Psychosocial Aspects of Rehabilitation in Neurodegenerative Diseases and Fields of Approach

Psychosocial health is a concept included in definition of health by World Health Organization and corresponds to state of emotional and social well-being. In the context of neurological disorder, psychosocial health refers to social reintegration and psychological adjustment. Studies reporting that neurological diseases are associated with negative psychosocial health outcomes such as a decrease in the quality of life, a decrease in ability to establish and maintain social relationships, and an increase in high levels of depression, stress and anxiety have increased in recent years. Therefore, it is important to consider programs and interventions that can improve the psychosocial health of people with neurodegenerative diseases. Currently, it is not clear which psychosocial approaches can produce definitively positive results. The aim of this study is to examine how being an individual with Multiple Sclerosis and Parkinson's, which are the most common neurodegenerative diseases in the clinic, affects psychosocial health in the rehabilitation process and the existing evidence-based psychosocial approaches. For this purpose, a descriptive review was prepared by scanning English and Turkish articles with keywords on psychotherapeutic, psychosocial and mindfulness-based interventions and stress management, published in the determined databases in the last 10 years. Studies have shown that psychosocial approaches such as interventions for acquisition of social integration and adaptive coping strategies, cognitive and social behavioral therapy methods, concentration and movement-based mind-body exercises are effective in rehabilitation of neurodegenerative diseases. These approaches were reported to have benefits in reducing anxiety, depression and fatigue, improving sleep quality and quality of life, relationships, employment, level of participation, motivation and self-efficacy in exercise and physical activity, improving physical functions, facilitating difficult and personal experiences and adaptation to new life in rehabilitation processes and more evidence-based studies are needed

The effect of physical activity status on quality of life during social isolation in Covid-19 epidemic

Bu çalışmada Türkiye’deki COVİD-19 salgını ve halk sağlığı kısıtlamaları sırasında genç-yetişkinbireylerin fiziksel aktivite (FA) durumlarını raporlamak, FA'nın yaşam kalitesi üzerindeki etkisiniaraştırmak amaçlandı. Bireyler, en katı halk sağlığı kısıtlamaları sırasında demografik bilgiler, FA, yaşamkalitesi bölümlerinden oluşan çevrimiçi anket ve sosyal medya duyurusu aracılığıyla çalışmaya dahil edildi.Bireyler arasında en yüksek oran inaktif bireylerde idi, bunu minimal aktif ile yeterince aktif bireyler izledi.FA seviyelerine göre, yaşam kalitesinin psikolojik alanı (PA) açısından farklılık görüldü; minimal aktifbireylerde PA’nın, inaktif bireylere göre yüksek olduğu ve FA’nin PA üzerinde etkili olduğu bulundu.Salgın süreçlerinde hükümetlerin halkı FA’ya teşvik etmesinin, sağlık uzmanlarının FA’yı artırmayayönelik önerilerde bulunmalarının, egzersiz yapmaya başlama ve sürdürmeyi sağlamaları adına yolgöstermelerinin özellikle ruhsal sağlığı korumak açısından gerekli olduğu düşünüldü. Sürecin aşırı egzersizyapma zamanı olmadığı; zihinsel refahlarını sürdürecek orta seviyede aktivite yapılmasının yaşam kalitesiüzerinde daha faydalı olacağı belirlendi.It was aimed to report physical activity (PA) levels of young-adult individuals and investigate effect of PA on quality of life (QOL) during COVID-19 outbreak and public health restrictions in Turkey. Individuals included through online questionnaire consisting demographic information, PA, quality of life sections and social media during strictest public health restrictions. Among individuals, highest rate was inactive individuals, followed by minimally active, sufficiently active. According PA levels, QOL was different in terms of psychological domain (PD); PD of minimally active individuals was found to be higher than inactive individuals; PA was effective on PD. In pandemic processes, it was thought; it is necessary for governments to encourage public to PA, health professionals to guide public towards increasing, starting and maintaining FA especially in terms of protecting mental health. Process isn’t time for excessive exercise; performing moderate activities that will maintain their mental well-being will be more beneficial on QOL

The effect of median nerve mobilization on two point discrimination

[Purpose] Two-point discrimination (TPD) is expressed as the minimum distance at which two mechanical stimuli applied simultaneously to the skin can be perceived as two separate points. The aim of this study was to investigate the effect of median nerve mobilization on TPD in healthy adults. [Participants and Methods] This study included 120 healthy adults. Participants were randomized according to their gender into the Neural Mobilization Group (NMG) and Control Group (CG). Demographic data of the participants (gender, age, height, weight, BMI, smoking) were recorded and TPD measurement was performed with baseline aesthesiometer on the palm with distal phalanges of the thumb, index and middle finger on the right-left hand. After the baseline TPD test, participants in the NMG performed Median Nerve Mobilization for 14 days. Measurements were taken before and after training. [Results] A statistically significant difference was found in all other measurements in both groups, except for the right and left palm TPD measurements in the control group. [Conclusion] It is thought that it would be beneficial to investigate the healing effects of the neural mobilization applications, which include all parts of the nerve line in disease conditions

Migrenli hastalarda fiziksel aktivite seviyesinin ağrı, fonksiyonellik ve yaşam kalitesine etkisi

OBJECTIVES: This study aimed to determine the physical activity (PA) level of individuals with migraine and examine its effects on pain intensity (PI), disability, and quality of life (QoL). METHODS: Individuals diagnosed with migraine between the ages of 18 and 55 were included in the study. PA levels are assessed by the International PA Questionnaire Short Form (IPAQ-SF), PI with the McGill Melzack Pain Questionnaire, disability with the Migraine Disability Assessment Scale (MIDAS), and QoL with the World Health Organization QoL Scale Short Form (WHOQOL-BREF). RESULTS: A total of 88 individuals, with a mean age of 34.11±10.51 years, were included in the study; 53.41% were low active (LA), 30.68% were moderate active (MA), and 15.91% were high active (HA). The physical health of LAs (p=0.047) was lower than that of MAs. General (p<0.001), physical (p[removed].Amaç: Bu çalışmada, migrenli bireylerin fiziksel aktivite düzeylerinin belirlenmesi ve ağrı şiddeti, engellilik seviyesi ve yaşam kalitesi üzerindeki etkilerinin incelenmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 18-55 yaş arası migren tanısı almış bireyler dahil edildi. Uluslararası Fiziksel Aktivite Anketi Kısa Formu (IPAQ-SF), McGill Melzack Ağrı Anketi ile ağrı şiddeti, Migren Özürlülük Değerlendirme Ölçeği (MIDAS) ile engellilik ve Dünya Sağlık Örgütü Yaşam Kalitesi Skalası Kısa Formu (WHOQOL-BREF) ile yaşam kalitesi değerlendirildi. Bulgular: Çalışmaya yaş ortalaması 34,11±10,51 yıl olan toplam 88 kişi dahil edildi; %53,41’i düşük aktif, %30,68’i orta aktif, %15,91’i yüksek aktifti. Düşük aktiflerin fiziksel sağlığı (p=0,047) orta aktiflerden daha düşüktü. Genel (p<0,001), fiziksel (p<0,001), psikolojik (p=0,003) sağlık puanları yüksek aktiflerden daha düşüktü. Düşük aktifler yüksek aktiflerden daha yüksek engelliliğe (p=0,042) ve ağrı şiddetine (p=0,001) sahipti. Fiziksel aktivite ile ağrı şiddeti (p=0,001) ve engellilik (p=0,005) arasında zayıf negatif korelasyon, fiziksel aktivite düzeyleri ile sosyal (p=0,007) ve çevresel (p=0,013) sağlık puanları arasında zayıf pozitif korelasyon ve fiziksel (p=0,000), genel (p=0,000) ve psikolojik (p=0,000) puanlarıyla orta düzeyde pozitif korelasyon vardı. Sonuç: Migrenli hastalarda fiziksel aktivite düzeyi arttıkça ağrı şiddetinin azaldığı, fonksiyonellik ve yaşam kalitesinin arttığı gözlendi. Egzersiz devamlılığının sağlanması migrenin olumsuz etkilerini iyileştirmede etkili görünmektedir

Joint position sense and its relationship with pain, range of motion, muscle strength, fear of movement, functionality, and quality of life parameters in chronic neck pain

Amaç: Çalışmanın amacı, kronik boyun ağrısı olan bireylerde eklem pozisyon hissini (EPH) değerlendirmek; ağrı seviyesi, eklemhareket açıklığı (EHA), kas kuvveti, yaşam kalitesi, hareket korkusu ve boyun ağrısı ile ilişkili fonksiyonel etkilenim seviyelerinideğerlendirerek sağlıklı bireylerle karşılaştırmak ve bu parametreler ile EPH arasında ilişki olup olmadığını belirlemektir.Yöntem: Kronik boyun ağrısı olan 50 birey kronik boyun ağrı grubuna (KBAG), 50 sağlıklı birey kontrol grubuna dahil edildi.Katılımcılara Lazer İmleç Yardımlı Açı Tekrarlama Testi (Lİ-YATT), manuel kas testi, gonyometre ölçümü, Vizüel Analog Skalası(VAS), Tampa Kinezyofobi Ölçeği (TKÖ), Northwick Park Boyun Ağrısı Anketi (NPBAA) ve Kısa Form-36 (KF-36) uygulandı, gruplarkarşılaştırıldı. EPH değerleri ile EHA, ağrı düzeyi, kas kuvveti, hareket korkusu, fonksiyonel etkilenim ve yaşam kalitesi değerleriarasındaki ilişki araştırıldı.Bulgular: EPH değerleri, sol lateral fleksiyon hariç değerlendirilen diğer tüm yönlerde, kontrol grubuna göre KBAG’de dahaolumsuz etkilendiği görüldü. Fleksiyon, ekstansiyon, sağ ve sol rotasyon yönlerindeki EPH ile sadece M. Trapezius kas kuvvetiile arasında zayıf kuvvette anlamlı negatif korelasyonlar elde edildi. EPH ile TKÖ ve NPBAA değerleri arasında zayıf ve ortakuvvette anlamlı pozitif korelasyonlar elde edildi (p<0,05). Ek olarak KBAG’de, EPH ile orta ve yüksek kuvvette olmak üzere tümyönlerdeki EHA’ları arasında anlamlı düzeyde pozitif; ağrı seviyesi, süresi ve NPBAA verileri arasında anlamlı düzeyde negatifkorelasyonlar elde edildi (p<0,001).Sonuç: Çalışmamızda kronik boyun ağrılı bireylerin değerlendirilen tüm parametreler açısından sağlıklı bireylere göre olumsuzyönde etkilendiği; EHA’daki kısıtlılık, ağrı seviyesi, M. Trapezius zayıflığı, hareket korkusu, fonksiyonel etkilenim ve yaşamkalitesi değerlerindeki artışın, EPH’deki azalma ile ilişkili olduğu gösterilmiştir.Purpose: Aim of the study is to evaluate joint position sense (JPS) in individuals with chronic neck pain; to evaluate level of pain,range of motion (ROM), muscle strength, quality of life, fear of movement, functionality associated with neck pain and comparewith healthy individuals, determine whether there is relationship between these parameters and JPS.Methods: 50 subjects with chronic neck pain were included in chronic neck pain group (CNPG), 50 healthy subjects included incontrol group. The Laser Pointer Assisted Angle-Reproduction Test (LP-ART), manual muscle test, goniometer measurement,Visual Analogue Scale (VAS), Tampa Kinesiophobia Scale (TKS), Northwick Park Neck Pain Questionnaire (NPNPQ) and ShortForm-36 (SF-36) applied to all participants, groups compared. Relationship between JPS and ROM, pain level, muscle strength,fear of movement, functionality, quality of life investigated.Results: Joint position sense affected more negatively in CNPG compared to control group in all directions evaluated except leftlateral flexion. Significant, negative weak correlations obtained between JPS and M. Trapezius muscle strength in flexion,extension, right, left rotation directions. Significant, positive weak-moderate correlations obtained between JPS and TKS andNPNPQ (p<0.05). In CNPG, there is significant, positive, medium-high correlations between JPS and ROM in all directions. Thereis significantly, negative correlations obtained between JPS and pain level, duration, NPNPQ levels (p<0.001).Conclusion: In our study, individuals with chronic neck pain affected negatively in all parameters evaluated compared to healthyindividuals. It has been shown that decrease of ROM, M. Trapezius muscle strength, functionality and increase in quality of life,fear of movement, and pain level are associated with decrease in JPS

Exercise intensity of active video gaming in cerebral palsy: Hip- versus wrist-worn accelerometer data

Objective The aim of this study was to compare exercise intensity of active video games (AVGs) between hip- and wrist-worn accelerometer data in cerebral palsy (CP). Methods Twenty children and adolescents (9.35 +/- 3.71 years) with CP performed two exercise sessions, completing a standardized series of AVGs. Exercise intensity was collected, while one accelerometer was fitted to wrist and hip in separate, counterbalanced sessions. Results Accelerometer counts per minute and cut-points determined were significantly different between the wrist- and hip-worn outputs (p < .001). Metabolic equivalents (METs) of performing AVGs exceeded the three METs moderate intensity threshold in wrist-worn (3.12 +/- 0.86) accelerometer and hip-worn data tend to underestimate intensity (1.16 +/- 0.08). Conclusions Previous studies showed METs required to perform AVGs were related to moderate intensity (3-6 METs) in CP with mild deficits. Wrist-worn accelerometer, exceeding 3 METs, seem to have higher accuracy in measuring exercise intensity of AVGs than hip-worn

Impact of COVID-19 on rehabilitation experiences of physiotherapists

BACKGROUND: As the COVID-19 pandemic progressed, pressures on almost all health sectors in many countries increased, and physiotherapy interventions were canceled for various reasons. OBJECTIVES: The aim of this study was to determine the status of physiotherapists who interrupted their services due to the pandemic and investigate procedures adopted by physiotherapists during face-to-face practice. METHOD: The measuring tool was an online survey administered via Google Forms between January 27 and February 27, 2021. In this descriptive cross-sectional study, the sample consisted of 558 physiotherapists, questions about their clinical experience during the pandemic were answered, and descriptive statistics were examined. RESULTS: Of the physiotherapists, 351 (62.9%) suspended their services due to pandemic, while 207 (37%) of all participants worked without suspending their services since the beginning of the process. Among participants, 303 (54.3%) needed education to use telerehabilitation methods, and 315 (56.5%) monitored their patients with remote communication methods. Handwashing (86.6%), disinfectant (85.3%), gloves (76.5%) and masks (86.6%) were the most common protective measures. CONCLUSIONS: Most physiotherapists had their face-to-face practice interrupted for a short time due to the COVID-19 outbreak, but they continue to treat all disease conditions in spite of inherent physical intimacy and increased risk of infection