Introduction. Guidelines endorse to implement an integrated and multidisciplinary team approach in the management of people with Parkinson’s disease (PD). However, there is no net and clear finding that shows the supremacy of multidisciplinary team interventions over conventional interventions for people with PD. Therefore, we perform a systematic review and meta-analysis to determine the supremacy of multidisciplinary interventions for people with PD. Methods. A systematic review and meta-analysis of randomized controlled trials were conducted. PubMed, Physiotherapy Evidence Database, Cochrane Library, and Google Scholar were searched from inception until May 2021. Randomized controlled trials comparing multidisciplinary intervention with conventional physiotherapy were included. The outcome measures were gait balance, disability status, quality of life, and depression level. The PEDro scale was used to systematically appraise methodological quality. Two reviewers screened, extracted, and performed a quality assessment of included studies independently. Review Manager V.5.4 (Cochrane Collaboration) software was used for statistical analysis. Heterogeneity was analyzed using I2 statistics, and a standardized mean difference with 95% CI and P value was used to calculate the treatment effect for outcome variables. Results. A total of 6 studies with 1260 participants were included. The average PEDro methodological quality score was 6.67. No statistically significant difference between multidisciplinary and conventional rehabilitation on functional capacity (SMD: 0.69; 95% CI: −0.13, 1.51; P = 0.10 ), disability status (SMD: 0.65; 95% CI: −0.16, 1.46; P = 0.11 ), and quality of life (SMD: 0.28; 95% CI: −0.31, 0.59; P = 0.08 ) was found. However, there is a statistically significant improvement in caregivers' anxiety levels in the multidisciplinary group (SMD: 0.39; 95% CI 0.06, 1.73; P = 0.02 ). Conclusion. This systematic review and meta-analysis show no significant difference between multidisciplinary and conventional rehabilitation on functionality, disability, and quality of life. Caregivers' anxiety levels show improvement following multidisciplinary interventions. However, large-scale studies with long-term follow-up were required for concrete and clinical recommendations.

Introduction: In individuals with transtibial amputation, the distal part of the lower extremity is lost. Therefore, the knee joint is of greater importance to be able to provide physical performance. The aim of this study was to evaluate the correlation between knee joint position sense and physical functional performance in individuals with transtibial amputation. Methods: The study included 21 subjects with transtibial amputation. A digital inclinometer was used to evaluate the joint position sense of the amputated side knee joint. The timed up and go test, the 4-square step test, and 10-m walk test were used to evaluate physical functional performance. Linear regression analysis was used to investigate the associations between independent variables and functional performance tests. Results: The mean age of the participants was 52.52 ± 15.68 years. The mean of the error in knee joint position sense was 5.33 degree (standard deviation = 3.08 degree). The error in knee joint position sense of the amputated limb predicted 45% of the variance in the 4-square step test and 22% of the variance in the 10-m walk test (P < 0.05). Conclusions: The knee joint position sense on the amputated side was found to be associated with physical functional performance in individuals with transtibial amputation. Residual limb knee joint position sense should be considered when prescribing prostheses and planning rehabilitation programs.

The relationship between temperament and characters with physical fitness and pain perception in firefighters Objective: Firefighting is a demanding profession which requires psychological and physical fitness. The purpose of this study was to examine the relationship between personality and other psychosocial properties, physical fitness, and pain perception in firefighters. Methods: The study participants consisted of 149 male firefighters. Participants were administered the Temperament and Character Inventory (TCI), Sensation Seeking Scale (SSS), The Impact of Events Scale-Revised (IES-R), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory, and Nottingham Health Profile survey. For physical fitness measurements; participants were evaluated with physical fitness parameters such as balance, flexibility, shortening, strength and endurance, agility, speed, and strength. In order to measure balance, functional reaching and standing on one foot tests are used. Results: 90 firefighters were able to complete the study fully. Harm Avoidance, Reward Dependence, and Persistence subscales of temperament and Self-directedness, Cooperativeness, and Self-Transcendence subscales of character dimensions, Sensation Seeking Scale, Impact of the Event Scale, and STAI were found to be correlated with physical fitness measurements. No correlations were found between other psychosocial measures and physical fitness measurements (p>0.05). Psychosocial measures that were associated with pain perception were Novelty Seeking, Harm Avoidance, and Persistence subscales and Thrill and Adventure Seeking subscale of the Sensation Seeking Scale. Conclusions: Our results have shown that a significant relationship exists between different psychosocial characteristics of firefighters and their physical fitness and pain perception. This relationship supports the notion that higher psychological and physical needs would have an impact on occupational performance of firefighters.

An important concept in patellofemoral joint function is the quadriceps angle (Q angle), but there is a standardization problem with the measurement method. The aim of the study was to compare the change of the Q angle in relaxed or maximum voluntary contraction (MVC) of the quadriceps using a standardized measurement method in patients with patellofemoral pain syndrome (PFPS). This cross-sectional analytical study includes 34 sedentary female patients aged 18-50 years with a diagnosis of PFPS. Measurements were carried out with a manual extendable fixedarm goniometer. For the first measurement, the patient was placed in quadriceps relaxed in supine position. Lower extremity rotation was neutralized using the axial rotation neutralizing apparatus (ARNA). For the second measurement, while the quadriceps was maximally contracted in the same position the midpoint of the patella was re-marked and then the measurement was repeated. The Q angle measurements taken in quadriceps relaxed and MVC were 18.44° ± 2.80° and 16.41° ± 2.83°, respectively (p = .00). It was determined that there was no correlation between age, height, weight, body mass index (BMI), leg length and Q angle measurements of the participants (p > .05). In conclusion, this measurement method offered measurement estimations that verified the effect of the quadriceps on the Q angle in patients with PFPS. The prevention of axial rotation in the leg and the use of an extendable fixed-arm goniometer contribute to the standardization of Q angle measurement.

Achilles is the tendon of our body that is the most powerful and capable of resisting great forces. Achilles tendon injuries observed during daily life and sports activities occur in the relatively avascular area 2-6 cm proximal to the calcaneus, the sticking point of the tendon Surgical or conservative treatment preferences in injury are affected by conditions such as the age of the patient, the type and localization of the tear, the profession of the patient, chronic disease. Especially immobilization performed with a long-term splint or plaster should not be preferred after surgery and long-leg plaster should be avoided. The fact that immobilization causes atrophy of muscles, adhesion, joint stiffness, shortening of tendons has increased the interest in functional rehabilitation. Early functional rehabilitation with early surgical or weight transfer, controlled range of motion, and a combination of both rehabilitation and the process involves dynamic mobilization exercises. In contrast to immobilization practices, early mobilization trainings (ankle exercises, early weight bearing activities, etc.) provide a rapid functional improvement and positively affect return to work, quality of life and patient satisfaction. Correctly planned and structured rehabilitation programs are important for maintaining and maintaining health and preventing diseases. Early functional rehabilitation practices that will be carried out with multidisciplinary approaches under the supervision of physiotherapists who demonstrate their clinical skills in accordance with the needs of the patient and closely follow the literature are very important in the return of the patient to quality of life and activities. Keywords: Achilles Tendon, Rupture, Functional Rehabilitation