Cross-cultural adaptation and validation of diabetes-39 in Turkish patients with type 2 diabetes.

PURPOSE: To translate Diabetes-39 quality of life scale (D-39) into Turkish, to accomplish a cross-cultural adaptation, to demonstrate validity and reliability of Turkish version (D-39-TR). METHODS: A total of 214 patients with type 2 diabetes were included, with an average age of 52.59 ± 14.83, a female/male ratio of 51/49%. Internal consistency and test-retest reliability were assessed by Cronbach's alpha coefficient and intraclass correlation coefficient (ICC), respectively. For structural validity, factor analysis was used. The SF-36 was used for convergent validity, and hemoglobin A1c (HbA1c) was used for differential validity. RESULTS: The Cronbach's alpha coefficient was over 0.70 for all subscales of D-39-TR and it was 0.93 for whole D-39-TR. No problematic items were detected in the scale. The ICC for test-retest reliability was 0.91 (95% CI 0.91-0.94). The test-retest consistency for the total score was r = 0.94, p < 0.001. D-39-TR was explained by five factors. The ratio of explaining the total variance of these 5 factors was determined as 53.97%. SF-36 (r=-0.48, p < 0.001) and HbA1c values (r = 0.31, p < 0.001) were moderately correlated with total score of D-39-TR. A significant difference was found between QoL values of patients with poor and good glycemic control (p < 0.001). CONCLUSION: Turkish version of D-39 is a reliable and valid scale for measuring QoL in patients with type 2 diabetes.IMPLICATIONS FOR REHABILITATIONThe Turkish version of the Diabetes-39 (D-39) is a valid and reliable questionnaire and can be used in patients with type 2 diabetes.The Turkish version of the D-39 offers a useful tool for better identifying quality of life of patients with type 2 diabetes who are at risk for adverse outcomes.The Turkish version of the D-39 can be used to evaluate the effectiveness of attempts to increase quality of life in patients with type 2 diabetes.

Caregiver Burden in Schizophrenia and Autism Spectrum Disorders: A Comparative Study.

OBJECTIVE: There is no study comparing schizophrenia and autism spectrum disorders (ASD) in terms of caregiver burden. This study aims to compare the caregiver burden among family members of the patients with schizophrenia and ASD and investigate the predictive factors. METHODS: A cross-sectional study with the family members living with and/or providing care to their patients was carried out. A sociodemographic form, the Beck Depression Inventory, the Self-Stigma Inventory for Families, and the Zarit Caregiver Burden Scale were utilized. Regression analyses were conducted to determine the predictive factors for higher burden. RESULTS: Caregiver burden in ASD was significantly higher than in schizophrenia. Regression analysis showed that the predictors of high caregiver burden were the need for self-care (OR=3.6), self-destructive behaviors (OR=3.4), self-stigma (OR=1.1), depression (OR=1.1), and level of income (OR=1.0) for all family members. When the diagnosis was removed from the equation, the factors determining the high burden did not change. CONCLUSION: This study suggests that characteristics of the illness are stronger predictors than family members' characteristics in explaining high caregiver burden for both illnesses. Psychological, social, and economic supports should be provided for families to help alleviate their caregiving burden.

The Effects of Narrative and Movie Therapy on the Theory of Mind and Social Functioning of Patients with Schizophrenia.

INTRODUCTION: The objective of this study was to investigate the effects of narrative therapy (NT) in which the patients tell their own life story in a group environment, and the movie therapy (MT), which is an interaction-based, emotion-themed, culturally compatible video screening activity, on chronic schizophrenia patients' theory of mind abilities, psychopathology, and social functioning. METHOD: Thirty patients with schizophrenia were included in this study. At the beginning of the study, 2 patients dropped out as they started to work in a job. Participants were randomly assigned into two groups: one group received NT, and the other had MT. Dokuz Eylül Theory of Mind Index (DEToMI), Reading the Mind in the Eyes Test (RMET), Social Functioning Assessment Scale (SFAS), the Positive and Negative Symptoms Scale (PANSS), and Montreal Cognitive Assessment Scale (MoCA) were applied to the patients before and after the study. Pre- and post-test results within the group were compared via Wilcoxon test. Mann-Whitney U and mixed-design ANOVA were used for group comparisons regarding treatment efficiency. RESULTS: In the NT group, PANSS negative and general psychopathology, DEToMI, SFAS, and MoCA scores significantly increased. In the MT group, PANSS negative, DEToMI, SFAS, MoCA, and RMET scores significantly enhanced. Regarding the comparisons for before and after the treatment, it was found that mean RMET scores and DEToMI faux pas sub-scale scores were higher in the MT group comparing to the NT group. CONCLUSION: This study suggests that NT and MT could be beneficial on different domains of the theory of mind, and may lead to a decrease in psychopathology, and increase in neurocognition and social functioning. MT might be a more effective treatment in the field of perceptual theory of mind.

Validity and reliability of Turkish version of STarT Back Screening Tool.

OBJECTIVES: The psychosocial factors that may affect the prognosis of patients with low back pain are generally disregarded. The StarT Back Screening Tool can help clinicians to analyze prognostic indicators and the risk associated with outcome by examining physical and psychosocial factors. The aim of this study was to investigate the psychometric properties of the Turkish version of the StarT Back Screening Tool, including cross-cultural adaptation, internal consistency, test-retest reliability, and construct validity. METHODS: In this study, 120 patients with non-specific low back pain were included. The Roland Morris Disability Questionnaire, Oswestry Disability Index, Beck Depression Inventory, Tampa Scale for Kinesiophobia, and the StarT Back Screening Tool were administered. One week after the initial testing, the same examiner repeated the tests. RESULTS: The mean age of the patients who participated in the study was 35.54±12.45 years. Cronbach's alpha coefficients in the analysis of scale reliability were 0.747 for the overall scale and 0.738 for the psychosocial subscale. The test-retest reliability of StarT Back Screening Tool (intraclass correlation coefficient: 0.90-0.93) was found to be excellent. Pearson correlation coefficients for the correlations between the overall StarT Back Screening Tool and the other measures were very good (r=0.678; p<0.001) for the Roland Morris Disability Questionnaire, good (r=0.473; p<0.001) for the Tampa Scale for Kinesiophobia, good (r=0.541; p<0.001) for the Oswestry Disability Index, and moderate (r=0.336; p<0.001) for the Beck Depression Inventory. CONCLUSION: The Turkish version of the StarT Screening Tool for non-specific back pain was determined to be valid and reliable. A good assessment of both physical and psychosocial factors in symptomatic patients can help clinicians make a thorough prognosis.

Effects of smartphone overuse on headache, sleep and quality of life in migraine patients.

OBJECTIVE: To investigate the effects of smartphone overuse on headache, sleep quality, daytime sleepiness and quality of life in migraine patients. METHODS: This study is a single-center, cross sectional comparative study. This study was conducted between July and September 2017 in the Neurology Clinic of a private hospital. Migraine disability assessment (MIDAS) questionnaire was used to evaluate the disability status, and Mobile Phone Problematic Use Scale (MPPUS) was used to evaluate smartphone use frequency. The Visual Analogue Scale (VAS), 24-h Migraine Quality of Life Questionnaire (24-h MQoLQ), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to evaluate the pain intensity, quality of life, sleep quality and daytime sleepiness, respectively. RESULTS: The study included a total of 123 patients. There was a significant difference between the groups in terms of pain intensity, frequency and duration as well as VAS, PSQI, 24-h MQoLQ and ESS (p less than 0.05) scores. There was a negative correlation between MPPUS and PSQI (r=-0.367, p less than 0.05); a strong positive correlation between MPPUS and ESS (r=0.675, p less than 0.05) and a negative correlation between MPPUS and 24-h MQoLQ (r=-0.508, p less than 0.05). CONCLUSION: Smartphone use has been observed to increase headache duration and frequency in migraine patients. Its overuse in migraine patients is related to poor sleep quality and daytime sleepiness; furthermore, as the smartphone use increases, sleep quality decreases, daytime sleepiness increases and quality of life decreases.

Different walk aids on gait parameters and kinematic analysis of the pelvis in patients with Adult Neuromuscular Disease.

OBJECTIVE: To investigate the effects of different walking aids (single cane, bilateral forearm crutch and walker) on gait parameters and kinematic analysis of pelvis in patients having adult neuromuscular diseases. METHODS: The study design was a self-controlled study. The study was conducted in the Department of Physiotherapy and Rehabilitation, Hacettepe University in Ankara, Turkey, between 2014-2015. The study included 18 adult patients with neuromuscular disease. The manual muscle test, the Rivermead mobility index, the motor function assessment scale, and the trunk control test were used as descriptive measurements. The 2-minute walking test, the modified Borg scale and the G-Walk gait analysis system (BTS Bioenginering S.p.A., Italy) were used as the outcome measures. The outcome measures were performed randomly during normal gait without walking aids (self control group), then during walking with single point cane, bilateral forearm crutch and walker. RESULTS: It was observed that the walking aids have decreased the walking speed, walking distance and cadence. When the pelvis kinematic was analyzed, there was only a significant difference in the extension of the pelvis between the groups (p<0.05). The most useful (61%), most comfortable (44.4%) and the most preferred (61%) walking aid was determined as single cane by patients and the safest (55%) one was determined as a walker. CONCLUSION: In the decision-making process for walking aids, the patient`s biomechanical, physiological and psychosocial needs, expectations, satisfactions and levels of independence should be considered before providing patients with aids for walking.

Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial.

PURPOSE: According to literature, virtual reality was found to reduce pain and kinesiophobia in patients with chronic pain. The purpose of the study was to investigate short-term effect of the virtual reality on pain, function, and kinesiophobia in patients with subacute and chronic non-specific low-back pain METHODS: This randomised controlled study in which 44 patients were randomly assigned to the traditional physiotherapy (control group, 22 subjects) or virtual walking integrated physiotherapy (experimental group, 22 subjects). Before and after treatment, Visual Analog Scale (VAS), TAMPA Kinesiophobia Scale (TKS), Oswestry Disability Index (ODI), Nottingham Health Profile (NHP), Timed-up and go Test (TUG), 6-Minute Walk Test (6MWT), and Single-Leg Balance Test were assessed. The interaction effect between group and time was assessed by using repeated-measures analysis of covariance. RESULTS: After treatment, both groups showed improvement in all parameters. However, VAS, TKS, TUG, and 6MWT scores showed significant differences in favor of the experimental group. CONCLUSION: Virtual walking integrated physiotherapy reduces pain and kinesiophobia, and improved function in patients with subacute and chronic non-specific low-back pain in short term.

Impairments of postural stability, core endurance, fall index and functional mobility skills in patients with patello femoral pain syndrome.

BACKGROUND: Postural control allows performance of daily and sports activities. The previous studies show that postural sway inceases in orthopaedic injuries such as osteoarthritis and total knee arthroplasty. OBJECTIVE: To compare postural sway, risk of falling and function between individuals with and without patellofemoral pain syndrome (PFS). METHODS: This study included 22 subjects with patellofemoral pain syndrome, age-matched pain-free 22 females serving as a control group. Visual anolog scale and Kujala were used to evaluate the pain. Posturographic assesment was performed by Tetrax posturographic device. Biering Modified Sorenson test for extensor endurance and sit-up test for flexor endurance were used for the evaluation of trunk endurance. Timed get-up and go test was used for lower extremity function. The Student's t Test was used to compare variables between the groups. The Pearson correlation coefficients were calculated to examine correlation between the quantitative variables. RESULTS: Postural sway included eyes open without pillow, eyes open on pillow, eyes closed on pillow, risk of falling, function and postural stabilization included flexor endurance, extansor endurance are impared in patient with patellofemoral pain syndrome when compare to controls. In subjects with PFPS increased postural sway significantly associated with body mass index (r= 0.52), pain duration (r= 0.43), postural control (extansor endurance) (r= -0.50) and risk of falling (r= 0.62) on pillow with open eyes. In addition we found function significantly related with postural control (extansor endurance and flexor endurance) (r= -0.59 and r= -0.59) and risk of falling (r= 0.77)CONCLUSIONS: Decreased neuromuscular control of the trunk core and increased postural sway and falling risk were found in patients with PFPS. Patients may be evaluated for deficits in postural control and falling risk before treatment.

Immediate effect of manual therapy on respiratory functions and inspiratory muscle strength in patients with COPD.

OBJECTIVE: The objective of this study was to investigate the immediate effect of manual therapy (MT) on respiratory functions and inspiratory muscle strength in patients with COPD. PARTICIPANTS AND METHODS: Thirty patients with severe COPD (eight females and 22 males; mean age 62.4±6.8 years) referred to pulmonary physiotherapy were included in this study. The patients participated in a single session of MT to measure the short-term effects. The lung function was measured using a portable spirometer. An electronic pressure transducer was used to measure respiratory muscle strength. Heart rate, breathing frequency, and oxygen saturation were measured with a pulse oximeter. For fatigue and dyspnea perception, the modified Borg rating of perceived exertion scale was used. All measurements were taken before and immediately after the first MT session. The ease-of-breathing visual analog scale was used for rating patients' symptoms subjectively during the MT session. RESULTS: There was a significant improvement in the forced expiratory volume in the first second, forced vital capacity, and vital capacity values (P<0.05). The maximal inspiratory pressure and maximal expiratory pressure values increased significantly after MT, compared to the pre-MT session (P<0.05). There was a significant decrease in heart rate, respiratory rate (P<0.05), and dyspnea and fatigue perception (P<0.05). CONCLUSION: A single MT session immediately improved pulmonary function, inspiratory muscle strength, and oxygen saturation and reduced dyspnea, fatigue, and heart and respiratory rates in patients with severe COPD. MT should be added to pulmonary rehabilitation treatment as a new alternative that is fast acting and motivating in patients with COPD.

Evaluation of Quality, Content, and Use of the Web Site Prepared for Family Members Giving Care to Stroke Patients.

This study was designed to evaluate the quality, content, usability, and efficacy of a Web site prepared for the purpose of improving the caregiving capability of family members who provide care for stroke survivors at home. The DISCERN score for the Web site was found to be 4.35 over 5. The first section that assesses reliability of the Web site was 4.38 over 5; mean score of the second section that measures the quality of the provided information on treatment/care options was 4.30, and mean score of the third section that gives a general evaluation of the material was 4.1. The Web site content achieved an average score of 3.47 over 4 after evaluation by experts. The Web site system usability score was found to be 79.4 over 100. The Web site was utilized mostly for exercises in bed (76.3%; n = 29), use of medications, and patient safety (68.4%; n = 26). It was determined that those who were younger and employed and had no previous experience of nursing any patient utilized relatively more from the section of patient nutrition and oral care and married family caregivers from the body hygiene section. The Web site quality and content were judged to be good and reliable to use. The Web site was efficiently used by caregivers.

Three different points of view in stroke rehabilitation: patient, caregiver, and physiotherapist.

BACKGROUND: The similarities or differences of the three some (physiotherapists, patients, and caregivers) thought about the process of stroke rehabilitation can play a key role in the success of rehabilitation. OBJECTIVE: The aim of this qualitative study was to investigate the perspectives of the three some, with regard to the two themes of the study: (1) What are the problems faced by the patients after stroke?; and (2) What does recovery after stroke mean to you? METHODS: The qualitative questions and possible answers were prepared by four physiotherapists. The answers were matched to International Classification of Functioning (ICF) components. Seventy patients who were having treatment as in-patient rehabilitation centers, their caregivers, and physiotherapists were invited to the study. After the questions were asked and the possible response choices were presented, subjects were asked to prioritize these response choices. RESULTS: One hundred and fifty-nine subjects, including 53 patients, 53 caregivers, and 53 physiotherapists, were included to the study. When the theme 1 were examined, we found that the patients' first priority was functional abilities (ICF: body function and structure) such as using the hands and feet while the caregivers and physiotherapists prioritized self-care problems (ICF: activity and participation). The most common response to the theme 2 was "being in same health condition before the disease" (ICF: activity and participation) among the patients and caregivers and "being able to move arm and leg on the affected side" (body function and structure) among the physiotherapists. CONCLUSION: As a conclusion, problems faced by the patients, caregivers, and physiotherapists were perceived under the same ICF domain and that caregivers' and physiotherapists' priorities were the same.

Phenprobamate dependence: a case report.

Phenprobamate (3-phenylpropylcarbamate) is a centrally acting muscle relaxant with mild sedative and anticonvulsant effects. Muscle relaxants can enhance and prolong the effect of narcotic drugs and enable to obtain same effect with a smaller amount of alcohol or illicit substance. Almost all of the centrally acting muscle relaxants have varying sedative effects on which their abuse potential mainly depends. Data related to abuse of carisoprodol, meprobamate, baclofen takes place in the literature. However, to our knowledge this is the first case report about abuse of and tolerance to phenprobamate. We aimed to attract attention to important points of prescribing drugs that have abuse potential like in our case who was using up to 16000 mg/day phenprobamate.

Pregnancy physical activity questionnaire (PPAQ): reliability and validity of Turkish version.

[Purpose] The aim of this study was to translate the Pregnancy Physical Activity Questionnaire into Turkish and test its reliability and validity among Turkish pregnant women. [Subjects and Methods] The subjects were 204 healthy, single pregnant women between the ages 18 and 40 who volunteered to participate in this study. Reliability was evaluated by measuring the one-week test-retest reliability with the intraclass correlation coefficient and Pearson's correlation analysis. Concurrent validity was examined by comparing the Pregnancy Physical Activity Questionnaire with the long form of the International Physical Activity Questionnaire and step counts with pedometer. [Results] The mean age of the participants was 28.23±4.94 years, and the mean for BMI was 26.09±4.40. For test-retest reliability, r values were respectively 0.961, 0.934, 0.957 and 0.981 for self-reported sedentary, light, moderate, and vigorous activity, respectively. Intraclass correlation coefficient scores ranged from 0.924 to 0.993. For validity, the Pearson's correlation coefficients between the Pregnancy Physical Activity Questionnaire and long form of the International Physical Activity Questionnaire ranged from moderate (r = 0.329) to high (r = 0.672). The correlation value between the total score of the Pregnancy Physical Activity Questionnaire and the step counts was 0.70. [Conclusion] The Turkish version of the Pregnancy Physical Activity Questionnaire is a valid and reliable tool for measurement of the physical activity level of pregnant women.

Validity and reliability of Turkish version of the Pain Attitudes and Beliefs Scale for Physiotherapists.

BACKGROUND: The initial purpose of this study was to perform a linguistic and cultural translation of the Pain Attitudes and Beliefs Scale for Physiotherapists into the Turkish language. Following the translation process the primary purpose of the study was to examine the validity and reliability of the Turkish version of Pain Attitudes and Beliefs Scale for Physiotherapists. MATERIALS AND METHODS: A survey study design was used. The Turkish version of Pain Attitudes and Beliefs Scale for Physiotherapists was developed. A pilot test was performed and a final version was completed. Participants were recruited to examine the reliability and validity of the new instrument. Participants received an online survey package with the PABS-PT-TR and Turkish Version of the Tampa Scale for Kinesiophobia. RESULTS: A total of 51 physiotherapists (response rate 60.7%) completed the PABS-PT-TR and Turkish Version of the Tampa Scale for Kinesiophobia and 28 physiotherapists completed the retest. Factor analysis was conducted to determine the construct of the scale. Two factors emerged: one focused on biomedical orientation and the second on biopsychosocial orientation. The test-retest reliability (ICC) for the biomedical scale was 0.81 (95% CI = 0.60-0.91) and 0.82 (95% CI = 0.61-0.91) for the biopsychosocial scale. Internal consistency for the "biomedical" scale was Cronbach's α = 0.72 and α = 0.59 for the biopsychosocial scale. When the relationship between PABS-PT-TR and TSK was investigated, r value was 0.39 (p < 0.05) indicating fair convergent validity. These results indicated that the PABS-PT-TR shows construct validity. CONCLUSION: The PABS-PT-TR appears to have good test-retest reliability, acceptable to good internal consistency, and acceptable construct validity.

Reliability and validity of Trunk Control Test in patients with neuromuscular diseases.

OBJECTIVE: The aim of our study was to determine the reliability and validity of the Trunk Control Test (TCT) in people with adult neuromuscular diseases (NMD). SUBJECTS: Sixty six people with NMD participated in the study. METHODS: Patients were evaluated using the TCT, manual muscle test (trunk, upper and lower extremities), Motor Function Measurement (MFM), Functional Independency Measurement (FIM) and the Rivermead Mobility Index (RMI). RESULTS: Test-retest reliability (intraclass correlation coefficients) was excellent for the TCT. The intraclass correlation coefficient score was 0.979 (95% confidence interval 0.968-0.986). Cronbach alpha value was 0.749, and item-to-total correlation coefficient for "rolling from supine to the dominant side," "rolling from supine to the other side" and "sitting up from lying down" was (r = 0.61), (r = 0.57) and (r = 0.92), respectively, for construct validity. The TCT was found to be correlated with MFM (r = 0.57), MFM trunk (r = 0.62), trunk muscle strength (r = 0.61), shoulder flexion muscle strength (r = 0.39), hip flexion muscle strength (r = 0.39), FIM (r = 0.35), FIM motor (r = 0.66) and RMI (r = 0.39) for convergent validity. CONCLUSION: Our results confirm that the TCT is an easy, reliable and valid instrument for the measurement of trunk performance in ambulatory NMD patients.

The increase of mean platelet volume in patients with Alzheimer disease.

BACKGROUND/AIM: Vascular risk factors play an important role in the progression of Alzheimer disease (AD). Mean platelet volume (MPV) is a determinant of platelet functionality and increased MPV is associated with an increased risk of vascular inflammation. Here we aimed to examine whether MPV could be used as a marker of vascular damage in AD and to discuss the relation between MPV and other vascular risk factors. MATERIALS AND METHODS: A total of 109 outpatients with AD and 81 healthy controls were included in this study. Diagnosis of AD was made according to defined criteria. The Turkish version of the Mini Mental State Examination (MMSE) was used for cognitive assessment. According to the test results, patients were divided into 2 subgroups, mild (MMSE ≥ 18) and moderate (MMSE < 18), and their MPV levels were compared. RESULTS: MPV levels were higher in the AD group. There was no statistically significant difference between the moderate group and the mild group according to MPV values. CONCLUSION: Increased MPV in patients with AD may point to platelet dysfunction. MPV is an indicator of increased in vivo platelet activation. Hence, platelets could be the link between vascular risk factors and AD. The assessment of MPV in patients with AD may help identify the patients that could benefit from additional antiplatelet therapy.