İlkşan Demirbüken

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.

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.

Beliefs towards mental illness in Turkish physiotherapy students

Abstract Mental health is a new area of specialization for physiotherapists. However, they usually meet patients with psychiatric co-morbidities secondary to other chronic diseases. It is important to explore the beliefs of future physiotherapists regarding mental illness in order to implement effective strategies to avoid possible stigmatizing attitudes that may interfere with the rehabilitation process. Moreover, the psychiatric field should be introduced to physiotherapists as a clinical and research area. Therefore, we aimed to question the beliefs of physiotherapy students regarding mental illness using the Beliefs towards Mental Illness Scale in two different universities in Turkey. The total score of 524 students was 46.5 ± 14.5 out of 105 while the Dangerousness Subscale score was 21.2 ± 5.8/40; Incurability and Poor Social and Interpersonal Skills Subscale score was 24.2 ± 9.3/55 and Shame Subscale score was 1.1 ± 1.9/10. Students who had a relationship with an individual having a mental problem and students who had consulted a psychiatrist/psychologist for any mental problem showed more positive beliefs. Future physiotherapists should be informed and trained regarding people with mental illness both to avoid stigma and to be aware of this area in physiotherapy settings. Therefore, it is important to implement new curricula for schools providing physiotherapy education including courses, lectures and clinical practices in the psychiatry field.

The relationship between objective balance, perceived sense of balance, and fear of falling in stroke patients

Abstract Objective: The objective of our study was to investigate the relationship between objective balance, fear of falling, and perceived sense of balance (PSB) in stroke patients. Methods: Seventy patients aged 18–65 years with chronically developed hemiplegia or hemiparesis were enrolled in the study. Patients’ objective balance scores, fear of falling, and PSB were obtained using the berg balance scale (BBS), the falls efficacy scale (FES), and a visual analog scale, respectively. The Standard Mini-Mental Examination was performed to exclude patients with mental disorders from the study. Results: There was a moderate negative correlation between PSB and BBS scores (p = 0.001, ρ = −0.588); a strong negative correlation between BBS and FES scores (p = 0.001, ρ = −0.808); and a strong positive correlation between PSB and FES scores (p = 0.001, ρ = 0.714). We found that BBS scores had negative correlation with PBS scores in left hemiplegic patients while there was no any relationship between BBS and PBS scores in right hemiplegic patients. Conclusion: PSB assessment, besides the BBS, should be considered among the routine assessment methods that enable the rehabilitation team to be aware of patients’ balance capacities.

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.

Unilateral upper extremity lymphedema deteriorates the postural stability in breast cancer survivors

Aim of the study There is little known about any change in postural balance caused by asymmetrical volume increase due to unilateral upper extremity lymphedema in patients who underwent breast surgery. The aim of this study was to determine whether there is a change in postural balance by measuring postural sway velocity (PSV), center of gravity (CoG) displacement and directional control (DCL) in patients with unilateral upper extremity lymphedema in breast cancer survivors. Material and methods Eighteen females 38–60 (M = 53) years old diagnosed with upper extremity lymphedema due to breast cancer surgery, and 18 healthy females with similar ages (M = 52.5) were assessed using the Balance Master system (Neuro Com, Clackamas, USA). Unilateral stance (US) and bilateral stance (BS) tests in eyes open and closed conditions and the limit of stability (LOS) test were applied to quantify postural sway velocity (PSV), CoG displacement, and directional control (DCL). Results The lymphedema group showed a significant increase in PSV in the US test on the ipsilateral leg with eyes open (p = 0.02) and eyes closed (p = 0.005) as well as on the contralateral leg with eyes open (p = 0.004) and eyes closed (p = 0.0001). Average displacement and position of the CoG were 25% of LOS (p = 0.0001) towards the lymphedema side and 60.6 degrees respectively. DCL in the lymphedema group was significantly lower in forward (p = 0.0001), back (p = 0.003), ipsilateral (p = 0.002), and contralateral (p = 0.03) directions. Conclusions These findings suggest that unilateral upper extremity lymphedema may have challenging effects on postural balance.

Sigara İçicisi Olan ve Olmayan Sağlıklı Sedanter Bireylerde Yorgunluk Seviyesi ve Fiziksel Aktivite Düzeyi

Amac : Bu calismada; sigara icicisi olan ve olmayan saglikli sedanter bireylerin yorgunluk seviyeleri ve fiziksel aktivite duzeylerinin arastirilmasi amaclandi. Yontemler : Calisma; gonullu ve aydinlatilmis onami alinan 191 saglikli sedanter universite ogrencisi (sigara kullananlar; 21,01±1,34 yas, sigara kullanmayanlar; 20,76±1,65 yas) ile gerceklestirildi. Fiziksel aktivite duzeyi, Uluslararasi Fiziksel Aktivite Anketi (UFAA)’ nin kisa formu ve yorgunluk seviyesi Piper Yorgunluk Olcegi (PYO) ile degerlendirildi. Bulgular : Sigara kullanim durumu ile yuksek, orta, dusuk siddetli fiziksel aktivite ve toplam fiziksel aktivite duzeyi arasinda anlamli fark bulunmadi (p>0,05). Sigara kullanan ve kullanmayan bireylerin duygusal yorgunluk seviyesi arasinda anlamli fark bulunmazken (p>0,05); bilissel, duyusal, davranissal ve toplam yorgunluk seviyesi sigara icenlerde anlamli yuksek bulundu (p<0,05). Sonuc : Calisma sonucunda sigara kullaniminin genc sedanter universite ogrencilerinde duyusal, davranissal, bilissel ve toplam yorgunluk seviyesi uzerinde olumsuz etkileri tespit edilmistir. Sigara kullaniminin yorgunluk uzerine etkileri hakkinda universite ogrencilerini bilgilendirmeye yonelik calismalarin yapilmasi toplum sagligi acisindan faydali olabilir.

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