A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial

Objectives: To compare the different stretching techniques, proprioceptive neuromuscular facilitation (PNF) stretching and static stretching, in patients with elbow stiffness after a treated elbow fracture. Design: Randomized-controlled, single-blind study. Setting: Department of physiotherapy and rehabilitation. Subjects: Forty patients with posttraumatic elbow stiffness (24 women; mean age, 41.34 +/- 7.57 years). Intervention: PNF stretching group (n = 20), hold-relax PNF stretching combined with a structured exercise programme (two days per week for six weeks); static stretching group (n = 20), static stretching combined with a structured exercise programme (two days per week for six weeks). Main measures: The primary outcome is the Disabilities of the Arm, Shoulder and Hand (DASH). The secondary outcomes are active range of motion (AROM), visual analogue scale (VAS), Tampa Scale for Kinesiophobia, Short Form-12 and Global Rating of Change. Participants were assessed at baseline, after a six-week intervention period and one-month later (follow-up). Results: After treatment, improvement in the mean DASH score was slightly better in the PNF stretching group (8.66 +/- 6.15) compared with the static stretching group (19.25 +/- 10.30) (p = 0.03). The overall group-by-time interaction for the 2 x 3 mixed-model analysis of covariance (ANCOVA) was also significant for elbow flexion AROM (mean change for PNF stretching group; static stretching group; 41.10, 34.42, p = 0.04), VAS-rest (-1.31, -1.08, p = 0.03) and VAS-activity (-3.78, -3.47, p = 0.01) in favour of PNF stretching group. The other outcomes did not differ significantly between the two groups. Conclusion: The study demonstrated that the structured exercise programme combined with PNF stretching might be effective in patients with posttraumatic elbow stiffness with regard to improving function, elbow flexion AROM, pain at rest and during activity

Intensive supervision of rehabilitation programme improves balance and functionality in the short term after bilateral total knee arthroplasty

To evaluate the short-term results of the rehabilitation programme with two different supervision on balance and functionality after simultaneously bilateral total knee arthroplasty (SBTKA) in patients with osteoarthritis and to compare the results with those of healthy individuals

Patients' preoperative perspectives concerning the decision to undergo total knee arthroplasty and comparison of their clinical assessments

[Purpose] The aims of our study were, 1. to assess pain, limitation of movement ability, and functionality in osteoarthritis patients scheduled to undergo total knee arthroplasty, 2. to determine if pain (Group 1) or function loss (Group 2) has a greater influence on the decision of patients to have surgery, and 3. to compare results between Group 1 and Group 2. [Subject and Methods] Fifty-five osteoarthritis patients classified as grades 3 and 4 according to the Kellgren-Lawrence system of classification were evaluated for preoperative pain intensity with the Visual Analogue Scale, knee flexion/extension range of movement with a clinical goniometer, and function with the Western Ontario and McMaster Universities Osteoarthritis Index. Patients were examined to reveal their reasons regarding the decision to undergo total knee arthroplasty (pain or function loss). [Results] The Visual Analog Scale scores at rest and during activity were 5.62 and 7.42, the knee flexion range of movement and extension limitation were 93.17 degrees and -7.04 degrees, and the Western Ontario and McMaster Universities Osteoarthritis Index value was 82.09. Regarding the decision to undergo surgery, 47.3% (n=26) of the knees were in Group 1, and 52.7% were in Group 2; the two groups were not significantly different. There were also no significant differences between the groups in Visual Analog Scale score during activity, the Western Ontario and McMaster Universities Osteoarthritis Index value, and knee flexion range of movement and extension limitation. The only statistically significant difference was found in the Visual Analog Scale score at rest in Group 1, which was significantly higher than that in Group 2. [Conclusion] Our results showed that osteoarthritis patients decided to undergo surgery only if all of the parameters were impaired significantly. Both pain and function loss have a similar impact on a patient's decision to undergo surgery. We observed no significant difference in clinical and self-reported outcomes between patients who decided to undergo surgery due to pain or function loss

The Negative Effects of Digital Technology Usage on Children’s Development and Health

Today, children and adolescents are growing up exposed to both traditional and modern technology. While it is known that the increase in the use of traditional technology, such as television and its content, have negative effects on children's development and health, studies have shown such modern technologies as smartphones, tablets, and computers that have been developed and become increasingly widespread over the past decade to be beneficial and to constitute health risks for children. It seems that children's inappropriate use of such technological devices in terms of content, duration, frequency, and the posture they adopt while using them pose a variety of health risks, including developmental problems, musculoskeletal problems, physical inactivity, obesity, and inadequate sleep quality. This study reviews the literature on the clinical problems that digital technology use has on children. In order for children and adolescents to adopt a healthy life style, it is important to monitor the time, frequency, and content viewed while using technological devices and to ensure that children have or develop adequate physical activity opportunities, healthy eating habits, proper sleep cycles, and a nurturing social environment

A comparison of two manual physical therapy approaches and electrotherapy modalities for patients with knee osteoarthritis: A randomized three arm clinical trial

A broad spectrum of physical therapy exercise programs provides symptom relief and functional benefit for patients with knee OA. Manual physical therapy, including tailored exercise programs provide relatively higher level benefit that persists to one year. It is currently unknown if there are important differences in the effects of different manual physical therapy techniques for patients with knee OA and there are virtually no studies comparing manual physical therapy and electrotherapy modalities. The aim of the study was to compare long-term results between three treatment groups (mobilization with movements [MWMs], passive joint mobilization [PJM], and electrotherapy) to determine which treatment is most effective in patients with knee OA. A single-blind randomized clinical trial with parallel design was conducted in patients with knee OA. Seventy-two consecutive patients (mean age 56.11 +/- 6.80years) with bilateral knee OA were randomly assigned to one of three treatment groups: MWMs, PJM, and electrotherapy. All groups performed an exercise program and received 12 sessions. The primary outcome measures of the functional assessment were the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and Aggregated Locomotor Function (ALF) test scores. The secondary outcome measures were pain level, measured using a pressure algometer and a visual analogue scale (VAS), range of motion (ROM), measured using a digital goniometer, and muscle strength, evaluated with a handheld dynamometer. Patients were assessed before treatment, after treatment and after 1year of follow-up. Patients receiving the manual physical therapy interventions consisting of either MWM or PJM demonstrated a greater decrease in VAS scores at rest, during functional activities, and during the night compared to those in the electrotherapy group from baseline to after the treatment (p<0.05). This improvement continued at the 1-year follow-up (p<0.05). The MWMs and PJM groups also showed significantly improved WOMAC and ALF scores, knee ROM and quadriceps muscle strength compared to those in the electrotherapy group from baseline to 1-year follow-up (p<0.05). In the treatment of patients with knee OA, manual physical therapy consisting of either MWM or PJM provided superior benefit over electrotherapy in terms of pain level, knee ROM, quadriceps muscle strength, and functional level