Validity and reliability of the Turkish Version of the Oral Behaviors Checklist.

OBJECTIVE: The aim of this study was to investigate the validity and reliability of the Turkish version of the Oral Behavior Checklist (OBC-TR). MATERIALS AND METHODS: The study included 223 patients with temporomandibular disorders (TMDs) and 94 individuals without TMD. Face and content validity were analyzed. Structural (with confirmatory factor analysis [CFA]), convergent (with pain intensity, Fonseca Anamnestic Index [FAI], Hospital Anxiety and Depression Scale [HADS], and Oral Health Impact Profile [OHIP-14]), divergent (with active pain-free maximum mouth opening [MMO]), and discriminant validity were investigated to evaluate the construct validity. Cronbach's alpha for internal consistency and the intraclass correlation coefficient (ICC) for test-retest reliability were computed. RESULTS: Face and content validity were satisfactory. The CFA has verified the structural validity of the OBC-TR. Strong associations between the OBC-TR score and pain intensity (r = 0.88), FAI (r = 0.90), HADS (r = 0.82-0.86), and OHIP-14 (r = 0.83) scores, and MMO (r = -0.85) verified the convergent and divergent validity of the OBC-TR. Concerning discriminant validity, the OBC-TR discriminated between patients with TMD and individuals without TMD (p < 0.05). Internal consistency (Cronbach's alpha = 0.89) and test-retest reliability (ICC = 0.91) were satisfactory. CONCLUSION: The OBC-TR is a valid and reliable instrument to measure the frequency of oral parafunctional behaviors in Turkish-speaking patients with TMD.

A Comparison of the Functioning and Disability Levels of Children With Hemiplegic and Diplegic Cerebral Palsy Based on ICF-CY Components.

We compared children with hemiplegic and diplegic cerebral palsy (CP) using the conceptual framework of the International Classification of Functioning, Disability and Health: Child and Youth version (ICF-CY). We enrolled 42 children with CP aged 5 - 13 years old (M age = 9.57, SD = 2.8 years). We assessed their trunk control and dynamic balance with the Trunk Control Measurement Scale (TCMS) and the Timed Up and Go test (TUG), and we used ABILHAND-Kids and Assessment of Life Habits (Life-H) to assess their manual ability and participation with activities of daily living. We administered the European Child Environment Questionnaire (ECEQ) to identify relevant environmental factors. We employed structural equation modeling (SEM) to identify specific factors contributing to potential differences between these CP groups. Children with hemiplegic CP demonstrated significantly better outcomes in terms of trunk control, dynamic balance, and environmental factors compared to those with diplegic CP (p < .05). In contrast, children with diplegic CP demonstrated superior outcomes regarding manual ability, compared to those with hemiplegic CP (p < .001). In our structural equation models, trunk control strongly predicted both dynamic balance (0.75) and environmental factors (0.74). Moreover, the relationships between trunk control and participation in daily and social activities were 0.54 and 0.47, respectively. Impaired trunk control and dynamic balance were significant contributors to increased activity restrictions and environmental barriers in children with diplegic CP. This suggests that improving disability and functioning in children with diplegic CP requires a focus on trunk control training and dynamic balance exercises.

Validity and reliability of the Turkish version of the 20-item jaw functional limitation scale.

PURPOSE: This study aimed to translate the 20-item Jaw Functional Limitation Scale (JFLS-20) into Turkish (JFLS-20-TR) and investigate the psychometric properties of the JFLS-20-TR. METHODS: This study included 232 patients with temporomandibular disorder (TMD) and 130 individuals without TMD. Structural (with confirmatory factor analysis [CFA]), convergent (with pain intensity, Fonseca Anamnestic Index [FAI], and Oral Health Impact Profile [OHIP-14]), discriminant (with maximum mouth opening [MMO]) and known-group validity were investigated to assess the construct validity. Cronbach's alpha for internal consistency and the intraclass correlation coefficient (ICC2,1) for test-retest reliability were calculated. Additionally, content and face validity, smallest detectable change (SDC95), and floor/ceiling effects were evaluated. RESULTS: According to CFA, the model fit indices were acceptable for JFLS-20-TR, confirming structural validity. Strong correlations were found between the global and subdomain scores of the JFLS-20-TR and pain intensity (r ≥ 0.80), FAI (r ≥ 0.83), OHIP-14 (r ≥ 0.76), and MMO (r ≥ -0.79) scores, confirmed the convergent and discriminant validity of the JFLS-20-TR. In addition, JFLS-20-TR differentiated between patients with TMD and individuals without TMD (p < .05). Internal consistency (Cronbach's alpha values: 0.91-0.93) was excellent, and test-retest reliability (ICC2,1 values: 0.91-0.95) was high. Content and face validity were satisfactory. The SDC95 values ranged from 0.79 to 1.43. No floor or ceiling effects were observed. CONCLUSION: The JFLS-20-TR is a valid, reliable, and useful tool for assessing jaw functional limitations in Turkish-speaking patients with TMD.

The Efficacy of Two Models of Intensive Upper Limb Training on Health-Related Quality of Life in Children with Hemiplegic Cerebral Palsy Mainstreamed in Regular Schools: A Double-Blinded, Randomized Controlled Trial.

BACKGROUND: Children with hemiplegic cerebral palsy (CP) are at risk of reduced upper limb function and poorer quality of life than their typically developing peers. Although upper limb impairments have potential negative impact on the health-related quality of life (HRQOL) in children with hemiplegic CP, the efficacy of upper limb rehabilitation approaches aiming to improve upper limb impairments on HRQOL has not been adequately investigated. OBJECTIVE: This study compares the efficacy of two modes of activity-based upper limb rehabilitation (modified constraint-induced movement therapy [mCIMT] and bimanual training [BIM]) on HRQOL outcomes in children with hemiplegic CP mainstreamed in regular schools. METHODS: Thirty children with hemiplegic CP aged between 7 and 11 years (mean age 8.53 ± 1.54 years) who had functional ability levels of I-III according to the Manual Ability Classification System (MACS), Gross Motor Classification System (GMFCS), and Communication Function Classification System (CFCS) were randomly assigned to receive mCIMT or BIM training. Result: Both mCIMT and BIM yielded statistically significant improvements in all HRQOL domains immediately after the 10-week interventions (P < .001), which were retained at 16 weeks. CONCLUSION: While there were some differences in the intervention effects, both of these upper limb rehabilitation approaches based on intensive unimanual or bimanual activity may be beneficial for improving perceived life satisfaction related to physical activity, general mood, family, friends, and school among children with hemiplegic CP mainstreamed in regular schools.

Validity and Reliability of the Turkish Version of the KIDSCREEN-27 for Individuals With Cerebral Palsy.

Our aims in this study were to examine the construct/concurrent validity and internal/test-re-test reliabilities of both the self-report and parent-report questionnaires of a Turkish version of the KIDSCREEN-27 for adolescents with cerebral palsy (CP). We used a convenience sample of 135 children and adolescents with CP aged 8-18 years (65 males, 70 females; M age = 12.39, SD = 3.57) and their parents/caregivers (123 mothers, seven fathers, and five grandmothers). We explored structural construct validity via confirmatory factor analysis (CFA). Concurrent validity was examined via Spearman's correlations between the KIDSCREEN-27 questionnaires and the self-report and primary caregiver report forms of the Cerebral Palsy Quality of Life for Children (CP QOL-Child) and adolescents (CP QOL-Teen). We explored test-retest and internal consistency reliabilities utilizing intraclass correlation coefficients (ICC) and Cronbach's alpha (α), respectively. CFA goodness-of fit indices verified that the predefined model of the KIDSCREEN-27 was a good fit for data from the CP population (X2/df<5, GFI >0.90, AGFI >0.90, RMSEA<0.80). Results showed the subdomains of both KIDSCREEN-27 forms to be significantly correlated with the matched subdomains of the CP QOL-Child and CP QOL-Teen questionnaires (ranges of r = 0.62-0.94). Overall, α and ICC coefficients for all subdomains of both KIDSCREEN-27 versions were acceptable (α and ICC >0.70). Both versions of the KIDSCREEN-27 have satisfactory psychometric properties for use in evaluating health-related quality of life (HRQOL) outcomes in children and adolescents with CP.

Comparing the effects of modified constraint-induced movement therapy and bimanual training in children with hemiplegic cerebral palsy mainstreamed in regular school: A randomized controlled study.

PURPOSE: The aim of this study was to compare the effects of modified constraint-induced movement therapy (mCIMT) and bimanual training (BIT) based on the International Classification of Functioning, Disability, and Health, Children and Youth (ICF-CY) conceptual framework. RESEARCH METHOD: A total of 32 children (mean age 10.43 years [SD 2.9 years]; 15 girls, 17 boys) whose functional motor and communication levels, according to the Manual Ability Classification System, Gross Motor Function Classification System, and Communication Function Classification System, changed between level I and III were randomly distributed to one of the mCIMT or BIT groups with equivalent dosing frequencies and intensities (10 weeks, 3 days/week, 2.5 h/day). Upper extremity body function outcomes (handheld dynamometer), activity outcomes (Quality of Upper Extremity Skills Test, The Children's Hand-use Experience Questionnaire, ABILHAND-Kids, Pediatric Upper Extremity Motor Activity Log), and participation outcomes (Child and Adolescent Scale of Participation) were assessed before and after treatment, and at 16 weeks postintervention. The clinical trial number of the study is NCT04577391. RESULTS: mCIMT resulted in more significant improvements in all outcomes than BIT at the immediate postintervention period (T2), which were maintained in the mCIMT group throughout the 16-week postintervention period (p<0.001; dmCIMT > dBIT). CONCLUSION: The potential advantage of mCIMT versus BIT is the larger short-term effect sizes (ESs) and the more sustainable improvements.

The forgotten sixth sense in cerebral palsy: do we have enough evidence for proprioceptive treatment?

Purpose: The aim of this study was to evaluate the proprioception treatment approaches as well as to investigate the effect of these approaches in individuals with Cerebral Palsy.Materials and methods: A systematic review was performed using American Academy of Cerebral Palsy and Developmental Medicine Methodology. PubMed, PEDro, ScienceDirect, The Cochrane Library, Scopus and Web of Science database were searched. All the articles included were evaluated based on their level of evidence and conduct.Results: Five articles met the inclusion criteria, children and adults with Cerebral Palsy. The effectiveness of different approaches has been examined in all studies and some studies showed effectiveness of treatment on proprioception or on motor performance. However, there was no superiority in between treatment approaches.Conclusions: The reasons that limits the studies analyzed in this review were small sample sizes and insufficient heterogeneity of groups included. Because of the significance of proprioception on movement and motor performance, it should be included in the evaluation and treatment programs of individuals with Cerebral Palsy.Implications for rehabilitationIt has been found that the various treatment methods applied appear to have a positive effect on proprioception with children and adults Cerebral Palsy.No treatment appears to be superior to the others.Treatment was found to be better as Gross Motor Function Classification System level severity decreased in adults with Cerebral Palsy.Treatments used in children with Cerebral Palsy were shown to have effects especially on gait parameters associated with proprioception improvement.