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Key Summary Points: Aim: To measure the effects of home exercises complemented with supervision on fall-related variables in older people. Findings: Supervised home exercise seems superior only on functional mobility (TUGT). Message: Older individuals who do not have exercise habits should be motivated to exercise training in daily life. Purpose: The aim was to measure the effects of the home exercises supported with supervision on the fall-related variables in older people. Methods: Seventy-five individuals over the age of 65 were enrolled. They were allocated to a "minimally supervised home exercise group" (group 1) or a "home exercise group" (group 2). Falls efficacy, fear of falling (FOF), fall risk, functional mobility, balance performance, and depression were assessed using the Falls Efficacy Scale International (FES-I), visual analog scale (VAS-FOF), the Elderly Falls Screening Test (EFST), the Timed Up and Go Test (TUGT), Tinetti's Balance Performance Oriented Mobility Assessment (BPOMA), and the Geriatric Depression Scale Short Form (GDS-SF), respectively. Participants performed a four-day weekly exercise program for eight weeks. Group 1 was supervised one day per week on a group basis. Results: Results are based on 75 subjects (group 1 n = 37, group 2 n = 38). Analysis of variance revealed significant interactions only for FES-I, VAS-FOF, TUGT, and BPOMA. The difference between groups was significant only for TUGT score; group 1 had better scores at 8 weeks and 6 months. FES-I, VAS-FOF, and BPOMA were significantly improved in both groups. EFST and GDS improved in the total sample but not at the group level. Conclusion: Supervised home exercise seems to be superior only for functional mobility (TUGT). Further studies with a larger sample are needed to draw conclusions about depression and fall risk. The intervention was feasible and atendible. Trial registration: ClinicalTrials.gov" NCT05337839. Retrospectively registered. [ABSTRACT FROM AUTHOR]

In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease. [ABSTRACT FROM AUTHOR]

We previously reported the efficacy of a 4-week home-based exercise therapy for patients with rheumatoid arthritis (RA). In this study, we aimed to investigate whether short-term improvements in the functional status and quality of life were maintained at 1 year. Patients who completed 4-week home-based exercise program were advised to maintain the same exercises for 1 year duration. Changes of functional status and quality of life in patients with RA were evaluated by the Health Assessment Questionnaire (HAQ) and the Rheumatoid Arthritis Quality of Life Scale (RAQoL). The change of the variables at the different time points (baseline, 4 weeks, and 1 year) was assessed by the repeated measure of ANOVA test with Geisser-Greenhouse correction. Pairwise ANOVA comparisons adjusted using the Bonferroni correction were conducted. Twenty-eight (63.6%) of 44 patients were available for follow-up at 1 year. The results of repeated measure ANOVA showed that there was a statistically significant difference between three assessments in the HAQ ( P = 0.015) and RAQoL ( P = 0.037) scores at the end of the follow-up. Improvements in the functional status and health-related quality of life at 4 weeks were maintained at 1-year follow-up. In conclusion, we observed significant improvements in the functional status and health-related quality of life by 4-week home-based exercise program. Furthermore, these improvements were maintained at 1-year follow-up. Further studies are needed to confirm the usefulness of the home-based exercise therapy. [ABSTRACT FROM AUTHOR]

The objective is to develop a Turkish version of the foot and ankle outcome score (FAOS) and to investigate its validity and reliability. The Turkish version of FAOS was developed after the translation and back-translation. The translated version was pretested on 20 patients with rheumatoid arthritis. Then, the Turkish FAOS was administered to 55 patients having foot and ankle problems. They were also evaluated by using the four subscales of the Turkish version of AIMS2, and the Turkish version of SF-36 questionnaire to test validity. Fifty patients filled out the FAOS for second time to determine test–retest reliability. Construct validity was investigated with use of Spearman’s rank correlation coefficient. Test–retest reliability was assessed with use of the intraclass correlation coefficient (ICC) and Cronbach’s alpha score. The psychometric properties of the Turkish FAOS were generally similar to the original FAOS. The random ICC for the five subscales ranged from 0.70 to 0.96. The Cronbach’s alpha coefficient ranged from 0.79 to 0.97. Construct validity of the FAOS was good. The Turkish FAOS correlated with the SF-36 and AIMS2 scales. The Turkish version of FAOS was valid and reliable instrument to assess the foot and ankle related problems. However, to assess its responsiveness further studies are needed. [ABSTRACT FROM AUTHOR]

This study was designed to evaluate (a) the frequency of fatigue and its multi-dimensional nature, and (b) its association with demographic variables, disease-specific variables, and other variables, covering depression and sleep disturbance in patients with ankylosing spondylitis (AS). Sixty-two patients with AS were included in the study. Fatigue was assessed by the fatigue item of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Multidimensional Fatigue Symptom Inventory—Short Form (MFSI-SF). While the disease activity was evaluated by the BASDAI, the functional state was assessed by Bath Ankylosing Spondylitis Functional Index, metrological measurements by Bath Ankylosing Spondylitis Metrology Index, global well-being by Bath Ankylosing Spondylitis Global Score, the pain on rest by VAS (0–10 cm), sleep disturbance by Pittsburgh Sleep Quality Index, and depressive symptoms by Zung Self-Rating Depression Scale. Fifty percent of the patients had severe fatigue. Multi-dimensional assessment with MFSI-SF enabled us to identify fatigue in more detail. The disease-specific variables, covering pain, stiffness, disease activity, and physical functioning, contributed significantly with both BASDAI fatigue and MFSI-SF as dependent variables, accounting for 61.3% and 44.7% of the variance, respectively. Disease activity was the most powerful predictor of both single-dimensioned and multi-dimensioned fatigue. It was also found that the contribution of depression on fatigue was 12%. In conclusion, it was observed that half of the patients had severe fatigue, and multi-dimensional assessment was provided to understand specific aspects of fatigue better. Even though disease activity had a considerable effect on fatigue, the effects of psychogenic factors, especially depression, should be taken into consideration in the management of AS. [ABSTRACT FROM AUTHOR]

The goal of our study was to develop a Turkish version of the Rheumatoid and Arthritis Outcome Score (RAOS) in patients with rheumatoid arthritis (RA) and to assess its reliability, validity, and sensitivity to change. The Turkish version of RAOS was developed according to cross-cultural guidelines by using the “translation–back translation” method. Fifty-eight patients with RA were assessed with it. To assess its validity, patients were also evaluated with Turkish versions of the Health Assessment Questionnaire, five subscales of Arthritis Impact Measurement Scales, and the Rheumatoid Arthritis Quality of Life questionnaire. Test–retest reliability of the RAOS questionnaire was calculated on 58 patients within 1 week. Construct validity was investigated with use of Spearman’s rank correlation coefficient. Test–retest reliability was assessed with use of the intraclass correlation coefficient (ICC) and Cronbach’s alpha score. Sensitivity to change after the 4-week home-based exercise program was evaluated with paired t test comparisons. The Turkish version of the RAOS met set criteria of reliability and validity. The random ICC for the five subscales ranged from 0.76 to 0.94. Interitem correlation measured by Cronbach’s alpha ranged from 0.81 to 0.94. Correlations were found between RAOS subscales and all of the evaluation parameters ( p < 0.01). RAOS subscales showed significant improvements after the 4-week home exercise program except for the symptom and quality of life subscales ( p < 0.05). The effect sizes were ranged from 0.20 to 0.37 and were considered small. The results of this study showed that the Turkish version of RAOS was reliable, valid, and responsive in patients with rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

In this study, we evaluated the relationship between the severity of enthesitis and outcome of measurement indices, clinical and laboratory parameters in patients with ankylosing spondylitis (AS). Thirty-three patients who fulfilled the modified New York criteria for AS were included in this study. Patients were asked to record the severity of current pain, night pain and morning stiffness on a 10-cm visual analogue scale. Stoke Enthesitis Index (SEI) was used to measure the severity of enthesitis. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Metrology Index (BASMI) were calculated. SEI was correlated positively only with BASDAI ( r = 0.370, P = 0.034). There was no relation between SEI and laboratory parameters (Erythrocyte Sedimentation Rate and C Reactive Protein). Our data suggest that using an enthesitis index such as SEI can be a valuable tool in the evaluation of disease activity in patients with AS. However, evaluation of enthesitis severity is based on information given by patient and should be combined with objective parameters such as spinal measurements when assessing disease activity. [ABSTRACT FROM AUTHOR]

The present study was undertaken to determine the relationship between spinal radiological changes of ankylosing spondylitis (AS), spinal mobility, and physical functioning. Thirty-one patients diagnosed as AS according to the modified New York criteria for AS were included in this study. Three radiographic scoring methods were used to assess spinal damage. Severity of spinal involvement was assessed by using Stoke Ankylosing Spondylitis Spine Score (SASSS) and Bath Ankylosing Spondylitis Radiographic Index–Spine (BASRI–S). To assess the extent of spinal involvement, the total number of vertebrae showing radiological findings attributable to AS [number of vertebrae involved (NoVI)] was calculated according to the AS grading system defined by Braun et al. Statistical analysis, consisting of bivariate correlation, Spearman correlation, and multiple linear regression analysis, was performed using Windows Statistical Package for the Social Sciences 13.0. NoVI was negatively correlated with modified Schober and lateral spinal flexion and was positively correlated with occiput-to-wall distance and BASMI. SASSS was negatively correlated with the modified Schober. BASRI–S was negatively correlated with the modified Schober and positively correlated with BASMI. When BASMI and Bath Ankylosing Spondylitis Functional Index were taken as dependent variables, only the NoVI was found to be associated with BASMI. In our data, the extent of spinal involvement (NoVI) showed a more significant correlation with spinal measurements such as modified Schober and BASMI as compared with the other radiologic scores (SASSS and BASRI–S). Furthermore, because only the NoVI was found to be associated with BASMI, we can conclude that the extent of spinal involvement, which also includes thoracic vertebrae, affects spinal measurements. [ABSTRACT FROM AUTHOR]

Radiographically detected vertebral fractures (VF) are a hallmark of osteoporosis. Several approaches to describe VF have been proposed. The objective of this study was to evaluate the intra- and interobserver variability of semiquantitative Kleerekoper’s method in osteoporotic VF assessment. Sixty-seven postmenopausal osteoporotic (L2–4 T-score ≤−2.5) women with a mean age of 65.2±7.51 years were included into the study. Lateral radiographs of thoracic and lumbar spine were evaluated in all patients. Kleerekoper’s method was used to define VF. Two observers evaluated all radiographs independently. To investigate intraobserver reproducibility, the first observer reevaluated all radiographs a month later on a separate occasion. Intra- and interobserver agreement was calculated using the kappa statistic. The agreement between two readings for the first observer was 86.3% with a corresponding kappa score of 0.573 (95% confidence limits of kappa score were 0.505–0.642). Interobserver agreement was 87.7% with a corresponding kappa score of 0.660 (95% confidence limits were 0.602–0.718). We observed a moderate agreement for Kleerekoper’s method in vertebral fracture assessment. There is no gold standard or standardized measurement or description for VF. Quantitative assessment of VF is essential in epidemiologic studies and in clinical drug trials, but a semiquantitative technique, which is done by experienced observers, should also be added to evaluate the entire spectrum of visible features that are helpful in identifying deformities. [ABSTRACT FROM AUTHOR]