Mine Gülden Polat

Efficacy of neurodevelopmental treatment combined with the Nintendo® Wii in patients with cerebral palsy

[Purpose] The aim of this study was to investigate the efficiency of Nintendo® Wii games in addition to neurodevelopmental treatment in patients with cerebral palsy. [Subjects and Methods] Thirty hemiparetic cerebral palsy patients (16 females, 14 males; mean age, 6–15 years) were included in the study and divided into two groups: a neurodevelopmental treatment+Nintendo Wii group (group 1, n=15) and a neurodevelopmental treatment group (group 2, n=15). Both groups received treatment in 45-minute sessions 2 days/week for six weeks. Use of the upper extremities, speed, disability and functional independence were evaluated using the Quality of Upper Extremity Skills Test, Jebsen Taylor Hand Function Test, ABILHAND-Kids test, and Pediatric Functional Independence Measure (self-care) before and after treatment. [Results] There were statistically significant improvements in all parameters for group 1 and group 2 (except quality of function) after six weeks of treatment. Intergroup analysis showed that group 1 was superior to group 2 in mean change differences in the Jebsen Taylor Hand Function Test. [Conclusion] Our results showed that neurodevelopmental treatment is effective for improving hand functions in hemiplegic cerebral palsy. To provide a enjoyable, motivational, safe, and effective rehabilitation program, the Nintendo® Wii may be used in addition to neurodevelopmental treatment.

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 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.

AB1467-HPR Measurement of cervical proprioception in patients with axial spondyloarthritis

Background Axial spinal inflammation and spinal posture disorders in axial spondyloarthritis (axSpA) may deteriorate proprioception which may be caused by pathologic involvement of spinal entheses containing proprioceptive afferents.1 Cervical spine is one of the main inflammation area in axSpA.2 Impaired cervical proprioception has negative effects on postural control system.3 The cervicocephalic relocation mesure by laser pointer is found a reliable method to measure cervical sensory function in healty participants in a recent study.4 And there is limited data that regarding cervical proprioception in axSpA. Objectives To examine the differences in cervical joint proprioception between patiens with axSpA and healthy subjects. Methods The cervical joint position errors (JPE) were measured to evaluate proprioceptive function accuracy in patients with 29 axSpA and 21 healthy subjects by laser pointer with cervical application. Neutral head position method was used to evaluate proprioception in flexion, extension, rotation and lateral flexion in right and left movement directions at sitting position (figure 1).5 Three measures were performed, and the average of the three trials was used for analysis. The distance between zero spot and joint position which patient had been reconstructed was measured by centimetre. Spinal mobility evaluated by BASMI, function evaluated by BASFI and HAQ-S; disease activity defined by BASDAI, pain and fatigue were evaluated by VAS.Abstract AB1467HPR – Figure 1 Results There were 29 patients (21 men, mean (±SD) age; 41.4±10.9 years) and 21 healthy subjects (15 men, mean age 41.1±11.3 years). BASMI, HAQ-S and fatigue score were significantly higher in patients (BASMI values were 3.9±2.3 vs 1.3±0.7, p<0.001; HAQ-S values were 2.1±0.8 vs 0.8±0.2, p<0.001; fatigue values were 37.2±23.3 vs 16.2±14.9, p=0.001). The comparison of cervical JPE showed significantly larger errors (p<0.05) in patients with axSpa, except right rotation (p=0.166) (table 1).Abstract AB1467HPR – Table 1 Comparison of joint position errors between patients with axSpa and healthy subjects Variable(cm) AxSpA patients(n=29)(mean±SD) Healthy subjects (n=21)(mean±SD) P value JPE in flexion 9.88±6.70 4.66±3.57 0.001 JPE in extension 12.99±8.99 5.55±2.98 0.001 JPE in right rotation 11.10±6.56 8.62±4.41 0.166 JPE in left rotation 10.59±6.51 7.02±5.78 0.011 JPE in right side bend 11.32±6.53 6.39±3.54 0.001 JPE in left side bend 9.62±6.18 6.14±4.46 0.036 JPE=Joint position error, p values are based on Mann-Whitney U test. Conclusions Cervical joint position sense is impaired in subjects with axSpa. Proprioceptive training may help to boost the effectiveness of rehabilitation. References [1] Pompeu JE, Romano RS, Pompeu SM, Lima SM. Revista brasileira de reumatologia. 2012;52(3):409–16. [2] Madsen OR. Rheumatol Int. 2018. doi: 10.1007/s00296–017–3920–1. [3] Malmström EM, Fransson PA, Jaxmar Bruinen T, Facic S, Tjernström F. Exp Brain Res. 2017;235(9):2755–2766. [4] Hatamvand S, Ghiasi F, Asgari Ashtiani A.R, Akbari A, Hossienifar M. International Journal of Medical Research & Health Sciences, 2016, 5, 7S:598–603. [5] Alahmari K, Reddy RS, Silvian P, Ahmad I, Nagaraj V, Mahtab M. Braz J Phys Ther. 2017;21(4):259–267. Disclosure of Interest None declared

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

FRI0583-HPR The Effects of Kinesiologic Taping Applied on Quadriceps and Hamstring Muscles on Functions of Lower Extremity in Patients with Knee Osteoarthritis

Background One of the most common musculoskeletal diseases, osteoarthritis (OA) is characterized by the progressive loss of articular cartilage in synovial joints (1). One of the first and most widely seen symptoms among patients with knee OA is muscle weakness (2). In the patients with OA, some symptoms like the decrease in the quality of life and in the ability to move, functional limitation in daily life activities might be seen frequently (3). The taping method is a physiotherapy approach that is recommended by clinic guides for patients with knee osteoarthritis (4). Objectives While studies investigating the effect of taping applied on patellar tendon in the patients with knee OA are available in the literature, no study investigating the effect of kinesiologic taping applied on quadriceps femoris and hamstring muscles has been found.Our study aim was to investigate the effects of kinesiologic taping applied on two muscle groups on pain, range of motion, muscle strength, postural balance, functionality and effusion in patients with knee OA. Methods A total of 54 patients with knee OA, who applied to the Private Meditepe Medical Center for treatment, were included in the study between the dates of November, 2012-February, 2013. Pain levels were measured with a visual analog scale, range of motion was calculated with a universal goniometer, effusion was measured with a tape measure, muscle strength was measured with a digital muscle strength dynamometer, functional condition was measured with a KOOS scale, and postural balance level was taken with a Libra EasyTech Balance device. Patients were separated into two groups randomly. A total of 28 people were included in the study group, the remaining 26 people were included in the control group. The treatment started after the first assessment and was applied as 15 sessions for a total of three weeks, five sessions per week. Results It was found that there were significant improvements in all measurements for post-treatment compared to pre-treatment in the control group (p<0.05). It was also found that there were significant increases in all measurements except hamstring muscle strength value for post-treatment compared to pre-treatment in the study group (p<0.05). There was no statistically significant difference between post-treatment values of two groups (p>0.05). Conclusions According to the results of the study, kinesiologic taping applied on quadriceps and hamstring muscles in addition to physiotherapy programme has no effect on range of motion, muscle strength, postural balance, pain level, and functionality. References Sezgin M, Erdal ME, Altintas ZM, Ankarali HC, Barlas IO, Turkmen E, Sahin G. Lack of association polymorphisms of the IL1RN, IL1A, and IL1B genes with knee osteoarthritis in Turkish patients. Clin Invest Med. 2007;30(2):E86-92. Stensrud S, Risberg MA, Roos EM. Knee function and knee muscle strength in middle-aged patients with degenerative meniscal tears eligible for arthroscopic partial meniscectomy. Br J Sports Med. 2012 Dec 14. Liao CD, Liou TH, Huang YY, Huang YC. Effects of balance training on functional outcome after total knee replacement in patients with knee osteoarthritis: a randomized controlled trial. Clin Rehabil. 2013 Aug;27(8):697-709. Page C.J., R.S. Hinman and K.L. Bennell. Physiotherapy Management Of Knee Osteoarthritis. International Journal Of Rheum Dis 2011;14(2): 145-151. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4602