Synchronous and asynchronous telerehabilitation methods produce similar benefits in individuals with non-specific neck pain

INTRODUCTION

Evidence exists on clinical benefits of synchronous and asynchronous telerehabilitation for patients with non-specific neck pain (NSNP); however, limited studies are comparing synchronous and asynchronous telerehabilitation (TR) programs in this population. The aim of this study was to estimate the relative effectiveness of an 8-week synchronous or asynchronous TR in improving pain, functional disability, kinesiophobia, and mobility in patients with NSNP.

MATERIALS AND METHODS

This was a randomized, controlled clinical trial carried out on 60 individuals with NSNP. Participants were randomly assigned to synchronous TR group (n = 30) or asynchronous TR group (n = 30) that received the same exercise program for 8 weeks. Pain measured by Numeric Pain Rating Scale (NPRS), disability measured by Neck Disability Index (NDI), kinesiophobia measured by Tampa Scale of Kinesiophobia (TSK), and cervical range of motion were used as outcome measures. Assessments were performed at baseline, 4th week, 8th week, and 16th week.

RESULTS

The analysis showed a significant effect of time and significant interaction between group and time in NPRS, NDI, TSK, and cervical mobility scores (p < 0.05), yet the group effect was not significant (p > 0.05). There were no significant differences between the groups at all time points (p > 0.05) except for cervical right lateral flexion at 8th week (p = 0.036).

CONCLUSION

Telerehabilitation technologies are expanding at a rapid rate, and it is essential to understand the outcomes produced using these technologies in health conditions. This study showed that synchronous and asynchronous telerehabilitation produces similar results in patients with NSNP, supporting that either method can be used interchangeably.

Extracorporeal Shock Wave Therapy Versus Low Level Laser Therapy in The Treatment of Plantar Fasciitis: A Randomized Controlled Trial

BACKGROUND

Plantar fasciitis (PF) is predominantly treated conservatively through some modalities such as extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT), yet the short effect of these modalities on pain and function is still ambiguous. This study aims to compare the short-term effectiveness of ESWT and LLLT on pain and function in patients with PF.

METHODS

Participants (n=47) were randomly assigned into 2 groups as ESWT (n=27) and LLLT (n=20). ESWT (once a week) and LLLT (three times a week) were administered to the participants for 3 weeks. Foot function index (FFI) including pain, disability, and activity limitation subscales was administered at baseline and post-treatment. A reduction of one point in total scores was considered as a minimum clinically important difference. Repeated measures of ANOVA were used to analyze the changes in outcomes and compare the groups.

RESULTS

There were significant main effects of time, and significant interaction effects between group and time on pain (P<0.001), disability (P<0.001), and activity limitation (P<0.05). The main effect of the group was not significant for all subscales (P=0.811, P=0.481, P=0.865, respectively). The LLLT group showed a significant decline in pain (P<0.001), disability (P<0.001), and activity limitation (P<0.001) while there was no change in the ESWT group over time (P=0.319, P=0.711, P=1.0 respectively). Consistently, 95% of participants in the LLLT had CID in the pain subscale whereas 48% of the ESWT group had.

CONCLUSIONS

LLLT was found to be superior to ESWT as an effective approach in the short-term management of PF.

Personal, social, and environmental correlates of physical activity and sport participation in an adolescent Turkish population

Background

Benefits of physical activity has been shown for adolescents; however, there is a decline trend in number of adolescents meeting current WHO recommendations. This trend underlines the importance of identifying factors associated with adolescents’ physical activity level (PAL) with considerations of regional and cultural differences to plan and implement effective policies. Therefore, the aim of this study was to determine personal, ecological, and social factors associated with PAL and sport participation in Turkish adolescents aged 11–14 years. A cross-sectional study was conducted by including 996 adolescents aged between 11 and 14 years from 39 secondary schools in İstanbul, Turkey. Logistic regression analyses performed to identify the significant personal (age, gender, sleep time, screen time, BMIz score, having siblings), ecological (presence of playground, type of school transportation), and social (family income, engaging a physical activity with family, and preferred activity at school breaks) predictors of PAL and sport participation.

Results

Adolescents who were active during break time at school (p < 0.001), engaging a physical activity with family (p < 0.001), and did not have a sibling (p = 0.029) were more likely to be physically active. Adolescents behaved active during break time at school (p < 0.001), had a playground at home (p < 0.001), spending time with family for physical activity (p < 0.001), and did not have a sibling (p = 0.021) were more likely to participate in a sport activity.

Conclusions

Predictors of PAL in this study indicates the need to promote active break time in school, increased physical activity time with family, and to design environmental policies to increase number of playgrounds.

Functional hip joint centre determination in children with cerebral palsy

BACKGROUND

Although functional methods determining the hip joint center (HJC) are becoming increasingly popular, no systematic investigation has been conducted yet to assess the reliability of functional hip joint calibration in patients with cerebral palsy (CP).

RESEARCH QUESTION

What is the most reliable way to conduct functional calibration motions for estimating HJC location in children with CP and movement disorders?

METHODS

Twenty-two patients with CP were included in the study. A marker set for Plug-in Gait with additional cluster markers was used. Two functional calibration movements, including a new movement, were proposed and tested with one and three repetitions each. Functional HJCs were determined using the SCoRE approach and compared to results obtained by applying the conventional regression method for assessing face validity.

RESULTS

The choice of calibration movement had significant impact on SCoRE residuals and HJC location. Increasingly repeating calibration movements did not improve results. A modified star movement by allowing the toes to tip the ground provided the most reliable data and is feasible for children with GMFCS level I-III. The feasibility of the method is further improved by analyzing hip motion in the contralateral stance limb and, among the calibration movements, gave the most precise HJC estimation.

SIGNIFICANCE

Type and performance of the functional calibration movement is one key factor for determining a robust HJC. Analyzing the data in the stance leg via the modified star motion yielded robust and reasonable results for the HJC location, which should be validated in further studies that include imaging methods. Using one repetition instead of three seems promising in terms of feasibility for patients with movement disorder.

Gender and age impact on plantar pressure distribution in early adolescence

Objective

The aim of the study was to investigate gender and age effect on dynamic plantar pressure distribution in early adolescence.

Methods

A total of 524 adolescents (211 women and 313 men; mean age: 12.58 ± 1.11 years (range: 11–14 years)) participated in pedobarographic measurements during gait at self-selected speed. Data of peak pressure (PP), maximum force (MaxF-Newton), body weight corrected maximum force (BW_MaxF), contact area (CA-cm²) were analyzed for total foot and four plantar regions (hindfoot, midfoot, forefoot and toes).

Results

Higher toes PP was found in the ages of 12–14 years in females compared to males (253.79 ± 104.93 vs 216.00 ± 81.12 for the age of 12, p = 0.011, 264.40 ± 65.02 vs 227.21 ± 83.4 for the age of 13, p = 0.044, 299.75 ± 140.60 vs 238.75 ± 103.32 for the age of 14, p = 0.005). Females' higher MaxF especially for toes (136.24 ± 48.54 vs 115.33 ± 46.03, p = 0.008) and smaller CA especially for forefoot (50.12 ± 5.79 vs 54.4893 ± 6.80, p = 0.001) were considerable in the late of early adolescence. Forefoot (305.66 ± 82.14 females p = 0.001, 281.35 ± 79.59 males p < 0.001) and total foot PP (374.08 ± 113.93 females, p = 0.035, 338.61 ± 85.85 males p = 0.009) at the age of 14 was significantly higher than in younger ages in both gender groups.

Conclusion

The results indicate that especially the age of 14 years in early adolescence is a critical age for alteration in plantar pressure distribution. Interestingly females tended to increase their toe and forefoot plantar pressures compared to males by increasing age. We suggest that gender and age impact on toes plantar pressure alterations in early adolescence may be a possible risk factor for further foot impairments.

Level of Evidence

Level III, Diagnostic Study.

The immediate effect of patellar tendon strap on weight-bearing asymmetry during squatting in patients with unilateral knee osteoarthritis: A pilot study

BACKGROUND

Knee osteoarthritis has commonly been associated with a symptom of pain resulting in an inter-limb weight-bearing asymmetry during functional tasks. Patellar tendon strap is one of the non-pharmacologic interventions to alleviate knee pain.

OBJECTIVES

To investigate the immediate effect of a patellar tendon strap on weight-bearing asymmetry during squatting in people with unilateral knee osteoarthritis.

STUDY DESIGN

Cross-sectional study.

METHODS

Ten patients with unilateral knee osteoarthritis and 10 healthy subjects were included in the study. Weight-bearing asymmetry of patients was assessed using a weight-bearing squat test during squatting at 30° and 60° both with and without patellar tendon strap. Pain intensity was assessed during squatting in unstrapped and strapped conditions with Visual Analog Scale.

RESULTS

The decrease in weight-bearing asymmetry values immediately after wearing patellar tendon strap during 30° (p = 0.006) and 60° (p = 0.011) of squatting tests was significantly higher in knee osteoarthritis patients than in healthy subjects. Reported pain intensity was similar in unstrapped and strapped conditions (p = 0.066).

CONCLUSION

The results of this study showed improved inter-limb weight-bearing symmetry during squatting. Further research with larger sample sizes investigating the effect of patellar tendon strap on weight-bearing asymmetry during functional activities in people with knee osteoarthritis is warranted.

CLINICAL RELEVANCE

Patellar tendon straps (easily fit and cheap unlike knee braces) had more improvements in inter-limb weight-bearing symmetry during squatting in people with knee osteoarthritis compared to healthy subjects. This study is a new insight for future studies to investigate clinical benefits of wearing patellar tendon straps in this population.

Kinesiophobia in relation to physical activity in chronic neck pain

BACKGROUND

Little research is available concerning physical activity and its determinants in people with chronic neck pain.

OBJECTIVE

To explore the relation between kinesiophobia and physical activity and gender effect on these relations in people with chronic neck pain.

METHODS

Ninety-nine subjects (34 men and 65 women) with chronic neck pain were participated in the study. Pain intensity was assessed with Visual Analog Scale and kinesiophobia degree was determined by using Tampa Scale of Kinesiophobia. Level of physical activity was assessed with short form of the International Physical Activity Questionnaire.

RESULTS

There was no statistically correlation between neck pain intensity and kinesiophobia degree (p= 0.246, r= 0.123) and physical activity level (p= 0.432, r= -0.083). It was also found that kinesiophobia degree was not correlated to physical activity level (p= 0.148, r= -0.153). There was a negative correlation between kinesiophobia degree and physical activity level only for women, not for men (p= 0.011, r= -0.318).

CONCLUSIONS

Our results showed that although people with chronic neck pain reported higher pain intensity and fear of movement, pain intensity and kinesiophobia degree did not associate to their physical activity levels. It can be speculated that high kinesiophobia degrees cause low physical activity levels for women, but not for men.

Association between the physical activity level and the quality of life of patients with type 2 diabetes mellitus

[Purpose] Physical activity and regular exercise play an important role in glycemic control, which is considered an important part of the treatment of type 2 diabetes mellitus. This study evaluated physical activity level and its relationship with quality of life in patients with type 2 diabetes mellitus. [Subjects and Methods] We evaluated 129 subjects with type 2 diabetes mellitus through a face-to-face interview using the short version of the International Physical Activity Questionnaire and Diabetes-39. Demographic data, diabetes symptoms, time of initial diagnosis, and treatment procedure/approaches were recorded. [Results] Of the study subjects, 51 (39.5%) had low, 67 had moderate (51.9%), and 11 (8.5%) had high activity levels. The mean weekly sitting duration was 302 minutes. The mean weekly walking time was 231.7 minutes. Except for the "diabetes control" domain, scores for all the subgroups and the total score in the quality-of-life assessment had a statistically significant negative correlation with physical activity level. [Discussion] Physical inactivity negatively affects the quality of life of diabetic patients. A planned exercise education program and incorporation of exercise into the lifestyle can improve the quality of life of patients with type 2 diabetes mellitus.

Altered movement strategies in sit-to-stand task in persons with transtibial amputation

BACKGROUND

Sit-to-stand movement is an essential function for participation in many activities of daily living. Although this movement is one of the most important functional tasks, there is limited research investigating strategies of sit-to-stand movement in transtibial amputees.

OBJECTIVES

To examine movement strategies of the sit-to-stand task in persons with transtibial amputation and healthy non-amputated individuals.

STUDY DESIGN

Cross-sectional study.

METHODS

A total of 12 male unilateral transtibial amputees and 19 healthy male subjects participated in this study. Sit-to-stand movement was evaluated in terms of weight transfer time, weight-bearing symmetry, sway velocity, and rising index by using Balance Master System.

RESULTS

Participants in both groups exhibited similar weight-bearing transfer time (p > 0.05). Transtibial amputees demonstrated significantly greater weight-bearing asymmetry, higher sway velocity, and lower rising index than healthy subjects during the sit-to-stand transfer movement (p < 0.05).

CONCLUSIONS

Transtibial amputees were unable to use the same movement strategies during a sit-to-stand task as healthy individuals; therefore, they had to develop new strategies to perform this task.

CLINICAL RELEVANCE

Little is known about the altered movement strategies during sit-to-stand task in transtibial amputees. The results of the study might provide some new insight into the motor components of the sit-to-stand movement in persons with transtibial amputation for both clinicians and researchers.