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SUMMARY OBJECTIVE: Low back pain is a common health problem that may lead to functional limitations and disability, restricting daily activities, reducing work productivity, and adversely affecting social participation and quality of life. This study aimed to evaluate the factors associated with functional capacity in patients with low back pain attending family medicine outpatient clinics. METHODS: This single-centre, cross-sectional study included 250 patients aged 18–65 years with chronic low back pain. Data were collected through face-to-face interviews using a structured questionnaire covering sociodemographic characteristics, chronic diseases, medication use, and low back pain characteristics. Pain intensity was assessed using the Visual Analog Scale, and functional capacity was assessed using the Back Pain Functional Scale. RESULTS: In the univariable analyses, lower Back Pain Functional Scale scores were observed in women, participants aged ≥55 years, individuals with obesity, housewives, those with lower educational attainment and income, and those with chronic diseases (all p<0.05). Back Pain Functional Scale scores were negatively correlated with pre-treatment Visual Analog Scale scores (Spearman's ρ=−0.419, p<0.001). In the multivariable analysis, male sex was independently associated with higher Back Pain Functional Scale scores, whereas higher body mass index, greater pain intensity, and reporting heavy lifting as the aggravating factor were independently associated with lower Back Pain Functional Scale scores (p<0.05). CONCLUSION: This study identified several factors associated with functional capacity in patients with low back pain. Higher body mass index, greater pain intensity, and heavy lifting as an aggravating factor were independently associated with poorer functional capacity. These findings may help clinicians identify patients at increased risk of functional impairment and support comprehensive assessment and management of low back pain.

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SUMMARY OBJECTIVE: The aim of this study was to analyze the profile of motorcycle accident victims treated at Hospital Monsenhor Walfredo Gurgel, a trauma referral center in Rio Grande do Norte, between February and October 2024. METHODS: This was an observational, retrospective, and descriptive study. Data regarding epidemiological profiles, mode of arrival, medical specialties involved, length of hospital stay, and clinical outcomes were extracted from electronic medical records. RESULTS: Among 7,176 recorded victims, there was a clear male predominance (75.52%, n=5,420), while females accounted for 24.47% (n=1,756). Analyzing victims aged 21–70 years, most cases occurred in the 21–30 age group (40.67%), followed by the 31–40 age group (28.66%). Most patients (71.27%) were admitted using specialized transport, including rural and state SAMU ambulances. General Surgery was the specialty most frequently involved in care (52.89%, n=3,178), followed by Orthopedics and Traumatology (36.98%), with Neurosurgery, Oral and Maxillofacial Surgery, Neurology, and Urology accounting for smaller proportions. CONCLUSION: Motorcycle injuries predominantly affect young, economically active men aged 21–40 years, accentuating the need for preventive strategies to reduce the burden on health services and improve pre-hospital and in-hospital care.

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SUMMARY OBJECTIVE: The aim of this study was to investigate whether serum zonulin, citrulline, and hemogram-derived inflammatory indices—the systemic immune-inflammation index, systemic inflammation response index, and pan-immune-inflammation value—are associated with newly diagnosed pediatric celiac disease and to characterize their ability to distinguish the study groups. METHODS: A total of 82 children, comprising 48 patients with celiac disease and 34 healthy controls, were included. Serum zonulin, citrulline, and tissue transglutaminase immunoglobulin A levels and the systemic immune-inflammation index, systemic inflammation response index, and pan-immune-inflammation value were compared between groups. Receiver operating characteristic analysis was used to describe group discrimination within the selected sample, highlighting the limited standalone utility of these markers. RESULTS: Zonulin, tissue transglutaminase immunoglobulin A, the systemic immune-inflammation index, the systemic inflammation response index, and pan-immune-inflammation value were higher in the celiac group (p≤0.024), whereas citrulline did not differ between groups (p=0.982). The area under the receiver operating characteristic curves of pan-immune-inflammation value (0.644), monocyte count (0.642), the systemic immune-inflammation index (0.614), and the systemic inflammation response index (0.612) indicated poor discrimination and did not support their use as stand-alone diagnostic tests. The systemic inflammation response index and pan-immune-inflammation value were strongly correlated (ρ=0.91, p<0.001); this association should be interpreted in view of their shared blood-count components. CONCLUSION: Zonulin and hematological inflammation indices are potential markers associated with increased intestinal permeability and systemic inflammation in pediatric celiac disease. Together with tissue transglutaminase immunoglobulin A, these parameters may have an adjunctive role in reflecting disease-related pathophysiological processes; however, their low discriminatory performance precludes their use as stand-alone diagnostic tests.

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SUMMARY OBJECTIVE: The aim of this study was to analyze the incidence, spatial distribution, and temporal trend of leprosy in Piauí, Brazil, between 2013 and 2023. METHODS: This ecological study used secondary data on new leprosy cases from the Notifiable Diseases Information System, available through DATASUS/TABNET. Cases among adults aged 18 years or older living in Piauí were included. For the spatial analysis, cases were grouped by health macro-region and development region of residence, and absolute and relative frequencies were calculated to identify territories with the highest concentration of notifications. Temporal trends were assessed by simple linear regression, with a 5% significance level. RESULTS: From 2013 to 2023, Piauí recorded 12,256 new leprosy cases. The highest concentration occurred in the Meio Norte macro-region and the Entre Rios development region. A significant decreasing trend was observed in Piauí (β=-54.11; 95%CI -85.24 to -22.98; p=0.003) and Brazil (β=-1,361.24; 95%CI -2,151.01 to -571.46; p=0.004), with a marked reduction in notifications in 2020. Low educational attainment, lack of bacilloscopy testing, and dimorphic clinical form predominated. CONCLUSION: Leprosy remains a relevant public health problem in Piauí, with spatial concentration and signs compatible with delayed diagnosis and surveillance weaknesses. Strengthening early detection, active surveillance, and health education is necessary to reduce transmission.

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SUMMARY OBJECTIVE: This study aimed to investigate the factors affecting physical activity and physical function in primary Sjogren syndrome. METHODS: In total, 63 women with primary Sjogren syndrome were examined for physical activity using the International Physical Activity Questionnaire, identified barriers to activity via the Self-Perceived Barriers for Physical Activity Questionnaire, and assessed physical function with the 30-s sit-to-stand and grip strength tests. Disease activity was measured with the EULAR Sjögren's Syndrome Disease Activity Index, symptom severity with the EULAR Sjogren's Syndrome Patient Reported Index, and fatigue using the Multidimensional Fatigue Inventory. Anxiety and depression levels were evaluated with the Hospital Anxiety and Depression Scale, while health perception was assessed with the Health Perception Scale. RESULTS: A one-unit increase in the HPS_Center of control score was associated with a 23.1-point increase in the median International Physical Activity Questionnaire total score (95%CIs 0.55; 63.52). An increase in the Hospital Anxiety and Depression Scale-Anxiety, Hospital Anxiety and Depression Scale-Depression, and MFI_total scores is associated with a rise in the Self-Perceived Barriers for Physical Activity Questionnaire score (0.69 [0.42; 1.13]), (1.07 [0.58; 1.41]), and (0.25 [0.1; 0.3]), respectively. Conversely, grip strength was associated with EULAR Sjogren's Syndrome Patient Reported Index, Hospital Anxiety and Depression Scale-Depression, and MFI_Reduced Motivation (-0.44 [-0.86; -0.01]), (-0.26 [-0.41; -0.08]), and (-0.22 [-0.48; -0.08]), respectively. However, the HPS_Self-awareness score had a positive effect on the 30-s sit-to-stand (0.18 [0.11; 0.3]). CONCLUSION: In women with primary Sjogren syndrome, emotional symptoms and fatigue were negatively associated with physical activity and function. Better health perception was positively associated with both. Health education and management of emotional disorders and fatigue can improve physical activity and function in primary Sjogren syndrome.

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SUMMARY OBJECTIVE: This study aimed to evaluate the preventive effect of adding a propolis gargle to standard oral care on the development of oral mucositis in critically ill patients with chronic obstructive pulmonary disease. METHODS: This randomized controlled trial included 60 critically ill patients with chronic obstructive pulmonary disease. Both groups received the institutional standard oral care protocol with 0.2% chlorhexidine gluconate three times daily. The intervention group additionally received a propolis gargle three times daily for 15 days. Oral mucosal status was evaluated using the total oral mucosa score. RESULTS: There was no significant difference in oral mucosa scores between the groups at baseline, whereas oral mucosa scores were significantly lower in the intervention group than in the control group at the 7- and 15-day follow-ups (p<0.001). CONCLUSION: Adding propolis gargle to standard oral care significantly reduced the development of oral mucositis in critically ill patients with chronic obstructive pulmonary disease. However, because the intervention group received additional oral care exposure, the independent effect of propolis cannot be determined and requires further investigation. Clinical Trial Registration Number: ClinicalTrials.gov Identifier: NCT07426198.

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SUMMARY BACKGROUND: Multimodal interventions integrating breathing regulation and rhythmic auditory stimulation may improve trunk stability and modulate stress-related psychophysiological responses. Evidence on combined core stabilization and autonomic regulation programs in young adults remains limited. OBJECTIVE: The aim of this study was to investigate the effects of a 12-week music-accompanied program combining core stabilization, diaphragmatic breathing, and relaxation exercises on trunk muscle endurance and stress-related outcomes in university students. METHODS: In this randomized controlled trial, 80 university students were randomly assigned to an intervention (n=40) or a waitlist control group (n=40). The intervention was performed four times weekly for 12 weeks under physiotherapist supervision, including progressive core stabilization integrated with diaphragmatic breathing and slow-tempo music. Outcomes included trunk extensor endurance (Biering-Sorensen), lateral trunk endurance (lateral plank), trunk flexor endurance, perceived stress (PSS-10), and state anxiety (STAI-S). A 2×2 mixed-design analysis of variance evaluated group×time interactions. Assessors were not blinded. RESULTS: Significant group×time interactions favored the intervention group for perceived stress (η2p=0.148, d=0.82), state anxiety (η2p=0.122, d=0.74), lateral trunk endurance (left lateral plank: η2p=0.052, d=0.46;right lateral plank: η2p=0.078, d=0.57), and trunk flexor endurance (η2p=0.123, d=0.74). No significant interaction was found for trunk extensor endurance. CONCLUSION: A 12-week multimodal program combining core stabilization, breathing, relaxation, and music improved trunk endurance and reduced stress and anxiety; the waitlist design does not permit isolating music's specific contribution.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate changes in inflammatory markers after cardiac surgery with cardiopulmonary bypass and assess the discriminatory ability of aortic cross-clamp time for postoperative acute kidney injury. METHODS: This retrospective single-center study included 109 patients undergoing cardiopulmonary bypass-assisted cardiac surgery between January 2024 and March 2025. Preoperative and postoperative (30–36 h) creatinine, urea, albumin, C-reactive protein, neutrophil, and lymphocyte levels were evaluated. Acute kidney injury was defined using the serum creatinine component of KDIGO criteria. C-reactive protein/albumin ratio, C-reactive protein/lymphocyte ratio, neutrophil/lymphocyte ratio, and albumin×lymphocyte/C-reactive protein (CALLY) were calculated. Given the limited number of acute kidney injury cases, analyses were exploratory. Aortic cross-clamp time was assessed by receiver operating characteristic analysis. RESULTS: Postoperative neutrophil, lymphocyte, and albumin levels differed significantly from preoperative values (all false discovery rate-corrected p<0.001). C-reactive protein, C-reactive protein/albumin ratio, C-reactive protein/lymphocyte ratio, neutrophil/lymphocyte ratio, and CALLY levels increased significantly (all false discovery rate-corrected p<0.001). Acute kidney injury developed in 15 patients and was more common among non-survivors (10.1 vs. 50.0%; p=0.006; false discovery rate-corrected p=0.022). Postoperative creatinine levels were higher in non-survivors (false discovery rate-corrected p=0.011). Aortic cross-clamp time showed limited discrimination for Acute kidney injury (area under curve=0.621). At the 52-min cutoff, sensitivity was 66.7%, and specificity was 60.2%. CONCLUSION: Cardiopulmonary bypass-associated cardiac surgery was accompanied by significant inflammatory changes. Aortic cross-clamp time showed limited discriminatory ability and should be considered an exploratory risk indicator rather than a standalone predictor of acute kidney injury.

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SUMMARY OBJECTIVE: People with multiple sclerosis often experience muscle weakness and fatigue, which impair proprioception and gait. The effects of knee muscle fatigue on these outcomes remain unclear. This study investigated the effects of a knee muscle fatigue protocol on knee position sense and gait in people with multiple sclerosis. METHODS: A total of 36 mildly affected people with multiple sclerosis and nine healthy controls participated in this case-control study with repeated pre- and post-fatigue assessments. Gait was assessed using a G-Walk sensor, and knee position sense with an active repositioning test on an isokinetic dynamometer. Muscle strength and fatigue indexes were determined isokinetically for the knee flexors and extensors. RESULTS: During the fatigue protocol, people with multiple sclerosis produced lower total workloads than healthy control, although fatigue indexes were similar. After fatigue, both groups showed increased cadence and reduced gait cycle duration, while gait speed increased only in people with multiple sclerosis. Knee position sense deteriorated bilaterally in people with multiple sclerosis and on the non-dominant side in healthy control. CONCLUSION: Localized knee muscle fatigue altered knee position sense and gait in both groups, with no significant group×time interaction, though the small control group warrants caution. Similar fatigue indices despite lower total work warrant cautious interpretation of the Cybex fatigue index, given its dependence on baseline torque. As proprioceptive acuity declined transiently after localized knee muscle fatigue, clinicians may consider performing balance- or coordination-demanding tasks beforehand in people with multiple sclerosis.

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SUMMARY OBJECTIVE: The aim of this study was to describe the prescription of medical nutrition therapy for critically ill patients who were admitted to an intensive care unit during the first 5 days. METHODS: In an observational, longitudinal, retrospective study conducted at the intensive care unit of a tertiary hospital in Mexico City, adult patients admitted from January to December 2018 and from November 2024 to February 2025 were included. Indications for fasting, the route of medical nutrition therapy (enteral nutrition—parenteral nutrition), caloric and protein intakes, sequential organ failure assessment score and lactate levels, and vasopressor requirements during the 5 days were evaluated. Delay in initiating medical nutrition therapy was defined as initiated after 48 h of intensive care unit admission. RESULTS: 100 critically ill patients were included; aged 53±18.8, and with a median sequential organ failure assessment score of 10 (7–12). The most frequent diagnoses at admission were pulmonary disease and septic shock. On the first day, 98% of patients were fasting, and 25% received high-dose vasopressor therapy (if the norepinephrine equivalent dose >0.3 μg/kg/min). Over 5 days, medical nutrition therapy transitioned progressively, predominantly from fasting through enteral nutrition (45%) and parenteral nutrition (11%). medical nutrition therapy delay in 54 patients and in a multivariate analysis was associated with age (OR 1.04; 95%CI 1.01–1.07), sequential organ failure assessment score (OR 1.20; 95%CI 1.02–1.40), and lactate levels (OR 1.8; 95%CI 1.10–3.00). CONCLUSION: Prescription of medical nutrition therapy in critically ill patients admitted to a intensive care unit during 5 days is dynamic, and in all patients, it is not possible to initiate at 48 h, associated with higher age and illness severity.

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SUMMARY OBJECTIVE: The aim of this study was to compare the triglyceride–glucose index and its derivatives between women with polyendocrine metabolic ovarian syndrome and healthy controls and to examine their associations with established fasting-based surrogate markers of insulin resistance. METHODS: The final analytical cohort consisted of 109 women with polyendocrine metabolic ovarian syndrome and 91 healthy controls. Homeostasis model assessment of insulin resistance, quantitative insulin sensitivity check index, fasting glucose-to-insulin ratio, triglyceride–glucose index, triglyceride–glucose-body mass index, and triglyceride-to-high-density lipoprotein cholesterol ratio were calculated. Between-group comparisons and correlation analyses were performed, with age, body mass index, and waist circumference considered in adjusted analyses. RESULTS: Women with polyendocrine metabolic ovarian syndrome had significantly higher homeostasis model assessment of insulin resistance values than healthy controls [median: 3.66 (range: 0.76–37.72) vs. 0.86 (range: 0.30–2.70), p<0.001]. The between-group difference in the triglyceride–glucose index remained significant after adjustment for age, body mass index, and waist circumference (F=20.489, p<0.001, ηp2=0.094). Within the polyendocrine metabolic ovarian syndrome group, triglyceride–glucose was positively correlated with homeostasis model assessment of insulin resistance (r=0.505, p<0.001) and negatively correlated with quantitative insulin sensitivity check index (r=-0.505, p<0.001) and fasting glucose-to-insulin ratio (r=-0.449, p<0.001). CONCLUSION: Triglyceride–glucose and triglyceride–glucose-body mass index were higher in women with polyendocrine metabolic ovarian syndrome than in healthy controls and were associated with fasting-based surrogate measures of insulin resistance. These findings suggest that triglyceride–glucose-based indices may provide complementary information regarding the metabolic profile associated with polyendocrine metabolic ovarian syndrome. Their clinical utility requires further validation in prospective studies using direct measures of insulin sensitivity.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the effects of transcranial direct current stimulation on motor functional independence in patients with stroke. METHODS: A comprehensive literature search was conducted in PubMed, Web of Science, Cochrane Library, Google Scholar, and the Council of Higher Education (YÖK) Thesis Center through January 2026 without time restrictions. Eligible studies were identified according to predefined inclusion and exclusion criteria. Data from the included studies were synthesized using meta-analytic and narrative approaches. RESULTS: Eleven studies were included in the meta-analysis. The findings demonstrated that transcranial direct current stimulation significantly improved motor functional independence in patients with stroke (SMD=-3.198; 95%CI -4.215 to -2.180; Z=-6.158; p<0.001). Substantial heterogeneity was observed among the studies (I2=89.18%). CONCLUSION: The findings suggest that transcranial direct current stimulation may contribute to improvements in motor functional independence following stroke. However, further studies with standardized intervention protocols and larger sample sizes are needed to confirm these findings.

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SUMMARY OBJECTIVE: The aim of this study is to examine the associations between Eysenck personality dimensions and orthorexia-related eating attitudes among young adults and to describe the distribution of these attitudes across sociodemographic and nutrition-related characteristics. METHODS: This cross-sectional online survey collected anonymous data from 436 young adults aged 19–25 years between May and July 2022. Orthorexia-related eating attitudes were measured with the Turkish ORTO-11 (lower scores indicate stronger tendencies) and analyzed as a continuous outcome. Personality was assessed with the abbreviated Eysenck Personality Questionnaire–Revised. Multiple linear regression examined independent associations, adjusting for sex and body mass index. RESULTS: The mean ORTO-11 score was 26.57±5.05. Women scored lower than men (26.25±4.86 vs. 27.41±5.48; p=0.033). In the adjusted model, higher neuroticism was associated with lower ORTO-11 scores (β=-0.11; p=0.024) and higher extraversion with higher scores (β=0.12; p=0.009), indicating stronger and weaker orthorexia-related attitudes, respectively. Psychoticism and body mass index were not associated. The model explained only 4.5% of the variance (R2=0.045; adjusted R2=0.033). CONCLUSION: Neuroticism and extraversion were statistically but weakly associated with orthorexia-related eating attitudes, whereas body mass index showed no independent association. The very low explained variance and the well-documented psychometric limitations of the ORTO-11, which cannot distinguish a healthy interest in nutrition from pathological orthorexia, mean that these findings are exploratory and should not be interpreted as evidence about orthorexia nervosa.

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SUMMARY OBJECTIVE: Gestational diabetes mellitus is characterized by metabolic dysfunction and altered inflammatory signaling. The aim of this study was to evaluate maternal serum oncostatin M levels in pregnancies complicated by gestational diabetes mellitus and explore their associations with metabolic and pregnancy outcomes. METHODS: In this prospective case–control study, 40 women with gestational diabetes mellitus and 40 healthy pregnant controls were enrolled. Maternal serum oncostatin M concentrations were measured during the third trimester using an enzyme-linked immunosorbent assay. RESULTS: Maternal serum oncostatin M levels were significantly lower in women with gestational diabetes mellitus than in controls (28.7 vs. 64.0 ng/L, p=0.001). Oncostatin M levels were negatively correlated with body mass index, insulin, hemoglobin A1c, and Homeostatic Model Assessment of Insulin Resistance, and positively correlated with gestational age at delivery (all p<0.05). Pregnancy outcomes were similar between groups. CONCLUSION: Maternal oncostatin M levels are reduced in gestational diabetes mellitus and are associated with markers of metabolic dysfunction, supporting a potential association with the immunometabolic adaptations of diabetic pregnancy.

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SUMMARY OBJECTIVE: The aim of this study was to assess how initial loop electrosurgical excision procedure margin subtype, glandular involvement, endocervical curettage findings, and specimen size relate to re-loop electrosurgical excision procedure pathology and receipt of further surgery. METHODS: In this retrospective cohort study, 287 patients undergoing re-loop electrosurgical excision procedure at a tertiary center (2015–2025) were reviewed. Initial margin status was classified as margin continuity, margin adjacency, or non-evaluable margin. Associations with re-loop electrosurgical excision procedure pathology, residual CIN2+ disease, and receipt of a third surgical intervention were assessed using chi-square/Fisher-Freeman-Halton tests, Cohen's kappa, and multivariate logistic regression. RESULTS: Initial and re-loop electrosurgical excision procedure pathology showed a significant group-level association (p=0.039) but no case-by-case agreement beyond chance (kappa=-0.009, p=0.754); most patients with initial CIN2/3 had CIN1 at re-loop electrosurgical excision procedure. Margin adjacency independently predicted residual CIN2+ disease at repeat loop electrosurgical excision procedure (OR 11.045, p=0.049), as did glandular involvement (OR 1.938, p=0.035). Among patients with negative re-loop electrosurgical excision procedure margins, residual CIN2+ disease was identified within the specimen in 27.1%, and human papillomavirus test negativity at the first follow-up visit was 88.2%, varying by genotype. Positive margin (OR 333.33, p<0.001) and positive endocervical curettage (OR 41.67, p<0.001) at repeat loop electrosurgical excision procedure were the strongest predictors of receiving a third surgical intervention. CONCLUSION: Margin adjacency and glandular involvement independently predicted residual CIN2+ at repeat loop electrosurgical excision procedure, whereas positive margins and positive endocervical curettage at re-loop electrosurgical excision procedure were strongly associated with receipt of a third surgical intervention. Post-loop electrosurgical excision procedure follow-up should integrate margin subtype, glandular involvement, endocervical curettage findings, and human papillomavirus surveillance rather than rely on margin status alone; genotype-specific differences in human papillomavirus test negativity require confirmation in larger cohorts.

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SUMMARY OBJECTIVE: The aim of this study was to determine the clock-face distribution of cervical lesions in women undergoing colposcopy for high-risk human papillomavirus positivity and to evaluate the association between lesion localization and high-grade cervical lesions (CIN2+; cervical intraepithelial neoplasia grade 2 or higher). METHODS: This single-center retrospective observational study included 298 women who underwent colposcopy because of high-risk human papillomavirus positivity between January 2024 and March 2026. Demographic characteristics, human papillomavirus genotypes, cervical cytology, colposcopic biopsy localization, and histopathological findings were retrospectively reviewed. Cervical lesions were classified according to the clock-face system and grouped into anterior, right lateral, posterior, and left lateral regions. The primary outcome was the presence of CIN2+. RESULTS: The mean age was 42.5±9.2 years, and CIN2+ lesions were identified in 54 women (18.1%). Lesions were most frequently located at the 12 and 6 o'clock positions. Compared with the normal/CIN1 group, patients with CIN2+ had a higher frequency of abnormal cytology (48.1 vs. 23.8%; p=0.001) and anterior cervical localization (88.9 vs. 66.8%; p=0.002). In multivariable logistic regression analysis, abnormal cytology (adjusted OR 2.84; 95%CI 1.43–5.63; p=0.003) and anterior cervical localization (adjusted OR 3.67; 95%CI 1.46–9.21; p=0.006) were independently associated with CIN2+. CONCLUSION: Cervical lesions in high-risk human papillomavirus-positive women showed a nonuniform clock-face distribution. Anterior cervical localization was independently associated with high-grade cervical lesions (CIN2+), suggesting that careful assessment and documentation of lesion location during colposcopy may improve the identification of clinically significant lesions.

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SUMMARY OBJECTIVE: Flexibility of the plantar flexors is important for preventing musculoskeletal injuries and ensuring proper muscle function. Static stretching, kinesiotape, and foam rolling are commonly used to enhance muscle flexibility. The aim of this study was to evaluate the acute effects of static stretching, kinesiotape, and foam rolling on muscle stiffness, fascicle length, and range of motion. METHODS: This randomized controlled trial involved 42 physiotherapy students randomly assigned to static stretching, kinesiotape, or foam rolling. Range of motion, weight-bearing lunge test, and shear wave elastography were measured before and after the interventions. RESULTS: All three interventions significantly increased range of motion and weight-bearing lunge test and decreased Achilles tendon stiffness (p<0.01). Gastrocnemius medialis stiffness decreased only after kinesiotape (p=0.005). Soleus stiffness decreased after kinesiotape (p=0.005) and foam rolling (p=0.017). Gastrocnemius medialis fascicle length increased after static stretching (p=0.014) and foam rolling (p=0.008), and gastrocnemius lateralis fascicle length increased after kinesiotape (p=0.049) and foam rolling (p=0.045). No significant differences were found between the three treatments on direct comparison. CONCLUSION: Static stretching, kinesiotape, and foam rolling are all effective in acutely increasing range of motion and weight-bearing lunge test while reducing Achilles tendon stiffness. Each technique also has specific effects on muscle stiffness and fascicle length. No single technique was superior, so method selection can be based on ease of application, equipment availability, and patient comfort.

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SUMMARY OBJECTIVE: The aim of this study was to compare menopausal symptom severity between postmenopausal women with and without fibromyalgia syndrome, and to estimate the independent association of fibromyalgia syndrome with menopausal symptom burden. METHODS: Comparative cross-sectional study of 80 postmenopausal women: 40 with fibromyalgia syndrome and 40 without. The primary outcome was the Menopause Rating Scale total score; pain, fatigue and sleep disturbance were rated on 0–10 visual analog scales. The association of fibromyalgia syndrome with Menopause Rating Scale total score was estimated by multivariable linear regression adjusted for age, body mass index, education and route of menopause. RESULTS: Menopause Rating Scale total score was 26.2±9.7 with fibromyalgia syndrome versus 12.9±6.1 in controls (mean difference 13.3 points, 95%CI 9.6–16.9; Hedges’ g=1.63; p<0.001). Severe symptoms (Menopause Rating Scale ≥17) occurred in 85.0% versus 27.5% (risk ratio 3.1; 95%CI 1.8–5.2). Fibromyalgia syndrome remained independently associated with Menopause Rating Scale total score after adjustment (β=13.13; 95%CI 9.32–16.94; p<0.001); further adjustment for pain, fatigue and sleep visual analog scales attenuated but did not abolish this association (β=10.11; 95%CI 6.07–14.16). CONCLUSION: Postmenopausal women with fibromyalgia syndrome carry a substantially greater menopausal symptom burden than women of comparable age and body mass index. This association was independent of measured demographic and reproductive characteristics, but its independence from the core features of fibromyalgia syndrome could not be established, given the overlap between the two symptom sets.