Objectives: In this study, we aimed to evaluate whether fibromyalgia patients had a higher fall risk compared to healthy individuals and to identify its relationship, if there was an increase, with clinical features. Patients and methods: Between March 2018 and September 2018, a total of 50 consecutive female patients with fibromyalgia (median age: 35 years; interquantile range [IQR], 27 to 40 years) and 50 healthy female volunteers (median age: 30 years; IQR, 23 to 40 years) were included in the study. Pain was evaluated with the Visual Analog Scale (VAS), life quality with the Nottingham Health Profile (NHP), balance functions with the Berg Balance Test (BBT), and the risk of falls with a posturography device. Disease activity of fibromyalgia patients was evaluated with the Fibromyalgia Impact Questionnaire (FIQ). Results: The mean fall risk index of the fibromyalgia patients was 45%. The fall risk index was significantly higher (p=0.010) and the BBT scores were significantly lower in the patient group (p<0.001). There was a significant difference in terms of fall risk between the control group and drug-free fibromyalgia patients; however, no significant difference was found between the balance scores of the two groups. In the fibromyalgia group, a weak positive relationship was determined between the fall risk index and the social isolation subscale of the NHP. Conclusion: Our study results showed an increased risk of loss of balance and falls in fibromyalgia patients, compared to healthy individuals. This fall risk increase was also detected in fibromyalgia patients who did not use drugs. These findings suggest a possible relationship between social isolation and an increased risk of falls.

Background: This cross-sectional study aimed to determine the status of kinesiophobia in patients with fibromyalgia syndrome (FMS) and to evaluate its relationship with cognitive functions, anxiety, depression, disease severity, and pain level. Methods: Fifty FMS patients (mean age 44.06 years; range 18 to 60 years) were included in the study. Fifty healthy participants (mean age 42.04 years; range 18 to 60 years) were included in the study as a control group. Participant recruitment for the study was conducted in a state hospital in Türkiye. Disease severity level in the FMS group was assessed using the Fibromyalgia Impact Questionnaire (FIQ). The Tampa Scale for Kinesiophobia (TSK) was administered to determine the participants’ kinesiophobia status. The Hospital Anxiety and Depression Scale (HADS) was used to assess the participants’ anxiety and depression status. The Montreal Cognitive Assessment (MoCA) test was administered to assess cognitive functions. Results: TSK, HADS-Anxiety, Visual Analog Scale (VAS), and FIQ scores were higher in the FMS group compared to the control group (p < 0.05). MoCA total scores, MoCA-Visuospatial/Executive, and MoCA-Attention scores were higher in the control group (p < 0.05). There was a weak positive correlation between TSK and FIQ scores in the FMS group (p: 0.02, r: 0.31). There was a weak negative correlation between TSK and MoCA-Naming scores in the FMS group (p: 0.02, r: −0.31). Conclusions: Increased kinesiophobia was found in FMS patients compared to the general population. It was determined that the level of kinesiophobia in FMS patients was related to disease severity and naming-related cognitive functions. Clinicians dealing with FMS should take this into particular consideration.

Objectives: This study aims to objectively assess the fall risk and postural balance status of systemic sclerosis (SS) patients and investigate its association with various clinical findings. Patients and methods: The cross-sectional study was conducted between July 2020 and September 2020. The study included 14 patients (12 females, 2 males; mean age: 48.4±12.3 years; range, 21 to 63 years) diagnosed with SS and a control group of 20 healthy volunteers (17 females, 3 males; mean age: 46.8±9.0 years; range, 25 to 60 years). Demographic and clinical data of the participants were noted. Results of anti-nuclear antibodies and anti-Scl-70 antibodies were recorded. The fall index, indicating fall risk, was determined using a posturography device, and postural stability measurements were performed. The Falls Efficacy Scale-International was used to evaluate fall activity. The modified Rodnan skin score was used to assess the degree of cutaneous involvement in SS. Results: Fall index results were higher in the SS group (p<0.05). The rate of falls in the past year among SS patients was 7.1%. The SS group showed deviations from the normal population in the postural measurement when eyes closed on a solid surface in normal position with the stability index, eyes closed on a pillow with the stability index, and eyes closed on a solid surface with the head tilted 30° forward with the weight distribution index (p<0.05). Fear of falling scores were higher in diffuse-type SS compared to limited-type SS (p<0.01). No differences were observed in other parameters. Conclusion: This study revealed impaired postural balance and increased fall risk in SS patients compared to the normal population. Evaluation of postural balance and fall risk in SS patients should be done in the early period, and necessary treatments should be applied.

Purpose: Upper extremity motor impairments following stroke substantially limit independence in daily living. Hand-tracking virtual reality (VR) rehabilitation systems may support intensive task-oriented practice while enhancing motivation; however, evidence integrating objective kinematic indicators with usability and patient-reported outcomes for controller-free consumer-grade VR remains limited. The primary aim of this single-arm pilot study was to evaluate the feasibility, safety (tolerability), and usability of a hand-tracking VR rehabilitation system delivered as an adjunct to conventional physiotherapy in individuals with stroke; describing its preliminary in-game kinematic profile and exploring participants’ experiences through open-ended feedback were secondary aims. The study was explicitly not designed or powered to test clinical efficacy. Materials and Methods: Ten individuals with stroke completed a 20-session (8-week) single-arm pilot intervention; all participants concurrently received standard hospital-based physiotherapy (median 3 sessions/week, ∼45 min/session). Early-phase (sessions 1–5) and late-phase (sessions 16–20) within-subject performance were compared using the Wilcoxon signed-rank test with Holm–Bonferroni correction across four pre-specified primary outcomes. Movement smoothness was assessed using the Spectral Arc Length (SPARC), usability was evaluated using the System Usability Scale (SUS), and cybersickness was monitored with the Simulator Sickness Questionnaire (SSQ). Results: Sixteen patients were screened, of whom fourteen started the intervention and ten completed the 8-week per-protocol program (intervention completion rate, 10/14 = 71.4%; per-protocol session adherence among the ten completers, 200/200 = 100%; no SSQ-defined adverse events). Within-subject comparisons showed a $+10.6$-point increase in success rate (adjusted $p=0.020$), a $+0.10$ m/s increase in mean movement speed (adjusted $p=0.020$), a $-341$ ms reduction in pause duration (adjusted $p=0.022$), and a $+27.0$-point Hodges–Lehmann median-difference increase in SS-QOL (95% CI $14.0$–$41.0$; participant-level median $\mathsf{\Delta }$$+18.5$; adjusted $p=0.020$). The mean SUS score was $78.5\pm 5.4$, indicating “good” usability. Thematic analysis of post-intervention open-ended feedback identified three themes—motivation and engagement, the value of feedback, and design and comfort suggestions—that converged with the high adherence and good usability ratings. Correlations between VR-derived kinematic change and clinical change were non-significant trends ($p\ge 0.12$). Conclusions: A controller-free hand-tracking VR system was found to be feasible, well tolerated, and rated as having good usability when delivered as an adjunct to conventional therapy. Because the study used a single-arm design, included only ten participants, and did not control for the confounding effect of concurrent conventional physiotherapy or natural recovery, the observed within-subject changes cannot be causally attributed to the VR intervention and should be interpreted as exploratory feasibility signals. Adequately powered randomized controlled trials with stroke-specific clinical scales (e.g., FMA-UE, ARAT) are required before clinical efficacy can be claimed.