Association between executive and physical functions in people with Parkinson's disease.

PURPOSE: People with Parkinson's disease (PD) can develop cognitive and physical impairments. There is limited evidence on the association between executive function and physical function in people with PD. OBJECTIVE: We aimed to investigate the association between the executive and physical functions in people with Parkinson's disease (PD) by comparing healthy controls. METHOD: Thirty-three patients diagnosed with PD and 33 healthy controls were included in the study. PD group was divided into two subgroups according to their scores on executive tests as high performers (PD-HPs; n = 17) and low performers (PD-LPs; n = 16). The severity of motor symptoms disease severity, executive function, global cognitive function, reaction time, hand function, functional capacity, physical activity, and balance confidence was assessed by the validated instruments. RESULTS: The PD group had less physical function and executive function compared to healthy controls (p < 0.05). The PD-LPs group had less physical and cognitive function than the PD-HPs group (p < 0.05). The executive functions were significantly correlated with almost all variables in both people with PD and healthy people, and correlations were moderate to strong (p < 0.05). However, the correlation coefficients were relatively higher in people with PD compared to healthy controls. CONCLUSION: There was a significant association between executive and physical function in people with PD. Future studies should be conducted to determine whether the treatment of one of these dysfunctions affects the other.

Effects of acute lower limb and trunk fatigue on balance, performance, and skin temperature in healthy males.

OBJECTIVE: It is unclear whether lower limb and trunk fatigue leads to different effects. Although some studies have compared the effects of muscle fatigue on balance and performance in healthy individuals, little is known about its effects on skin temperature. This study aimed to compare the effects of lower limb and trunk fatigue on balance, performance, and skin temperature in healthy males. METHODS: Twenty participants performed trunk and lower limb fatigue protocols on two separate days. Balance (Y-Balance Test-YBT), trunk performance (plank test), lower limb performance (Single-Leg Triple Hop-SLTH and Countermovement jump-CMJ), and skin temperature were assessed pre-fatigue and post-fatigue. Infrared Thermography assessed the skin temperatures of the trunk and lower limb. RESULTS: Compared with trunk fatigue, the lower limb fatigue protocol had a more significant adverse effect on reducing YBT score, CMJ parameters, and SLHT distance (p<0.05). Both fatigue protocols resulted in lower plank test times and trunk skin temperature (p<0.05). The changes in plank times and skin temperature were similar between protocols (p>0.05). CONCLUSIONS: Taken together, these results suggest that lower limb fatigue adversely affected balance and lower limb performance more than trunk fatigue. Trunk performance and trunk skin temperatures decreased after both fatigue protocols. Lower limb and trunk fatigue-induced changes in trunk performance and skin temperatures were similar.

Clinical and laboratory measures of balance and comparison of balance performances according to postural instability and gait disorders in individuals with Parkinson's disease.

PURPOSE/AIM: Primary aim was to investigate the association between laboratory measures of balance and clinical balance tests in individuals with Parkinson's disease (PD). The secondary aim was to compare the balance performances according to postural instability and gait disorders (PIGD). MATERIALS AND METHODS: Sixty-four individuals with PD were included in the study. Clinical data were investigated using modified Hoehn and Yahr Scale and Unified Parkinson's Disease Rating Scale (UPDRS). Berg Balance Scale (BBS), Timed Up&Go Test (TUG), Five Times Sit-to-Stand Test (FTSST) were used for clinical measures of balance. Laboratory measures of balance were evaluated by Balance Master System including the modified Clinical Test of Sensory Interaction of Balance (mCTSIB), Limits of Stability Test (LOS), Sit to Stand Test (STS), and Tandem Walk Test (TW). The relationship between clinical and laboratory measures of balance was determined. After participants were divided into two groups based on UPDRS: patients with and without PIGD, their balance performance was compared. RESULTS: There were significant correlations between BBS and mCTSIB, LOS-Movement Velocity, and LOS-Endpoint Excursion. FTSST was correlated with STS-Weight Transfer and STS-Rising Index, and TUG was correlated with TW-Speed. Patients with PIGD had worse scores of balance assessments including FTSST, LOS-Movement Velocity, STS-Rising Index. CONCLUSION: Laboratory measures are associated with clinical balance tests and they may reflect clinical balance outcome measures. Furthermore, PIGD may negatively affect balance performance in patients with PD.

What are the hemodynamic and respiratory effects of passive limb exercise for mechanically ventilated patients receiving low-dose vasopressor/inotropic support?

Passive limb exercises (PLEs) are used widely in the management of unconscious patients and an early start is recommended. The aim of this study was to determine the effects of PLEs on hemodynamic and respiratory parameters in mechanically ventilated critically ill patients receiving low-dose vasopressor/inotropic support. The charts of 120 mechanically ventilated patients who underwent PLEs were evaluated retrospectively between January 2000 and July 2002. Patients were grouped on the basis of administration of vasopressor/inotropic support. Thirty-eight patients did not get vasopressor/inotropic support (group 1) and 82 patients received low-dose vasopressor/inotropic support (dopamine <10 µg/kg/min, noradrenaline/adrenaline <0.1; group 2). Central venous pressure, heart rate, mean arterial pressure, and oxygen saturation were recorded before and immediately after PLEs. After PLEs in group 1 patients, central venous pressure and mean arterial pressure values increased significantly, and in group 2 patients, central venous pressure increased significantly (P < .05). No statistically significant difference was observed in the rate of change of hemodynamic or respiratory parameters between the 2 groups after the PLEs (P > .05). This retrospective study confirmed that PLEs result in similar hemodynamic and respiratory changes in critically ill patients who received low-dose vasopressor/inotropic support versus those who do not.

Determinants of 6-minute walk test in people with Parkinson's disease.

BACKGROUND: Most of the previous studies, investigating determinants of 6-minute walk test (6MWT), were conducted on small sample sizes and/or have not explored different aspects such as freezing of gait, physical activity, gender, dual-task cost, and/or have not been able to explain large portion of variation in 6MWT in people with Parkinson's disease. AIMS: This study aimed to investigate the determinants of 6MWT, including aspects that previous studies have not explored. METHODS: In this descriptive cross-sectional study, 6MWT determinants were investigated upon 42 people with Parkinson's disease. After recording participants' demographic data, walking capacity, disease stage, severity of motor symptoms, freezing of gait, balance, physical activity, fear of falling, functional balance, and dual-task cost values were evaluated and grouped into modifiable and unmodifiable variables to investigate possible therapeutic benefits aiming improvement in walking capacity. RESULTS: The mean distance for 6MWT was 401.7 ± 92.7 m. Significant differences between women and men were found for height, walking capacity and speed, fear of falling, and functional balance (p<0.05). Hierarchical regression analysis showed that gender, age, and time since diagnosis significantly explained 52.4% of the variance in 6MWT and disease stage, freezing of gait, dual-task cost, and functional balance added an extra 35.6% to the explained variance. CONCLUSIONS: These results showed that gender, age, disease stage, freezing of gait, dual-task cost, and functional balance values are significant contributors to the variance in 6MWT. Therefore, while planning rehabilitation strategies to improve walking capacity, one should focus on these aspects in people with Parkinson's disease.

Investigating Wrist Joint Position Sense and Hand Functions in Children With Polyarticular Juvenile Idiopathic Arthritis With Wrist Involvement.

Comparing the wrist joint position sense and hand functions between children with juvenile idiopathic arthritis (JIA) and healthy controls, and determining possible relationships between these parameters in children with JIA were the aims of this study. Twenty children with polyarticular JIA with wrist involvement (JIAWrist+), 20 children with other subtypes of JIA without wrist involvement (JIAWrist-), and 20 healthy controls were included. Wrist joint position sense was evaluated by measuring joint repositioning error. Hand functions were assessed by using the Purdue Pegboard test, hand grip strength, pinch strength, and Duruoz Hand Index. Joint position sense and hand functions were diminished in the JIAWrist+ group compared with healthy control group (P < .05). Few moderate relationships were detected between hand functions and wrist joint position sense (P < .05). Improving proprioceptive acuity by appropriate training methods may have a role in enhancing hand functions.

Decreased muscle strength and scapular muscle endurance associated with shoulder function after neck dissection.

BACKGROUND: Shoulder disability is a common problem following neck dissection. Even if nerve structures are preserved, this may occur after the surgery. OBJECTIVE: The primary aim was to research changes in rotator cuff and scapular muscles strength, and scapular muscle endurance after neck dissection in patients with head and neck cancer. The secondary aim was to investigate the relationship between these changes and postoperative shoulder function. METHODS: This cross-sectional and prospective follow-up study included 14 patients who underwent neck dissection (9 unilateral and 5 bilateral). Evaluations were performed preoperatively and at 3 months postoperatively. Muscle strength measurements, including trapezius, serratus anterior, and rotator cuff muscles, were obtained using a handheld dynamometer. The scapular muscle endurance test was used for muscle endurance assessment. Postoperative shoulder function was evaluated using Constant-Murley shoulder score. RESULTS: A decrease in muscle strength and the scapular muscle endurance test was found at 3 months postoperatively, except for the subscapularis muscle strength (p< 0.05). There were moderate to strong correlations between Constant-Murley shoulder score and percentage changes in muscle strength and the scapular muscle endurance test, except for the upper trapezius muscle strength (p< 0.05). CONCLUSIONS: Muscle strength and scapular muscle endurance may reduce following neck dissection. These reductions are associated with postoperative shoulder function. Thus, muscle strength and endurance training may be beneficial for early postoperative rehabilitation in patients with head and neck cancer.

Differences in Pain Characteristics and Functional Associations between Nursing Home Residents and Community-Dwelling Older Adults: A Cross-Sectional Study.

BACKGROUND: Pain is one of the most critical issues in older adults, and the place of residence may play an important role in pain characteristics and related factors. However, it is an understudied subject. This study investigated differences in pain characteristics and functional associations between nursing home residents and community-dwelling older adults. METHODS: Older adult participants were recruited from nursing homes (n=73) and the community (n=73). Pain characteristics, including type, intensity, and number of pain sites, were evaluated. Other outcome measures were functional mobility, walking speed, functional independence, physical activity, anxiety, depression, and health-related quality of life. RESULTS: Nursing home residents experienced musculoskeletal pain more frequently and had a greater number of pain sites than community-dwelling older adults (p<0.05). Walking speed and mobility were significantly lower and anxiety and depression were significantly higher in nursing home residents (p<0.05). While higher pain intensity was significantly correlated with low scores on physical measures, low health-related quality of life, and higher depression and anxiety symptoms in both groups (p<0.05), the magnitudes of the correlations were much higher in nursing home residents. The number of pain sites was significantly correlated with low scores on physical measures, low health-related quality of life, and higher depression and anxiety symptoms mainly in nursing home residents (p<0.05). CONCLUSION: Compared to community-dwelling older adults, nursing home residents experienced musculoskeletal pain more frequently and at more sites in the body. Higher pain intensity and number of pain sites were associated with worse clinical variables, mainly in nursing home residents. This study highlights the importance of regular pain assessment, especially in nursing home care settings.

Physical workload during caregiving activities and related factors among the caregivers of children with cerebral palsy.

BACKGROUND: Caregiving demands contribute to both psychological and physical health of caregivers. Physical workload (PW) can be an important cause of musculoskeletal disorders in caregivers of children with cerebral palsy (CP). AIMS: To investigate PW during caregiving activities and related factors among caregivers of children with CP. METHODS: Children with CP (n = 291) and their caregivers (n = 291) were recruited for this cross-sectional study. Caregivers were categorized as their child has presence of intellectual disability (ID) and independent walking ability. Gross motor function was assessed using the Gross Motor Function Classification System (GMFCS) in children. PW; presence and distribution of musculoskeletal pain sites; levels of disability of neck, low back, arm, and leg; levels of depressive symptoms; and health-related quality of life (HRQOL) were assessed in caregivers. RESULTS: Significant differences were observed in PW, low back pain-related disability, depressive symptoms, and HRQOL between caregivers of children with and without an ID (p < 0.05). All study variables were significantly different between caregivers of children who can and cannot independently walk (p < 0.05). PW was correlated with caregiver's age, body mass index, lower extremity dysfunction, depressive symptoms, and child's GMFCS level (p < 0.05). CONCLUSIONS: Caregivers of a child having an ID and walking disability had higher PW. These caregivers had more problems related to musculoskeletal disorders, higher depressive symptoms, and lower HRQOL. Higher PW was associated with lower level of gross motor function of child and older age, higher body mass index, higher level of lower extremity disfunction and low back pain disability, and lower HRQOL of caregivers.

One-Year Change in the Physical Functioning of Older People According to the International Classification of Functioning Domains.

BACKGROUND AND PURPOSE: It is important to determine physical functioning declines in older people according to the International Classification of Functioning, Disability and Health (ICF) framework, given its advantages. This study was performed to investigate 1-year changes in the physical functioning of older people using the ICF framework. METHODS: Eighty older people were enrolled and completed baseline measures in this longitudinal, single-group study while 33 of these participants were reassessed at 1 year. Reliable and valid methods commonly used in geriatric rehabilitation settings for determining physical functioning were applied to evaluate ICF domains including Body Functions, Activities (capacity), and Activities and Participation (performance). Body Functions were assessed by measuring lower extremity muscle strength and exercise tolerance test performance. The Activities (capacity) measures included walking, balance, mobility, sit-to-stand, and upper extremity functional performance. The Activities and Participation (performance) domain included the Falls Efficacy Scale-International, Modified Barthel Index, and Rapid Assessment of Physical Activity scale. RESULTS: There were significant decreases in muscle strength in both hip abductors and knee extensors (P < .001, d > 0.80) at 1 year versus baseline, but there were no significant changes in exercise tolerance test parameters (P > .05, d = 0.44-0.71), with the exception of diastolic blood pressure (P = .019, d = 0.90). Significant deterioration was observed in all Activities (capacity) measures (P < .05, d > 0.80). No significant changes were observed in the Falls Efficacy Scale-International (P = .051, d = 0.72), Modified Barthel Index (P = .107, d = 0.59), or Rapid Assessment of Physical Activity-Flexibility and Strength subscale (P = .763, d = 0.11). CONCLUSIONS: Significant declines were seen in lower extremity muscle strength, walking capacity, speed, mobility, sit-to-stand performance, upper extremity function, and balance performance at 1 year. On the contrary, no significant changes were observed in the levels of participation in activities of daily living, activities related to balance, or physical activity. According to the ICF framework, during 1 year, our sample of older people showed declines in the Body Functions and Activities (capacity) domains, but the Activities and Participation (performance) domain remained stable.

A comparison of the relationship between manual dexterity and postural control in young and older individuals with Parkinson's disease.

The motor symptoms of Parkinson's disease (PD) cause deterioration in manual dexterity. This deterioration affects independence in activities of daily living negatively. The loss of postural control, which occurs more frequently with disease progression, restricts physical functions and reduces mobility in patients with PD. Impaired postural control may affect distal mobility of an individual. The aim of this study was to investigate postural control and manual dexterity in individuals ≤ 65 and >65 years with PD and analyze the relationship between these variables according to age. Sixty-six individuals with PD participated in the study. The participants were categorized according to age (n = 29 for 65 years of age or younger and n = 37 for older). Manual dexterity (Dominant and Non-dominant hand) was assessed by the Nine Hole Peg Test (NHPT). Postural control was evaluated by the Limit of Stability Test (LoS) using a computerized balance measuring instrument. There was no statistically significant difference between the age groups on the combined dependent variables after controlling for disability, gender, weight, and height; F(7, 54) = 0.804, p = 0.587. Only LoS-Maximum Excursion was higher in the individuals ≤ 65 years (p = 0.035). Significant correlations were found between NHPT-Dominant and LoS-Reaction Time, LoS-Maximum Excursion; NHPT-Non-dominant and LoS-Reaction Time, LoS-Endpoint Excursion, LoS-Maximum Excursion in the older group (p < 0.05). There was no difference manual dexterity and postural control according to age except for LoS-Maximum Excursion. LoS-Maximum Excursion was higher in the young group. The manual dexterity was associated with postural control in individuals over 65 years of age with PD; however, not associated in younger individuals.

Timed Up and Go Test With a Cognitive Task: Correlations With Neuropsychological Measures in People With Parkinson's Disease.

Background The Timed Up and Go (TUG) test is a simple and widely used clinical test for the assessment of lower extremity function, balance, mobility, and fall risk in various populations. The TUG has been found as a valid and reliable measure in people with Parkinson's disease (PD). Besides, the addition of a cognitive task to the TUG (TUG-cognitive) enhances predictive validity related to fall risk in people with PD. However, further investigation is needed about the correlations of the TUG-cognitive test with neuropsychological measures in people with PD. Methods Thirty-three people with PD [modified Hoehn and Yahr scale, median (min-max)=2.5 (1.0-3.0)] participated in this cross-sectional study. The TUG was administered in the traditional way and with a cognitive task (counting backward by three from any number between 20 and 100). Neuropsychological measures included the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), and the Simple Reaction Time (SRT) test for stepping. The self-reported number of falls in the last six months was also recorded. Results The TUG-cognitive [13.1 (SD=8.5) seconds] was significantly longer than the TUG-traditional [12.2 (SD=8.1) seconds] (p<0.01). The TUG-cognitive significantly correlated with the MoCA [(rho=-0.712), TMT part A (TMT-A; rho=0.722), TMT part B (TMT-B; rho=0.694), SRT (rho=0.794), and number of falls (rho=0.960)] (p<0.01). The TUG-traditional also significantly correlated with the MoCA (rho=-0.682), TMT-A (rho=0.684), TMT-B (rho=0.746), SRT (rho=0.755), and number of falls (rho=0.702) (p<0.01). Conclusion Both the TUG-cognitive and TUG-traditional strongly correlated with neuropsychological measures; while the correlations were slightly stronger for the TUG-cognitive, the difference was not significant. The TUG-cognitive can be used in the clinical practice as a simple and more informative alternative to the TUG-traditional in people with PD.

Turkish adaptation of Parkinson fatigue scale and investigating its psychometric properties.

Parkinson's disease (PD) is one of the most common chronic degenerative diseases of the nervous system. In PD, nonmotor symptoms are seen as frequently as motor symptoms. Fatigue can occur in all stages of PD and leads to significant disabilities. The aim of this study was to investigate the psychometric properties of the Turkish version of Parkinson fatigue scale (PFS). Ninety-six patients with idiopathic PD were included in this study with a cross-sectional and test-retest design. Structural validity, internal consistency and test-retest reliability of PFS were analyzed. For convergent validity, fatigue severity scale and modified fatigue impact scale were used. Internal consistency was determined by the Cronbach's α coefficient. For test-retest reliability, PFS was repeated after a 7-14-day period. Significant strong correlations were found between the PFS and the fatigue severity scale (rs=0.844) and the modified fatigue impact scale (rs=0.764), which indicate a high convergent validity. The Cronbach's α coefficient, which indicates the internal consistency of the scale, was calculated as 0.947. The test-retest reliability was found to be high (intraclass correlation coefficient=0.928). This study suggests that the Turkish version of PFS is valid and reliable. PFS is suitable for use by researchers and healthcare professionals to assess fatigue in Turkish-speaking patients with PD.

Reliability, validity and responsiveness of the squares test for manual dexterity in people with Parkinson's disease.

OBJECTIVE: Impaired manual dexterity is one of the major disorder in people with Parkinson's Disease (PwPD). However, there is limited research examining the measurement properties, especially the validity and responsiveness of the tools used to assess manual dexterity. The aim of this study was to examine reliability, validity, and responsiveness of the Squares Test (ST) in PwPD. PATIENTS AND METHODS: Fifty-seven PwPD and 50 healthy people, all of whom were right-handed, were recruited. The ST, Nine-Hole Peg Test, Unified Parkinson's Disease Rating Scale (UPDRS), and Hoehn and Yahr scale were performed in ON state. For responsiveness analysis, the ST and UPDRS motor score (UPDRS-III) were also performed in OFF state. RESULTS: The ST showed excellent test-retest reliability. The ST was found to correlate significantly with other outcome measures, which indicated good concurrent validity. PwPD demonstrated significantly lower scores of the ST than healthy people, which demonstrated satisfactory known-groups validity. The ST had excellent discriminant validity. The ST scores of 52 for more affected hand and 62 for less affected hand were shown to best discriminate between PwPD and healthy people. The ST is high internal responsiveness based on standardized effect size and standardized response mean (0.79 and 1.88, respectively for more affected hand and 0.85 and 1.83, respectively for less affected hand), and also PwPD had better performance based on the ST in ON state than in OFF state (p < 0.001 for both hands). Moderate correlations were found between the change scores of the ST and UPDRS-III, which reflected adequate external responsiveness. CONCLUSIONS: The ST is a reliable, valid and responsive measurement tool for assessing manual dexterity in PwPD.

Effect of deep breathing exercises on oxygenation after major head and neck surgery.

OBJECTIVES: To investigate respiratory and hemodynamic responses to deep breathing exercise (DBE) during the follow-up period in the intensive care unit after major head and neck surgery. STUDY DESIGN: Prospective study. SUBJECTS AND METHODS: Thirty-five patients were instructed to perform DBE every hour for 3 consecutive hours during the first postoperative day. The ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO(2)/FiO(2)), oxygen saturation (SpO(2)), respiratory rate (RR), heart rate (HR), and mean arterial pressure (MAP) was recorded. RESULTS: DBE increased the PaO(2)/FiO(2) ratio from 416.7 +/- 143.6 to 453.4 +/- 141.4 mm Hg and increased SpO(2) from 97.4 +/- 1.9 to 99.2 +/- 0.9. DBE decreased the RR from 24.1 +/- 3.3 to 21.8 +/- 2.9 breaths/min (P < 0.05). No statistically significant difference in HR or MAP was observed after DBE (P > 0.05). CONCLUSION: DBE improves oxygenation after major head and neck surgery, without causing additional harmful hemodynamic effects.

The physical activity of patients after herniated lumbar disc surgery.

OBJECTIVE: We evaluated the level of pain, disability, performance, and physical activity changes in patients who underwent lumbar disc hernia surgery. METHODS: This study included 31 patients who underwent lumbar disc hernia surgery in the Neurosurgery Department of Dokuz Eylul University Hospital, Izmir, Turkey over a 13-month period from April 2003 to May 2004. Changes in the patients` pain were determined using a visual analog scale, and disability changes were evaluated using the Oswestry Disability Index. Total times for the following performance tests were recorded: rolling from right to left and vice versa, loaded reach, repeated sitting/standing, 50-foot walk, and 5-min walk. The Compendium of Physical Activities questionnaire was used to assess physical activity levels in a 24-hour period. The assessments were performed 2, 4, and 6 months postoperatively. RESULTS: Significant differences were observed in the pain, disability, performance, and physical activity levels 2, 4, and 6 months postoperatively (p=0.000), with the worst values at 2 months and the best at 6 months. CONCLUSION: A need exists not only to direct patients toward more active lifestyles and physical fitness, but also to use assessments to accelerate the recovery period, ensuring continuity in the postoperative period.

Are the alterations in body posture related to decreased trunk muscle endurance in healthy young adults?

BACKGROUND: Trunk muscle endurance exercises are commonly used for correcting the postural alterations. However, there is no study investigating the relationship between postural alignment and trunk muscle endurance in healthy young adults. OBJECTIVE: The aim of this study was to examine whether the three-dimensional (3D) body posture is related to trunk muscle endurance in healthy young adults. METHODS: Forty-two healthy young adults enrolled in this study. For 3D evaluation of the body posture, an internet-based postural assessment system was used. Alterations in posture (head, ribcage, and pelvis) were evaluated by using the Posture Index which represents the total score of postural displacements. The higher Posture Index scores indicate more severe displacements in the posture. Trunk muscle endurance measurements included side bridge, trunk flexors and trunk extensors endurance tests. Spearman's rho was used to evaluate the associations between measured parameters. RESULTS: The median age of the participants were 22 (IQR: 21.0-23.0) years. The only significant correlation was detected between the side bridge endurance test and the total Posture Index score (rho =⁣-0.402, p= 0.008). CONCLUSIONS: These results indicated that the alterations of the body posture was significantly related to lower lateral trunk muscle endurance scores. These findings support the importance of trunk muscles, especially lateral trunk musculature to have a better body posture.

Validity and reliability of the Turkish version of the Physical Workload Questionnaire.

BACKGROUND: Although it is necessary to regularly record and assess physical workloads in a workplace to prevent work-related musculoskeletal disorders, there is no easy to use, valid and reliable questionnaire such as the Physical Workload Questionnaire (PWQ) in Turkish. OBJECTIVE: To linguistically and culturally adapt the PWQ into Turkish, and to examine the validity and reliability of this adapted version. METHODS: One hundred twenty-six participants were recruited. All participants filled in the Oswestry Disability Index (ODI) and the Nordic Musculoskeletal Questionnaire. To determine test-retest reliability, all participants filled in the PWQ after a time interval of one week. RESULTS: There was a significant difference in the PWQ indices between the participants with an occupation requires less vs. higher workload (p < 0.05). The PWQ index was significantly correlated with the proximal musculoskeletal symptoms (ρ= 0.301, p < 0.05), but not significantly correlated with distal musculoskeletal symptoms (ρ= 0.121, p > 0.05). The PWQ index was significantly correlated with the ODI (ρ= 0.193, p < 0.05). The internal consistency of the PWQ was excellent (α= 0.865) and item-total correlations were acceptable. Test-retest reliability was high (ICC = 0.865). CONCLUSIONS: The PWQ is the unique valid and reliable questionnaire available in Turkish for assessing physical workload due to body posture and strenuous effort during work.

Validity and Reliability of the Turkish Version of the 8-Item Parkinson's Disease Questionnaire.

INTRODUCTION: Symptomatic control and improvement of health-related quality of life (HRQoL) is a key feature of the management of patients with Parkinson's disease (PD). The 39-item Parkinson's Disease Questionnaire (PDQ) and its short version, PDQ-8, validated disease-specific patient-reported instruments, have been highly recommended to use for assessing HRQoL in patients with PD. The aim of this study was to assess the reliability and validity of the Turkish version of the PDQ-8. METHODS: Eighty-three patients with PD were recruited for this methodological and cross-sectional study. The PDQ-8 was repeated to assess the test-retest reliability after one-week interval. The participants completed the 36-Item Short Form Health Survey (SF-36) as a generic HRQoL previously validated in Turkey. The Hoehn & Yahr stages of the patients were also determined. The SF-36 and Hoehn & Yahr stages were used to assess the convergent validity of the PDQ-8. RESULTS: The Cronbach's alpha coefficient was 0.78 (95% CI: 0.70-0.84, p<0.001) for PDQ-8. The test-retest reliability was very high as the intra-class correlation coefficient was 0.97 (95% CI: 0.93-0.99, p<0.001). The PDQ-8 had significant correlations with the physical and mental component scores of SF-36 (ρ=-0.52, p<0.001 and ρ=-0.64, p<0.001, respectively) and Hoehn & Yahr stages (ρ=0.56, p<0.001). There was no evidence of floor or ceiling effects. CONCLUSION: The results of this study suggest that the Turkish version of the PDQ-8 is a reliable, valid, less time-consuming, and brief disease-specific instrument to assess HRQoL in patients with Parkinson's disease.