that physical literacy, gender, and enjoyment from activity can be determinants of high or moderate physical activity levels. Therefore, improving physical literacy among late adolescence may be key to achieving increased physical activity level.

Inflammatory Arthritis Facilitators and Barriers (IFAB) for physical activity questionnaire: cross-cultural adaptation into Turkish and evaluation of its psychometric properties

PURPOSE

We aimed to conduct the translation and cross-cultural adaptation of the Inflammatory arthritis Facilitators and Barriers (IFAB) questionnaire into Turkish language for patients with axial spondyloarthritis (axSpA) and analyze the psychometric properties of the IFAB-Turkish version (IFAB-Tr).

METHODS

Data from ninety-three patients with axSpA were analyzed who completed the IFAB-Tr, Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS) and Bath Ankylosing Spondylitis Functional Index (BASFI). Internal consistency, test-retest reliability, convergent validity, floor and ceiling effect, measurement error were examined. Exploratory factor analysis (EFA) and confirmatory factor analysis were conducted.

RESULTS

Small modification was needed in the translation and cultural adaptation process. Internal consistency of the IFAB-Tr total score was 0.71 and test-retest reliability was excellent for IFAB-Tr (ICC = 0.90). A moderate negative correlation was found between IFAB-Tr total score and HAQ, HADS, BASFI scores. No floor and ceiling effect was detected. Minimal detectable change was 10.34 points. EFA revealed two factors which accounted for 55% of the variance.

CONCLUSIONS

The IFAB was successfully translated into the Turkish language and seems suitable for evaluating barriers and facilitators for physical activity in rheumatic diseases and could be used in clinical settings before designing a physical activity intervention.IMPLICATIONS FOR REHABILITATIONThe Turkish version of the Inflammatory arthritis FAcilitators and Barriers (IFAB) is a valid and reliable tool to assess barriers and facilitators to physical activity for patients with axial spondyloarthritis.More work is needed to assess all psychometric properties of the IFAB questionnaire in other inflammatory rheumatic disorders.The Inflammatory arthritis FAcilitators and Barriers questionnaire in Turkish is an easy and quick way to determine potential barriers to physical activity in clinical and research settings.

POS1537-HPR PERCEIVED BARRIERS AND FACILITATORS TO PHYSICAL ACTIVITY AND ITS ASSOCIATED FACTORS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

Background

Physical activity is a core treatment method in the management of axial spondyloarthritis (axSpA). Barriers to physical activity including high disease activity, symptoms such as pain, stiffness and fatigue and lack of time have been reported in qualitative and quantitative studies in patients with axial spondyloarthritis (axSpA). Inflammatory Arthritis FAcilitators and Barriers (IFAB) questionnaire has been developed to assess perceived barriers and facilitators to physical activity in patients with inflammatory arthritis. Identifying barriers and facilitators to physical activity using a rheumatic-specific tool may help to plan better patient management strategies in clinical practice.

Objectives

To determine barriers and facilitators of physical activity in patients with axSpA and explore associations between perceived barriers and facilitators to physical activity and education level, disease duration, functional status, anxiety, depression.

Methods

Between September and December 2021, 93 patients with axSpA were included in this study. Besides demographic and clinical variables, patients completed the IFAB questionnaire to determine the perceived barriers and facilitators to physical activity or exercise. Also, anxiety and depression status was determined with Hospital Anxiety and Depression Scale (HADS) and functionality was measured with Health Assessment Questionnaire (HAQ). Physical activity level was assessed using the International Physical Activity Questionnaire Short-Form (IPAQ-SF). Multiple linear regression analysis was used to investigate the association of HADS score, HAQ score, disease duration, educational status and the IFAB score.

Results

Of the 102 patients included, 93 were analyzed, 46 % were women. The mean age was 44.81±10.71 and the mean disease duration was 6.91 ± 6.92 months. According to the IPAQ-SF scores, 47.3 % of the patients were inactive, 49.5 % were moderately active and 3.2 % were active. The mean IFAB score was 4.61 ± 22.22, and 26 % of patients‘ score was below -5. One level increase in educational status resulted in an increase of 3,55±1,77 points in the IFAB score and a one-point increase in HADS-Depression score lead to a 2,00±0,57 decrease in the IFAB score.

Conclusion

In this axSPA population, 26 % scored below -5, indicating significant barriers and a need for a physical activity intervention. IFAB score was independently associated with education status and level of depression. Our results may propose that a comprehensive physical activity program should be designed considering psychological factors and should be prepared according to the educational status of the patients.

References

[1]Rausch Osthoff et al. Ann Rheum Dis. 2018.

[2]Davergne et al. BMC Musculoskeletal Disorders, 2021.

Table 1.

Characteristics of the included patients.

CharacteristicsMean ± SD (Median)Age (years)44.81±10.71 (47)Time since diagnosis (years)6.95±6.95 (5)BMI (kg/m2)27.17±4.75 (27)BASDAI4.49±2.22 (4.5)HAQ0.35±0.36 (0.25)HADS-anxiety7.89±5.44 (7)HADS-depression6.76±4.78 (6)IFAB-total score4.61 ± 22.22 (5)Figure 1.

Educational status of the included patients.

Disclosure of Interests

None declared

POS1528-HPR FACTORS ASSOCIATED WITH FRAILTY STATUS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

Background

Frailty is characterized by increased fatigue and vulnerability which leads to adverse health outcomes. Recent studies have reported the increased prevalence of frailty in various rheumatological diseases regardless of age. However, information about the prevalence of frailty in patients with axial spondyloarthritis (axSpA) is limited.

Objectives

This study aims to determine prevalence of frailty and its assocaited factors in patients with axial spondyloarthritis (axSpA).

Methods

In this monocentric cross-sectional study 50 patients (26 women) with axSpA aged between 40 to 65 were included. Frailty status was determined using Kihon checklist. Patients were groups as pre-frail, frail and robust according to the Kihon Checklist and <4 was accepted as robust, ≥4 pre-frail, 8≥ frail. Nutritional status, disease activity, functional level and quality of life were assessed using Mini Nutritional Assessment (MNA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankilozan Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) respectively. Analysis of variance and multivariate linear regression analyses were used to assess group differences and factors associated with frailty status.

Results

The mean age of the patients was 51.78±6.77, the mean disease duration was 7.8±8.41 years, the mean body mass index was 29.98 ±4.72 kg/m2. Twenty-one patients were classified as frail, 16 was pre-frail and 13 was robust. Compared to robust patients, pre-frail and frail individuals had significantly higher BASFI, BASDAI and ASQoL scores. There was a significant high correlation between the Kihon chekclist score and worse BASFI (r=0.62, p<0.001), BASDAI (0.69, p<0.001), ASQoL scores (0.73, p<0.001). Poor nutritional status was moderately correlated with frailty index score (r=-0.53, p<0.001). In multivariable linear regression analysis, nutrition status and level of quality of life were independently associated with frailty index score (p<0.001).

Figure 1.

Percentages of patients according to their frailty status.

Table 1.

Comparison of patients according to their frailty status

Robust (n= 13)Pre-frail (n=16)Frail (n=21)P1P2P3Age (years)53.84±7.2749.75±6.2252.04±6.74.24.73.56Sex, women/men (n)2/1110/614/7---BMI (kg/m2)27.86±5.6128.31±3.1530.19±5.07.96.35.46BASDAI2.39±1.814.83±1.605.93±1.83.00.00.15BASFI1.96±2.012.87±2.105.41±2.19.48.00.00ASQoL4.23±3.947.75±4.7612.61±4.22.08.00.00Mini Nutritional Assessment25.61±1.4724.59±2.1323.59±2.16.36.01.29

BMI; body mass index, BASDAI; Bath Ankylosing Spondylitis Disease Activity Index, BASFI; Bath Ankilozan Spondylitis Functional Index, ASQoL; Ankylosing Spondylitis Quality of Life Questionnaire. P1; P value between robust and pre-frail individuals, P2; P value between robust and frail individuals, P3; P value between robust and frail individuals.

Conclusion

Frailty or pre-frailty is common in patients with axSpA and the main factors associated with frailty status were poor nutritional status and level of quality of life. Since it is a reversible condition, identifying the frailty status and its associated factors may help to prevent further decline in functional level and to design appropriate treatment interventions. Further studies are needed to determine frailty prevalence and its predictors in patients with axSpA.

References

[1]Trujillo et al. Arthritis Rheumatol, 2019

[2]Lieber et al. ACR Open Rheumatol, 2022.

Disclosure of Interests

None declared

P279 Prevalance of frailty in patients with ankylosing spondylitis: a cross-sectional study

Background/Aims

Frailty is characterised by increased fatigue and vulnerability, which leads to adverse health outcomes. Although common in older adults, recent studies have reported the increased prevalence of frailty in various rheumatological diseases regardless of age. However, there are very few studies of the prevalence of frailty in people with ankylosing spondylitis (AS). Thus, this study aims to address this gap in the literature by investigating frailty prevalence in a group of AS patients and assessing the disease-specific outcome measures.

Methods

50 AS patients aged between 40 and 65 were included in this monocentric cross-sectional study. The study protocol was approved by the university ethics committee and all participants provided written informed consent. Patients were grouped as pre-frail, frail and robust according to the Kihon Checklist; &lt;4 was accepted as robust, ≥4 pre-frail, and 8≥frail. Grip strength, walking speed, pain during activity and rest were determined. Nutritional status, disease activity, functional level and quality of life were assessed using the Mini Nutritional Assessment (MNA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) respectively. One-way ANOVA was conducted to compare the patients in groups with post-hoc comparisons.

Results

26% of patients were robust, 32% were pre-frail and 42% were frail. Compared to robust individuals, the pre-frail and frail individuals had significantly higher BASFI, BASDAI, ASQoL scores and a higher level of pain severity during rest. Pain during activity and walking speed were not significant between frail and pre-frail individuals.

Conclusion

Our preliminary findings indicate that frailty or pre-frailty is common in working-age AS patients. Being frail resulted in higher disease activity and pain severity, and especially worse self-reported outcome measure scores. Since frailty is a reversible condition, identifying the pre-frailty and frailty status of AS patients may help to prevent further decline in functional level and to design appropriate treatment interventions.

Disclosure

Ö. Öztürk: None. Ö. Feyzioğu: None.

Effects of custom-made insoles on foot pressure redistribution, gait parameters, and pain in calcaneal apophysitis-a pretest and posttest study

BACKGROUND

Calcaneal apophysitis is a self-limiting disorder that often affects adolescents with a high level of activity and leads to increased pain severity, impairments in gait parameters, and poor health-related quality of life.

OBJECTIVE

To investigate the combination of custom-made insoles and exercise on foot pressure distribution, spatial-temporal gait parameters, and pain intensity in patients with calcaneal apophysitis.

STUDY DESIGN

A one-group pretest-posttest design.

METHODS

Forty patients, aged between 8 and 15 years, diagnosed with calcaneal apophysitis, were included in this study. Patients were asked to use the custom-made insoles and to perform a home exercise program for 3 days a week. The duration of treatment was 4 weeks. The pain severity was evaluated with the Visual Analog Scale. The spatial-temporal gait parameters and foot pressure distribution were assessed with the Zebris FDM-THM-S treadmill system before and after the treatment.

RESULTS

At posttreatment assessment, there were significant changes in step length, stance phase percentage, swing phase percentage, and gait speed (P < 0.05), except step width and cadence (P > 0.05). Moreover, significant differences were found in forefoot, midfoot, and rearfoot pressure distribution (P < 0.05). There was also a significant decrease in pain intensity during activity compared to the pretreatment (P < 0.05).

CONCLUSION

Our study results suggest that the combination of the custom-made insoles and exercise program created improvements in spatial-temporal gait parameters and foot pressure distribution by reducing the pain severity.

Changes in prefrontal cortex activation with exercise in knee osteoarthritis patients with chronic pain: An fNIRS study

The role of exercise on pain modulatory mechanism of the prefrontal areas is not clear. We aimed to determine the effects of exercise on functional activity of the prefrontal cortex in patients with knee osteoarthritis (OA) with chronic pain and to assess the relationships between changes in clinical variables and cortical hemodynamics with exercise via functional near-infrared spectroscopy (fNIRS). Fifteen patients with knee OA with chronic pain were included. All participants attended an exercise program 3 times a week for 6 weeks. Pain during activity was assessed by visual analogue scale (VAS). Pain catastrophization, kinesiophobia and functionality were also measured. Brain hemodynamic activity was assessed with a 47-channel fNIRS system before and after the exercise. Pain, pain catastrophization, kinesiophobia and functionality scores significantly improved (p < 0.05) while functional activity of the dorsolateral prefrontal cortex (DLPFC) during painful stimuli was significantly reduced after exercise program (p < 0.05). Change in cortical hemodynamic activity within the DLPFC was significantly correlated with change in pain perception (R = 0.54, p < 0.05) and pain catastrophization scores (R = 0.44, p < 0.05). Exercise resulted in improvements in clinical assessments of pain severity and pain catastrophization which was accompanied by alterations in prefrontal cortex activation. We provided evidence about the pain modulatory effects of exercise at cortical level which is correlated with clinical improvements in patients with chronic pain. We demonstrate the feasibility and potential of fNIRS methodology for i) elucidating the neural mechanisms underlying chronic and stimulus evoked pain, and ii) exploring the effect of treatment methods on brain functionality.

Effects of additional action observation to an exercise program in patients with chronic pain due to knee osteoarthritis: A randomized-controlled trial

BACKGROUND

Knee osteoarthritis (OA) leads to pain, stiffness, and functional impairment and eventually decreased level of the quality of life. Although several treatment methods have been used to achieve pain relief, patients still complain of pain.

OBJECTIVE

The aim of this study was to investigate the effects of the addition of action observation therapy to an exercise program on pain severity, pressure pain threshold, kinesiphobia functionality, and pain catastrophization in knee OA patients with chronic pain.

METHODS

This prospective, randomized-controlled, superiority trial included a total of 36 patients with knee OA. The patients were randomly divided into two groups as the treatment group (n = 18) receiving action observation therapy in addition to exercise and control group (n = 18) receiving exercise alone. The interventions were performed three times weekly for six weeks. The primary outcomes were pain and pressure pain threshold. Secondary outcomes were kinesiphobia, functionality, and pain catastrophization. All participants were assessed at baseline (pre-intervention) and after the six-week treatment (post-intervention).

RESULTS

There was no significant difference in the primary and secondary outcome measures before and after the intervention between the groups (p > 0.05). Both groups showed a significant improvement in all outcome measures after the intervention (p < 0.01).

CONCLUSION

Our study results suggest that action observation therapy in addition to an exercise program does not contribute any additional benefits to pain, pressure pain threshold, kinesiophobia, pain catastrophization, and functionality in knee OA patients with chronic pain. Nonetheless, further large-scale, long-term, prospective studies are needed to gain a better understanding on this subject.

Statics and dynamics of polymeric droplets on chemically homogeneous and heterogeneous substrates

We present a molecular dynamics study of the motion of cylindrical polymer droplets on striped surfaces. We first consider the equilibrium properties of droplets on different surfaces, we show that for small stripes the Cassie-Baxter equation gives a good approximation of the equilibrium contact angle. As the stripe width becomes nonnegligible compared to the dimension of the droplet, it has to deform significantly to minimize its free energy; this results in a smaller value of the contact angle than the continuum model predicts. We then evaluate the slip length and thus the damping coefficient as a function of the stripe width. For very small stripes, the heterogeneous surface behaves as an effective surface, with the same damping as a homogeneous surface with the same contact angle. However, as the stripe width increases, damping at the surface increases until reaching a plateau. Afterwards, we study the dynamics of droplets under a bulk force. We show that if the stripes are large enough the droplets are pinned until a critical force. The critical force increases linearly with stripe width. For large enough forces, the average velocity increases linearly with the force, we show that it can then be predicted by a model depending only on droplet size, contact angle, viscosity, and slip length. We show that the velocity of the droplet varies sinusoidally as a function of its position on the substrate. However, for bulk forces just above the depinning force we observe a characteristic stick-slip motion, with successive pinnings and depinnings.

Validity and reliability of the Turkish "Patient-Rated Wrist Evaluation" questionnaire

OBJECTIVE

The Patient-Rated Wrist Evaluation (PRWE) scale is a self-administered outcome questionnaire used to determine level of pain and disability in wrist problems. The scale includes pain (PRWE-P) and function (PRWE-F) subscales, the latter consisting of specific function (PRWE-SF) and usual (PRWE-UF) function. This study aimed to evaluate the validity and reliability of the Turkish versionof the PRWE scale.

METHODS

Permission was sought and received from the original author of the PRWE for a Turkish translation for use in the study. The study included 110 patients (85 female and 25 male; mean age: 50.8±1.53 years; range: 18 to 85) with distal radius fracture, carpal tunnel syndrome, wrist ganglion cyst, De Quervain syndrome, Kienböck disease, and connective lesions affecting the wrist, all of whom completed the Turkish version of both the PRWE (PRWE-T) and the Disabilities of the Arm Shoulder and Hand scale (DASH). Reliability and validity of the PRWE-T scale were evaluated via an internal consistency analysis and a factor analysis respectively. The level of correlation between PRWE-T and DASH scores was also examined.

RESULTS

Cronbach's alpha coefficient was calculated as 0.86, 0.82 and 0.88 for PRWE-P, PRWE-F and PRWE-T respectively for the scale and all subscales. The PRWE-T scale was found to be highly reliable. A statistically significant correlation was found between PRWE-T and DASH in the criterion-related validity analysis (Spearman's rho=0.9).

CONCLUSION

The PRWE-T was found to be valid and reliable. It is therefore suggested for use in evaluating patient-based pain and disability levels in routine clinical practice.

Postoperative granuloma after stapedectomy: is it destiny or avoidable?

OBJECTIVE

The aims of this study were (1) to investigate the pathophysiological characteristics of the middle ear mucoperiosteum against the caustic nature of the gastric content (GC), which consists largely of acid and pepsin components, and (2) to investigate the possible role of gastroesophageal reflux and postoperative vomiting (POV) in the etiology of poststapedectomy granuloma.

METHODS

40 Spraque-Dawley rats of either sex and with a body weight of 200-300 g were used, and divided into different study groups: group 1: GC administration to the middle ear (n = 8); group 2: phosphate-buffered saline administration to the middle ear (n = 8); group 3: GC (pH: 2) administration in the presence of a Teflon piston (TP) (n = 6); group 4: phosphate-buffered saline administration in the presence of a TP (n = 6); group 5: GC administration in the presence of a wired piston (WP) (n = 6); group 6: phosphate- buffered saline administration in the presence of a WP (n = 6). GC was administrated to the middle ear cavities by way of the eustachian tube (ET). In order to overcome the pressure of the ET, a pump mechanism was used. The increased nasopharyngeal pressure caused a passive opening of the ET, and transferred a bolus to the middle ear. The animals were decapitated after 1 week, and the bullae were isolated. The tympanic bullae were serially cut and examined with light microscopy.

RESULTS

In the saline controls, there was only a mild amount of polymorphonuclear cell (PMN) infiltration in the mildly thickened subepithelial space, indicating a less pronounced inflammation as compared to the gastric acid group. In the GC group, in addition to focal hemorrhage and severe subepithelial infiltration of PMNs, the middle ear mucosa was dramatically thickened with subepithelial edema and dilated capillaries. In the subepithelial tissue, retention cysts and granulation tissue were present. In the piston groups (TP and WP), there was extensive subepithelial inflammation and edema after GC and saline administrations. Granulation tissue filling the entire bulla around the piston segments was detected.

CONCLUSION

The relationship between the administration of GC and middle ear inflammation, and the possible role of POV in the etiology of poststapedectomy granuloma are emphasized with our experimental study. The length of the TP may be considerably important to prevent POV which may lead to gastric reflux to the middle ear.