There has been a growing interest in demonstrating the health benefits of exercise among people with epilepsy in recent years. Although exercise is recommended for people with epilepsy, there is ...uncertainty concerning the effects of yoga and aerobic exercise on multiple health outcomes in epilepsy.
The aim of this trial was to examine the effects of yoga and aerobic exercise training on physical activity, seizure frequency, health-related physical fitness, mental, emotional, and psychological health status, and quality of life.
This study was designed as a single-center, 8-week, randomized controlled trial in a three-arm parallel group. Participants will be randomly allocated to yoga, aerobic exercise, or wait-list control groups. The primary outcome is physical activity/sedentary behavior measured by the ActiGraph GT9X accelerometer and seizure frequency. Secondary outcomes include functional capacity, lower extremity strength, balance, body composition, waist and hip circumference, cognition, depression, anxiety, perceived stress, fatigue, sleep quality, and quality of life. The outcomes will be evaluated at baseline and at 8 weeks of follow-up.
This study is the first randomized controlled trial comparing the effects of yoga and aerobic exercise among people with epilepsy. The findings of this study could provide important information about the effects of yoga and aerobic exercise training on a variety of health conditions in people with epilepsy.
ClinicalTrials.gov identifier: NCT05066880, registered October 4, 2021.
Postural instability is one of the cardinal features in Idiopathic Parkinson's disease. It is a significant factor of disability in Parkinson's disease. We aimed to examine the physical activity ...levels in patients with Parkinson's disease comparing with healthy subjects and their association with the postural stability. Fifty-six Parkinson's disease patients and 58 healthy subjects were involved. The disease-specific disability of patients was determined by using Modified Hoehn and Yahr Scale and Movement Disorder Society Unified Parkinson's Disease Rating Scale. The physical activity levels of participants were evaluated using SenseWear Arm Band activity monitor. The participants used the activity monitor for seven consecutive days. The postural stability was assessed using NeuroCom Balance Master system. The Parkinson's disease group was found to take fewer steps and to have shorter duration of sleep and sedentary behavior but a higher level of energy expenditure than the healthy control group (P < 0.05). In Parkinson's disease group, the data obtained from the activity monitor were found to be in correlation with disease-specific disability and the parameters of NeuroCom Balance Master system (P < 0.05). We found that the physical activity levels of patients with a mild or moderate stage of Parkinson's disease were lower compared to healthy subjects and were affected by the disease-specific symptoms, dynamic postural instability, and walking function. To increase the activity level in Parkinson's disease, these factors should be aimed to improve, as well as designing the personalized physiotherapy programs starting from the early-mid stage.
Physiotherapists (PTs) are responsible for the prevention and promotion of physical and mental health. Their beliefs toward mental illness (MI) are important to disclose stigmatization.
To ...investigate the beliefs of PTs toward MI.
Beliefs toward Mental Illness Scale were sent to an e-mail network of Turkish Physiotherapy Association. The scale has three subscales: 1) Dangerousness; 2) Incurability and Poor Social and Interpersonal Skills (IPSIS); and 3) Shame. Total and subscale scores were used for analysis as higher scores indicated more negative beliefs.
In total, 155 PTs completed the questionnaires. The median total score was 45/105, while Dangerousness, IPSIS, and Shame scores were 20/40, 23/55, and 0/10, respectively. Dangerousness score was higher in PTs with a bachelor's degree compared to PTs with a postgraduate education (p = .049). IPSIS score was higher in PTs who did not consult a health professional in the presence of MI compared to PTs who consulted (p = .023). Total and IPSIS scores were higher in PTs exposed to an individual with MI during physiotherapy sessions compared to PTs having a family member with MI (p = .006 and p = .012, respectively).
Postgraduate education may affect the positivity of the beliefs regarding the dangerousness of MI. Negative beliefs about the curability of MI, frustration in interpersonal relationships, and perception that the mentally ill are untrustworthy may hinder the health-seeking behavior, even the individual is a health-care professional. Having a family member with MI may positively affect the beliefs of PTs in case of an exposure to a patient with MI during physiotherapy sessions.
•Sedentary PD patients had worse scores in postural control and walking performance.•However, deteriorated dynamic stability might not lead to sedentary lifestyle.•Balance training may not be ...adequate to improve activity level in PD.•Behavioral and motivational strategies should be integrated into PD rehabilitation.
The International Classification of Functioning, Disability and Health (ICF) is a framework providing information on disability and health. Physical activity’s behavior is complex and affected by various factors. We aimed to examine the ICF domains in Parkinson’s disease (PD) patients; to compare them in sedentary and non-sedentary PD patients and their association with activity level.
Sixty PD patients (25 sedentary PD group, 35 non-sedentary PD group) were included in this retrospective study. Functional disability was evaluated using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale. The physical activity level was measured by the SenseWear Arm Band activity monitor. Patients’ cognitive function, severity of depression and anxiety, the functional impact of fatigue, balance performance (NeuroCom Balance Master System), functional mobility (Timed Up and Go Test, TUG), walking capacity (Six-Minute Walk Test, 6MWT), fear of falling, health-related quality of life are also analyzed.
Sedentary PD patients had worse scores in NeuroCom Balance Master System parameters, TUG score, and 6MWT distance in activities domains of the ICF model as a guide than non-sedentary group (p < 0.05). No statistically significant differences were found in the body structures and function, participation, personal and environmental domains of the ICF model between sedentary and non-sedentary PD groups (p > 0.05). There was no correlation between steps taken per day and NeuroCom Balance Master System parameters, TUG score, and 6MWT distance in both groups (p > 0.05).
Patients with sedentary lifestyle had worse scores in postural control/balance, sit-to-stand and walking performance. However, deteriorated dynamic balance may not lead to sedentary lifestyle. Physiotherapy programs should be including the behavior change interventions and motivational strategies to promote activity level in PD.
Mental health is a new area of specialization for physiotherapists. However, they usually meet patients with psychiatric co-morbidities secondary to other chronic diseases. It is important to explore ...the beliefs of future physiotherapists regarding mental illness in order to implement effective strategies to avoid possible stigmatizing attitudes that may interfere with the rehabilitation process. Moreover, the psychiatric field should be introduced to physiotherapists as a clinical and research area. Therefore, we aimed to question the beliefs of physiotherapy students regarding mental illness using the Beliefs towards Mental Illness Scale in two different universities in Turkey. The total score of 524 students was 46.5 ± 14.5 out of 105 while the Dangerousness Subscale score was 21.2 ± 5.8/40; Incurability and Poor Social and Interpersonal Skills Subscale score was 24.2 ± 9.3/55 and Shame Subscale score was 1.1 ± 1.9/10. Students who had a relationship with an individual having a mental problem and students who had consulted a psychiatrist/psychologist for any mental problem showed more positive beliefs. Future physiotherapists should be informed and trained regarding people with mental illness both to avoid stigma and to be aware of this area in physiotherapy settings. Therefore, it is important to implement new curricula for schools providing physiotherapy education including courses, lectures and clinical practices in the psychiatry field.
Amaç:Beynin arka dolaşım sistemini etkileyen serebrovasküler olay (SVO) sonrası, santral vestibüler işlev bozukluğu olan akut dönem hastalarında farklı iki denge rehabilitasyon programının denge, ...yürüme, özürlülük seviyesi, düşme riski ve işlevsel bağımsızlık üzerine etkilerinin belirlenmesidir.Yöntem:Çalışmaya beyin sapı ve serebellar enfarkt geçirmiş 25 hasta dahil edildi. Tüm hastalar hastane içi dönemde çalışma ve kontrol grubuna randomize edildikten sonra çalışma grubu hastalarından kart çekme yöntemiyle iki farklı rehabilitasyon grubu oluşturuldu. Kontrol grubu, hastanede öğretilen egzersizleri 6 hafta boyunca evde uygulamaya devam etti.Çalışma grubu ise 6 hafta süreyle bireye özgü egzersizlerden oluşan rehabilitasyon programlarına alındı. Tedavi yöntemlerinden bir tanesi bilgisayarlı denge sisteminde uygulanan (NeuroCom System Version 8.1 Balance Master) rehabilitasyon programı idi. Sistemde görsel geri bildirim ile hastaya uygun özel denge egzersizleri oluşturuldu. Diğer tedavi yöntemi olan gözetimli ev programı grubunda ise hastalar, haftada bir kez kontrole gelerek vestibüler rehabilitasyon egzersizlerini evde uyguladı. Altı haftanın sonunda tüm hastalara tedavi öncesinde uygulanan değerlendirmeler tekrar edildi. Değerlendirmede Berg Denge Ölçeği, Ataksi Değerlendirme ve Derecelendirme Ölçeği, Başdönmesi Engellilik Envanteri, Aktiviteye Özgü Denge Güvenlilik Ölçeği, Düşme Etki Ölçeği, Dinamik Yürüme İndeksi, Süreli Kalk Yürü Testi, Enstrümental Günlük Yaşam Aktiviteleri Ölçeği ile Balance Master denge ve performans test cihazının statik ve dinamik denge testleri kullanıldı.Bulgular:Tüm gruplarda denge ölçeklerinin sonuçları, anlamlı iyileşme göstermiş (p<0.05) fakat gruplar arasında tedavi sonu değerleri açısından anlamlı farklılık görülmemiştir (p>0.05). Balans Master sisteminde dengenin kliniğe uyarlanmış duyusal etkileşim testine (DKUDET) göre yerçekimi merkezi salınım hızı, tüm gruplarda anlamlı iyileşirken (p<0.05) gruplar arasında tedavi sonu değerleri açısından anlamlı farklılık saptanmadı (p>0.05).Dinamik denge yeteneklerini yansıtan kararlılık sınırları testi sonuçlarında postürografi eğitim grubu hastalarında tedavi sonrasında anlamlı iyileşme saptandı (p<0.05).Topuk-parmak ucu yürüme testinde ev programı grubunun, normal yürüme testinde ise kontrol grubu hastalarının anlamlı iyileşme gösterdiği tespit edildi (p<0.05).Sonuç:Elde edilen sonuçlar, üç grubun denge işlevleri tedavi sonrası iyileşme göstermiştir fakat iyileşme miktarları açısından gruplar arasında anlamlı görülememiştir. Sonuçlara göre erken dönemde rutin programlara ek olarak uygulanan tedavilerin iyileşme üzerine ek katkı sağlamadığı düşünülmektedir. Dolayısıyla hastaların akut dönemi geçirdikten sonra devam eden dengesizlik şikayetleri mevcutsa uygun rehabilitasyon programlarına katılmasının daha başarılı sonuçlar doğuracağı yorumu yapılmıştır.
Objective: The aim of our study is to investigate the effects of home exercise program on balance, postural control, coordination and functional strengthening in parkinsonian patients. Methods: The ...study was consisted of idiopathic Parkinson's disease patients, who were not given any exercise training previously. The program including stretching, strengthening, coordination and balance exercises was structured according to the severity of disease. The patients were taught the exercises by a physiotherapist and in addition, were given an illustrated annotated leaflet for home program. Patients were asked to perform the exercises 2 times a day, with 10 times repetitions, for 12 weeks. The static and dynamic balance capacities (Berg Balance Scale-BBS, functional reach test), timed performance capacity (timed up&go test, sit to stand test) of the patients were evaluated before the exercise training. The stage of the disease was evaluated using Modified Hoehn-Yahr Parkinson's Disease Staging, also the severity of the disease was assessed using the United Parkinson's Disease Rating Scale (UPDRS) motor score and the activities of daily living were measured using the Schwab and England Activities of Daily Living Scale. All assessments were repeated following the 12-week exercise program. Results: The mean age of the parkinsonian patients, who completed the exercise program, was 68.34 + or - 8.92 year (51-88) and the mean duration of disease was 4.94 + or - 4.25 (1-20) year. A significant increase in the scores of BBS, functional reach test (both forward and backward), and a significant decrease in the score of single timed chair-rise test were observed following the home exercise program. A significant improvement was observed in the scores of the Schwab England Activities of Daily Living Scale (p<0.05). Conclusion: Home exercises enhance the balance abilities and provide improvement on activities of daily living of Parkinson's disease patients. Therefore, besides the medical treatment, exercise programs should be included in the treatment of Parkinson's patients. (Archives of Neuropsychiatry 2010; 47:53-7) Key words: Parkinson's disease, exercise, physiotherapy Amac: Calismamizin amaci Parkinson hastalarinda ev programi olarak verilen denge, postural kontrol, koordinasyon ve kuvvetlendirmeye yonelik egzersiz programinin hastalarin denge yetenekleri ve fonksiyonel kapasiteleri uzerine olan etkilerini incelemektir. Yontemler: Calismaya daha once egzersiz egitimi verilmemis idyopatik Parkinson hastalari alindi. Egzersiz programi, hastaligin siddetine uygun olarak secilmis germe, kuvvetlendirme, koordinasyon ve denge egzersizlerini icermekteydi. Egzersizler fizyoterapist tarafindan hastalara ogretildi ve ayrica resimli ve aciklamali olarak ev programi seklinde verildi. Hastalardan egzersizleri gunde 2 kez, 10 tekrarli olarak ve 12 hafta boyunca yapmalari istendi. Hastalarin egzersiz egitimi oncesi statik-dinamik dengeleri (Berg Denge Olcegi, Fonksiyonel uzanma testi) ve sureli yurume, sandalyeye oturma, oturmadan ayaga kalkma aktivitele-riyle sureli performanslari degerlendirildi. Hastalik evresi modifiye Hoehn-Yahr evrelemesi, hastalik siddeti Birlesik Parkinson Hastaligi Degerlendirme Olcegi (BPHDO) motor skoru, gunluk yasam aktiviteleri Schwab England Gunluk Yasam Etkinlikleri Olcegi ile degerlendirildi. Tum degerlendirmeler 12 haftalik egzersiz programindan sonra tekrarlandi. Bulgular: Egzersiz programini tamamlayan 29 Parkinson hastasinin yas ortalamasi 68.34 + or - 8.92 yil (51-88) ve hastalik baslangic suresi 4.94 + or - 4.25 (1-20) yil idi. Hastalarin ev egzersiz programi sonrasinda Berg Denge Olcegi (BDO) skorlarinda, one ve arkaya fonksiyonel uzanma testinde anlamli artis ve sureli performans testlerinden olan sandalyeden bir kez ayaga kalkma testinde anlamli azalma saptandi. Schwab England Gunluk Yasam Aktiviteleri Olcegi skorlarinda anlamli duzelme gozlendi (p<0.05). Sonuc: Parkinson hastaliginda ev egzersizleri hastalarin denge yeteneklerini duzeltmekte ve gunluk yasam aktivitelerinde iyilesme saglamaktadir. Bu nedenle Parkinson hastalarinin tedavisinde medikal tedavilerin yani sira egzersiz programlari da mutlaka yer almalidir. (Noropsikiyatri Arsivi2010; 47:53-7) Anahtar kelimeler: Parkinson hastaligi, egzersiz, fizyoterapi
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