Validity and reliability of the Turkish version of the functional assessment of cancer therapy-bone marrow transplant (FACT-BMT) quality of life questionnaire in patients undergoing bone marrow transplantation.

OBJECTIVE: The Functional Assessment of Cancer Therapy-Bone Marrow Transplant Version 4 (FACT-BMT) is a widely used instrument to assess quality of life in individuals treated with bone marrow transplantation (BMT). Our aim was to determine the reliability and validity of the Turkish version of the FACT-BMT in patients undergoing BMT. METHOD: Patients between the age of 20 and 65 years and who had undergone BMT at least 3 months before the study were included. Validity was determined using exploratory and confirmatory factor analysis. To determine convergent validity, the European Cancer Research and Treatment Organization Quality of Life Questionnaire-Cancer30 (EORTC QLQ-C30), the Brief Fatigue Inventory (BFI), and the Eastern Cooperative Oncology Group (ECOG) performance score were used. Cronbach's alpha, intra-class correlation coefficient (ICC), and item-total correlation (ITC) values were calculated to assess the reliability of the FACT-BMT. RESULTS: Totally, 114 patients (F/M: 47/67) treated with BMT (mean age: 49.50 ± 12.50 years) were included. Confirmatory and exploratory factor analysis revealed that the FACT-BMT and the Bone Marrow Transplantation Subscale (BMTS) had sufficient fit. The FACT-BMT was moderately to strongly correlated with the EORTC QLQ-C30, the BFI, and the ECOG performance score (p < 0.001). Cronbach's alpha and ICC values of the FACT-BMT were acceptable (0.925 and 0.956, respectively). The ITC values of each item of the FACT-BMT were also acceptable (ranged from 0.296 to 0.737). Patients undergoing autologous BMT had a significantly higher BMTS score than those undergoing allogeneic BMT (p < 0.05). SIGNIFICANCE OF RESULTS: The Turkish version of the FACT-BMT is valid, reliable, and sensitive to changes in quality of life in patients undergoing BMT.

Investigation of the validity and reliability of the Turkish version of the Functional Assessment of Cancer Therapy-Cognitive Function in cancer patients.

OBJECTIVE: The Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) is a questionnaire that is used to evaluate the quality of life and cognitive functions according to individual self-reports. The aim of this study was to investigate the validity and reliability of the Turkish version of the FACT-Cog. METHODS: Cancer patients who were treated with chemo or radiotherapy and had a score of 24/30 and more in Mini-Mental State Examination (MMSE) were included in this study. Cognitive functions assessed with the FACT-Cog and the European Organization of Research and Treatment of Cancer Quality of Life Core Questionnaire Core 30: Cognitive Function subscale (EORTC QLQ-CF). RESULTS: One hundred and forty cancer patients [female = 87 (62.1%), male = 53 (37.9%)] were included. The mean age of the participants was 47.93 ± 11.90 years. The Cronbach's α of the FACT-Cog scale was 0.82. Test-retest intraclass correlation coefficient values of the FACT-Cog questionnaire were varied from 0.855 to 0.954. There were found low correlations between the total score of the FACT-Cog and the MMSE (r = 0.26, p = 0.002), and moderate correlations between the EORTC QLQ-CF subscale and the FACT-Cog (r = -0.43; p < 0.001). SIGNIFICANCE OF RESULTS: It showed the validity and reliability of the Turkish version of the FACT-Cog questionnaire for cancer patients. It may be beneficial to use this questionnaire for the effects of cancer treatment.

Screening supportive care needs, compliance with exercise program, quality of life, and anxiety level during the COVID-19 pandemic in individuals treated with hematopoietic stem cell transplantation.

PURPOSE: The primary aim was to assess supportive care needs, compliance with home exercise program, quality of life level (QOL), and anxiety level during the COVID-19 pandemic in individuals treated with hematopoietic stem cell transplantation (HSCT). The secondary aim was to investigate demographic and medical factors associated with the recorded outcomes. METHODS: The present study included individuals treated with HSCT and previously referred to physical therapy. The data were collected by interviews with the participants on the phone. Supportive care needs were assessed using the Supportive Care Needs Survey-Short Form 29TR. Compliance with the exercise program was recorded as the number of patients regularly performed strengthening and stretching exercises and the ratio of the walking duration to the recommended duration. The European Cancer Research and Treatment Organization Quality of Life Questionnaire-Cancer30 was used to assess the QOL. The State-Trait Anxiety Inventory-I and the Visual Analogue Scale were used to assess anxiety level. RESULTS: The present study included 101 individuals treated with HSCT. The psychological and physical supportive care needs were predominant in participants. Compliance with exercise program was low. General anxiety level was low, yet anxiety about COVID-19 was moderate level in participants. Supportive care needs were related to female gender, performance level, time since HSCT, and QOL level (p Ë‚ 0.05). Anxiety level was correlated with supportive care needs, COVID-19-related anxiety, and QOL (p Ë‚ 0.05). Compliance with exercise program was associated with age, performance level, and QOL (p Ë‚ 0.05). CONCLUSION: Our results offer that supportive telehealth interventions should be considered during the COVID-19 pandemic for individuals treated with HSCT to decrease unmet supportive care needs and isolation-related physical inactivity.

Physical activity level, exercise behavior, barriers, and preferences of patients with breast cancer-related lymphedema.

PURPOSE: To identify physical activity level, exercise behavior, barriers, and preferences in female patients with breast cancer-related lymphedema (BCRL). METHODS: Patients with BCRL consulted to physical therapy to receive lymphedema treatment were included. Age, gender, body mass index matched healthy controls (HC) were included to identify differences. The transtheoretical model was used to determine exercise behavior. Physical activity level was assessed by the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The exercise barriers and preferences of patients with BCRL were recorded using a checklist based on the previous studies. RESULTS: A total of 48 female patients with BCRL and 38 female HC participated in the study. Physical activity level was significantly lower in patients with BCRL when compared to HC (p ˂ 0.05). However, the number of participants who engaged in regular exercise was significantly higher in patients with BCRL than HC (33.2% vs 7.9%, p ˂ 0.05). The most common exercise barriers were fatigue (64.5%), having other responsibilities (60.4%), and weather-related factors (56.2%). Majority of the participants preferred to participate in a supervised (79.1%), structured (66.6%), combined-type (77.1%), and moderate intensity (79.1%) exercise program, and they preferred to be informed at the time of the cancer diagnosis (45.8%) by a physiotherapist (66.6%). Moreover, the most preferred exercise type was walking/jogging (66.6%). CONCLUSION: The present study showed inadequate physical activity and exercise behavior in patients with BCRL. Supportive care interventions are needed to overcome barriers for patients with BCRL. Preferences of patients and exercise enjoyment should also be taken into consideration to increase the participation in exercises.

An evaluation of participation restrictions and associated factors via the ICF-CY framework in children with acute lymphoblastic leukemia receiving maintenance chemotherapy.

Our aim was to determine impairments in physical functions, activity limitations, and participation restrictions with the International Classification of Functioning, Disability and Health version for Children and Youth (ICF-CY) framework in children with acute lymphoblastic leukemia (ALL) receiving treatment. Physical functions were assessed in terms of pain level, fatigue level, handgrip strength, and motor proficiency. Fine motor activities and lower extremity performance were assessed to determine activity limitations. Participation was assessed with a patient-reported questionnaire. Thirty children with ALL (mean age: 8.45 ± 3.33 years) were included. Pain and fatigue level were mild. Poor handgrip strength was found; their mean handgrip strength was 60% of the normative. Fifty-six percent of the children had below-average motor performance. Participation scores were considerably high, except for sport and physical functioning sub-score. Participation level was positively associated with bilateral coordination and duration after diagnosis, while negatively correlated with pain and fatigue level (p ˂ 0.05).Conclusion: The ICF-CY-based evaluation was useful to understand children's limitations in everyday life. Children with ALL need supportive interventions during treatments in terms of physical functioning and participation in activities. Children with ALL with higher pain and fatigue, poor bilateral coordination, and who were in earlier period after diagnosis had higher risk for participation restriction. What is Known: • Children with ALL had physical functioning limitations on treatments. • Participation restrictions were described in children with ALL off treatment. What is New: • The ICY-CY-based health and functioning evaluation allows health care professionals to globally determine limitations of everyday life in children with ALL on treatment. • Impairments in physical functions, pain severity, fatigue severity, and duration after diagnosis are associated with participation to everyday life in children with ALL on treatment.

Cross-cultural adaptation, validity and reliability of Turkish version of the Waterloo Handedness and Footedness Questionnaire-Revised.

This study investigated the validity and reliability of Turkish versions of the Waterloo Handedness and Footedness Questionnaire-Revised (WHQ-R and WFQ-R). Turkish versions of the WHQ-R and the WFQ-R, and other assessments (the Handedness Questionnaire and the Footedness Preference Test) were applied to 444 healthy participants aged between 18 and 65 years. The translation and cultural adaptation process of the WHQ-R and the WFQ-R was provided by the following proposed guideline. For test-retest reliability, translated versions were re-applied to 88 participants in a 7-day interval. Cronbach's alpha of the WHQ-R was 0.984 and that of the WFQ was 0.905. The test-retest intra-class correlation coefficients (ICC) of the WHQ-R varied from 0.741 to 0.933 and those of the WFQ-R from 0.649 to 0.814. There were moderate to strong correlations between the WHQ-R and the Handedness Questionnaire (r = -853, p < 0.001) and between the WFQ-R and the Footedness Preference Test (r = -0.687, p < 0.001). Confirmatory factor analysis revealed a two-factor structure of the WHQ-R and the WFQ-R. The results of this study demonstrated that Turkish versions of the WHQ-R and the WFQ-R are reliable and valid inventories for assessing handedness and footedness in this population.

Effects of partly supervised and home-based exercise program in patients undergoing hematopoietic stem cell transplantation: a case-control study.

PURPOSE: The aim of this study was to determine effectiveness of an individual exercise program by starting before hematopoietic stem cell transplantation (HSCT) and continued with home exercise program after discharge up to 100 days after transplantation. METHODS: Totally, 50 patients were included in this study, and participants were assigned to two groups as intervention group (IG, n = 25) and control group (CG, n = 25). Participants were assessed at three time points: before HSCT, at the discharge, and at the 100th day after HSCT. Functional exercise capacity, physical functions, muscle strength, cognitive functions, quality of life, fatigue, and emotional status of the individuals were assessed. For IG, aerobic, muscle strengthening, endurance, and stretching exercises were performed through hospitalization, and an individual exercise and walking program was advised as home exercise program after discharge. RESULTS: Peripheral muscle strength and quality of life level was higher in IG than CG as a result of inpatient supervised exercise program (p Ë‚ 0.05). At the 100th day, positive effects of the home exercise program on cardiopulmonary exercise capacity, peripheral muscle strength, quality of life, and fatigue level continued when compared with CG (p Ë‚ 0.05). CONCLUSION: As a result of our study, an exercise program continued up to 100 days after HSCT which is individual and partly supervised by a physiotherapist has positive effects on physical functions, clinical status, fatigue, and quality of life level throughout HSCT. Exercise programs for individuals undergoing HSCT should be performed day by day according to the patients' daily clinical and hematologic status and their performance capacity.

Short and long-term impairments of cardiopulmonary fitness level in previous childhood cancer cases: a systematic review.

PURPOSE: To describe the impairments in physical fitness in individuals who were previously diagnosed and treated for childhood cancer. METHODS: Using the PRISMA-guidelines, a systematic search was performed in PubMed, Web of Science, and Embase using a combination of the following predefined keywords: "exercise capacity" OR "aerobic capacity" OR "fitness" OR "cardiorespiratory fitness" OR "cardiopulmonary fitness" OR "physical fitness" OR "exercise testing" OR "exercise tolerance" OR "exercise" OR "oxygen consumption" AND "leukemia" OR "childhood cancer" OR "childhood cancer survivors (CCS)". Studies that met our inclusion criteria were reviewed on methodological quality, while the Newcastle-Ottawa Scale was used for evidence synthesis. RESULTS: A total of 2644 articles were identified from the database search. After screening based on the eligibility (abstracts) and inclusion (full texts) criteria, 49 articles remained. Even though the risk-of-bias scores in the studies were generally low, yet the results from those with high-quality studies revealed that poor fitness levels were prevalent in individuals with acute lymphoblastic leukemia, brain tumor, and mixed cancer histories, compared to healthy controls. CONCLUSIONS: A global glance at CCS shows poor levels of fitness that is continuous and life-long even after active cancer treatment has ended. Nevertheless, the results presented in this review were based on a limited number of high-quality studies suggesting the need to for additional clinical trials in the topic area.

Effects of multimodal exercise on clinical status and patient-reported outcomes in children undergoing hematopoietic stem cell transplantation.

There are limited data available regarding effectiveness of exercise training in children undergoing hematopoietic stem cell transplantation (HSCT). We aimed to investigate effects of multimodal exercise program on clinical status and patient-reported outcomes including pain, fatigue, depression, and quality of life (QOL) level of children and their parents' QOL level. Twenty-six children undergoing HSCT participated in this study. Clinical status, pain, fatigue, depression, and QOL level of children were assessed three times: before HSCT, at discharge, and one month later. For intervention group (IG, n = 15), multimodal exercise program was performed five days a week, throughout hospitalization and children were advised to continue exercise program at home. For control group (CG, n = 11), being active as much as possible was advised. The number of painful day and pain intensity was significantly lower in IG than in CG during hospitalization (p < .05). Depression level decreased in IG at the time points (p ˂ .05); however, there was no significantly difference between groups. The QOL level was higher in IG than CG only at control measurements (p ˂ .05). In addition, QOL level of the parents decreased in both groups (p ˂ .05). There was no statistically difference between groups in terms of other clinical variables. The multimodal supervised exercise program has positive effects on children's pain and QOL level. Exercise program was also well tolerated by children during hospitalization. In addition, QOL levels of the parents were also negatively affected during hospitalization, and interventions aiming to increase QOL level of the parents should be considered.

Investigation of the Effects of an Exercise Program on Physical Functions and Activities of Daily Life in Pediatric Hematopoietic Stem Cell Transplantation.

BACKGROUND: The aim of this study was to determine the effectiveness of an implemented exercise program for children throughout the hematopoietic stem cell transplantation (HSCT) process. PROCEDURE: Twenty-two children aged between 3 and 17, who were earlier selected for HSCT, were divided into two groups-intervention and control. Children's physical function, functional performance, and activities of daily life (ADL) were assessed before HSCT, at discharge, and 1 month later. The exercise program, which consisted of strengthening, endurance, stretching, and relaxation exercises, was implemented to the intervention group for 5 days a week throughout hospitalization; and these exercises were given as home program at discharge. RESULTS: The results of the supervised exercise program during hospitalization showed that the children's physical function and functional performance increased statistically significantly in the intervention group (P < 0.05) and decreased statistically significantly in the control group (P < 0.05). For the ADL, no difference was found between the two groups (P ˃ 0.05). CONCLUSIONS: The present study determined that the exercise program had positive effects throughout the HSCT process, but these effects did not continue during the follow-up period. Exercise programs implemented by physiotherapists are important for children undergoing HSCT, and after transplantation it is necessary to continue supervised exercise program during follow-up.

Rehabilitation, exercise, and related non-pharmacological interventions for chemotherapy-induced peripheral neurotoxicity: Systematic review and evidence-based recommendations.

Pharmacological strategies for chemotherapy-induced peripheral neurotoxicity (CIPN) are very limited. We systematically reviewed data on rehabilitation, exercise, physical therapy, and other physical non-pharmacological interventions and offered evidence-based recommendations for the prevention and treatment of CIPN. A literature search using PubMed, Web of Science and CINAHL was conducted from database inception until May 31st, 2021. 2791 records were title-abstract screened, 71 papers were full-text screened, 41 studies were included, 21 on prevention and 20 on treatment of CIPN. Treatment type, cancer type, chemotherapy compounds were heterogeneous, sample size was small (median: N = 34) and intention-to-treat analysis was lacking in 26/41 reports. Because of the methodological issues of included studies, the reviewed evidence should be considered as preliminary. Exercise, endurance, strength, balance, and sensorimotor training have been studied in low-to-moderate quality studies, while the evidence for other treatments is preliminary/inconclusive. We offer recommendation for the design of future trials on CIPN.

Motor and Basic Cognitive Functions in Children with Acute Lymphoblastic Leukemia Undergoing Induction or Consolidation Chemotherapy.

Children with acute leukemia (ALL) often suffer from several disease and treatment related side-effects during treatment. The aim of the present study was to determine the gross and fine motor functioning and basic cognitive performance of children (n = 25) with ALL who were undergoing induction or consolidation chemotherapy and to compare these characteristics to a normative group (n = 21) of age-matched typically developing children. We assessed the children's motor functions with the Bruininks-Oseretsky Test of Motor Proficiency Second Edition-Short Form and the Nine-hole Peg Test, and we used the Modified Mini-Mental State Exam (MMSE) to evaluate their cognitive performance. Compared to the normative group, children with ALL had lower scores on total motor proficiency and sub-tests scores of motor functions (p < .05), and on the Nine-hole Peg Test performance (p < .05); but their cognitive performance on the MMSE was not significantly different. Children with ALL would likely benefit from structured exercise and rehabilitative interventions during chemotherapy to prevent and/or ameliorate ALL-related motor dysfunction. We also suggest that their cognitive functioning should be further investigated with more extensive well-validated neurocognitive tests for children (e.g., the Wechsler intelligence scales).

Culture-sensitive and standard pain neuroscience education improves pain, disability, and pain cognitions in first-generation Turkish migrants with chronic low back pain: a pilot randomized controlled trial.

Purpose: To compare the effectiveness of culture-sensitive and standard pain neuroscience education (PNE) on pain knowledge, pain intensity, disability, and pain cognitions in first-generation Turkish migrants with chronic low back pain (CLBP).Methods: Twenty-nine Turkish first-generation migrants with CLBP were randomly assigned to the culture-sensitive (n = 15) or standard PNE (n = 14) groups. Primary (pain knowledge, pain intensity, and disability) and secondary outcomes (pain beliefs, catastrophization, and fear of movement) were evaluated at baseline, immediately after the second session of PNE (week 1), and after 4 weeks.Results: There was a significant main effect of time in pain knowledge (p < .001), pain intensity (p = .03), disability (p = .002), organic and psychological pain beliefs (p = .002, p = .01), catastrophization (p = .002), and fear of movement (p = .02). However, no significant difference was found between groups in terms of all outcome measures (p > .05).Conclusions: Both PNE programs resulted in improvements in knowledge of pain, pain intensity, perceived disability, and pain cognitions. Nevertheless, the superiority of the culture-sensitive PNE approach could not be proved. Therefore, maybe migrants who are living in the host country for longer length of time do not need culturally adapted therapies due to cultural integration, while these adaptations might be essential for the recent migrants or the autochthonous population in Turkey. Further research is required to investigate the effects of culture-sensitive PNE alone or in combination with physiotherapy interventions in recent migrants or Turkish natives with CLBP.

[Motor Proficiency in Children with Attention Deficit Hyperactivity Disorder: Associations with Cognitive Skills and Symptom Severity]. / Dikkat Eksikligi Hiperaktivite Bozuklugu Olan Çocuklarda Motor Yeterlilik: Bilissel Beceriler ve Belirti Siddeti ile Iliskisi.

OBJECTIVES: Of children with Attention Deficit Hyperactivity Disorder (ADHD), 45-70% have motor skill problems, which can adversely affect social competence, peer relations, and academic skills. The aim of this study is to assess motor skills in school-aged children with ADHD, and to elucidate if there are any relationships between ADHD symptoms and cognitive function. METHOD: Included in this study were 58 children (38 ADHD, 20 controls) between 8-11 years of age. Children were diagnosed with ADHD via the Schedule for Affective Disorders and Schizophrenia for School-Aged Children Present and Lifetime Version. The parents were asked to fill out the Conner's' Parent Rating Scale - Revised Short Turkish Form to determine the symptom domains and the symptom severity. The Wechsler Children's Intelligence Scale-IV was used to assess cognitive skills, and the Bruininks -Oseretsky Motor Proficiency Test was used to assess motor skills. RESULTS: Children with ADHD had impaired performance in many motor skill areas compared to the controls. Impairments in fine motor skills were correlated with problems in attention, working memory, and processing speed. In the ADHD group, age was not correlated with motor skills enhancement. CONCLUSION: The multistage clinical evaluation of ADHD should include screening for problems in motor skills. If deficiencies are found, the child should be clinically evaluated for motor proficiency and, if necessary, should be referred for appropriate objective assessment and intervention programs.

Reliability and Validity of the Turkish Version of the PedsQL 3.0 Cancer Module for 2- to 7-Year-Old and the PedsQL 4.0 Generic Core Scales for 5- to 7-Year-Old: The Hacettepe University Experience.

OBJECTIVE: The aim of this study was to investigate the reliability and validity of the Turkish version of the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module for 2- to 7-year-old and the PedsQL 4.0 Generic Core Scales for 5- to 7-year-old in childhood cancer. MATERIALS AND METHODS: The PedsQL 3.0 Cancer Module and PedsQL 4.0 Generic Core Scales were administered to children with cancer and their parents at Hacettepe University. Internal consistency was determined by using Cronbach's alpha and test-retest reliability was determined by using the intraclass correlation coefficient (ICC). Construct validity was assessed by comparing the results of the PedsQL 3.0 Cancer Module with those of the PedsQL 4.0 Generic Core Scales. RESULTS: Cronbach's alpha of the PedsQL 3.0 Cancer Module varied from 0.803 to 0.873 and that of the PedsQL 4.0 Generic Core Scales from 0.665 to 0.841. Test-retest ICC values of the PedsQL 3.0 Cancer Module varied from 0.877 to 0.949 and those of the PedsQL 4.0 Generic Core Scales from 0.681 to 0.824. The correlation of the PedsQL 3.0 Cancer Module with subscale scores of the PedsQL 4.0 Generic Core Scales showed that there were excellent to fair correlations between the two scales. The relationship between parent proxy-report and child self-report of the PedsQL 3.0 Cancer Module had very good correlation (r=0.694, p<0.001), as did the PedsQL 4.0 Generic Core Scales (r=0.540, p=0.002). CONCLUSION: This study demonstrated the reliability, validity, and feasibility of the Turkish version of the PedsQL 3.0 Cancer Module in 2- to 4-year-old and 5- to 7-year-old and the PedsQL 4.0 Generic Core Scales in 5- to 7-year-old in childhood cancer.