Zübeyir Sarı

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.

Investigation of the Efficacy of Different Physiotherapy Methods for Neck Pain

Objectives This study was carried out to compare the efficacy of mobilization, Kinesio tape [KT], and classic treatment methods in patients with neck pain. Methods Sixty patients with neck pain were enrolled. The patients were divided into three groups with 20 patients in each, for classic therapy, classic therapy plus mobilization, and classic therapy plus KT administered respectively to the first, second, and third groups. Pain levels and effects of the pain on daily life were assessed, respectively, with a visual analog scale and neck disability index [NDI]. Results Following the treatment, decreases were observed in pain and NDI scores in all three groups [P<0.001]. However, no significant difference was observed in the inter-group comparison [P>0.05]. While all three groups individually responded significantly to treatment, none of the groups superseded the others. Conclusions The results of this study suggest that KT and mobilization may be helpful as an alternative treatment in neck pain. Multi-centered studies in which the efficacy of KT and mobilization can be compared more objectively would be beneficial.

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.

AB1275 Research contribution to the journal of annals of the rheumatic diseases from 2012 to 2016: a bibliometric analysis

Background Rheumatology, a subspecialty of medicine, is devoted to diagnosis and therapy of rheumatic diseases, including clinical problems in joints, soft tissues, and autoimmune diseases. “Annals of the Rheumatic Diseases” is one of the most read and prestigious journals in the field of rheumatology. Bibliometric studies concerning the quantity and quality of articles published in rheumatology journals are scarce. The scientific production in the field of rheumatology from 1996 to 2010 was compared by Cheng.1 On the other hand, as to our knowledge, there is no study investigating research contribution to Annals of the Rheumatic Diseases since 2012. Objectives This study aims to investigate countries’ research contribution in the field of rheumatology by classifying scientific papers according to their countries between 2012 and 2016 in Annals of the Rheumatic Diseases, official journal of EULAR. Methods All scientific papers which were published from 2012 to 2016 in Annals of the Rheumatic Diseases were screened. Some scientific papers such as editorial, viewpoint notes, or letters were excluded. In addition, supplementary issues were excluded as well. Rest of the papers were separated in two different part: “clinical and epidemiological research” and “basic and translational research”. The papers were investigated one-by-one to determine their countries. All papers were classified according to their corresponding author. Results A total of 1616 scientific papers were investigated. Totally 1092 papers were included. While clinical and epidemiological research included 753 articles, basic and translational research contained 339 articles. There are 211, 188, 260, 235, 198 published articles in 2012, 2013, 2014, 2015, 2016, respectively. ,In 2012 ,2014 and 2015 the top countries to publish articles in Annals of the Rheumatic Diseases are England, Netherlands and USA. In 2013 and 2016, France is in the list of top countries instead of Netherlands. While, 46, 37 and 37 articles were published from England, Netherlands and USA, respectively in 2012, 53, 35 and 18 articles were published from England, USA and France, respectively in 2016. Conclusions According to our results, Western Europe and USA clearly dominate the production of scientific papers in Annals of the Rheumatic Diseases, official journal of EULAR. Our results are in accordance with the literature. We conclude that research resources, financial and other some issues may contribute the publishing process. Reference [1] Cheng T, Zhang G. Worldwide research productivity in the field of rheumatology from 1996 to 2010: a bibliometric analysis. Rheumatology (Oxford). 2013Sep;52(9):1630–4. Disclosure of Interest None declared

FRI0734-HPR Effects of virtual rehabilitation on shoulder periarthritis

Background The virtual rehabilitation (Nintendo Wii) program works with a 3-dimensional, computer-assisted, virtual reality creation system.The system creates a mirror effect and provides the smoothness of the movement of the adult. It keeps visual and sensory feedback during exercise.The avatar that appears on the screen detects motion and displays the result thanks to the control commander. The use of virtual reality practice in the exercise program is a new way of improving participation and motivation of participants. Objectives The aim our study is to investigate the effect of virtual rehabilitation on kinesophobia and clinical fragility in patients with shoulder periathritis. Methods Fifteen cases diagnosed with shoulder periarthritis were included in the study. In our study, we used Tampa Kinesophobia Scale for kinesophobia, VAS for pain severity, manual muscle test for muscle strength and goniometer for ROM. In addition to Clinical fragility Scale for fragility and 4-item Quality of Life Questionnaire were used to assess quality of life. Finally, Shoulder Pain and Disability Index (SPADI) was used for shoulder disability. Eight of 15 patients were included in the control group (CG) and 7 in the virtual rehabilitation group (VRG). Both groups were treated with Therapeutic US, TENS and Cold Pack. In addition to these, the control group consisted of 15 sessions of active stretching and strengthening exercises for 20 minutes each session; the VRG was given a total of 15 sessions of the virtual rehabilitation program for 45 minutes each session, with 3 sessions per week. Intra-group pretreatment and post-treatment differences were analyzed by Wilcoxon test, and inter-group comparisons were analyzed by Mann-Whitney U test. Results Statistically significant reductions in Frajilite, Kinesophobia, SPADI and VAS values were observed in the VRG analyzes; A statistically significant increase in the 4-item quality of life questionnaire, range of motion and muscle strength values was assessed (p<0.05). In the CG, there was a statistically significant decrease in kinesophobia, VAS and SPADI values; There was a statistically significant increase in joint range of motion and muscle strength evaluations (p<0,05). There was no statistically significant difference in the fragility evaluation of the CG (p>0,05). Fragility and kinesophobia decreased in both groups after treatment compared to before treatment, but this decrease was found to be higher in VRG (p<0.05). Conclusions As a result of our study, virtual rehabilitation in the treatment of kinesophobia and fragility in shoulder periarthritis patients was game-focused and it was found to be an effective method for increasing participation and biofeedback. Virtual rehabilitation was considered as an alternative to conventional physiotherapy and rehabilitation programs. References Cherniack EP, Florez HJ, Troen BR. Emerging therapies to treat frailty syndrome in the elderly. Altern Med Rev 2007;12:246–58. Topinková E. Aging, disability and frailty. Ann Nutr Metab 2008;52:6–11. Bal, A. Ekşioğlu, E. Gürçay, E. Karaahmet, Ö. Küçük, S. ve Çakcı, A. (2008). Subakromiyal sıkışma sendromlu hastalarda omuz dizabilitesinde etkili faktörlerin değerlendirilmesi. Turkiye Klinikleri Journal of MedicalSciences, 28, 468–472. Disclosure of Interest None declared

SAT0743-HPR Risk factors for fear of falling in patients with knee osteoarthritis

Background Severe knee osteoarthritis (OA) is characterized by stiffness, pain, and disability of the knee joint. Severe pain negatively affects muscle strength, coordination, postural stability, proprioception, mobility, and increases fall risk and possibly fear of falling. Individuals with severe knee OA experience loss of self-efficacy, activity avoidance, loss of self-confidence, and finally fear of falling without actually experiencing a fall (1). Despite the high prevalence of falls in patients with OA, few studies have investigated fear of falling in patients with knee OA (2). Objectives The present study was conducted to determine the risk factors affecting fear of falling and to investigate the relationship between fear of falling and age, gender, body mass index, pain level, range of motion, muscle strength, knee swelling, postural stability, and functional status in patients with knee OA. The purpose of our study was to evaluate the regression of fear of falling and identify its risk factors in patients with severe knee OA. Methods A total of 71 patients who were diagnosed with knee OA according to the American College of Rheumatology (ACR) and who were accepted as stage 2 and 3 based on the Kellgren-Lawrence criteria, were included in the study. Outcome measures included fear of falling, pain intensity, and range of motion, quadriceps and hamstring muscle strength, knee swelling, postural stability, and functional status. Pearson correlation and multiple logistic regression test was used to determine the risk factors of fear of falling and relationships between fear of falling and age, body mass index, pain intensity, range of motion, muscle strength, knee swelling, postural stability, and functional status. Results Multiple logistic regression analysis showed that age (odds ratio=12.5, p=0.011), body mass index (odds ratio=14.5, p=0.030), pain intensity (odds ratio=3.5, p=0.045), range of motion (odds ratio=9.8, p=0.012), and knee swelling (odds ratio=8.4, p=0.019) were independent risk factors for fear of falling among patients with knee OA. Conclusions We conclude that age, body mass index, pain intensity, range of motion and knee swelling influence the fear of falling. They are viewed as an important predictor of fear of falling in knee OA. Our results could be used to help select knee OA patients who should be enrolled in fall prevention programmes. References Tsonga T, Michalopoulou M, Kapetanakis S, et al. Risk factors for fear of falling in elderly patients with severe knee osteoarthritis before and one year after total knee arthroplasty. J Orthop Surg (Hong Kong). 2016 Dec;24(3):302–306. Levinger P, Menz HB, Wee E, Feller JA, Bartlett JR, Bergman NR. Physiological risk factors for falls in people with knee osteoarthritis before and early after knee replacement surgery. Knee Surg Sports Traumatol Arthrosc. 2011 Jul;19(7):1082–9. Disclosure of Interest None declared

FRI0771-HPR Work – related lumbar pain in physiotherapists who work in different fields – a pilot study

Background Having a job exposing the load on the lumbar region increases lumbar pain risk. Lumbar pain takes first place in musculoskeletal disorders among health care workers. A survey which investigated musculoskeletal disorders in physiotherapists indicated that the most common musculoskeletal disorders have seen in the lumbar region. Objectives The aim of this study was to determine the work – related lumbar pain in physiotherapists who work in different fields and differences in terms of occupational and personal variables. Methods This was a prospective, comparative and multi – central study. Physiotherapists who accepted to participate in this study voluntarily and work at any of paediatric, orthopaedic and neurological fields were received. Eighty – eight physiotherapists were taken first assessment. Their demographic information were taken and they filled out the Oswestry Low Back Disability Questionnaire. Twenty – nine cases who had any orthopaedic disease, surgical history and did not fill the entire of the Oswestry Low Back Disability Questionnaire excluded from the study. Twenty – eight women and 31 men met the criteria for inclusion. Physiotherapists were divided into three groups as paediatric (n=21), orthopaedic (n=24) and neurological (n=14). Lumbar pain level, the number of daily patient transfer, daily working hours and daily standing working hours in three groups were compared. One – way ANOVA was used to compare the groups. SPSS v11.5 was used for the statistical analysis. Results There were no significant differences in lumbar pain levels between groups (p=0.342). Daily standing working hours of paediatric group were significantly less than orthopaedic group (p=0.021) and the number of daily patient transfer were significantly higher in paediatric group according to orthopaedic group (p=0.028). Daily standing working hours and the number of daily patient transfer of neurological group had no differences between other groups (p=0.173). Conclusions We think that the reason why no differences between the pain level of paediatric and orthopaedic group may be due to more daily transfers in paediatric group and more daily standing working hours in orthopaedic group. The cause why no differences between neurological field and others, might be because of another working factors which we did not assessed. There is a need for research examining in detail on working conditions and trials including more cases. Disclosure of Interest None declared

AB1237-HPR Postural stability and ankle proprioception in different subgroups of subjects with hallux valgus

Background Hallux valgus (HV) is lateral deviation of the great toe towards the second with subluxation of the first metatarsophalangeal joint and medial deviation of the first metatarsal (1). Increasing HV severity has been shown to negatively impact on health-related quality of life and self-reported function, and HV has been linked to increased falls risk in older adults (2). HV, in particular, is associated with poorer performance during postural stability and functional testing in older adults (3). Objectives Despite the findings of impaired postural stability in older adults with hallux valgus, the links between functional status and postural stability, ankle proprioception are not well established in HV. One of clinical significance of this study was to determine whether impaired postural stability was caused by deficits in ankle proprioception and impaired functional status in HV subjects. Our purpose of this study was to assess postural stability and ankle proprioception in different subgroups of HV. In this study, we hypothesized that subjects with severe deformity would exhibit poorer postural stability and ankle proprioception performance compared to subjects with mild and moderate deformity in HV. Methods Thirty-five adults diagnosed with unilateral HV according to the Manchester Oxford Foot Questionnaire deformation grade 2 and on were participated in the study. They were distributed among three groups: Mild (grade 2), moderate (grade 3), and severe deformity (grade 4). Functional status was measured with a disease specific score (the hallux valgus scale of the American Orthopaedic Foot and Ankle Society). While postural stability was measured with Pedalo Sensamove® System, ankle proprioception was measured with Biodex Balance System Pro 4. Results Subjects in HV with severe deformity group showed poorer postural stability performance than those in HV with mild (p=0.024) and moderate (p=0.039) deformity groups. However, there was no significant difference between the groups in ankle proprioception. There was a significant correlation between postural stability and functional status (p<0.05, r=0.771) in all subjects with HV. In addition, it was found that ankle proprioception was not correlated to functional status and postural stability (p>0.05). Conclusions It has been concluded that HV with severe deformity affects postural stability according to the results of our study. On the other hand, ankle proprioception is not as an important predictor as postural stability for rehabilitation in different subgroups of HV. Therefore subjects in HV with severe deformity should be focused on stability exercises, in particular, in addition to home – based exercise programs, foot orthoses, footwear recommendations, and patient education in their rehabilitation. References Booth S, Bhosale A, Mustafa A, Shenoy R, Pillai A. Triple osteotomy for the correction of severe hallux valgus deformity: Patient reported outcomes and radiological evaluation. Foot (Edinb). 2016 Aug;28:30–35. Hurn SE, Vicenzino B, Smith MD. Functional impairments characterizing mild, moderate, and severe hallux valgus. Arthritis Care Res (Hoboken). 2015 Jan;67(1):80–8. Sadra S, Fleischer A, Klein E, Grewal GS, Knight J, Weil LS Sr, Weil L Jr, Najafi B. Hallux valgus surgery may produce early improvements in balance control: results of a cross-sectional pilot study. J Am Podiatr Med Assoc. 2013 Nov-Dec;103(6):489–97. Disclosure of Interest None declared

AB1239-HPR The Effects of Kinesiologic Taping and Extracorporeal Shock Wave Therapy (ESWT) on Functional Outcomes in Patients with Plantar Fasciitis – a Randomized Trial

Background Plantar Fasciitis is a common cause of heel pain that affects up to 10% of the population and accounts for approximately 600,000 outpatient visits annually (1,2). Multiple treatment options range from conservative to surgical interventions, although studies of the effectiveness of each modality have had conflicting results (1). The preferred treatment is physiotherapy, which has the aims of suppressing the pain, restoring the mechanical function of plantar fascia and improving the gait (2). In addition, treatments for plantar fasciitis using shockwaves have shown good results with regard to pain relief and functional improvement (3). However, although alleviating symptoms, nonsurgical interventions, such as rest, exercise, and modalities do not address the underlying pathology of poor foot biomechanics, and therefore may only provide temporary relief (4). On the other hand, kinesiologic taping, applying to address the underlying the problem of poor foot biomechanics can be used as an adjunct to ESWT for the treatment of plantar fasciitis. Objectives It is hypothesized that kinesiologic taping applied as an adjunct to ESWT will show a greater decrease in pain, and an increase in functional activity, and mobility compared to ESWT in patients with plantar fasciitis. To our knowledge, this is the first study to compare kinesiologic taping with ESWT and ESWT for plantar fasciitis. Methods This was a randomized, prospective, comparative clinical study. Forty five patients with a diagnosis of plantar fasciitis were divided randomly into two treatment groups. Twenty five subjects in intervention group received kinesiologic taping and ESWT for one week, while twenty subjects in control group only received ESWT. Outcomes were Visual Analog Scale (VAS) for pain intensity, Foot and Ankle Outcome Score (FAOS) for functionality and Time Up&Go Test for mobility. Evaluations were assessed at baseline before treatment and one week after treatment. Results It was found that there were significant improvements in all measurements for post-treatment compared to pre-treatment in both groups (p<0.05). There was no statistically significant difference between post-treatment values of two groups (p>0.05). Conclusions Treatment of plantar fasciitis with kinesiologic taping plus ESWT resulted in improved functional outcomes. Kinesiologic taping plus ESWT had no superiority in terms of functional outcomes compared to ESWT. References Covey CJ, Mulder MD. Plantar fasciitis: How best to treat? J Fam Pract. 2013 Sep;62(9):466-71. Grecco MV, Brech GC, Greve JM. One-year treatment follow-up of plantar fasciitis: radial shockwaves vs. conventional physiotherapy. Clinics (Sao Paulo). 2013;68(8):1089-95. doi: 10.6061/clinics/2013(08)05. Höfling I, Joukainen A, Venesmaa P, Kröger H. Preliminary experience of a single session of low-energy extracorporeal shock wave treatment for chronic plantar fasciitis. Foot Ankle Int. 2008 Feb;29(2):150-4. doi: 10.3113/FAI.2008.0150. Hyland MR, Webber-Gaffney A, Cohen L, Lichtman PT. Randomized controlled trial of calcaneal taping, sham taping, and plantar fascia stretching for the short-term management of plantar heel pain. J Orthop Sports Phys Ther. 2006 Jun;36(6):364-71. 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