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This research was conducted to observe the effects of diabetes mellitus (DM) and rheumatoid arthritis (RA) on sleep efficiency and to explore the physiological mechanisms contributing to night-to-night sleep variability. Inconsistent sleep schedules or night-to-night sleep variability are arising concerning harmful health consequences. This research used the Midlife in United States Second Wave Research (MIDUS-2). The design was a cross-sectional research consisting of 434 participants. Data was collected from all the participants after taking informed consent. Participants were divided into four groups based on the presence of any systemic disorder. Age, gender, body mass index (BMI), symptoms of depression, and prescribed medicines were included as control variables. Data has been analyzed on SPSS. Of 434 participants, 61.05% were female, 39.63% only had RA, 0.06% had DM alone, and 44.23% were healthy; that is, they were the control group. The sleep efficiency of the healthy group was 81.55%, of patients having only RA was 78.37%, of patients having only DM was 75.35%, and the group having both disorders was 74%. DM is a chronic condition that develops due to a lack of capability to produce energy. RA is a painful autoimmune disorder. The research's results showed a marked difference in the sleep efficiency of these patients. [ABSTRACT FROM AUTHOR]

Aim: To assess the feasibility of video game-based trunk exercises using the Valedo® system in a chronic stroke population. Method: Ten chronic stroke survivors (eight males and two females, mean age 63 ± 15 years) were asked to complete 18 intervention sessions, each lasting 45 min., over 6–8 weeks. Feasibility was evaluated quantitatively using the Psychosocial Impact of Assistive Devices Scale (PIADS) as well as through recruitment, retention, adherence, and safety measures. Qualitative data on feasibility were collected through post-intervention semi-structured interviews. Descriptive analysis was used to summarize participant characteristics, recruitment, retention, and adherence. Qualitative data were analyzed using thematic analysis of the interviews. Results: Twelve stroke survivors were recruited from Southampton (United Kingdom) and Riyadh (Kingdom of Saudi Arabia), with two participants dropping out after the baseline assessment session. The remaining ten participants completed the study with a mean adherence of 96.11% to the planned sessions. No serious adverse effects were reported, however, four participants did experience trunk muscle tightness and fatigue. Post-intervention interviews revealed that participants encountered some physical and cognitive challenges while playing the Valedo video games. However, they felt that the implementation of trunk exercises using video games was safe, as the exercises were performed in a secure environment and in safe positions. Conclusions: The findings suggest that the Valedo system is feasible for delivering trunk exercises to chronic stroke survivors. Several factors should be considered when implementing this type of intervention in the future. [ABSTRACT FROM AUTHOR]

Background and Objective: The aim of this study was to evaluate cardiorespiratory fitness (CRF) measures, maximal oxygen consumption (VO2 max), and minute ventilation/carbon dioxide production (VE/VCO2 slope and others) among the T2DM population based on glycated haemoglobin (HBA1c). Material and Methods: The present study comprised a cross-sectional design, with two groups, based on HbA1c values (≤7 and ≥7.1). Laboratory samples were taken to evaluate glycated haemoglobin and fasting blood glucose (FBS). Cardiopulmonary exercise testing was performed to calculate various fitness-related parameters. Data analysis: An independent t-test was used to analyse the outcomes in the two groups. p < 0.05 was considered significant. Linear regression was used to examine the influence of predictor variables on dependent variables. Results: A total of 70 patients agreed to participate in the study, with 19 females and 51 males. The mean (standard deviation) BMI (body mass index) of all participants was 29.7(5.2), the mean (SD) weight was 84.4 (18.9) kg, and the mean height was 167.4 (23) cm. The average age of the individuals was 52 ± 8 years. The independent t-test revealed a significant difference between the two groups in terms of CRF measures. Conclusions: The current research identified the presence of poor glycaemic control and cardiorespiratory fitness measures among the Brazilian population with T2DM. HBA1c, duration of diabetes, age, and BMI can be employed to predict the ventilatory threshold (VT) and VO2 max. [ABSTRACT FROM AUTHOR]

Context: The international sports community is becoming more proactive in clinical mental health practice and research. An athlete-specific psychological distress screening tool can identify potential mental health illness. Design: The Athlete Psychological Strain Questionnaire (APSQ) is a simple screening tool for detecting early signs of athlete-specific strain and related mental health concerns. Methods: We evaluated the internal consistency and reliability of the translated and culturally adjusted Arabic version of the APSQ (APSQ-Ar) with Arabic-speaking elite athletes. The final translation underwent standard forward and backward translation, an inspection by a team of experts, and then preliminary testing. The APSQ-Ar was cross-culturally validated and then assessed for internal consistency and reliability among (n = 98) Arabic-speaking athletes. Results: There were no problems with the patients' understanding or interpretation of the items on the APSQ-Ar translation. The intraclass correlation value was.93 (95% confidence interval,.89–.95), and the mean difference was 2.4 with a minimal detectable change of 5.12, demonstrating strong test–retest reliability. Moreover, Cronbach alpha showed excellent internal consistency (.76). Conclusions: The APSQ-Ar was demonstrated to be good, reliable, and internally consistent. With APSQ-Ar, sports medicine professionals in Arabic-speaking countries will be able to identify psychological distress and symptoms in athletes and, as a result, provide them with mental health support. [ABSTRACT FROM AUTHOR]

Cognitive impairment negatively impacts health, psychological, social, and economic domains. Cognitive impairment commonly affects physical functions in older adults, whereas these are deteriorated. However, the prevalence and associated factors of cognitive impairment among community-dwelling adults in Saudi Arabia have not been investigated yet. This study aimed to examine the prevalence of severe cognitive impairment and its associated factors in community-dwelling older adults in Saudi Arabia. This cross-sectional study involved adults aged ≥50 years. Demographic data and clinical data, including number of medications and body mass index (BMI), were collected. Cognitive impairment and depressive symptoms were measured using Arabic versions of the Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9), respectively. The participants were divided into severe cognitive impairment and mild cognitive impairment or normal cognitive function groups based on a score of <20 or ≥20, respectively, using the MoCA. Physical measures included dynamic gait index (DGI) scores, timed up-and-go (TUG), 5 times sit-to-stand (5XSST), functional reach test, and 6-minute walk test. A total of 206 participants (female: n = 96) were included. The prevalence of severe cognitive impairment in the community-dwelling older adults was 12.6%. The number of chronic conditions (odds ratio [OR]: 2.31, p<0.001), number of medications (OR: 1.36, p = 0.003), and depressive symptoms using PHQ-9 (OR: 1.11, p = 0.009) were significantly associated with severe cognitive impairment after adjustment for other covariates, including age, sex, and BMI. Based on the physical function measures, only the scores for DGI (OR: 0.86, p = 0.003), TUG (OR: 1.16, p = 0.035) and 5XSST (OR: 1.25, p <0.001) were significantly associated with severe cognitive impairment. This study revealed a high prevalence of severe cognitive impairment among community-dwelling adults in Saudi Arabia. Its major risk factors include depressive symptoms, number of chronic conditions and medications, and physical measures, including DGI, TUG, and 5XSST. [ABSTRACT FROM AUTHOR]

aimel,1 Bader A Alqahtani,1 Ahmed S Alhowimel,1 Mohammed M Alshehri,2 Afrah K Alhelal,1 Lujain G Al-assaf,1 Aqeel M Alenazi11Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-kharj, 11942, Saudi Arabia; 2Department of Physical Therapy, Jazan University, Jazan, 45142, Saudi Arabia Correspondence: Mohammed M Alshehri, Department of Physical Therapy, Jazan University, Jazan, 45142, Saudi Arabia, Email [email protected] Background: Clinical guidelines emphasize the use of standardized outcome measures (SOMs) in post-stroke rehabilitation. However, the extent of SOM utilization among physiotherapists in this context in Saudi Arabia remains unclear. Aim: 1) assess the current use of SOMs by physiotherapists involved in stroke rehabilitation in Saudi Arabia and 2) identify facilitators and barriers influencing the use of SOMs. Methods: An online survey was administered using a three-section questionnaire designed for this study. The first section collected demographic data, the second evaluated the use of SOMs recommended by the American Physical Therapy Association, and the third explored factors facilitating or hindering SOM use in clinical practice. Only highly recommended outcome measures capturing the three levels of the International Classification of Functioning, and Disability (ICF) model were considered: body structure and function, activities, and participation. Poisson regression analysis was used to investigate the association between SOMs utilization and educational level, work experience, type of work facility, and the number of patients treated per week. Results: A total of 138 physiotherapists responded. Most participants (98.5%) used at least one outcome measure in clinical practice. Regression analysis showed that number of strokes treated per week and facility type were associated with the likelihood of using higher number of SOMs. Physiotherapists managing more than 10 stroke patients per week and working in private sector had significantly higher odds of using a greater number of SOMs. The most pronounced barriers were time restrictions and limited resources. Conclusion: Physiotherapists working with stroke patients in Saudi Arabia demonstrate a high awareness and positive attitude toward SOM utilization. Addressing barriers such as time management and resource allocation is crucial to enhancing SOM integration in clinical practice. Clinical Rehabilitation Impact: Organizational support in terms of adequate time and resources is needed to enhance the use of SOMs among physiotherapists. [ABSTRACT FROM AUTHOR]

Background: Hypertension (HTN) is prevalent in individuals with type 2 Diabetes Mellitus (T2DM), doubling the risk of developing chronic complications. Despite normal routine checks, many patients with diabetes exhibit abnormal blood pressure (BP) profiles identified by 24-hour ambulatory Blood Pressure monitoring (ABPM). This study aimed to analyse blood pressure variability in patients with diabetes to enhance current knowledge and improve clinical practice. Methods: This cross-sectional study obtained ethical approval from Jazan University and involved 58 patients with type 2 Diabetes Mellitus (T2DM) who adhered to the strict inclusion and exclusion criteria. Comprehensive clinical and laboratory data, including demographic, clinical, and essential laboratory parameters, were collected using a standardized form. Blood Pressure (BP) was meticulously monitored using the Sun Tech Oscar 2 ABPMR device, with measurements commencing between 8 am and 10 am, extending over 24 hours. The study calculated averages and evaluated systolic and diastolic percentage dipping during 24-hour, daytime, and night-time intervals. Participants classified as "dippers" experienced a BP reductions of at least 10%. Results: Fifty-eight normotensive T2DM patients, with a mean age of 45.51 ± 6.7 years, were monitored over 24 months. Among the 58 individuals assessed using ABPM, a non-dipping pattern was observed in 45 participants (77.58%), whereas 13 (22.41%) exhibited a dipping pattern. Postprandial and fasting blood sugar levels were distinct; the dipper group demonstrated better post-meal glucose control (p=0.02), whereas the non-dipper group had superior fasting glucose control (p=0.04). The dipper group showed a higher 24-hour average systolic BP (p=0.00) and increased dipping percentages for systolic and diastolic BP during sleep. Conclusion: Over 77% of ABPM-evaluated individuals showed non-dipping patterns, with a higher BMI being strongly associated. Laboratory findings revealed distinct variations in the postprandial and fasting blood sugar levels, suggesting a potential genetic predisposition. [ABSTRACT FROM AUTHOR]

Background and Objectives: Our objectives were to examine the association between balance confidence, functional mobility measures, and the presence of disability in older adults in Saudi Arabia and to identify the optimal cutoff scores for these measures that predict disability. Materials and Methods: A cross-sectional study was conducted among 324 community-dwelling older adults (65 ± 7 years, 59% women). Disability was assessed using the Arabic version of the basic activities of daily living (ADLs) scale. Balance confidence was evaluated using the Arabic version of the Activities -Specific Balance Confidence (ABC) scale, and functional mobility was assessed using the 30-Second Chair Stand Test (30s-CST). Results: The prevalence of disability was 33.6% among the participants. Logistic regression revealed a 6% increase in disability odds for each one-unit decrease in the 30s-CST (OR: 0.94) and a 3% increase per one-point decrease in the ABC score (OR: 0.97). The optimal cutoff scores were ≤5 repetitions for the 30s-CST (sensitivity: 74.4%; specificity: 51.4%; AUC: 0.64) and ≤40 for the ABC scale (sensitivity: 80.8%; specificity: 61.4%; AUC: 0.75). Conclusions: Impaired balance and functional mobility are significantly associated with disability among older adults. The 30s-CST and the ABC scale can be used as effective screening tools, but the cross-sectional design of the current study limits its generalizability. Longitudinal research is needed to validate these findings. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate and compare the prevalence of Forward Head Posture (FHP) in car and bike drivers, and its potential correlation with neck and cardiopulmonary parameters. Methods: This cross-sectional study involved 400 participants from urban and suburban areas around Lucknow, Uttar Pradesh, India, including 200 car drivers and 200 bike drivers aged 18–65 years with a minimum five-year driving history. Neck health was assessed using measurements such as cervical range of motion and Neck Disability Index (NDI), cardiopulmonary parameters were evaluated through resting heart rate, blood pressure, and pulmonary function tests using the spirometry test, and FHP was assessed using Surgimap application. Statistical analysis was performed using IBM SPSS Statistics software (version 26.0) and included descriptive statistics, hypothesis testing, Chi-square or Fisher's exact test for binary data, and correlation analyses. Results: The result show that difference in the mean FHP between car and bike drivers was statistically significant (p = 0.0001), indicating a higher prevalence of FHP among car drivers than among bike drivers. Correlation analyses revealed significant associations between FHP and neck health metrics, especially cervical flexion (r = 0.71, p<0.05), (r = 0.78, p<0.05) and left-side rotation (r = 0.56, p<0.05), (r = 0.61, p<0.05) in car and bike drivers. Among the cardiopulmonary parameters, significant correlations with FHP were observed in resting heart rate (r = 0.33, p<0.05), (r = 0.42, p<0.05), spirometry results FVC (r = 0.29, p<0.05), FEV1 (r = 0.22, p<0.05), and FVC (r = 0.31, p<0.05) for car and bike drivers. Conclusion: We observed a higher incidence of FHP in car drivers, indicating that a prolonged static posture may lead to greater postural deviation than dynamic movement during biking. This association suggests that FHP could have wide-reaching implications for systemic health, beyond musculoskeletal issues. These findings have the potential to influence preventative strategies and interventions aimed at improving the overall health outcomes for drivers. [ABSTRACT FROM AUTHOR]

Transcranial direct current stimulation (tDCS) is known to modulate the brain excitability and enhance cognitive functions and neuroplasticity, although adherence to its administration in post-stroke rehabilitation is still being understudied. This study set out to develop and content validate a questionnaire to assess clinical physiotherapists’ knowledge, attitude, and practices regarding the use of tDCS following a stroke. In order to gather expert opinion and come to a consensus on a certain topic, the Delphi technique was employed. The measure was validated using both qualitative (cognitive interviewing) and quantitative (content validity) methods on a panel of 32 experts. Calculations were made for the content validity ratio (CVR), content validity index (CVI), item-level CVI (I-CVI), and scale-level CVI universal agreement (S-CVI/UA). A total of 48 interdisciplinary experts in the field of neurosciences were invited. In all, 32 specialists from Neurology, General Medicine, Neurophysiotherapy, and Physiology departments accepted the invitation and provided their opinion for instrument analysis. After two rounds, early iterations of this instrument demonstrated an acceptable CVR value of 1, high overall content validity (S-CVI/UA = 0.86), and high content validity of individual items (I-CVI range: 0.83-1.00). The kappa value varied between 0.75 and 1, which is excellent. Its content is therefore deemed validated. Through an iterative process, its development and assessment revealed strong item-content validity for determining the domains of the questionnaire. It is anticipated that this metric could be utilized to increase the adherence rate of post-stroke tDCS application in Saudi Arabia. [ABSTRACT FROM AUTHOR]

To systematically explore the effects of trunk exercises using virtual reality technology compared to conventional exercises for trunk impairment in patients with subacute and chronic strokes. A comprehensive search of literature published from inception until December 2022 was conducted using PubMed, Cochrane Library, Web of Science, Scopus, IEEE, and the Physiotherapy Evidence Database (PEDro). The inclusion criteria encompassed all randomized controlled trials (RCT) published in the English language involving adults who had had strokes and the evaluation of the effectiveness of virtual reality -based trunk exercises in reducing trunk impairment post stroke as measured by the trunk control test (TCT) and/or the trunk impairment scale (TIS) compared to conventional trunk exercises. A total of 397 studies were retrieved, and six studies were included in the current analysis. A random-effects meta-analysis of six studies indicated that video games had a very large, significant effect (SMD = 1.11; 95%, P < 0.0001) on the delivery of trunk exercises to reduce trunk impairment post stroke at both the subacute and chronic stages. The study findings indicate that trunk exercises using virtual reality have a highly significant effect on reducing trunk impairment in patients with subacute and chronic stroke. Large RCTs are needed to study the effects of virtual reality trunk exercises on the acute, subacute, and chronic stages of stroke. [ABSTRACT FROM AUTHOR]

This study examined the independent association between MLTC and the presence of disability with the risk of falls among community adults. Methods: A cross-sectional study included 324 adults (age ≥ 50). Demographic and clinical data included age, sex, body mass index (BMI), MLTC (≥ two chronic diseases) risk of fall (ie, history of fall in the previous 12-months, number of falls, and recurrent falls). The Barthel Index and Falls Efficacy Scale-International (FES-I) were used to assess disability and fear of fall, respectively. Results: MLTC (Odds Ratio (OR) 2.50, 95% Confidence Interval (CI) [1.26, 4.95], p=0.009), and disability (OR 1.71, 95% CI [1.04, 2.79], p = 0.034) were independently associated with history of falls. MLTC (Incidence Rate Ratio (IRR) 2.87, 95% CI [1.93, 4.29], p < 0.001) and disability (IRR 1.86 95% CI [1.46, 2.36], p < 0.001) were independently associated with an increased number of falls. MLTC (OR 4.50, 95% CI [1.78, 11.36], p = 0.001) and disability (OR 2.82, 95% CI [1.58, 5.05], p < 0.001) were independently associated with recurrent falls. MLTC (B = 6.45, p < 0.001) and disability (B = 3.05, p = 0.025) were independently associated with increased fear of falling. Conclusion: This study indicated that both MLTC and disability are independently associated with falls, number of falls and fear of falling in this population. [ABSTRACT FROM AUTHOR]

aimel,1 Mohammed M Alshehri,4 Bader A Alqahtani,1 Faris A Alodaibi51Department of Health and Rehabilitation Sciences, College of Applied Medical Science, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia; 2Department of Physical Rehabilitation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 3Joint Clinic, Riyadh, Saudi Arabia; 4Physical Therapy Department, Jazan University, Jazan, Saudi Arabia; 5Department of Rehabilitation Science, King Saud University, Riyadh, Saudi Arabia Correspondence: Ahmed S Alhowimel, Department of Health and Rehabilitation Sciences, College of Applied Medical Science, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia, Tel +96611558888, Email a.a; [email protected] Purpose: This cross-sectional study aimed to validate the Arabic version of the Attitude toward Education and Advice for Low Back Pain (AxEL) Questionnaire. Patients and Methods: This study was conducted in two phases. First, the AxEL questionnaire was translated into Arabic and cross-culturally adapted. Second, the psychometric properties (such as validity) of the translated AxEL were evaluated. Results: The results showed that back translators and language specialists had no trouble translating the AxEL. The translators' agreement was very high (88.2%), and the questionnaire items were logically and clearly translated from English into Arabic. Conclusion: The Arabic version of AxEL is a valid tool that can assess individuals' beliefs and attitudes towards low back pain (LBP). It fills a significant void in cross-cultural research and can help healthcare providers understand the attitudes and beliefs influencing individuals' management of LBP within the Arabic context. [ABSTRACT FROM AUTHOR]