Cadence feedback with ECE PEDO to monitor physical activity intensity: A pilot study

The purpose of this study was to examine the monitoring capabilities of the equipment for clever exercise pedometer (ECE PEDO) that provides audible feedback when the person exceeds the upper and lower limits of the target step numbers per minute and to compare step counts with Yamax SW-200 (YX200) as the criterion pedometer. A total of 30 adult volunteers (15 males and 15 females) were classified as normal weight (n=10), overweight (n=10), and obese (n=10). After the submaximal exercise test on a treadmill, the moderate intensity for walking was determined by using YX200 pedometer and then the number of steps taken in a minute was measured. Lower and upper limits of steps per minute (cadence) were recorded in ECE PEDO providing audible feedback when the person's walking speed gets out of the limits. Volunteers walked for 30 minutes in the individual step count range by attaching the ECE PEDO and YX200 pedometer on both sides of the waist belt in the same session. Step counts of the volunteers were recorded. Wilcoxon, Spearman correlation, and Bland-Altman analyses were performed to show the relationship and agreement between the results of 2 devices. Subjects took an average of 3511-426 and 3493-399 steps during 30 minutes with ECE PEDO and criterion pedometer, respectively. About 3500 steps taken by ECE PEDO reflected that this pedometer has capability of identifying steps per minute to meet moderate intensity of physical activity. There was a strong correlation between step counts of both devices (P<0.001, r=0.96). Correlations across all three BMI categories and both sex remained consistently high ranging from 0.92 to 0.95. There was a high level of agreement between the ECE PEDO and YX200 pedometer in the Bland-Altman analysis. Although both devices showed a strong similarity in counting steps, the ECE PEDO provides monitoring of intensity such that a person can walk in a specified time with a desired speed. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved

Pathophysiology and etiology of neurogenic heterotopic ossification

Neurogenic heterotopic ossification (NHO) is the formation of pathological bone tissue in the soft tissues around joints after neurological injury, where ossification is not observed normally. This condition, frequently seen in patients with spinal cord injury (SCI) and traumatic brain injury (TBI), can cause complications such as severe limitation of motion, difficulty in daily living activities, nerve compression and pressure ulcers. NHO etiopathogenesis was reviewed with current literature, to enlighten the research studies planned on treatment and the precautions to prevent it. Etiology of NHO is not completely revealed in patients with SCI and TBI, however humoral, neural, immunological and local factors probably play a role in the pathophysiology. In patients with SCI, complete lesion, immobilization, exercise, microtrauma and proprioceptive alterations may possibly take a role in NHO development. The most important risk factors for patients with TBI are: spasticity, prolongation of coma state more than 2 weeks, immobilization, fractures of long bones, limitation of range of motion, infection, and development of autonomic disregulation. However, it is not known which of the factors affect the severity and the long-term outcomes of the disease. Considering the etiopathogenesis of NHO, it is concluded that more comprehensive studies are needed to detect and prevent the risk factors before it develops, to determine the type of therapeutic exercises and the suitable timing of exercises. Turk J Phys Med Rehab 2010;56:81-7. © Turkish Journal of Physical Medicine and Rehabilitation, Published by Galenos Publishing

Efficacy of moderate-intensity walking provided feedback by ECE PEDO on abdominal fat in overweight and obese women: A randomized, exercise study

Objectives: The aim of this study was to investigate the effectiveness of walking with Equipment for Clever Exercise (ECE PEDO) compared to supervised, moderate-intensity, aerobic, treadmill walking exercise in overweight and obese women. Patients and methods: Between September 2014 and January 2015, 28 women with overweight and obesity were assigned to two groups: supervised treadmill walking (Group 1, n=14) or walking with ECE PEDO (Group 2, n=14). The target heart rate (HR) corresponding to values of 50 to 70% VO2max were determined by submaximal treadmill test. Group 1 was instructed walking at their target HR on treadmill. The number of steps in a min corresponding to the target HR was calculated by a criterion pedometer and Group 2 was instructed walking in this step range recorded to the ECE PEDO giving audible feedback. Before and after a 12-week exercise program, all participants were evaluated by Body Mass Index (BMI) and waist circumference (WC). Ultrasonographic visceral fat thickness (VFT) and ergospirometric VO2max. Results: The VFT decreased in both walking groups in association with reduced WC and weight loss and also significant increases in the VO2max after exercise intervention (p&lt;0.05). The VFT decreased only in women by walking with ECE PEDO compared to the other group (p&lt;0.05). Conclusion: Our study results showed that both moderate-intensity exercise provided by a novel pedometer and supervised treadmill walking showed significant improvements in abdominal obesity and VO2max. © 2017 by Turkish Society of Physical Medicine and Rehabilitation

Lateral antebrakial kutanöz nöropatili bir asker: Temaruz ya da gerçek?

Introduction: Compression of the lateral antebrachial cutaneous nerve (LACN) is a rarely recognized but clearly definable syndrome. It should be taken into account in the differential diagnosis in the context of soldiers who are suspected of avoiding military duties by assuming the sick role. In this report, we describe a 23-year-old soldier who presented with avoidance of elbow extension due to a burning pain in the right forearm induced by extension. LACN neuropathy, which occurred after physical training including palm-away pull ups in the military camp and was initially suspected to be malingering, was later diagnosed according to the clinical and electrodiagnostic findings. People who are accused of malingering in military settings should be examined carefully also concerning the training-related injuries of the peripheral nervous and musculoskeletal systems. Especially for patients complaining of forearm pain that leads to inability to extend the elbow, LACN neuropathy should be considered in the differential diagnosis and confirmed by electrophysiological examination. © Turkish Journal of Physical Medicine and Rehabilitation, Published by Galenos Publishing

Turkish version of the paindetect questionnaire in the assessment of neuropathic pain: A validity and reliability study

Objectives: The aim of this study was to develop a Turkish version of the painDETECT questionnaire (PD-Q) and assess its reliability and validity. Methods: Two hundred and forty patients who were diagnosed by expert pain physicians in daily clinical practice and classified as having either neuropathic, nociceptive, or mixed pain for at least 3 months were enrolled in this study. After the usual translation process, the Turkish version of the PD-Q was administered to each participant twice with an interval of 48 hours. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Douleur Neuropathique en 4 questions (DN4) and a pain visual analog scale were assessed along with the PD-Q. Chronbach's α was calculated to evaluate internal consistency of the PD-Q. Intraclass correlation coefficient was calculated to examine test-retest reliability. Convergent validity was assessed by correlating the scale with LANSS and DN4. Discriminant statistics-sensitivity, specificity, Youden index, positive predictive value, negative predictive value-were also assessed. Results: A total of 240 patients with chronic pain, 80 patients in each neuropathic, nociceptive, and mixed pain group, were included in this study. Mean age of the patients was 54.1 years, and majority of the patients were female (52.9%). Chronbach's α of the Turkish version of the PD-Q was 0.81. The test-retest reliability of the Turkish version of the PD-Q was determined as 0.98 for the total score and ranged from 0.86 to 0.99 for individual items. The Turkish version of the PD-Q was possitively and significantly corralated with LANSS (r 0.89, P<0.001) and DN4 (r 0.82, P<0.001). When the two cutoff values in the original version were used, sensitivity was found 77.5% for a cutoff value ≤19, and specificity was 82.5%. Sensitivity and specificity were 90% and 67.5%, respectively, for the other cutoff value ≤12. Scores ≤12 represents a negative predictive value=87%, and scores 19≤ represents a positive predictive value=82%. When mixed pain patients were included in the neuropathic pain group, discriminant values were reduced as expected. Conclusions: The Turkish version of the PD-Q is a reliable and valid scale to be used to determine neuropathic component of chronic pain in Turkish patients. © 2013

Functional status, patient satisfaction and quality of life in patients with arthroscopic partial meniscectomy

Objectives: This study aims to investigate the effects of clinical and demographic variables on functional status, patient satisfaction and quality of life following arthroscopic partial meniscectomy. Patients and methods: Between January 2001 and December 2010, 98 patients (44 males, 54 females; mean age 52.1±12.5 years; range 18 to 88 years) who underwent arthroscopic partial meniscectomy in our clinic and were eligible for the study. Demographic and clinical data of patients and surgical characteristics were recorded. Preoperative activity levels of patients were measured. Severity of activity pain and patient satisfaction following surgery were evaluated using Visual Analog Scale (VAS). Functional status was evaluated by Lysholm knee score and WOMAC (Osteoarthritis Index Western Ontario and McMaster Universities), while quality of life was evaluated by Short Form-36 (SF-36). Results: Postoperative mean time from surgery was 62.5±26.1 (8-120) months, VAS score at rest was 1.7±2.6 (0-10), VAS activity score was 3.4±3.3 (0-10) and VAS patient satisfaction score was 7.0±3.0 (0-10). It was found that 68 of the patients (69.4%) were evaluated themselves as excellent or better than preoperative period with a mean Lysholm knee score of 73.8±17.4 (24-95). Significant influences of body mass index and preoperative symptom duration on evaluation parameters were not detected. Male gender, less than five years after surgery, less intraoperative joint degeneration and moderate to severe activity level before the onset of symptoms had a positive influence on the severity of pain, patient satisfaction and functional status. Conclusion: Our study provided critical data for optimal patient selection during the preoperative period to predict which patients may have better results in the mid-term follow-up after arthroscopic partial meniscectomy

The effect of aerobic exercise program on pulmonary function and cardiorespiratory capacity in obese women

Objective: To examine the effects of a six-month aerobic exercise program on pulmonary function and cardiorespiratory capacity in obese women. Materials and Methods: A total of 50 subjects - 25 obese women who neither did regular exercise nor applied a special diet program, and 25 healthy controls - were included in the study. Body mass index (BMI), maximum oxygen consumption (VO2max) and pulmonary function tests (PFT) values were measured as evaluation parameters in both groups. Obese women were enrolled to a supervised hospital-based bicycle aerobic exercise program for six months at an individualized target heart rate range (50-85% of heart reserve), with an increasing frequency and duration. Evaluation parameters were reevaluated after the exercise program and were compared with the pre-exercise values. Results: VO2max, forced vital capacity (FVC), forced expiratory volume at first second (FEV1), FEV1/FVC, and maximum mid-expiratory flow rate (FEF25-75) were significantly lower in obese women (p&lt;0.05). There was a statistically significant decrease at BMI and statistically significant increase at VO2max, FEV1, FEV1/FVC, and FEF25-75 among obese women after completing the 6-month exercise program. Conclusion: It was shown that obese women had lower cardiopulmonary capacity and PFTs when compared to non-obese ones and, aerobic exercise could improve cardiopulmonary capacity and PFTs in obese women. © Turkish Journal of Physical Medicine and Rehabilitation, Published by Galenos Publishing

Hemorheological responses to progressive resistance exercise training in healthy young males

Background: This study aimed to explore the effects of progressive resistance exercise training (PRET) on hemorheology. Material/Methods: Exercise sessions included 1-3 sets of 8-12 repetitions at 40-60% of 1-repetition maximum (1-RM)for 3 weeks and at 75-80% of 1-RM during weeks 4-12. Red blood cell (RBC) deformability and aggregation were determined by ektacytometry, plasma and whole blood viscosities (WBV) by rotational viscometry. Lactate concentration was evaluated by an analyzer and fibrinogen was evaluated by coagulometry. Plasma total oxidant/antioxidant status was measured by colorimetry. Results: Following an acute increase after exercise on the first day, RBC deformability was elevated during weeks 3 and 4 (p=0.028; p=0.034, respectively). The last exercise protocol applied in week 12 again caused an acute increase in this parameter (p=0.034). RBC aggregation was increased acutely on the first day, but decreased after that throughout the protocol (p&lt;0.05). At weeks 4 and 12 pre-exercise measurements of WBV at standard hematocrit and plasma viscosity were decreased (p=0.05; p=0.041, respectively), while post-exercise values were increased (p=0.005; p=0.04, respectively). Post-exercise WBV at autologous hematocrit measured at week 12 was increased (p=0.01). Lactate was elevated after each exercise session (p&lt;0.05). Fibrinogen was decreased on the third week (p&lt;0.01), while it was increased on the 4th week (p=0.005). Plasma antioxidant status was increased at week 3 (p=0.034) and oxidative stress index was decreased at week 4 (p=0.013) after exercise. Conclusions: The results of this study indicate that PRET may have positive effects on hemorheological parameters. © Med Sci Monit

Anthropometry and exercise in obesity

This chapter aims to review the effects of exercise on body measurements in overweight and obese people. Firstly, obesity is described in detail with regard to frequently associated medical problems and weight-related health risk. The necessity of the inclusion of an exercise training program in obesity management is underlined, and exercise training and exercise prescription for obese patients described. An overview of the anthropometric measurements used in assessing body fat distribution and monitoring the changes in body composition over an exercise training program in obese people is presented. The most commonly used body measurement methods in obesity outcome studies include simple anthropometric measurements and body composition measurement techniques. The outcome of body composition alterations with exercise is summarized as a slight decrease in total body weight, prevention of decrease in fat-free mass and relative increase in visceral fat-mass loss. The magnitude of these changes varies directly with the intensity, duration, and type of the exercise, e.g., aerobic versus strength trainin g. The implementation of resistance exercise improves body composition by increasing fat-free mass. Dissimilar results of exercises on genders should be taken into consideration in obese men and women. Studies with a longer follow-up duration would provide further information regarding the effects of regular exercise in overweight or obese people. © Springer Science+Business Media, LLC 2012. All rights reserved

Kırık Sekeli Nedeniyle Fizik Tedavi Gören 21 Olgunun Adli Tıp Açısından İrdelenmesi

Mahkemeler zaman zaman travmatik kırığa maruz kalmış şahısların hayati tehlike geçirip geçirmedikleri, mutad iştigalden ne kadar süreyle kaldıkları, uzuv tatili veya devamlı uzuv zaafına duçar olup olmadıkları ve maluliyet oranlarını öğrenmek amacıyla tıbbi bilirkişilerin mütalalarını almaktadır. Bu çalışmada travmatik kırık sonucu sekel kalan ve fizik tedavi uygulaması programına alınan 21 olgu yaş, cinsiyet, meslek, kırık yeri, fizik tedaviye kadar geçen süre gibi bir takım parametreler yönünden incelenmiş, fizik tedaviden önce ve sonraki genel vücut çalışma güçlerinden kayıp oranları hesaplanmış ve durumları uzuv tatili ve devamlı uzuv zaafı açısından tartışılmıştır. Anahtar Kelimeler: Travmatik Kırık, Fizik Tedavi, Maluliye