Comparison of the efficacy of Schroth and Lyon exercise treatment techniques in adolescent idiopathic scoliosis: A randomized controlled, assessor and statistician blinded study

BACKGROUND

Adolescent idiopathic scoliosis (AIS) is the most common vertebral disorder in adolescence.

OBJECTIVES

The purpose of this study was to compare the effectiveness of Schroth and Lyon exercise methods on Cobb angle (CA), angle of trunk rotation (ATR), quality of life (QoL), and perceived trunk appearance in patients with AIS.

METHODS

The 31 participants diagnosed (diagnosis age = 12.2 ± 0.9) with AIS by a physician following the Lenke criteria and subsequently referred to the outpatient clinic were enrolled in the study. All participants were randomly assigned between the Schroth group (SG) and Lyon group (LG) for 6 months of supervised and home treatment. The participants' CA, ATR, Scoliosis Research Society-22 (SRS-22), and Walter-Reed Visual Assessment Scale (WRVAS) were assessed as a baseline, and again following the treatment by the same researcher who remained blinded to the study.

RESULTS

In 2-way mixed-design repeated-measures ANOVA analysis, when the change in time was analyzed between the groups (Group × Time [interaction]), a statistical difference was found more significant in SG for the CA-thoracic (F = 103.1, p < .01, 95% CI = 4.1; 2.0 to 6.2), CA-lumbar (F = 19.1, p < .01, 95% CI = 1.7; 1.0 to 2.4), ATR (F = 64.1, p < .01, 95% CI = 1.7; 1.2 to 2.3), and WRVAS (F = 169.5, p < .01, 95% CI = 6.5; 3.2 to 9.9) parameters. The LG was only more significantly improved in the SRS-22 total score (F = 15.7, p < .01, 95% CI = -0.9; -0.2 to -1.6).

CONCLUSION

In the study, The Schroth exercises gave more favorable results than Lyon exercises in terms of CA-T, CA-L, ATR and WRVAS in the conservative treatment of AIS, while Lyon exercises gave more favorable results in terms of QoL. Additionally, according to the results of this study, it was found that the QoL of participants in SG decreased after treatment compared to baseline.

Assessment of Physical Activity During Pandemic Periods: Development of the Questionnaire, Determination of Primary Validity, and Psychometric Properties

This study aimed to develop the "Pandemic Period Physical Activity Scale (PPPAS)" to determine the physical activity level of healthy individuals during the pandemic period. Research data were collected from the "Socio-Demographic Questionnaire Form," "International Physical Activity Short Form," "Tampa Scale for Kinesiophobia," "Coronavirus Anxiety Scale," "Epidemic Anxiety Scale," "Expert Evaluation Form," and "Pandemic Period Physical Activity Scale," exploratory factor analysis revealed that the scale consisted of 3 sub-dimensions and 31 items. Confirmatory factor analysis suggested that the fit indices χ2/Df: 2.343; root mean square error of approximation: 0.048; incremental fit index: 0.955; comparative fit index: 0.954; goodness of fit index: 0.912; normed fit index: 0.923; non-normed fit index: 0.950; adjusted goodness of fit index: 0.896; root mean square residuals: 0.060; standardized root mean square residual: 0.047. The total Cronbach Alpha coefficient of the scale was found to be 0.912 while the intraclass correlation coefficient of the scale was calculated as 0.958 (p<0.001). As a result of the analyses conducted, it was concluded that the PPPAS is a valid and reliable measurement.

The effectiveness of mobilization with movement on patients with mild and moderate carpal tunnel syndrome: A single-blinded, randomized controlled study

STUDY DESIGN

Single-blinded, randomized controlled study.

INTRODUCTION

Carpal Tunnel Syndrome (CTS) causes pain and loss of function in the affected hand. The mobilization with movement (MWM) technique is a manual therapy method applied to correct joint movement limitation and to relieve pain and functional disorders.

PURPOSE OF THE STUDY

This study aimed to examine the effectiveness of MWM technique on pain, grip strength, range of motion, edema, hand reaction, nerve conduction, and functional status in patients with CTS.

METHODS

A total of 45 patients enrolled in the study. The MWM group (n = 18) completed a 4-week combined conservative physiotherapy and MWM program, whereas the control group (n = 18) received only the 4 weeks of conservative physiotherapy. Pain severity according to the numerical rating scale was used as primary outcome.

RESULTS

We found an improvement within the subjects in resting pain (MWMG:5.1 ± 3.6 vs 1.1 ± 2.4, Effect Size (ES)=1.3; CG:4.5 ± 3.3 vs 1.0 ± 2.2, ES=1.1), in activity pain (MWMG:6.5 ± 3.7 vs 1.1 ± 2.4, ES=1.5; CG:4.8 ± 3.4 vs 2.2 ± 2.3, ES=1) and in night pain (MWMG:5.9 ± 3.2 vs 1.8 ± 2.5, ES=1.2; CG:5.3 ± 4.2 vs ± 2.3 ± 3.5, ES=0.9). For between the groups, a statistical difference was found for the activity pain, Disabilities of the Arm Shoulder and Hand Questionnaire score (MWMG:52.2 ± 23.8 vs 27 ± 24.7, ES=1.3; CG:47.0 ± 24.8 vs 41.5 ± 22.1, ES=0.2), Michigan Hand Outcomes Questionnaire (MHQ-1), (MWMG:44.4 ± 23.7 vs 74.7 ± 24.5, ES=1.3; CG:44.8 ± 17.4 vs 57.4 ± 21.7, ES=0.9) and MHQ-5 (MWMG:68.8 ± 13.1 vs 82.5 ± 11.5, ES=0.9; CG:63.4 ± 26.7 vs 59.3 ± 25.8, ES=0.1) parameters in favour of MWM group.

DISCUSSION

This study showed that MWM compared to conservative physiotherapy might be more effective in reducing perceived symptoms in mild and moderate CTS patients.

CONCLUSIONS

MWM produced a small benefit to recovery of activity pain and upper extremity functionality level outcomes of patients with mild to moderate CTS when added to a traditional CTS physical therapy program.

Factors influencing of quality of life in adolescent idiopathic scoliosis

BACKGROUND

Adolescent idiopathic scoliosis (AIS) is the lateral and horizontal deformity of the vertebral column which occurs idiopathically during adolescence. The aim of this study is to identify independent predictors of quality of life in AIS patients.

METHODS

In total, 31 adolescent patients diagnosed with AIS aged between 10 and 18 years old were included in the study. The scoliosis severity was determined for each patient according to the Cobb method, and their scoliosis perception using the Walter Reed Visual Assessment Scale, a pain assessment was conducted based on the Visual Analog Scale, quality of life using the Scoliosis Research Society-22 questionnaire, and depression level according to the Children's Depression Scale. Multiple Linear Regression analysis was then performed in order to determine the independent determinants of health-related quality of life.

FINDINGS

According to the Linear Regression analysis results, children's depression scale, walter reed visual assessment scale, cobb, and anterior trunk rotation explained 52.7% of the variance as independent determinants of SRS-22.

INTERPRETATION

The study examined the determinants affecting the quality of life in AIS patients. The results of the study showed that scoliosis severity, perception of cosmetic deformity, degree of rotation, and depression level to be predictors of quality of life in AIS patients. "This trail registered with NCT05242601."

Effects of Subtalar Joint Mobilization with Movement on Muscle Strength, Balance, Functional Performance, and Gait Parameters in Patients with Chronic Stroke: A Single-Blind Randomized Controlled Study

BACKGROUND

Losses in muscle strength, balance, and gait are common in patients with chronic stroke (CS). Ankle joint movements play a key role in this population to maintain a sufficient level of functional activity. The aim of this study was to investigate the effects of the subtalar joint (STJ) mobilization with movement (MWM) technique on muscle strength, balance, functional performance, and gait speed (GS) in patients with CS.

METHODS

Twenty-eight patients with CS were randomly divided into the control group (n = 14) and the STJ MWM group (n = 14). A 30-min neurodevelopmental treatment program and talocrural joint MWM were applied to both groups. Also, STJ MWM was applied to the STJ MWM group. The patients were treated 3 days a week for 4 weeks. Ankle dorsiflexion and plantarflexion muscle strength, Berg Balance Scale, Timed Up and Go test, and GS were evaluated before and after treatment.

RESULTS

Berg Balance Scale and Timed Up and Go test scores, dorsiflexion and plantarflexion muscle strength, and GS improved in both groups after the treatment sessions (P < .05), but the improvements were greater in the STJ MWM group compared with the control group (P < .05).

CONCLUSIONS

According to these results, STJ MWM together with neurodevelopmental treatment and talocrural joint MWM can increase ankle muscle strength, balance, functional performance, and GS on the affected leg in patients with CS.

Are Biomechanical Features of the Foot and Ankle Related to Lumbopelvic Motor Control?

BACKGROUND

Any pathomechanical change in the foot or ankle is expected to cause adverse biomechanical effects on the lumbopelvic region. However, no objective data can be found in the literature regarding the effects of musculus transversus abdominis (mTrA) and musculus lumbar multifidus (mLM), which are effective muscles in lumbopelvic motor control, or regarding the extent of their effects.

METHODS

Sixty-four healthy young adults were assessed by a physiotherapist (C.K.) experienced in treating feet and a radiologist (Y.D.) specialized in muscular imaging. In the determination of biomechanical properties of the foot, the navicular drop test (NDT), Foot Posture Index (FPI), pedobarographic plantar pressure analysis, and isokinetic strength dynamometer measurements were used in determining the strength of the muscles around the ankle. Ultrasonographic imaging was used to determine mTrA and mLM thicknesses.

RESULTS

Significant correlation was found between NDT results and mTrA and mLM thicknesses (P < .05) and between FPI results and mTrA thicknesses (P < .05). As the peak pressure of the foot medial line increased, mTrA and mLM thicknesses decreased (P < .05). Although dorsiflexion muscle strength was also effective, mTrA and mLM thicknesses were found to increase especially as plantarflexion muscle strength increased (P < .05).

CONCLUSIONS

These results show that the biomechanical and musculoskeletal properties of the foot-ankle are associated with lumbopelvic stability.

The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: A single-blind, randomized-controlled trial

OBJECTIVES

The purpose of this study was to compare the efficacy of two different types of exercise methods in patients with adolescent idiopathic scoliosis.

METHODS

In total, 28 subjects with adolescent idiopathic scoliosis with a mild curve magnitude (10°-26°) were randomly divided into two groups: the Schroth group (n = 14) and the core group (n = 14). The patients in the Schroth group were treated with supervised Schroth exercises, and the patients in the core group were treated with supervised core stabilization exercises; both groups performed the exercises for three days per week for a total of 10 weeks, and both were given additional traditional exercises to perform. Assessment included Cobb angle (Radiography), trunk rotation (Adam's test), cosmetic trunk deformity (Walter Reed Visual Assessment Scale), spinal mobility (Spinal Mouse), peripheral muscle strength (Biodex System 4-Pro), and quality of life (Scoliosis Research Society-22 questionnaire).

RESULTS

It was found that patients in the Schroth group showed greater improvement in Cobb angles, thoracic trunk rotation angle, cosmetic trunk deformity, spinal mobility, and quality of life than those in the core group (p<0.05), except for in lumbar trunk rotation angle. Peripheral muscle strength improvement was greater in the core group than in the Schroth group (p<0.05).

CONCLUSION

Schroth exercises are more effective than core stabilization exercises in the correction of scoliosis and related problems in mild adolescent idiopathic scoliosis, and core stabilization exercises are more effective than Schroth exercises in the improvement of peripheral muscle strength.

TRIAL REGISTRATION

NCT04421157.

Effects of Using Insoles of Different Thicknesses in Older Adults: Which Thickness Has the Best Effect on Postural Stability and Risk of Falling?

BACKGROUND

Postural stability (PS) problems arise as individuals grow older, and as a result, risk of falling (RoF) increases in older adults. We sought to examine the effects of insoles of various thicknesses on PS and RoF in older adults.

METHODS

Fifty-six study participants had PS and RoF evaluated statically and dynamically under five different conditions: barefoot, only-shoes, with 5-mm insoles, with 10-mm insoles, and with 15-mm insoles. Standard shoes with identical features were used. To avoid time-dependent problems, these assessments were performed under the same conditions in 3 consecutive weeks. The average of these three values was recorded.

RESULTS

Insoles of different thicknesses significantly affected static PS (overall: P =.003; mediolateral [ML]: P =.021; anteroposterior [AP]: P =.006), static RoF (overall, ML, and AP: P < .001), dynamic RoF (overall: P = .003; ML: P = .042; AP: P = .050), and dynamic PS (overall: P = .034; AP: P = .041) but not dynamic PS ML (P = .071). For static PS overall, dynamic PS AP, static RoF overall and ML, and dynamic RoF overall and ML, the highest PS scores and the lowest RoF were recorded when using 10-mm insoles (P < .05).

CONCLUSIONS

The use of insoles of different thicknesses has been shown to be effective on all RoF and PS measurements except dynamic PS ML. The 10-mm-thick insole was a better option for elderly individuals to increase PS and reduce RoF compared. For older adults, 10-mm-thick insoles made of medium-density Plastozote may be recommended to help improve PS and reduce RoF.

Does Plantar Pressure Distribution Influence the Lumbar Multifidus Muscle Thickness in Asymptomatic Individuals? A Preliminary Study

BACKGROUND

Atrophy can occur in the lumbar multifidus (LM) muscle quickly as a result of various musculoskeletal problems. Knowing factors influencing muscle thickness of the LM will provide important clues about lumbopelvic stability.

OBJECTIVES

Although there are several studies in the literature investigating the adverse effects of foot-ankle postural disorders on the lumbopelvic region, to our knowledge there has been no investigation of plantar pressure distribution (PPD) as a factor influencing muscle thickness of the LM. The aim of this study was to determine whether PPD could affect LM muscle thickness.

METHODS

This observational study consisted of 25 asymptomatic individuals. Ultrasonographic imaging was used to determine the thickness of the LM. All participants were subjected to PPD analysis using the Digital Biometry Scanning System and Milletrix software in 9 different plantar pressure zones. The Pearson product-moment correlation coefficients were used to examine the correlations between the LM muscle thickness and other variables. Stepwise multiple linear regression analysis was used to determine the variables with the greatest influence on LM muscle thickness.

RESULTS

Peak pressures of medial and lateral zones of the heel were the significant and independent factors influencing static LM thickness, with 39.5% of the variance; moreover, the peak pressures of heel medial and fourth metatarsal bone were the significant and independent factors influencing dynamic LM thickness, with 38.7% of the variance.

CONCLUSIONS

Plantar pressure distribution could be an important factor influencing LM thickness, although further research is required. Examining foot-ankle biomechanics may provide information about the stability of the LM.

Reliability and validity of the Turkish version of Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-T)

Background/aim

This study aimed to assess validity and reliability of the Turkish version of Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-T).

Materials and methods

The individuals who met inclusion criteria of the study were in patients of a hospital and a long-term care facility. Mini Mental Status Exam (MMSE), Cornell Dementia Depression Scale (CDDS), Global Deterioration Scale (GDS), visual analogue scale (VAS), and PACSLAC-T were administered to all subjects. The scales were repeated with an interval of two weeks for test–retest reliability.

Results

A total of 112 patients with dementia were included in the study. The intraclass correlation coefficient ICC for test–retest reliability of the PACSLAC-T was 0.713 with a 95% confidence interval of 0.486–0.843. The Cronbach’s α coefficient for total PACSLAC-T was 0.842 for test and 0.888 for retest, which indicated substantial internal consistency. In convergent validity, there were significant correlations between PACSLAC-T total score VAS (r = 0.684, P < 0.001), while no correlation was found between PACSLAC-T total score and CDDS (r = 0.127, P = 0.094), and GDS (r = 0.096, P = 0.167). Also, significant correlations were found between PACSLAC-T total score and MMSE (r = –0.468, P = 0.016).

Conclusion

This study showed that PACSLAC-T could be a promising tool for the management of pain in older adults with limited communication skills.

The Turkish Version of Pain Assessment in Advanced Dementia (PAINAD) Scale

Introduction

This study was conducted to test the reliability and validity of the Turkish version of the "Pain Assessment In Advanced Dementia (PAINAD) Scale".

Methods

One hundred and six older adults with advanced dementia (AD) were recruited in the study. Detailed medical history and demographic data of the participants were recorded. Initially, the Turkish version of PAINAD (PAINAD-TR), which was prepared by means of "back-translation", was applied. Along with this scale, Mini Mental State Examination, Clinical Dementia Rating scale, and Visual Analog Scale were also used.

Results

The Cronbach's α coefficient was 0.82 and 0.85 for the test and re-test, respectively. For the test-retest reliability of the PAINAD-TR scale, values of the intraclass correlation coefficient (ICC) and 95% confidence interval (CI) were 0.812 and 0.763-0.850 respectively. According to the results of a factor analysis carried out on the scale, a 2-domain structure was proved.

Conclusion

The PAINAD-TR scale can be used for the assessment and management of pain in non-communicative older adults with AD.