Background Total hip arthroplasty (THA) is an established intervention for managing advanced osteoarthritis, offering substantial improvements in pain relief. However, relationship between sleep quality and functional outcomes after THA remains underexplored. Objective This longitudinal study aimed to evaluate changes in nocturnal sleep quality and daytime sleepiness and their association with functional recovery in 55 patients undergoing primary THA. Methods Patients undergoing primary THA were enrolled in this prospective cohort study. Nocturnal sleep quality, daytime sleepiness, functional outcomes, and health-related quality of life were assessed preoperatively and at one, three, and sixxs months postoperatively using the PSQI, ESS, WOMAC, HOOS, and SF-36. Statistical analyses included Friedman's test with post-hoc Wilcoxon signed-rank tests and Kendall's tau correlations. Results WOMAC, PSQI, all HOOS dimensions, and both SF-36 components significantly improved over time. PSQI scores significantly decreased from the preoperative assessment to the postoperative follow-ups, indicating improved nocturnal sleep quality. In contrast, the median ESS score was 5 at each assessment, and no statistically significant group-level change in ESS was detected (p = 0.996). WOMAC and ESS were significantly correlated at one and six months, suggesting an association between functional recovery and daytime sleepiness at these timepoints. Conclusions THA was associated with significant improvements in pain, function, health-related quality of life, and nocturnal sleep quality up to six months postoperatively. No statistically significant group-level change in daytime sleepiness was detected. However, these findings should be interpreted cautiously, and larger prospective studies are needed to confirm them.
Background The rapid integration of technology into daily life has raised concerns about physical and psychosocial health. Problematic smartphone and internet use may coexist with prolonged static postures and musculoskeletal discomfort among university students. Objective To examine the relationships of smartphone and internet addiction with academic performance, musculoskeletal discomfort, life satisfaction, and health-related quality of life among university students. Methods This descriptive cross-sectional study began in 2020 and included 473 university students (258 males, 215 females). Validated questionnaires assessed smartphone and internet addiction, musculoskeletal discomfort, health-related quality of life, and life satisfaction. Grade point average was recorded. Descriptive statistics, one-way analysis of variance, and Pearson correlations were used. Results Smartphone and internet addiction scores showed weak and negligible positive correlations with musculoskeletal discomfort, respectively ( r = 0.111 and r = 0.091). Both scores were weakly associated with poorer health-related quality of life. Internet addiction scores were weakly associated with lower life satisfaction; the association for smartphone addiction scores was not statistically significant. Neither score was significantly associated with grade point average. Conclusion Higher smartphone and internet addiction scores were associated with greater musculoskeletal discomfort and poorer health-related quality of life, although the associations were small.
Background Chronic non-specific low back pain (CNSLBP) is a major global cause of disability. While medical ozone injections have a long history, their comparative effectiveness against passive electrothermal modalities as adjuncts to exercise remains unclear. This study aimed to evaluate the preliminary clinical outcomes of these two adjunctive strategies. Methods We conducted a pilot randomized controlled trial with 64 adult patients suffering from CNSLBP. All participants were instructed in a standardized home exercise program. They were then randomly assigned to receive either three weekly sessions of paravertebral ozone injections or ten sessions of passive electrothermal modalities. The primary endpoint was functional disability measured by the Oswestry Disability Index (ODI version 2.1a) at 3 months post-intervention. Secondary outcomes included Visual Analogue Scale (VAS) pain scores at 1, 3, and 6 months. Results At the 3-month primary endpoint for disability, ANCOVA adjusting for baseline ODI score, age, and BMI revealed no statistically significant between-group difference (adjusted mean difference [MD]: 2.67, 95% CI: −1.40 to 6.74; p = 0.195 ). Similarly, no statistically significant between-group differences in pain intensity were detected at 1 month ( p = 0.095 ), 3 months (adjusted MD: 0.18, 95% CI: −1.03 to 1.39; p = 0.767 ), or 6 months ( p = 0.119 ). Conclusions In patients with CNSLBP engaged in a structured home exercise program, no statistically significant differences in pain or functional disability were detected between adding a 3-session course of paravertebral ozone injections and adding a 10-session course of passive electrothermal modalities within this pilot study. Given the study design and sample size, these findings indicate a lack of statistically significant between-group differences. Larger, multi-arm definitive trials including an exercise-only control arm are required.
Aim To compare balance performance, posturographic measures, and limits of stability (LOS) between patients with Sjögren's disease (SjD) and healthy controls and examine associations with fatigue, functional disability, symptom burden, and fear of falling. Methods The study included 45 patients with SjD and 35 healthy controls. Balance was assessed using the Berg Balance Scale (BBS), computerized posturography, and LOS testing. Fatigue, symptom burden, fear of falling, kinesiophobia, and psychological symptoms were assessed using the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), EULAR Sjögren's Syndrome Patient-Reported Index (ESSPRI), Falls Efficacy Scale–International (FES-I), Tampa Scale for Kinesiophobia (TSK), and Hospital Anxiety and Depression Scale (HADS), respectively. Posturographic parameters and LOS were analyzed using mixed-design repeated-measures ANOVA. Associations were examined using Spearman correlation analysis and multivariable linear regression. Results Patients with SjD had greater fatigue and fear of falling than controls (both p < 0.05), while BBS scores were statistically lower with a small absolute difference. No significant overall group effects were found for posturographic parameters or LOS, although group-related interactions occurred for balance score and directional LOS. Fear of falling was associated with poorer functional balance, greater fatigue, higher symptom burden, kinesiophobia, and depressive symptoms (all p < 0.05). Posturographic balance scores were not correlated with BBS, FACIT-F, TSK, or FES-I (all p > 0.05). ESSPRI remained independently associated with fear of falling (β = 0.347, p = 0.043). Conclusion In patients with predominantly low systemic disease activity, posturographic performance was largely preserved despite increased fear of falling. Posturographic and clinical measures may capture complementary aspects of balance-related problems in SjD.
Background Chronic ankle instability (CAI) is a complex condition characterized by recurring sprains. Objective Our study aimed to compare the tone, stiffness, and elasticity of the periarticular muscles, Achilles tendon (AT), and plantar fascia (PF) between the affected and non-affected limbs of individuals with unilateral CAI. Methods The cross-sectional study included 75 volunteers aged 18 to 45 years who had been diagnosed with CAI by a physician. Ankle instability was assessed using the Identification of Functional Ankle Instability (IdFAI). Passive mechanical properties (PMP), including frequency, stiffness, and logarithmic decrement, of the tibialis anterior (TA), peroneus longus (PL), medial and lateral gastrocnemius (MGC – LGC), AT, and PF were assessed bilaterally using the MyotonPRO. PMP were compared between sides, and relationships between IdFAI scores and PMP on the affected side were examined. Results The mean age was 27.46 ± 4.23 years. Logarithmic decrement and stiffness values were higher on the affected side in the TA (p = 0.011, p = 0.027), PL (p = 0.017, p = 0.031), and PF (p = 0.020, p = 0.028) compared to the non-affected side. Logarithmic decrement was also higher in the MGC (p = 0.029) and LGC (p = 0.005). No significant difference in frequency was observed for any of these structures (p > 0.05). The AT showed no significant differences in frequency, stiffness, or logarithmic decrement between the affected and non-affected sides (p > 0.05). Conclusions CAI is a multidimensional pathology characterized by deterioration of the PMP of the surrounding muscles and PF. These findings suggest that management of CAI should include interventions aimed at improving myofascial tissue elasticity in addition to neuromuscular rehabilitation. Trial registration: ClinicalTrials.gov, TRN: NCT06987435.
