Background During the COVID-19 pandemic, individuals faced psychological stress caused by fear and anxiety due to the high transmission and mortality rate of the disease, the social isolation, economic problems, and difficulties in reaching health services. Fibromyalgia (FM) is a chronic centralized pain sensitivity disorder. Psychological, physical and/or autoimmune stressors were found to increase FM symptoms. This pilot study aimed to evaluate the COVID-19 fear and anxiety level, and to examine their effect on disease severity, sleep quality, and mood in FM patients compared to control group. Methods This pilot study conducted as a cross-sectional study, and included 62 participants. Participants were divided into two groups: FM patient group (n = 31) and control group (n = 31). Symptom severity, sleep quality, and mood were determined using the Revised Fibromyalgia Impact Questionnaire (FIQR), Pitsburg Sleep Quality Index (PSQI), and Hospital Anxiety Depression Scale (HADS), respectively. In order to evaluate the level of COVID-19 fear and anxiety, the Fear of COVID-19 Scale (FCV-19S) and Coronavirus Anxiety Scale (CAS) were used compared to control group. Results FIQR, PSQI, HAD-A, HAD-D, FCV-19S and CAS scores were significantly higher in the FM group (p = 0.01). A positive significant correlation was found between FCV-19S and CAS results and FIQR, PSQI, and HAD-anx results in FM patients (p < 0.05). Conclusion This pilot study showed that, the individuals with FM can be more affected by psychological stress, and this situation negatively affects the symptom severity, sleep quality, and mood in FM patients, so these patients should be closely monitored in terms of psychological stressors and their effects during pandemics. More studies with more participants are necessary to describe the challenges lived by fibromyalgia population.

Background The sudden and unexpected pandemic changed the daily routine of the children with cerebral palsy (CP) and their caregivers. Aims This study aimed to investigate the impact of the novel coronavirus (COVID-19) pandemic on the utilization of health and rehabilitation services and the general health and physical status of children with CP. In addition, the second aim of the study was to examine the effects of the COVID-19 pandemic on caregivers’ quality of life (QOL) and their fear of COVID-19. Methods The utilization of children health and rehabilitation services during the pandemic, the general health and physical status of the children during the pandemic, and the children and caregivers’ history of COVID-19 infections were questioned. Furthermore, the caregivers’ level of fear of COVID-19 and their QOL were examined. Results One hundred twenty caregivers were contacted by phone, and 94 (78.33%) caregivers agreed to participate in the study. Sixty-three of 94 children (67.1%) did not attend their routine control check-up during the pandemic. Twelve children (12.8%) discontinued their physical therapy sessions during the pandemic. Caregivers physical and mental QOL significantly decreased during the pandemic ( p < 0.05). The median of caregivers’ Fear of COVID-19 scale (FCV-19S) was 17.5 (7–35). Conclusion We think that more attention should be given to telerehabilitation and telemedicine services of the clinicians who deal with the children with CP, and their caregivers in order to prevent the negative effects of future pandemic periods.

Background The genicular nerve block (GNB) is demonstrated from several reports to alleviate pain and improve knee functionality in patients with chronic knee osteoarthritis (OA). Ultrasound (US)-guided GNB has been the most used imaging method. This study aimed to compare the effectiveness of US-guided versus blind GNB in the treatment of knee OA. Methods This prospective, randomized clinical trial included patients with knee OA based on American College of Rheumatology diagnostic criteria. The patients were evaluated for clinical and dynamometer parameters at the baseline, 4 weeks after treatment, and 12 weeks after treatment. The patients underwent blind injection or US-guided injection. Results When compared with the baseline, both groups showed significant improvement in pain, physical function, and quality of life parameters. Significant differences were observed between the groups for clinical parameters (30-second chair stand test, 6-minute walk test) in favor of the US-guided group. On the other hand, blind injection was more significantly effective on some parameters of the Nottingham Health Profile. There wasn’t any significant improvement in isokinetic muscle strength for either group. Conclusions This study demonstrated that both US-guided and blind GNB, in the treatment of knee OA, were effective in reducing symptoms and improving physical function. GNB wasn’t an effective treatment for isokinetic muscle function. US-guided injections may yield more effective clinical results than blind injections.

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Functional electrical stimulation (FES)-cycling is a technique used to provide voluntary muscle contraction during a functional task. The aims were primarily to determine the effects of FES-cycling on shoulder pain and subluxation, and secondarily to evaluate the improvement of upper extremity motor function in patients with acute–subacute stroke patient. In this prospective trial, 21 patients with acute–subacute stroke, randomly assigned into the FES-cycling group or the standard rehabilitation program (control group). Analyses of shoulder subluxation were carried out by radiography. The numeric rating scale was used to evaluate the intensity of pain, Fugl-Meyer and Frenchay arm tests for motor function, and functional independence measure for functional status. The outcome data were evaluated at baseline and at the end of 4-week treatment. Intragroup comparisons showed improvement of acromiohumeral distance, Fugl-Meyer assessment, and functional independence measure in both groups after treatment. In intergroup comparison, FES-cycling group exerted better outcomes in shoulder pain compared with the control group (P=0.015). Correlation analyses demonstrated only positive correlation between shoulder subluxation and pain (P=0.022). FES-cycling was superior to standard rehabilitation therapy for shoulder pain relief in patients with acute–subacute stroke. Therefore, combining FES-cycling with a standard rehabilitation program alleviates shoulder pain and may prevent development of shoulder subluxation over time.

Background This study was performed to reveal the relationships between the cross-sectional areas (CSAs) of the paraspinal muscles and the severity of low back pain (LBP), including the level of disability. Methods This single-center cross-sectional study was conducted on 164 patients with chronic LBP. The effects of demographic characteristics, posture, level of physical activity, disc herniation type, and sarcopenia risk on the CSAs of paraspinal muscles were evaluated along with the relationship between the CSAs and severity of pain and disability in all patients. The CSAs of paraspinal muscles were evaluated using the software program Image J 1.53. Results A negative significant correlation was found between age and the paraspinal muscle’s CSA ( P < 0.05), whereas a positive correlation was present between the level of physical activity and the CSA of the paraspinal muscle at the L2-3 and L3-4 levels. The CSAs of paraspinal muscles in patients with sarcopenia risk was significantly lower than those in patients without sarcopenia risk ( P < 0.05). The CSAs of paraspinal muscles at the L2-3 and L3-4 levels in obese patients were significantly higher than those in overweight patients ( P = 0.028, P = 0.026, respectively). There was no relationship between the CSAs of paraspinal muscles and pain intensity or disability. Conclusions Although this study did not find a relationship between paraspinal CSAs and pain or disability, treatment regimens for preventing paraspinal muscles from atrophy may aid pain physicians in relieving pain, restoring function, and preventing recurrence in patients with chronic LBP.

Background & Objective: This study aimed to examine the factors affecting sitting function in non- ambulatory children with cerebral palsy (CP) who spend most of their daily life in a sitting position. Methods: Thirty- five non-ambulatory children with CP were included in this cross sectional study. Data included demographics, socio-economic features, examination findings, personal and family history, and accompanying problems of patients. The participants’ lower extremity spasticity was evaluated using the Modified Ashworth scale (MAS); manual ability was evaluated using the Manual Ability Classification System (MACS); sitting function using the Gross Motor Functional Measure (GMFM)-sitting subscale; and trunk control using the Trunk Impairment Scale (TIS). The relationship between sitting function and the other evaluation parameters was analyzed. Results: Children with scoliosis had significantly lower scores in TIS-static and TIS-total (p<0.05). Hip problems negatively affected the GMFM-sitting subscale, TIS-static, and TIS-total (p<0.05). Strong positive correlations were found between GMFM- B (sitting subscale) scores and TIS-static, dynamic, coordination, and TIS-total scores (p<0.05). Duration of hospitalization in neonatal intensive care and MACS were correlated with GMFM-B (p<0.05). Multivariate analyses showed that trunk control and upper extremity function were independent risk factors on sitting function. Conclusion: More attention should be paid to rehabilitation programs which incorporate trunk control exercises and upper extremity functions in order to improve sitting function. Preventing hip dislocation may be an option to increase sitting function of non-ambulatory children with CP.

BackgroundUltrasonographic evaluation of trigger points detected by physical examination in patients with myofascial pain syndrome is being used more frequently in clinical care. However, the sonographic appearance of trigger points, in association with pain and disability, has not been adequately described.ObjectiveTo reveal the presence of trigger points with ultrasonography in those with myofascial pain syndrome and to determine if ultrasound images can help discriminate between demographic and disease characteristics.MethodsFifty‐two participants with chronic neck pain (NP) were in this cross‐sectional study. The pain intensity was evaluated using a 0–10 cm visual analog scale (VAS). The neck disability index measured the NP‐induced disability status of the participants. Ultrasonography was used to measure the thicknesses of the paraspinal muscles and the presence of hypoechoic areas within these muscles.ResultsThere was a positive correlation between the VAS scores of the participants and the ultrasonographic detection of myofascial trigger points (MTPs) in the multifidus and middle trapezius muscles (right/left r = .30, p = .027; r = .29, p = .029; r = .32, p = .009, r = .30, p = .011, respectively). These features correlated with the disability levels of the participants and the MTPs on both the right and left sides of the splenius, multifidus, upper trapezius, and middle trapezius (r = .32, p = .028; r = .38, p = .013, r = .25, p = .027; r = .33, p = .016; r = .25, p = .025, r = .32, p = .018, r = .28, p = .013, r = .29, p = .016, respectively). A significant correlation was present between the detection of MTP at ultrasonography and decreased muscle thickness in the relevant muscles (between p = .001 and p = .034).ConclusionThe detection of MTPs with ultrasonography is associated with the severity of pain and disability in those with chronic NP. Features on ultrasound include hypoechoic changes within muscle and reduced muscle thickness associated with MTPs.