Knowledge, attitude and practice of physiotherapists about lymphedema: A Turkish perspective.

BACKGROUND: Physiotherapists are important members of the healthcare team in the management of lymphedema. Therefore, the level of knowledge and awareness of physiotherapists on this disease is substantial. This study was planned to investigate knowledge, attitude, and practice of physiotherapists about lymphedema in Turkey. METHOD: This study was a qualitative, prospective, and cross-sectional research. Data were collected with the web-survey which consisted of the demographical characteristics information, evaluation of their own knowledge and practice in lymphedema management, and current knowledge of physiotherapists about lymphedema based on the current literature. RESULTS: Two hundred seventy-four physiotherapists (174 Female: 100 Male; mean age: 29.87 ± 6.9 years) completed the web-survey. From 274 physiotherapists, 52.60% of them had no education about lymphedema, 13.90% of them had never seen any patient with lymphedema, and 57.70% of them had not taken part in the management of a patient with lymphedema. 71.90% of the physiotherapists did not think they have enough knowledge about lymphedema. It was identified that physiotherapists' general and risk factors knowledge about lymphedema was sufficient. However, physiotherapists showed a lack of knowledge on the evaluation, treatment, and recommendations for lymphedema. CONCLUSION: Physiotherapists' education and experience in lymphedema management are crucial as they are important members of the multidisciplinary team. To raise qualified physiotherapists in this field, from undergraduate education, special training programs about lymphedema should be added to their lifelong learning process.

Two-Point Discrimination for Upper Extremity and Face in Healthy Young Adults: A Cross-Sectional Study.

BACKGROUND AND AIM: The threshold values of two-point discrimination (TPD) provide a numerical measure of tactile acuity. Normal reference values are needed to decide whether sensory variability is within normal sensorial limits. The study aimed to determine the upper extremity and face threshold values in healthy young adults. MATERIALS AND METHODS: Static TPD thresholds of 67 healthy young adults aged 18-35 years were assessed. Eight skin areas in the face and upper extremity on the dominant side were assessed using a "method of limits" approach with an aesthesiometer. Differences between genders were examined with the Mann-Whitney U test. The Spearman correlation analysis investigated the relationship between age and TPD measurements. RESULTS: TPD values ranged between 4.66 and 19.16 mm and 1.33-68.66 mm in the face and upper extremity, respectively, in the participants with a mean age of 23.83 ± 4.66 years. Fingertips and the area over the lateral mandibula showed the greatest sensitivity. The threshold values of TPD showed both interindividual and intraindividual variability. There was no statistical difference in the TPD values according to gender in any of the measured areas, and there was no relationship between age and TPD test values. CONCLUSIONS: The threshold values of TPD have clinical applicability in various diseases affecting the sensation of the upper extremity and/or face. These data may help the detection of early sensory loss.

The effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease: A systematic review and meta-analysis of systematic reviews.

BACKGROUND: The aim of the study was to evaluate the effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease. MATERIALS AND METHODS: A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses up to the end of October 2021. 601 studies were identified, and 16 of them were included in our study. RESULTS: According to our meta-analysis; there was a significant effect of Tai Chi on balance (SMD, -0.777 95% CI -0.921 to -0.633; p = 0.000), functional mobility (SMD, -0.719 95% CI -0.944 to -0.494; p = 0.000), and falls (SMD, -0.456 95% CI -0.668 to -0.245; p = 0.000) in PD. CONCLUSION: Our systematic review and meta-analysis found significant effects of Tai Chi on functional mobility, balance and falls in patients with PD.

The clinical and urodynamic results of a 3-month percutaneous posterior tibial nerve stimulation treatment in patients with multiple sclerosis-related neurogenic bladder dysfunction.

AIM: The aim of this study was to investigate the effect of PTNS after 12 weeks, on the urodynamic findings in the Multiple Sclerosis (MS) patients with neurogenic detrusor overactivity (NDO). METHODS: A total of 19 MS patients with NDO were enrolled in the study. Urodynamic studies before and after 12 weeks PTNS were performed. PTNS was applied unilaterally from the medial malleolus and posterior to the edge of the tibia by using charge-compensated 200 micros pulses with a pulse rate of 20 Hz, weekly, during 3 months. The effects of PTNS on urodynamic variables were compared of baseline and after PTNS data in MS patients. RESULTS: Mean volume at the first involuntary detrusor contraction (1st IDCV) on standard cystometry was 124.2+/-37.6 ml, while it was 217.5+/-66.4 mL after PTNS. Mean maximum cystometric capacity (MCC) on standard cystometry was 199.7+/-29.3 mL, while it was 266.8+/-36.9 mL after stimulation. The improvements in the 1st IDCV and MCC were statistically significant after stimulation. Mean P(detmax) at first involuntary detrusor contraction, maximal detrusor pressure at maximum cystometric capacity, detrusor pressure at maximal flow (P(detQmax)) and maximal flow rate (Q(max)) were statistically significant after PTNS for 12 weeks. CONCLUSIONS: These results have demonstrated that PTNS is effective to suppress NDO in MS patients after PTNS. Although long-term efficacy of PTNS is known, the findings showed prominent improvements on the clinical and urodynamic outcome, we think that the use of PTNS for DO in MS patients will be promising in clinical practice in the future.

Trunk control and functionality in children with spastic cerebral palsy.

PURPOSE: To investigate the relationship between trunk control in sitting and functionality in children with spastic cerebral palsy (CP). METHODS: Fifty-eight children with spastic CP were included in the study. Functional abilities were evaluated with the Gross Motor Function Measurement-88 (GMFM-88) and the Pediatric Evaluation of Disability Inventory Functional Skills domain (PEDI-FSD). Trunk control in sitting was tested with the Trunk Control Measurement Scale (TCMS) and the Trunk Impairment Scale (TIS). The scores of the TCMS and TIS were compared with GMFM-88 and PEDI-FSD with Spearman correlation analysis. RESULTS: The total score of GMFM-88 was significantly correlated with the total score of TCMS (rho = 0.90, p < 0.01) and TIS (rho = 0.78, p < 0.01). The total score of PEDI-FSD was also significantly correlated with the total score of TCMS (rho = 0.76, p < 0.01) and TIS (rho = 0.72, p < 0.01). CONCLUSIONS: The evaluation of trunk control can provide valuable information for functional abilities of children with spastic CP.

Trunk Control in Children With Ataxic Cerebral Palsy.

This study aimed to investigate the clinical characteristics of trunk control in children with ataxic cerebral palsy (CP). We included 15 children with ataxic CP with a mean age of 9.46 years (SD = 1.08 years, 5-17 years) and 15 healthy children with a mean age of 9.06 years (SD = 0.84 years, 5-13 years). While the small sample size and large age range used here were not ideal for generalizability, they were made necessary by the rarity of this clinical sample. We used the Gross Motor Function Classification System Expanded and Revised (GMFCS-E&R) to classify the children's functional levels, and we tested trunk control with the Trunk Control Measurement Scale (TCMS). We then used the Gross Motor Function Measurement-88 (GMFM-88) to assess their gross motor functions. We compared the total and subscale scores of the TCMS in healthy children and children with ataxic CP by using the Mann-Whitney U Test. We also analyzed differences between TCMS scores according to the children's GMFCS levels with the Mann-Whitney U Test and also compared TCMS scores with the GMFM-88 by means of Spearman correlation analysis. Spearman correlation analysis was used to compare the scores of the TCMS with the GMFM-88. Our results showed that healthy children showed significantly higher scores than children with ataxic CP in total and subscale scores of TCMS (p < .05).There was no significant difference between the TCMS scores in children of different GMFCS levels, but the GMFM-88B subscale was significantly correlated with the static sitting balance (rho = .568, p < .05) and dynamic sitting balance (rho = .547, p < .05) TCMS subscales and with the TCMS total score (rho = .590, p < .05). We concluded that trunk control, especially its dynamic aspects, was impaired in children with ataxic CP.

The effect of Tai Chi and Qigong on health-related quality of life in Parkinson's disease: a systematic review and meta-analysis of systematic reviews.

The overall aim of the treatment in Parkinson's disease is to optimize functional independence, safety, well-being and thereby health-related quality of life. Tai Chi and Qigong are widely used exercises in Parkinson's disease, but there is insufficient evidence to support or refute the efficacy of Tai Chi and Qigong, especially on health-related quality of life in patients with Parkinson's disease. The aim of this study was to conduct a systematic review and a meta-analysis from the systematic reviews that evaluate the effectiveness of Tai Chi and Qigong on health-related quality of life in Parkinson's disease. A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses by using Cochrane Library, MEDLINE, PubMed, etc., databases up to the end of November 2018. From 1504 articles, seven fulfilled the inclusion criteria and were included in our study. Five of the included systematic reviews were about Tai Chi, and two of them were about both Tai Chi and Qigong. According to our meta-analysis, there was no significant effect of Tai Chi and Qigong on health-related quality of life in patients with Parkinson's disease, when compared to the control group (standardized mean difference -0.166, 95% confidence interval -0.676 to 0.344; P = 0.523). In conclusion, our systematic review and meta-analysis showed no significant effect of Tai Chi and Qigong statistically on health-related quality of life in patients with Parkinson's disease, but the small effect size in our study favoured the potential benefit of Tai Chi and Qigong on health-related quality of life in Parkinson's disease.

Validation of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) in a sample of Turkish non-ambulatory children with cerebral palsy.

AIM: The aim of this study was to translate and transculturally adapt the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire into the Turkish language and test the reliability and validity. MATERIAL AND METHODS: Eighty-two children with cerebral palsy and their parents were included in the study. The majority of children had spastic cerebral palsy. According to the Gross Motor Function Classification System, 26 children were level III, 30 children were level IV, and 26 children were level V. International accepted guidelines were used in the transcultural adaptation and validation process. Reliability was assessed through statistical analysis of the test results for test-retest and internal consistency. To assess construct validity, Caregiver Priorities and Child Health Index of Life with Disabilities was compared with the Child Health Questionnaire Parent Form. Concurrent validity was assessed by examining how Caregiver Priorities and Child Health Index of Life with Disabilities scores changed according to Gross Motor Function Classification System levels. RESULTS: The mean total score of Caregiver Priorities and Child Health Index of Life with Disabilities was 58.34±26.39. The intraclass correlation coefficient for the total questionnaire score was 0.75, ranging from 0.43 to 0.89 for six domains. Cronbach's alpha was above 0.80 in all domains of Caregiver Priorities and Child Health Index of Life with Disabilities, except the health domain. The construct validity was good because there was a positive correlation between total Child Health Questionnaire Parent Form and Caregiver Priorities and Child Health Index of Life with Disabilities scores (r=0.58, p<0.01) according to the Pearson correlation analysis. Caregiver Priorities and Child Health Index of Life with Disabilities scores were found to be different between Gross Motor Function Classification System levels (p<0.05). CONCLUSION: This study showed that the Caregiver Priorities and Child Health Index of Life with Disabilities appears to be easy to administer, seems to have significant validity and reliability, and may be useful in the evaluation of health-related quality of life of children with cerebral palsy.

AMAÇ: Bu çalismanin amaci, Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi anketinin Türkçe'ye uyarlanmasi, geçerlilik ve güvenirliligini çalismaktir. GEREÇ VE YÖNTEMLER: Çalismaya 82 beyin felçli çocuk ve ailesi alindi. Ayrica çalismaya alinan çocuklarin büyük çogunlugu spastik tip beyin felci olup, 26'si Kaba Motor Fonksiyon Siniflama Sistemi'ne göre seviye III, 30'u seviye IV ve 26'si seviye V idi. Öncelikle, Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi'nin çeviri ve geri çeviri islemi gerçeklestirildi. Güvenirlik, test-tekrar test ve iç tutarlilik ile degerlendirildi. Yapi geçerliligi, Çocuk Sagligi Ebeveyn Formu ile degerlendirildi. Eszamanli geçerlilik ise çocuklarin Kaba Motor Fonksiyon Siniflama Sistemi seviyeleriyle, engelli çocuk yasam saglik endeksi skorlarinin nasil degistigine bakilarak degerlendirildi. BULGULAR: Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi için ortalama toplam skor 58,34±26,39 olarak belirlendi. Ölçegin iç tutarlilik degeri her 6 alt ölçüm için 0,43 ile 0,89 arasinda degisen degerlerde olup, toplam skor için 0,75 olarak saptandi. Cronbach alpha degeri saglik alt basligi hariç bütün alt ölçümlerde 0,80 degerinin üstünde bulundu. Yapi geçerliligi için yapilan Pearson korelasyon çözümlemesine göre Çocuk Sagligi Ebeveyn Formu ile Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi arasinda pozitif yönde bir iliski bulundu (r=0,58, p<0,01). Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Endeksi skorlari Kaba Motor Fonksiyon Siniflama Sistemi seviyeleri arasinda farkli bulundu (p<0,05). ÇIKARIMLAR: Bu çalisma, Bakim Veren Öncelikleri ve Engelli Çocuk Yasam Saglik Ölçegi'nin beyin felçli çocuklarda saglikla iliskili yasam kalitesinin degerlendirilmesinde önemli derecede yararli oldugunu, ölçegin oldukça yüksek geçerlilik ve güvenirlige sahip oldugunu göstermistir.

The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study.

STUDY DESIGN: The cultural adaptation of Neck Disability Index (NDI), the validity and reliability of Turkish version. OBJECTIVE: The aim of this study was to conduct a study concerning the cultural adaptation of NDI and investigate the validity and reliability of its Turkish version in patients with neck pain. SUMMARY OF BACKGROUND DATA: The NDI is a reliable evaluation instrument for disability but there is no published Turkish version. METHODS: Eighty-eight patients with neck pain for at least 3 months were included in the study. NDI, The Neck Pain and Disability Scale, and Visual Analogue Scale (VAS) were completed by all subjects. Test-retest reliability was determined by using intraclass correlation coefficient and Pearson correlation analysis. For the determination of concurrent validity, the relation between NDI and VAS was examined by Pearson correlation analysis and for the determination of construct validity, the relation between NDI and Neck Pain and Disability Scale was investigated. RESULTS: Intraclass correlation coefficient score for test-retest reliability was 0.979 (95% confidence interval = 0.968-0.986). For concurrent validity, the relation between NDI and VAS was investigated, the r value for test and retest was 0.508 and 0.620, respectively (P < 0.0001). For construct validity, the relation between NDI and the Turkish version of Neck Pain and Disability Scale was investigated, the r value for test and retest was 0.659 (P < 0.0001) and 0.728 (P < 0.0001), respectively. CONCLUSION: The results suggest that the Turkish version of the NDI validated in this study is an easy to understand, reliable, and valid instrument for the measurement of the limitation of activities of daily living and pain caused by neck disorders in the Turkish-speaking population.

The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: a Turkish version study.

OBJECTIVES: The aim of this study was to conduct the cross-cultural adaptation of Neck Disability Index (NDI) and investigate the validity and reliability of Turkish version in patients with neck pain. SUMMARY OF BACKGROUND DATA: The NDI is a reliable evaluation instrument for disability but there are no published Turkish version. METHODS: Eighty-eight patients with neck pain for at least 3 months were included in the study. NDI, The Neck Pain and Disability Scale and Visual Analogue Scale (VAS) were completed by all subjects. Test-retest reliability was determined by using intraclass correlation coefficient and Pearson's correlation analysis. For the determination of concurrent validity, the relation between NDI and VAS was examined by Pearson's correlation analysis and for the determination of construct validity, the relation between NDI and Neck Pain and Disability Scale was investigated. RESULTS: Intraclass correlation coefficient score for test-retest reliability was 0.979 (95%, confidence interval = 0.968-0.986). For concurrent validity, the relation between NDI and VAS was investigated, the r value for test and retest was 0.508 and 0.620, respectively (P < 0.0001). For construct validity, the relation between NDI and the Turkish version of NPDA was investigated, the r value for test and retest was 0.659 (P < 0.0001) and 0.728 (P < 0.0001), respectively. CONCLUSION: The Turkish version of NDI was found to be a valid and reliable method of measurement for evaluating disability, caused by problems of the neck region as it is easy to comprehend by the patients and the time needed to apply is short in clinics.