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Whole body vibration (WBV) applications have been used in recent years to increase muscle strength, power, and postural control in healthy and various disease populations. This study aims to investigate the effects of WBV on postural control in patients with ataxia. Twenty-four patients were randomly allocated to two groups. In the first group, whole body vibration and exercise therapy (WBV + E) were applied together for the first 8 weeks; after 1 week washout, only exercise program (OE) was applied for the second 8 weeks. In the second group, the OE program was applied first followed by the WBV + E program. Outcome measures were Sensory Organization Test (SOT), Adaptation Test (ADT), Limits of Stability Test (LOS), International Classification Ataxia Ratio Scale (ICARS), Berg Balance Scale (BBS), and Timed Up and Go Test with cognitive task (TUG-C). Twenty patients (mean age ± SD, 34.00 ± 9.16 years) completed the study. The scores of SOT, ICARS, and BBS improved significantly after both OE and WBV + E program (p < 0.05). Improvements in the WBV + E program were higher (p < 0.05). The scores of ADT, TUG-C, and three parameters of LOS improved significantly after WBV + E (p < 0.05), while there was no significant change after OE (p > 0.05). This study demonstrated that exercise programs supported by WBV can play an important role in the improvement of all components of postural control in patients with ataxia. ClinicalTrial.gov Identifier: NCT02977377

Objectives: The study aimed to examine the pandemic-related attitudes and behaviors of adult individuals with neuromuscular disease during the coronavirus disease 2019 (COVID-19) pandemic. Patients and methods: A total of 87 individuals (55 males, 32 females; mean age: 39.7±14.5 years; range, 19 to 80 years) with neuromuscular disease were included in the cross-sectional study between July 2022 and December 2022. After obtaining the demographic information of the individuals, information about neuromuscular disease and COVID-19, vaccination status, and their situation during the pandemic were questioned with yes/no or open-ended questions. Results: While the most prevalent neuromuscular disease was spinal muscular atrophy (n=30, 34.5%), 72 (82.8%) individuals had no comorbities. Twenty-nine (33.3%) individuals had COVID-19, and seven (24.1%) of these individuals had COVID-19 with high severity. Eighty-two (94.3%) individuals were vaccinated. Among the individuals who had COVID-19, 10 (34.5%) individuals stated that their physical condition was worse than before the pandemic. Among the whole participants, 40 (48.3%) individuals stated that it was worse and much worse. Only 15 (17.2%) individuals continued to participate in physical therapy practices during the pandemic period. Forty-three (49.4%) individuals said that their social life was worse and much worse than before the pandemic. Conclusion: The course of COVID-19 in individuals with neuromuscular disorders may not be as severe as expected. Further studies are needed to generalize these findings to the broader neuromuscular disease population.

The aim of this study is to investigate the effects of scapular taping on scapular kinematics by three-dimensional electromagnetic system during shoulder elevation in facioscapulohumeral muscular dystrophy patients. A total of 11 patients with facioscapulohumeral muscular dystrophy were included in the study. Scapular anterior-posterior tilt, upward-downward rotation, and internal-external rotations were evaluated using the three-dimensional electromagnetic system during the elevation of the upper limbs in the scapular plane before and after kinesio taping. For maximum humerothoracic elevation, there were no differences between the patients before and after taping on both dominant (p = 0.72) and non-dominant sides (p = 0.64). For scapular internal rotation, upward rotation, and posterior tilt, there were no differences between patients before and after taping during humerothoracic elevation on both dominant and non-dominant sides (p > 0.05). These results showed us that the excessive and abnormal movements of the scapula observed during the humeral elevation in facioscapulohumeral muscular dystrophy patients cannot be supported with flexible methods like kinesio taping. Therefore, we recommend to evaluate the scapula position by applying flexible and rigid taping to the patients who can reach over 90o in humerothoracic elevation in future studies.

The aim of this study was to formulate an exercise program according to GAS, an approach that reflects the patients’ point of view and expectations and investigate the effects of this program in ataxia rehabilitation. This study was designed as an assessor-blinded, single-group trial, and 24 patients with cerebellar ataxia were included. Treatment goals, postural control, disease severity, and daily living activities were assessed pre- and post-treatment using the Goal Attainment Scaling (GAS), the Sensory Organization Test (SOT), the International Cooperative Ataxia Rating Scale (ICARS), and the Barthel Index (BI), respectively. An exercise program was applied by taking patients’ individual expectations and treatment goals into account. The participants enrolled in the physiotherapy program for 8 weeks, 3 days a week for 1 hour per day. The mean age of the patients was 34.00 ± 9.15 years. While the GAS, kinetic functions ICARS subscores, ICARS total scores, SOT-composite, and BI scores improved significantly after treatment (p < 0.05), other ICARS subscores did not change after treatment (p > 0.05). The results showed that putting the patient at the center of the evaluation and treatment process while formulating a treatment plan had a positive effect on treatment outcome. If the functions that patients consider important are known and the treatment process concentrates on these functions, a patient’s participation in his/her individual treatment is supported by increasing his/her motivation and contribution to more successful rehabilitation practices.

Objective: The aim of this study was to investigate the physical activity of adults with muscle diseases relative to healthy controls. Materials and Methods: Individuals participated in this cross-sectional study by completing the International Physical Activity Questionnaire-Long Form and using SenseWear Armband Activity Monitor over a 5-day period to assess physical activity levels subjectively and objectively. Results: Forty healthy controls (16 males, 24 females) (aged 30.40±4.55 years) and 40 adults with muscle diseases (21 males, 19 females) (aged 32.67±6.57 years) participated in this study. We found that SenseWear Armband (step counts, duration of moderate and vigorous physical activity) and International Physical Activity Questionnaire (walking physical activity, vigorous physical activity, working physical activity, and total physical activity) parameters were significantly lower in the adults with muscle disease group than the healthy controls (p<0.05), whereas the total amount of energy expenditure was similar between the groups (p>0.05). Conclusion: Adults with muscle diseases expend the same amount of energy as healthy controls, but over fewer steps. This difference between energy expenditure and number of steps could be due to the higher energy requirements for walking in adults with muscle diseases. These findings will help healthcare professionals plan treatment strategies for adults with muscle diseases.

Objective: Balance problems and falls due to a progressive loss of muscle strength in neuromuscular diseases (NMD) negatively affect the activities of daily living and functional independence of patients. The timed up and go (TUG) test is an easy-to-apply and objective measure of balance. This study aimed to determine the cut-off value of the TUG test in adult individuals with NMD. Materials and Methods: This retrospective study included 102 patients. The receiver operating characteristic analysis was performed and cut-off, sensitivity, and specificity values were calculated in NMD to determine the diagnostic validity of the TUG test. Results: The mean ages of 55 patients with a fall history and 47 patients without a fall history were 34.40+-10.41 and 31.87+-10.11 years, respectively. The mean values of the TUG scores of these individuals were calculated as 11.79+-4.30 and 7.33+-1.51 s, respectively. The cut-off value of the TUG test in adult individuals with the NMD was determined as 8.9 s. Conclusion: The present study revealed that individuals with NMD who complete the TUG test over 8.9 s have a high risk of falling. Determining the risk of falling in NMD, which is one of the neurological patient groups where falling complaints are most common, is extremely important for patient safety and the effectiveness of rehabilitation.

IntroductionThe Berg Balance Scale, possibly the most widely used balance-related measure, has gained popularity in clinical trials. It provides information about patients’ balance-related abilities and can be used to assess improvement or worsening after rehabilitation. The aim of this study is to determine the cut-off value of the Berg Balance Scale for the fall risk in patients with multiple sclerosis (MS).MethodsThis study was designed as a prospective descriptive trial, and 186 patients with MS were included. Fall history was recorded by interview; balance was assessed using the Berg Balance Scale (BBS).ResultsThe mean ages of 96 patients with a fall history within the previous month and 90 patients without a fall history were 35.98 ± 8.58 and 35.71 ± 9.33 years, respectively. The mean value of the BBS score of the faller group was 49.44 ± 5.43 while 52.36 ± 3.53 in non-faller group. The cut-off value of the BBS for fall risk in patients with MS was determined as 50.50 points.ConclusionsFor patient safety and the success of rehabilitation, it is crucial to evaluate the risk of falling in patients with MS, one of the neurological patient groups where complaints about falling are most prevalent. The results showed that BBS is a sensitive and specific measure for identifying in patients with MS at risk of falling.

Exergame trainings might have therapeutic value in ataxic patients. The aim of this study was to investigate the effect of exergame training with an exercise program on postural control by comparing it with traditional balance and coordination exercise program. Nineteen patients were randomly allocated to two groups. In the first group, exergame training and an exercise program (EEP) were applied together for the first 8 weeks; after 10 weeks washout, a conventional exercise program (CEP) was applied for the second 8 weeks. In the second group, the CEP was applied first followed by the EEP. Outcome measures were Limits of Stability test (LoS), International Classification Ataxia Ratio Scale (ICARS), Berg Balance Scale (BBS), and Timed-Up and Go test with a cognitive task (TUG-C), Reactive postural control and sensory orientation subscales of the Mini-BESTest. Seventeen patients (mean age ± SD, 32.53 ± 11.07 years) completed the study. ICARS, BBS scores improved only after EEP (p < 0.05). While there was no change in the RT and MVL parameters of the LoS test after EEP, the MXE, EPE, and DCL parameters improved significantly (p < 0.05). The MXE and MVL parameters of LoS improved after CEP (p < 0.05). There were no significant improvements in the Mini-BESTest’s reactive postural control and sensory orientation subscale scores after both EEP and CEP (p > 0.05). The results of the present study demonstrated that exergame training can be used as a complementary training option in physiotherapy to improve postural control in patients with ataxia. ClinicalTrial.gov Identifier: NCT03607058

ObjectiveThe aim of this study was to compare activation levels of rectus femoris, biceps femoris, tibialis anterior, and soleus muscles and biomechanical properties of individuals with muscle disease and healthy individuals during sit-to-stand.MethodsFifteen patients (11 muscular dystrophy, 4 myopathy) and 15 healthy individuals were included in the study. A Noraxon superficial electromyography device and high-speed cameras were used to evaluate muscle activations and biomechanical properties.ResultsThere was a difference between the activation levels of bilateral rectus femoris, tibialis anterior, soleus, and right biceps femoris of patients and healthy subjects (p < 0.05). When groups were compared in terms of biomechanical properties, there was no difference in the range of motion during sit-to-stand (p > 0.05), but there was a difference in phase 1: flexion momentum phase, phase 3: extension phase, phase 4: stabilization phase, and total time of sit-to-stand (p < 0.05).ConclusionWe observed that individuals with muscle disease are able to stand up in a similar sit-to-stand pattern to healthy individuals with longer duration and higher muscle activation levels. Prolonged high muscle activation during functional activities may cause fatigue and muscle destruction in patients. For this reason, planning of exercise programs for appropriate muscles and phases will enable the patients to perform the activity of sit-to-stand more easily. Thus, patients will become more functional and independent in their daily lives with less effort.

The published version of this article unfortunately contained a mistake in Fig. 2. Only one graphic of different movement of scapula was published instead of three. The Figure is corrected here.