Bahar Özgül

Effects of unilateral backpack carriage on biomechanics of gait in adolescents: a kinematic analysis

OBJECTIVE The aim of this study was to analyze the biomechanical alterations during unilateral backpack carriage in adolescents and to compare the kinematic parameters of the loaded and unloaded sides. METHODS Twenty adolescents (mean age: 13 ± 1.2 years) were assessed during walking with no backpack and with a backpack on one shoulder. The kinematic parameters of a gait at a self-selected speed were analyzed using motion analysis. Specific kinematic peak points were compared between asymmetric walking; unloaded, loaded side and mean of unloaded walking. RESULTS Peak ankle dorsal flexion, mean knee varum angle, peak value of hip extension and range of pelvic rotation decreased; and knee flexion at initial contact, hip adduction angle, mean pelvic anterior tilt and mean pelvic obliquity increased on the loaded side relative to the unloaded side and unloaded walking. Decreased maximum hip extension during late stance, increased hip adduction, elevated pelvis and increased anterior pelvic tilt were seen on the loaded side and the pelvis was lowered, ankle dorsal flexion increased and the hip was abducted on the unloaded side as a counter effect. CONCLUSION Both the unloaded and loaded sides were affected by asymmetrical backpack carriage. The biomechanical alterations seen in asymmetrical backpack carriage may put some extra load on the lumbar vertebral joints and altered frontal knee biomechanics contribute to low back pain and pathologies in the knee joint.

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.

The application of matrix rhythm therapy as a new clinical modality in burn physiotherapy programmes

PURPOSE The aim of the present study was to investigate the use of matrix rhythm therapy (MRT) as one of the electrotherapeutic modalities in clinics. METHODS This study was carried out in the Burn and Wound Treatment Department of Dr. Lütfi Kırdar Kartal Education and Research Hospital in Istanbul between October 2010 and August 2011. A treatment protocol including whirlpool, MRT and exercise was applied to a group of patients who had burn injury of upper extremity. The evaluation of each patient included assessment of pain, range of motion, muscle strength, skin flexibility and sensory function at pre- and post-treatment. RESULTS There was no significant difference in values of pain, muscle strength and flexibility between pre- and post-treatment assessments (p>0.05). A significant increase was found in the range of motion and sensory function at pre-treatment according to post-treatment (p<0.01). CONCLUSION The usage of MRT in order to maintain and improve the range of motion and to minimise the development of scar tissue was investigated in this study. We suggest conducting randomised controlled studies that carry out a comparison of the MRT with other treatment modalities with more cases and investigate the long-term effects of MRT.

A comparison of three different physiotherapy modalities used in the physiotherapy of burns.

The present study compared the effectiveness of matrix rhythm therapy, ultrasound treatment (UT), laser treatment (LT) used in the physiotherapy of burns. The study was conducted at the Wound and Burn Healing Center, Dr. Lütfi Kırdar Kartal Education and Research Hospital (Turkey) from June 2009 to January 2012. The case series comprised 39 individuals with second- and third-degree upper-limb burns, whose burn traumas ended approximately 1 to 3 months previously. Participants were separated into three groups: matrix rhythm treatment (MRT), UT and LT; each group was also applied a treatment protocol including whirlpool and exercise. Pain, range of motion (ROM), muscular strength, skin elasticity, and sensory functions were evaluated before and after the treatment. Pressure sense and passive ROM were higher in the MRT group than in the LT group (P < .05). Pain was lower in the LT group than in the UT group, and passive ROM was higher in the UT group than the in LT group (P < .05). Active ROM was found to increase in all treatment groups, whereas passive ROM increased only in the MRT and UT groups; pressure sense increased only in the MRT group, and pain decreased only in the LT group (P < .05). MRT was found to be more effective in the restoration of sensory functions than LT, whereas LT was more effective in reducing pain than UT. No significant difference was observed in terms of skin elasticity according to the results of three treatment modalities. It is suggested that further research with more cases should be conducted to examine the long-term effect of treatment modalities.

The Effectiveness of Bobath Treatment Approach in Physiotherapy ofCase with Ehlers-Danlos Syndrome

Ehlers-Danlos Syndrome (EDS) is one of the most frequent connective tissue diseases (1:5,000–1:10,000) and characterized by multiple clinical findings depending on connective tissue weakness in body system. Most of EDS patients consists of “hypermobility type (EDS-HT)” Physiotherapy program has an important place in the treatment of children with EDS-HT diagnosis and Bobath therapy aims to regulate muscle tone, provide postural alignment with special grip techniques and improve functions with the active participation of individual. The case with EDS-HT diagnosis is 5 year- old female child with 14 kg body weight, and 96.7 cm height. In 18th month, the case was directed to physiotherapy program towards hypotony and postural control problems in Private YA±ldA±z Cocuk Special Education and Rehabilitation Center. The case was evaluated three times for three years. Motor functions of the case were evaluated using Gross Motor Function Measurement (GMFM) scale, the disability level of the case was determined using Gross Motor Function Classification Scale and the functional independence level of the case was evaluated using Functional Independence Measure for Children (WeeFIM) scale. The applied physiotherapy program was designed from the exercises used in Bobath treatment approach. According to subsequent evaluations made through GMFM and weeFIM for throughout 3 years when the case received physiotherapy, a significant increase was observed in the scores of all parameters of GMFM and weeFIM, and an increase at one level in disability level was observed in GMFCS evaluation.

FRI0623-HPR Kinesiophobia Affects Range of Knee Flexion at Early Stage Following Anterior Cruciate Ligament Reconstruction

Background One of the most common complications following anterior cruciate ligament (ACL) reconstruction in sport rehabilitation is loss of knee motion (1). A fear of re-injury of ACL may contribute limitations of knee functions in terms of range of motions during rehabilitation process (2). Some athletes are not able to return to their pre-injury level due to loss of knee function and fear of motion in other words kinesiophobia. Objectives To investigate the relationship between range of motion (ROM) of the knee which is an important target in rehabilitation and kinesiophobia degree following ACL reconstruction in professional athletes. Methods The study was carried out with 14 certified athletes (8 male and 6 female, mean age: 21.5±5.86 years; mean body weight: 68.7±15.2 kg; mean height: 177.5±10.3 cm) who had unilateral ACL reconstruction and started post-op physiotherapy treatment participated in the study. All assessments were performed at 15th day following reconstruction. Kinesiophobia degrees of the athletes were assessed with Tampa Kinesiophobia Scale. A high score obtained from the scale indicates a high degree of kinesiophobia. Active and passive flexion degrees of knee joint were measured by using goniometer in accordance with Kendall-McCrearys criteria. All ROM measurements were performed 3 times and mean values of 3 measurements were saved for data analysis. The relationships between kinesiophobia degrees and active & passive flexion of the knee joint were analyzed by using Spearmans Correlation test. Results There was a strong negative relationship between the kinesiophobia degrees and active (r=-0.881, p<0.001) & passive (r=-0.887, p<0.001) ROM degrees of knee flexion. Conclusions One of the important aims of the treatment following ACL reconstruction is regaining functional level before injury and providing an early return to sports without any movement limitation. The results of this study revealed that presence of kinesiophobia at early stage influenced active and passive range of motion of knee joint negatively. Assessment of the kinesiophobia at early stage in ACL reconstructions could make a significant contribution to rehabilitation process in terms of achieving projected ranges of motions sooner in clinical settings. References Peter J. Millett, MD, MSc. Sports Medicine and Orthopaedic Surgery. ACL Reconstruction Rehabilitation Protocol. [Accessed 2016 January 30] Available from: http://drmillett.com/wp-content/uploads/2014/03/acl-rehab-protocol.pdf Kvist, J., Ek, A., Sporrstedt, K., & Good, L. (2005). Fear of re-injury: a hindrance for returning to sports after anterior cruciate ligament reconstruction. Knee surgery, sports traumatology, arthroscopy, 13(5), 393–397. Disclosure of Interest None declared