Assessing walking adaptability in children with cerebral palsy: validity and reliability of the walking adaptability ladder test for kids.

INTRODUCTION: Assessing gait adaptation in children with cerebral palsy (CP) requires cost-effective and easily applicable methods. OBJECTIVE: To evaluate the reliability and validity of the Walking Adaptability Ladder Test for Kids (WAL-K) in assessing gait adaptation in children with CP. METHODS: Sixty-six participants (40 children with CP and 26 controls), aged 6-18 years, underwent WAL-K testing under single- and double-run conditions with video recording. Test-retest reliability, interrater reliability, concurrent validity, and known-group validity were assessed. Concurrent validity was assessed using the Timed Up and Go Test (TUGT), Four-Square Step Test (FSST), and Five Times Sit-to-Stand Test. RESULTS: Interrater intraclass correlation coefficients (ICC3,k) values were > 0.999 for the WAL-K single- and double-run tests. The test-retest reliability ICC3,k values were 0.988 for the WAL-K single-run, and 0.963, 0.962, and 0.963 for the WAL-K double-run (p < .05). WAL-K double-run showed a strong correlation with FSST (r = 0.791), while WAL-K single-run correlated weakly with TUGT (r = 0.394) (p < .01). Moderate correlations were observed between other tests (p < .01). Children with CP had higher scores in all WAL-K tests compared to controls (p < .001). CONCLUSION: The WAL-K test demonstrated validity and reliability, making it suitable for clinical use without requiring specialized laboratory settings. It enables repeated assessments of gait adaptation in children with CP.

Protective Effects of Different Doses of Ginsenoside-Rb1 Experimental Cataract Model That in Chick Embryos.

PURPOSE: There has been increased interest in phytochemical antioxidants to prevent protein damage and aggregate formation in cataract treatment. In this study, the protective effect of different doses of Rb1 (GRb1), one of the ginsenosides of Panax Ginseng, in the experimental cataract model formed in chick embryos was investigated. METHODS: Five different experimental groups were formed with 100 SPF fertilized eggs: Control (0.9% NaCl to physiological saline), hydrocortisone hemisuccinate sodium (HC), low dose (HC + L-GRb1 (1 mg/kg)), medium dose (HC+). M-GRb1 (2.5 mg/kg)), and high dose (HC + H-GRb1 (5 mg/kg)). All solutions were given to air sack at 15 days of incubation. On the 17th day, the bulbous oculi of the chick embryos were dissected. Cataract formations of the lenses, glutathione (GSH), malondialdehyde (MDA), total antioxidant (TAS), total oxidant (TOS) levels, Caspase-3 H-score, and TUNEL index were determined. In addition, crystalline alpha A (CRYAA) gene expression was evaluated. RESULTS: Cataracts were observed in the control, HC, HC + L-GRb1, HC + M-GRb1, and HC + H-GRb1 groups with a frequency of 0%, 100%, 75%, 56.25%, and 100%, respectively. There were statistically significant differences between the control and HC groups in terms of TAS, TOS, MDA, GSH, Caspase-3 H-score, and TUNEL index (p < .05). When the therapeutic effect of the GRb1 groups was evaluated, the HC group showed significant differences with the HC + L-GRb1 and HC + M-GRb1 groups in almost all parameters (p < .05), while there was no statistical difference with the HC + H-GRb1 group (p > .05). In addition, gene expression levels differed between the groups, although not statistically significant (p > .05). CONCLUSION: 1 mg/kg and 2.5 mg/kg GRb1 applications show therapeutic properties on the HC-induced cataract model. This effect is more pronounced at 2.5 mg/kg.

Automatic segmentation of the cerebellum using volBrain software in normal paediatric population.

BACKGROUND: Morphological differences that can lead to cerebellar volume changes are associated with the pathogenesis of paediatric diseases. The aim of this study was to examine cerebellum volume in a healthy paediatric population. MATERIALS AND METHODS: To provide MRI-based volumetric measurements of the cerebellum, images from the years 2019 to 2021 were scanned retrospectively. A total of 100 images, including the paediatric population aged 0-15 years, were imported into the volBrain software. Volumetric segmentations were obtained automatically, and each lobular cerebellar volume was obtained. The samples were divided into groups of 0-2 years (n = 18), 3-5 years (n = 24), 6-11 years (n = 34) and 12-15 years (n = 24). Obtained cerebellar volumes, age groups, gender and bilateral side comparisons were made. RESULTS: In the comparative analyses performed for the total cerebellum and each of the 12 lobular segments, statistically significant differences were found between the age groups in all measurements except Crus II, lobules VIIB, VIIIA and VIIIB (p < 0.05). In multiple comparison tests, statistically significant differences were found between defined age groups, especially infants and toddlers and early adolescence groups (p < 0.05). There was a significant positive correlation between the ages of the subjects and their cerebellum volumes (p < 0.05). Statistically significant differences were found in lobules I-II, VI, VIIIB, IX and X in right and left side volumes (p < 0.05). CONCLUSION: There is a tendency to increase in cerebellar volume during the transition from childhood to adolescence. The cerebellum has volumetric differences in the first years of life and during adolescence. When the development of a healthy cerebellum is analysed based on volumetric segmentation, differences are observed. The findings of this study may be useful in confirming various theories attributed to the cerebellum in the clinic.

Morphometric examination of trigeminal nerve and its adjacent structures in patients with trigeminal neuralgia: a case-control study.

BACKGROUND: Morphological differences that can lead the trigeminal nerve to neurovascular conflict and a new solitary pontine lesion are associated with the pathogenesis of trigeminal neuralgia (TN). In this case-control study, we aimed to contribute to the current discussions about the pathogenesis of TN by investigating the anatomical structures that may have an effect on the morphometric parameters of the trigeminal nerve. METHODS: This study included 25 patients with TN followed up for pain in the Department of Algology, Faculty of Medicine, and 25 age- and gender-matched controls. We performed morphometric measurements including the length and volume of the trigeminal nerve, cerebellopontine cistern, pons, and posterior fossa in the MRIs of these individuals. Comparative analyses were performed for the mean of the affected and unaffected sides of the TN patients and the right, left, and both sides of the control group. RESULTS: In patients with TN, on the affected side, length and volume of the trigeminal nerve and cerebellopontine cistern volume were found smaller than controls (p < 0.05). Pons volume was higher in patients with TN compared to controls (p < 0.05). The length of the affected nerve was significantly related to prepontine cistern length and cerebellopontine cistern volume (p < 0.05). DISCUSSION: The cerebellopontine cistern volume has a significant impact on the morphometric characteristics of the trigeminal nerve. Especially, whether the increase in the volume of pons causes a decrease in the volume of cerebellopontine cistern should be clarified with further research.

Investigation of developmental toxicity of favipiravir on fetal bone and embryonic development.

BACKGROUND: Favipiravir is one of the essential antiviral drugs used for the treatment of coronavirus disease (COVID-19) in some countries. However, there is not enough information about used, especially in pregnancy. Therefore, in this study, it was aimed to determine the developmental toxicity of favipiravir on fetal bone development and embryonic development. METHODS: In this study, 16 pregnant wistar albino rats were used. The rats were divided into four groups: Control (saline) and Group A (50 mg/kg × 5 days), Group B (50 mg/kg × 1 days + 20 mg/kg × 4 days), Group C (20 mg/kg × 5 days). Solutions were administered to the rats by oral gavage from the 10th to 14th days of pregnancy, twice a day. The skeletal system development of fetuses was examined with double skeletal staining and immunohistochemical staining methods. RESULTS: A total of 72 fetuses from pregnant rats, 18 in each group, were included in the study. As a result, depending on favipiravir dose increase, in experimental groups, it was determined that the statistically significant decrease on the ossification rates of anterior and posterior extremity bones, and length and weight of fetuses. CONCLUSION: Exposure to favipiravir during pregnancy impairs bone metabolism and bone formation-resorption stages and may cause developmental delay.

Comparison of gait parameters under single- and dual-task conditions between children with specific learning disorder and typically developing children.

BACKGROUND: Children with specific learning disorder (SLD) have some cognitive and postural stability problems compared to typically developing (TD) children. Their single and dual-task gait performance may be affected depending on these problems. RESEARCH QUESTION: Are there any differences between the gait parameters of children with SLD and TD under single- and dual-task conditions? METHODS: A comparative-descriptive study was conducted among 35 children with SLD and 33 TD children. All participants were assessed for gait parameters using a custom wireless inertial sensor under single and dual-task conditions. In the dual-task gait tests, there were the following tasks: to carry a glass of water and to tell apart the color of the paper. RESULTS: The children with SLD exhibited gait deterioration in both single and dual-task gait (p < 0.05). Dual-task cost cognitive values were higher in children with SLD (p < 0.05). SIGNIFICANCE: This study highlights the worse gait performance of children with SLD under single- and dual-task conditions compared with TD children. However, interventions for their gait impairments are limited. At this point, SLD specialists can focus on multitasking to improve their walking skills.

A Comparative study on the assessment of dual task performance in rheumatic diseases.

BACKGROUND: In task-oriented studies showed that the chronic pain is effective on dual tasks. Chronic pain is the main health problem that prevents mobility restriction and participation in most rheumatic diseases. RESEARCH QUESTION: Do rheumatic diseases have an effect on dual task gait performance? METHODS: This comparative-descriptive study included 75 individuals who aged 18-65 years and divided in two groups as Rheumatic Disease Group (RG; 23 women, 14 men) and Control Group (CG; 20 women, 18 men). The individuals have a chronic pain (> 3.4 cm according to Visual Analogue Scale, VAS) and Standardized Mini Mental State Examination score above 24 were included in this study as the RG. The individuals who were did not have any known disease were included in the CG. The health status of RG was evaluated with the Arthritis Impact Measurement Scale 2 (AIMS-2). The 10-meter Walk Test was applied under single and dual task conditions (dual task cognitive, DTcognitive; dual task motor, DTmotor) for assessing gait performance. RESULTS AND SIGNIFICANCE: The mean age of the individuals in the study was 40.6 ±â€¯11.34 years (RG=43.08 ±â€¯11.30; CG=38.18 ±â€¯11.00). There was a significant difference in favor of CG between the groups both in terms of gait speed in DTcognitive and its cost (p < 0.05). VAS scores correlate with single and DTcognitive and DTmotor gait parameters (p < 0.05). Many subdivisions of AIMS-2 were associated with single, DTcognitive and DTmotor gait parameters (p < 0.05). This study concluded that rheumatic diseases may reduce gait performance in concurrent motor-cognitive dual task conditions due to chronic pain. Single and dual task gait parameters may be related with psychosocial factors. Therefore, applications including pain control and biopsychosocial approach may be beneficial in the management gait disturbances and falls due to a rheumatic disease.

Evaluation of the facet joints with magnetic resonance images in the patients with disc degeneration and spondylolisthesis.

PURPOSE: We aimed to research in detail the morphology of the facet orientation (FO) and tropism (FT) in degenerative diseases. METHOD: This study consisted of patients with disc degeneration (DD) and with lumbar spondylolisthesis (LS) as well as a control group without these two diseases. The group of patients with DD was separated by DD grades. Vertebral body and intervertebral discs' (IVDs) morphometric values, facet joint osteoarthritis (OA) grading, FO and FT were examined in all the groups. All measurements were applied to MRIs of 353 patients. RESULT: There was a significant difference in facet angle values between the groups at L4-L5 (FO: p = 0.001). There was a significant negative correlation between FO at L4-L5 and L4 vertebral body anterior posterior diameter and L5 mid-vertebral body height, in 353 patients (p = 0.003; p = 0.010). Facet joint OA grading scores were lower in the control group than in the disc degeneration patient (DDP) and LS groups (p < 0.05). Sagittal FO was seen with the increase of facet joint OA scores at L4-L5 in the control and DDP groups (control: p = 0.001; DDP: p = 0.40). CONCLUSION: Facet joints can show different orientation values in LS and DDP groups at L4-L5. The presence of FT is a risk factor for an LS patient at L4-L5. Sagittal FO is seen with vertebral slip at L5-S1. FO is affected by the morphometric changes of the vertebral body at L4-L5. Discussions in this regard need to be resolved through further research.