The aim of the study was to investigate the effectiveness of electrical stimulation to agonist muscles after injection of Botulinum toxin A (BTX-A) in children with spastic diplegic cerebral palsy (SDCP). Between October 2009 and October 2010, 38 patients with SDCP (19 males, 19 females; mean age 6.3 years; range, 4 to 10 years) were included. The patients were able to walk independently or with minimal assistance by foot equine and had spasticity in the calf muscles between Grades 1+ and 3 according to the Modified Ashworth Scale (MAS). The patients received either BTX-A injection + electrical stimulation (Group 1, n=19) or BTX-A injection alone (Group 2, n=19). All patients were evaluated using the MAS, Penn Spasm Frequency Scale (PSFS), Gross Motor Function Measure-88 (GMFM-88) (Dimensions D and E), and walking velocity. A decrease in spasticity was evident for the right, left, and bilateral lower extremities for both groups (p<0.05). There were no statistically significant differences in the MAS, PSFS, GMFM-88 (Dimensions D and E), and walking velocity between the groups. Our study results showed that both patient groups benefited from the treatment and the administration of electrical stimulation to the gastrocnemius motor points produced no additional benefit for patients with SDCP.

Background and Objectives: The use of anabolic–androgenic steroids (AASs) by competitive and recreational athletes has been studied and well documented. There are numerous studies showing its effects on personality traits and risky behaviors like aggression. The relationship between AAS use, aggression, and narcissism is complex and intricate. We examined this relationship in male bodybuilders who use AASs. Materials and Methods: A total of 319 healthy subjects aged 18–44 years (33.4 ± 9.4) who have been regularly training at bodybuilding for at least 3 years participated voluntarily in the study and completed a demographic data inventory, the Five-Factor Narcissism Inventory Short Form (FFNI-SF), and the Buss–Perry Aggression Scale anonymously. Demographic data were given as percentages, comparisons of aggression and narcissism scores according to AAS use were performed by using an independent sample t test, and effects of narcissism and aggression levels on AAS use was assessed by using logistic regression analysis. All analyses were performed by using SPSS Statistics 22.0. Results: Results showed that AAS users had significantly higher scores on the overall FFNI-SF Scale (p < 0.001) and all sub-dimensions of narcissism (p < 0.001) and on the overall Buss–Perry Aggression Scale (p < 0.001) and all sub-dimensions of aggression (p < 0.001). It was also shown that there were significant and positive correlations between the FFNI-SF overall score (p < 0.001) and both the vulnerable narcissism and grandiose narcissism sub-dimensions (p < 0.001) and the scores of the Buss–Perry Aggression Scale (p < 0.001), physical aggression (p < 0.001), anger (p < 0.001), hostility (p < 0.001), and verbal aggression (p < 0.001) sub-dimensions. Conclusions: These results show a strong relation between AAS use, narcissism, and aggression in bodybuilders. However, it is not clear whether AAS use leads to aggression and narcissism or whether narcissistic and/or aggressive people tend to use AASs. Furthermore, including a lot of potential third variables shows that it does not have to be either one or the other way around. There is a need to conduct future studies to determine this causality.

Objectives: This study aimed to examine effects of core stabilization and aerobic exercises on lumbar stabilizer muscles and diaphragm motility in individuals with chronic low back pain (CLBP). Patients and methods: Fifty-one patients (19 males, 32 females; mean age: 32.7±8.8 years; range, 20 to 60 years) with CLBP were included in this randomized controlled trial between March 2021 and May 2022. The patients were divided into three groups: the core group, the aerobic group, and the control group. Conventional treatments (hotpack, transcutaneous electrical nerve stimulation, ultrasound, and McKenzie exercises) were applied to all three patient groups. The core group received core stabilization exercises, and the aerobic group received aerobic exercises. The control group received only conventional treatments. Exercises were continued for six weeks. All patients were assessed through the Beck Depression Inventory (BDI), Visual Analog Scale (VAS), Roland Morris Disability Questionnaire (RMDQ), and Nottingham Health Profile (NHP). Trunk flexor and extensor strength, as well as trunk flexor and back extensor endurance, was examined. Structural features of the multifidus (MF), transversus abdominis (TrA), external oblique (EO), internal oblique (IO), and diaphragm muscles, as well as diaphragm motility, were evaluated with ultrasound imaging. All measurements were repeated before and after six weeks of treatment. Results: In all groups, post-treatment values of VAS rest/activity, trunk flexor endurance, back extensor endurance, trunk flexor/extensor muscle strength, BDI, RMDQ and, NHP scores improved significantly compared to pre-treatment (p=0.001). Resting and contraction thicknesses of TrA, MF, EO, and IO muscles increased significantly in both the core (p=0.001/0.001, p=0.001/0.002, p=0.001/0.001, and p=0.001/0.001, respectively) and aerobic groups (p=0.001/0.013, p=0.002/0.020, p=0.001/0.004, and p=0.001/0.010, respectively), while the control group did not show any significant difference (p=0.229/0.064, p=0.052/0.102, p=0.069/0.449, and p=0.094/0.146, respectively). After treatment, all groups showed significant increments in end-expiratory thickness (p=0.001), end-inspiratory thickness (p=0.001), motility of diaphragm during normal breathing (control, p=0.003; core, p=0.001; aerobic, p=0.001), and deep breathing (control, p=0.007; core, p=0.001; aerobic, p=0.001). Conclusion: While aerobic and core stabilization exercises provided significant improvements in individuals with CLBP, the core stabilization group showed the best improvement in all parameters. Accordingly, the necessity of aerobic and core stabilization exercises in treatment programs comes to the fore in individuals with CLBP.