Effects of Gluteus Maximus Muscle Strength on Ataxia, Gait, and Equilibrium in Multiple Sclerosis

Introduction: Multiple sclerosis (MS) is an autoimmune disease that causes scar tissue in the nervous system and seriously affects the quality of life of people. Muscle weakness, spasticity and coordination problems are seen primarily in the lower extremities. Strengthening exercises improve muscle strength in people with multiple sclerosis, but there is no consensus on their effect on walking capacity. Methods: To determine the relationship between gluteus maximus muscle strength, ataxia, balance and walking capacity in Multiple Sclerosis. An experimental study design was applied. Gluteus maximus muscle strength was measured using a dynamometer. Walking capacity was determined by the 6-minute walk test (6MWT) and dynamic gait index (DGI). Balance was evaluated with the one-leg standing test (SLS). The severity of ataxia was measured with the International Ataxia Rating Scale (ICARS). Fatigue was evaluated with VAS and quality of life of all patients with SF36 short form. Results: EDSS mean of the study = 3.39 ± 1.4; 2 men and 16 women with mean age = 37.17 ± 9.16 years were included. 6MWT, DGI, ALS, ICARS, VAS were different before and after treatment (p\u3c0.05). There was no significant difference other than physical function and general health among the sub-parameters of SF36 (p\u3e0.05). Correlation of muscle strength with ataxia, gait and balance was not significant (p\u3e0.05) Conclusion: In individuals with MS, the fact that the treatment program consists of modalities that include balance and sensory exercises as well as muscle strengthening exercises increases the success of rehabilitation

Comparing the acute effect of myofascial release techniques and passive stretching on hind foot dynamic loading in patients with multiple sclerosis: A cohort-blinded study

Study aim: It is important for therapists to incorporate new practical methods into therapy programs when they have demonstrable efficacy in the treatment of multiple sclerosis. Investigating the acute effects of myofascial release techniques (MFR) and passive stretching (PS) on hind foot loading and the severity of spasticity in individuals with multiple sclerosis (MS) was the aim of the study

Sensorimotor Integration Training In Parkinson'S Disease

Objectives: To determine the effects of sensorimotor integration training on postural control in Parkinson's disease. Methods: This prospective, randomized controlled trial was conducted at Hacettepe University (Ankara, Turkey). The study was carried out from August 2012 until March 2015 and included 24 Parkinson's patients with stage 2-3 according to the Modified Hoehn&Yahr Rating Scale. The patients were divided into 2 groups (control and study). The control group received conventional physiotherapy; the study group received sensorimotor integration training combined with conventional physiotherapy, 2 times per week for 6 weeks. We assessed the patients with clinical balance tests and computerized dynamic posturography. Assessments were performed at baseline, 7- and 12-weeks follow-up. Results: Computerized dynamic posturography posturography values (5th and 6th positions, composite balance, and vestibular system scores) were higher in the study group than in the control group. The improvements were maintained at the 12-week follow up except 6th positions scores (p<0.05). Conclusions: Sensorimotor integration training combined with conventional physiotherapy approach ameliorated postural control by improving vestibular system in patients with Parkinson's disease by improving sensory processes.WoSScopu

Expiratory Muscle Strength As A Predictor Of Functional Exercise Capacity In Generalized Myasthenia Gravis

Objectives: To investigate the correlations between the 6-minute walk test and disease severity, pulmonary functions, and respiratory muscle performance in patients with generalized myasthenia gravis (MG) and to determine whether MG disease severity, pulmonary functions, and respiratory muscle performance contribute to 6-minute walk test distance in generalized MG. Methods: This cross-sectional trial was conducted at Hacettepe University in Ankara, Turkey. The study was carried out from February to August 2017. Twenty-eight class II-III MG patients participated in the study. Patients disease severity was determined with the Myasthenia gravis composite scale. All participants underwent the 6-minute walk test, pulmonary function tests, and respiratory muscle strength and endurance assessment. Results: Approximately 40% of patients' expiratory muscle strength were under the lower limit of normal. Multiple linear regression analysis revealed that the percentage of predicted expiratory muscle strength that patients reached were significant and independent predictor of percentage of 6-minute walk test distance that patients reached according to reference values (R2=0.493, F [1-27]=25.275, p<0.001). Conclusion: Expiratory muscle strength is a significant determinant of functional exercise performance in generalized MG with mild or moderate weakness affecting muscles other than the ocular muscles.WoSScopu

The Effect of Physical Activity Awareness Training on Young Individuals’ Activity Levels, Gait, Emotional Status and Quality of Life

Amaç: Genç bireylerde, fiziksel aktivitenin sağlık üzerine etkilerini anlatan farkındalık eğitiminin, fiziksel aktivite(FA) düzeylerine olan etkilerini incelemekti. Gereç ve Yöntem: Çalışmaya, yaşları 18-35 arasında ve sağlık sorgulama formuna göre FA yapmasına engel sağlık problemi olmayan gönüllüler dâhil edildi. 6 Dakika Yürüme Testi(6DYT), Uluslararası Fiziksel Aktivite Anketi (kısa formu versiyon-2), Nottingham Sağlık Profili, Beck Depresyon Anketi, Pittsburgh Uyku Kalitesi İndeksi uygulandı. Aktivite günlüğüne göre, bireyler 10000 altı ve üstü adım atanlar olmak üzere iki gruba ayrıldı. Ardından her iki grupta randomizasyon yapıldı ve gruplardaki 20’şer kişiye, düzenli ve planlı yapılan FA’nın sağlık üzerindeki olumlu etkileri hakkında bilgi ve farkındalık eğitimi verildi. Bireyler ilk değerlendirmelerin ardından, eğitim programına alındı ve eğitimden 1-ay sonra ikinci kez değerlendirildi. Eğitim almayan bireyler ilk ve 1-ay süre sonra değerlendirildi. Sonuçlar: Bireylerin 6DYT sonuçları incelendiğinde, eğitim alan 10000 altı ve üstü adım atan her iki grubun eğitim öncesi ve sonrası değerlerinin arttığı kaydedildi(p<0.05). FA, yaşam kalitesi, depresyon ve uyku değerlendirme sonuçlarında, eğitim ile birlikte her iki grupta iyileşme kaydedildi(p<0.05). Tartışma: Genç bireylerin minimal aktif olduğu saptanmıştır. Eğitimle, farkında olarak yapılan planlı FA ve günlük adım sayısının 10000 adım üzerinde olması, FA düzeyi, uyku kalitesi, emosyonel durum ve yaşam kalitesini olumlu etkileyerek genel sağlık değişkenlerinde gelişim sağlamıştır.Purpose: To investigate the effects of the awareness training which is about the health-related effects on physical activity (PA) levels in younger individuals. Material and Methods: Volunteers (aged 18-35) who didn’t have any health problem for doing PA, according to the health inquiry form were included. 6- Minute Walking Test (6MWT), International Physical Activity Questionnaire (short form version-2)(IPAQ), Nottingham Health Profile (NHP), Beck Depression Questionnaire (BDQ) and Pittsburgh Sleep Quality Index (PSQI) were used. Individuals were divided into two groups of 10-thousand less and more steps. Randomization was performed in groups and 20 individuals were given awareness training about the regular and planned PA on health. After the initial evaluations, they were taken into the training program and assessed again a month after the training. Untrained individuals were assessed after the first-one month later. Results: When 6MWT results were examined, it was noted that the pre/post-training values of both groups who took 10-thousand less and more steps were significantly different (p<0.05). When the results of PA, NHP, BDQ and PSQI were examined, the results showed development in both groups (p <0.05). Conclusions: Young individuals were minimally active. With the training provided, aware planned PA and number of daily steps over 10-thousand steps will improve the general health variables by positively affecting the PA level, sleep quality, emotional status and life qualit

Psychometric properties of Fullerton Advanced Balance Scale in patients with stroke

Patients experience falls frequently after stroke. Preserved or acquired balance skills decrease fall risk and improve independence. Feasibility of Fullerton Advanced Balance Scale (FAB) has been shown in balance assessment in some neurological diseases except stroke. The purpose of this study was to investigate the reliability and validity of Turkish version of FAB (FAB-T) in patients with stroke (PwS). This cross-sectional study included 51 PwS (60.64 ± 7.66 years). Reliability analyses were conducted with Cronbach’s alpha, intraclass correlation coefficient (ICC), and Spearman correlation analysis. Intra-rater and inter-rater reliability were assessed with three raters. FAB-T, Stroke Rehabilitation Assessment of Movement (STREAM), Brunnstrom Recovery Stages (BRS), Barthel Index (BI), and 36-Item Short Form Health Survey (SF-36) were used for convergent validity. Correlations of FAB-T with Berg Balance Scale (BBS) and Mini-Balance Evaluation Systems Test (Mini-BESTest) were measured for concurrent validity. Spearman correlation analysis was used for convergent and concurrent validity. For predictive validity patients’ self-reports of falling were analyzed with ROC. Intra-rater (ICC = 0.998) and inter-rater reliability (ICCs = 0.984; 0.984; 0.990), and internal consistency (Cronbach’s alpha = 0.930) were excellent. FAB-T had good correlations with STREAM (ρ = 0.677) and BI (ρ = 0.628), moderate correlations with BRS (ρ = 0.504 and ρ = 0.579) and physical function of SF-36 (ρ = 0.436). FAB-T excellently correlated with Mini-BESTest and BBS (ρ = 0.928 and ρ = 0.942). The cutoff score of FAB-T was determined to be 21.5 points, with sensitivity of 84% and specificity of 61% (AUC = 0.749). FAB-T is a reliable and valid balance assessment tool with an acceptable accuracy of fall prediction in PwS.</p

Functional Exercise Capacity Evaluated By Timed Walk Tests In Myasthenia Gravis

Introduction: We sought to evaluate the test-retest reliability and construct validity of the 6- and 2-minute walk tests (6mWT and 2mWT, respectively) in patients with myasthenia gravis (MG). Methods: Thirty-one patients with generalized MG were enrolled in this study. The 6mWT, 2mWT, MG-specific quality of life questionnaire Turkish version (MG-QoL15T), quantitative myasthenia gravis test (QMG), and pulmonary function tests were administered. Results: The intraclass correlation coefficients of 2mWT and 6mWT were 0.894 and 0.932, respectively. The 6mWT and 2mWT had moderate correlations with forced vital capacity, maximal inspiratory pressure, QMG score, and MG-QoL15T score (rho for 6mWT: 0.579, 0.539, -0.572, and -0.474; rho for 2mWT: 0.460, 0.446, -0.532, -0.457). Both tests had similar performances for predicting disease severity (area under the curve = 0.761 for 6mWT and 0.759 for 2mWT). Discussion: The 6mWT and 2mWT have excellent test-retest reliability as well as moderate construct validity for the evaluation of functional exercise capacity patients with MG. Muscle Nerve 59:208-212, 2019WoSScopu