RELIABILITY OF SONOGRAPHIC MUSCLE THICKNESS MEASUREMENTS OF THE THENAR AND HYPOTHENAR MUSCLES

Introduction This study was undertaken to assess the intra-and interrater reliability of sonographic thickness measurements of the thenar and hypothenar muscles. Methods: The thickness of the thenar and hypothenar muscles of both hands of 15 volunteers (7 male, 8 female) were evaluated with a 4-13-MHZ linear probe by 2 examiners who were blinded to each other's measurements. Interrater reliability was then evaluated. To assess intrarater reliability, the first examiner also performed a second measurement after an interval of at least 1 day. Results: Mean age of the subjects was 31.169.0 years. Test-retest reliability showed excellent intrarater reliability (intraclass correlation coefficient range: 0.889-0.963) and substantial to excellent results for interrater reliability (intraclass correlation coefficient range: 0.692-0.937). Discussion: We found that ultrasound is a reliable method for thickness measurements of the thenar and hypothenar muscles

Chelsea Physical Assessment Tool for evaluating functioning in post-Intensive Care Unit COVID-19 patients

By this letter, we aimed to address the need of an adequate assessment of functional status in post-Intensive Care Unit (ICU) Coronavirus Disease 2019 (COVID-19) patients. COVID-19 patients are at risk for post-intensive care syndrome, with an impaired functional status. Physical and Rehabilitation Medicine (PRM) physicians have to face both acute and post-acute COVID-19 patients and provide them with an adequate respiratory and neuromotor rehabilitation plan. To date, specific assessment tools are warranted to provide information regarding COVID-19 patients' functioning. Chelsea Critical Care Physical Assessment Tool (CPAx) is a bedside assessment tool specifically designed to assess function in post-ICU patients and has demonstrated validity, reliability, and responsiveness in critical care population. Taken together, we retain that the CPAx, due to its characteristics, might be used by PRM physicians for assessing functioning in post-ICU COVID-19 patients. This article is protected by copyright. All rights reserved

Breaking bad news to patients with spinal cord injury in Turkey - physiatrists' perspective.

To explore Turkish physiatrists' experiences and opinions about breaking bad news (BBN) to patients with spinal cord injury (SCI)

Breaking bad news in spinal cord injury; a qualitative study assessing the perspective of spinal cord injury survivors in Turkey.

Prior abstract publication: 2nd Medical Rehabilitation Congress; Nov 4-7, 2010; Ankara, Turkey Objective: This study aims to investigate the process of breaking bad news from the perspective of spinal cord injury survivors

Is the word "osteoporosis" a reason for kinesiophobia?

Osteoporosis is a systemic skeletal disease that causes weakening of the bones which increases the risk of fractures. Especially hip fractures lead to substantial physical, psychological, social and economic burden both for the patients and the governments. Exercises and physically active life style are essential preventive and therapeutic approaches for osteoporosis. Kinesiophobia is an irrational fear of movement due to the belief of susceptibility to injury. It is associated with lower levels of physical activity. Having a diagnosis of osteoporosis without an adequate education about the disease may lead to kinesiophobia in patients due to an illogical belief about increasing possibility of falls and related fractures during physical activity

Effects of isokinetic, isometric, and aerobic exercises on clinical variables and knee cartilage volume using magnetic resonance imaging in patients with osteoarthritis

Objectives: This study aims to evaluate the effect of isokinetic, isometric, and aerobic exercise protocols on pain, disability, physical function, and articular cartilage in osteoarthritis. Patients and methods: A total of 45 women (mean age 52.1 years; range 45 to 65 years) who were admitted to the Physical Medicine and Rehabilitation outpatient clinic and were diagnosed with primary bilateral knee osteoarthritis between May 2008 and January 2010 were included. The patients were randomly divided into three groups as isokinetic (n=15), aerobic (n=15), and isometric exercise groups (n=15). Exercise protocols were applied five days a week for four weeks. Pain was evaluated using a 10 cm Visual Analog Scale for Pain (VAS-pain), pain, joint stiffness and physical function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and disability was assessed using the Lequesne Index before and after the interventions. Isokinetic knee muscle strength measurements were also obtained. Patellar and femoral cartilage volumes were analyzed using magnetic resonance imaging. Results: The VAS-pain, WOMAC, and Lequesne scores and peak torque values of knee extension improved in all groups with the highest improvement in the isokinetic group. For the knee flexion peak torque values, improvements were significant only in the isokinetic group at both velocities. There was no significant change in the femoral cartilage volume in any group after the interventions. However, patellar cartilage volume significantly increased in the isometric group (p=0.036). Conclusion: A four-week isokinetic, aerobic, and isometric exercise programs improved pain and functional capacity in patients with knee osteoarthritis. Isokinetic exercise also increased the muscle strength with improved maintenance of the quadriceps/hamstring ratio. Only isometric exercise increased the patellar cartilage volume

Breaking bad news in spinal cord injury; a qualitative study assessing the perspective of spinal cord injury survivors in Turkey

Objective: This study aims to investigate the process of breaking bad news from the perspective of spinal cord injury survivors. Design: A cross sectional, qualitative study. Setting: Community. Participants: Fourteen spinal cord injury survivors. Interventions: Subjects participated in a semi-structured interview about `when', `where' by whom' and `how' they received and `would' prefer to receive bad news. Outcome measures: Answers to `how' questions were coded according to SPIKES protocol (Setting, Perception, Invitation, Knowledge, Empathizing, Summary). Results: Eight participants (57\%) reported that they received bad news from a physician, mostly during rehabilitation. All would prefer to be informed by a physician and majority preferred to be gradually informed during rehabilitation. Half were not satisfied with the content of information. Only half felt that his/her physiatrist understood his/her emotional distress. Majority of participants who received bad news from physicians reported that the setting was private and their family members accompanied them. Conclusion: Most spinal cord injury survivors were unsatisfied with knowledge and emotional support provided by rehabilitation physicians. Participants would prefer to receive bad news by a senior physiatrist in a planned meeting during rehabilitation

Breaking bad news to patients with spinal cord injury in Turkey - physiatrists' perspective

Objective: To explore Turkish physiatrists' experiences and opinions about breaking bad news (BBN) to patients with spinal cord injury (SCI). Design: A cross sectional study. Setting: Turkey. Participants: Sixty-nine physiatrists completed a questionnaire about experiences and opinions regarding BBN and self-assessment of communication skills (CS). Results: Eleven percent of specialists and 53\% of residents were trained on basic CS. All participants believed that physiatrists should play a role in BBN and the majority reported that they delivered the bad news in their clinic. Sixty-seven percent believed that the primary responsibility belongs to physiatrists. Sixty-eight percent reported that the most appropriate time for BBN is during rehabilitation. Self-assessments of CS were considered satisfactory in most steps of SPIKES protocol. Twenty percent told absolute truth to patients while 80\% stated that they did so sometimes or partially. Only 41\% confirmed that they do not use unrealistic statements to comfort patients. Fewer than 60\% stated that they performed the most appropriate and excellent behaviors for items in ``empathy{''} section. Conclusion: Physiatrists had different opinions about the style of BBN. Self-assessments of CS were optimistic, however physiatrists were not fully satisfied with their empathy skills

Efficacy of robotic exoskeleton for gait rehabilitation in patients with subacute stroke : a systematic review

BACKGROUND: Stroke is the most common cause of disability in Western Countries. It can lead to loss of mobility, capability to walk and ultimately loss of independence in activities of daily living (ADL). Several rehabilitative approaches have been proposed in these years. Robot-assisted gait rehabilitation (RAGT) plays a crucial role to perform a repetitive, intensive, and task-oriented treatment in stroke survivors. However, there are still few data on its role in subacute stroke patients. AIM: The aim of the present study was to assess the efficacy of RAGT for gait recovery in subacute stroke survivors. DESIGN: Systematic review with meta-analysis. SETTING: The setting of the study included Units of Rehabilitation. POPULATION: The analyzed population was represented by subacute stroke patients. METHODS: PubMed, Scopus, Web of Science, CENTRAL, and PEDro were systematically searched until January 18, 2021, to identify randomized controlled trials (RCTs) presenting: stroke survivors in subacute phase (≤6 months) as participants; exoskeleton robots devices as intervention; conventional rehabilitation as a comparator; gait assessment, through qualitative scales, quantitative gait scales or quantitative parameters, as outcome measures. We also performed a meta-analysis of the mean difference in the functional ambulation category (FAC) via the random effect method. RESULTS: Out of 3188 records, 14 RCTs were analyzed in this systematic review. The 14 studies have been published in the last 14 years (from 2006 to 2021) and included 576 stroke survivors, of which 306 received RAGT, and 270 underwent conventional rehabilitation. Lokomat robotic system was the most investigated robotic exoskeleton by the RCTs included (N.=9), albeit the meta-analysis demonstrated a non-significant difference of -0.09 in FAC (95% CI: -0.22.0.03) between Lokomat and conventional therapy. According to the PEDro scale, 11 (78.5%) were classified as good-quality studies, two as fair-quality studies (14.3%), and one as poor-quality study (7.1%). CONCLUSIONS: Taken together, these findings showed that RAGT might have a potential role in gait recovery in subacute stroke survivors. However, further RCTs comparing the efficacy of RAGT with conventional physical therapy are still warranted in the neurorehabilitation field. CLINICAL REHABILITATION IMPACT: This systematic review provides information on the efficacy of RAGT in allowing subacute stroke patients to perform high-intensity gait training with a lower physical burden on PRM professionals