Pelvic floor symptoms and symptom-related quality of life in the mothers of children with cerebral palsy: a pilot cross-sectional study.

Pelvic floor symptoms may occur in women with low back pain due to dysfunction of the spinal stabilization muscles. Low back pain is the most common musculoskeletal problem experienced by the mothers of children with cerebral palsy (CP). Therefore, our aim in this study was to examine pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP. The study included 48 mothers of children with CP (n = 23) or without neurodevelopmental problems (n = 25). The mothers' pelvic floor symptoms and symptom-related quality of life were evaluated with the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). PFDI-20 and PFIQ-7 scores did not differ between the two groups of mothers (p > .05). Additionally, moderately significant positive correlations were found between the age of the child with CP and duration of carrying and the PFDI-20 (r = 0.419, p = .047) and PFIQ-7 (r = 0.427, p = .042) scores. Pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP were similar to those in the mothers of children without neurodevelopmental problems. As the age of the child with CP and duration of carrying increase, the urinary symptoms and urinary and colorectoanal symptoms-related quality of life in their mothers may worsen.

Quality of upper extremity skills and disability inventory via manual ability classification in children with neonatal brachial plexus palsy.

PURPOSE: The aim of study was to investigate the relationship between upper extremity skill quality and disability inventory according to manual ability classification system in children with neonatal brachial plexus palsy (NBPP). MATERIALS AND METHODS: Children with NBPP were included between the ages of 4-7.5 years. Children were classified in Manual Ability Classification System (MACS). Upper extremity skill quality was evaluated with Quality of Upper Extremity Skills Test (QUEST), disability status was assessed with Pediatric Evaluation of Disability Inventory (PEDI). RESULTS: Total of 63 children (girls:31/boys:32), and mean age was 6.32 ± 1.73 years. 37 (58.73%) of children were at MACS Level-2. According to MACS classification, significant differences were noted in PEDI scores (p = 0.001), dissociated movements (p = 0.016) and grasp (p = 0.002) domains of QUEST. However, no significant differences between QUEST total scores (p = 0.079). PEDI (ROC; AuC = 0.762) and QUEST total score (ROC; AuC = 0.714) were sensitive to difference between groups across MACS in children with NBPP. CONCLUSION: The PEDI and QUEST are sensitive in distinguishing the disability of children with NBPP at different MACS levels. Assessment of children with NBPP is not limited to functionality, disability, and quality of movement, it is multidimensional. Outcomes measures studies of movement's quality in children with NBPP are needed.

Functionality evaluation in children with neonatal brachial plexus palsy is multidimensional.Appropriate assessment of functionality in children with neonatal brachial plexus palsy provides accurate information about daily living activities and disability levels.We propose using Quality of Upper Extremity Skills Test (QUEST) and Pediatric Evaluation of Disability Inventory (PEDI) to evaluate the relationship between the quality of upper extremity movements and disability in school-aged children with neonatal brachial plexus palsy at different Manual Ability Classification System (MACS) levels.

Assessment of motor development using the Alberta Infant Motor Scale in full-term infants.

The Alberta Infant Motor Scale (AIMS) is a well-known, norm-referenced scale that evaluates the gross motor development of children from birth to 18 months. The aim of the study was to compare the Canadian norms with the AIMS scores of a Turkish sample of infants, and to investigate whether the current reference values of the AIMS are representative for Turkish full-term infants. The study was conducted with 411 Turkish infants of both sexes (195 girls and 216 boys), born with gestational age 38 weeks and older, weighing ≥2500 g at birth. Motor performance of all the cases at different ages were assessed with the AIMS which was used by a physiotherapist. The mean AIMS scores of Turkish infants were compared with the norm values of the original AIMS established in a Canadian sample of infants. The results showed no statistically significant differences between the AIMS scores of Turkish and Canadian infants during the first 18 months of life except at 0- < 1 and 2- < 3 months of age. The AIMS scores were significantly lower in Turkish infants than in Canadian infants at 0- < 1 (p=0.025) and 2- < 3 (p=0.042) months of age. In conclusion, the AIMS can be used in Turkish children to assess gross motor development, especially after 4 months of age. However, this paper was presented as a preliminary study to compare AIMS results between Turkish and Canadian infants, and further studies are needed to realize the Turkish validation of AIMS.

Is short-term hand therapy effective in a child with congenital radioulnar synostosis? A case report.

STUDY DESIGN: Case report. INTRODUCTION: Congenital radioulnar synostosis (CRUS) is a rare malformation that causes the restriction of the rotational movements of the forearm, and it is common in congenital elbow anomalies. PURPOSE OF THE STUDY: The aim of this case report was to present the results of physiotherapy in a patient with CRUS who did not undergo surgery. METHODS: A 7-year-old male patient with CRUS began outpatient physical therapy. The child underwent a physiotherapy program for a total of 10 weeks in the presence of a physiotherapist, 2 days per week, and with a home schedule at other times. Observational posture assessment, range of motion measurements of the upper extremities, the Jebsen-Taylor Hand Function Test, finger and hand grip strength, and Canadian Occupational Performance Measure were used to evaluate the patient before and after the physiotherapy program. RESULTS: An increase in Jebsen-Taylor Hand Function Test, Canadian Occupational Performance Measure, and grip strengths were found; however, there was no change in the range of motion values for our patient. DISCUSSION: This report contains physiotherapy results of a patient with CRUS who did not undergo surgery. Further short- and long-term follow-up studies are needed to demonstrate the effects of physiotherapy on surgical and nonsurgical patients with CRUS. CONCLUSIONS: Physiotherapy can be effective in the functional use of the upper extremities in patients with CRUS who do not undergo surgery; long-term follow-up would demonstrate whether functional changes are permanent over time.

Body image perception, compliance with a prosthesis and cognitive performance in transfemoral amputees.

OBJECTIVE: The aim of the study was to assess mutual associations of body image perception, compliance with the prosthesis and cognitive performance in transfemoral amputees. METHODS: Fourty transfemoral amputee (30 male and 10 female), who had a traumatic and unilateral amputation were included in this study. The mean age of the patients at the time of study was 37 ± 9.9 and the mean age at amputation was 12.6 ± 9.4 years. Patients's body image perception and compliance with the prosthesis paramaters were evaluated with Amputee Body Image Scale (ABIS) and Trinity Amputation and Prosthesis Experience Scales (TAPES). MoCA (The Montreal Cognitive Assessment) has been used to determine the cognitive ability of the participant. All tests has been administered by dual task method during ambulation. Patients who had neurologic or cognitive deficit were excluded from the study. RESULTS: There was a statistically significant relationship between an individual's body image perception and cognitive performance. Body image perception was significantly and negatively correlated with the MoCA score (r = -0.514, p < 0.001). There was a statistically significant positive correlation between psychosocial adjustment, prosthesis satisfaction and MoCA scores (r = 0.550, p < 0.001). CONCLUSIONS: Body image satisfaction, psychosocial adjustment, lack of activity restriction, and satisfaction with prosthesis are positively associated with cognitive performance of transfemoral amputees. Before beginning the amputee rehabilitation programs, we recommend to include not only physical functions, but also consider body image and cognitive functions as assessment parameters. LEVEL OF EVIDENCE: Level IV, Diagnostic Study.

Reliability and validity of the Brachial Plexus Outcome Measure in children with obstetric brachial plexus palsy.

STUDY DESIGN: Clinical measurement and cross-sectional study. INTRODUCTION: Numerous scales have been developed to examine activities of daily living and function in children with brachial plexus palsy. The Brachial Plexus Outcome Measure (BPOM) scale was developed in 2012 by Emily S. Ho and contains 14 items that measure activity and self-evaluation. PURPOSE OF THE STUDY: The aim of the study was to cross-culturally translate the BPOM scale into Turkish and test its measurement properties in children with brachial plexus palsy. METHODS: The scale was translated into Turkish using standard cross-cultural translation procedures. Forty-eight children with obstetric brachial plexus palsy (OBPP) were included in psychometric evaluations. Internal structure consistency and test-retest reliability were measured for reliability analyses. For each item on the scale, Cronbach alpha coefficient and item-total score correlations for all subscales were calculated. The scale was administered at baseline and 1 week later by 2 different physiotherapists to evaluate test-retest reliability. Concurrent construct validity was assessed using Pearson correlations between the OBPP and the Mallet classification system. RESULTS: Eighteen (37.5%) girls and 30 (62%) boys, in total 48 children, whose mean age was 8.7 ± 2.4 (minimum-maximum = 5-14) years were included in the study; 9 (18.9%) have a history of both early microsurgery and tendon transfers and 39 (81.3%) have a history of only tendon transfer. Cronbach alpha ranged from 0.89 to 0.96, and for the whole scale, it was calculated as 0.938. DISCUSSION: Test-retest reliability was high. Moderate correlations were observed between the measures. CONCLUSION: The Turkish BPOM scale is a valid and reliable measurement for assessing function in children with OBPP in the Turkish population.

The relationship of pain on the upper extremity functions and quality of life in patients with carpal tunnel syndrome.

BACKGROUND AND OBJECTIVES: The aim of study was researching the relationship of pain in patients with carpal tunnel syndrome on Quality of Life (QoL) and upper limb functionality. METHODS: Demographical and physical measurements were performed by a physiotherapist. Pain levels were measured by Visuel Analog Scale at rest, on motion and in fatique, and the patients' results were recorded. Functionality levels were evaluated by 'Boston Carpal Tunnel Syndrome Questionnaire' and QoL by 'Short Form 12' (SF-12). Patients had 10 sessions of the physiotherapy and rehabilitation program. Assessments were repeated 1 month later. RESULTS: The mean age 49.97 ± 11.15 years of 28 patients were included. While pre- and post-treatment between pain and functionality evaluation found a significant relationship (p< 0.05); there was no significant relationship in QoL (SF-12 p> 0.05). CONCLUSIONS: As a result while we found statistical differences between pain and symptomatic status; there were no statistical differences between functionality, daily living activities and QoL. Appropriate rehabilitation programs should be taken into consideration to help patients obtain functionality, daily living activities and QoL.

Lymphoedema functioning, disability and health questionnaire Turkish version: translation, cross-cultural adaptation and validation.

[Purpose] The purpose of this study was to adapt the Lymphoedema Functioning, Disability and Health Questionnaire into the Turkish language, and to evaluate the psychometric properties of the Turkish version in patients with breast cancer-related lymphedema. [Subjects and Methods] After the translation, inter-rater and test-retest reliability were assessed between patients and physiotherapists using the intra-class correlation coefficient. Thirty patients with breast cancer-related lymphedema were asked to fill out the Turkish version of the Lymphoedema Functioning, Disability and Health Questionnaire two times, one week apart. Internal consistency was tested using Cronbach's alpha, and the test-retest reliability was assessed by calculating the intra-class correlation coefficient. Construct validity was investigated by comparing the results of the Lymphoedema Functioning, Disability and Health and Short Form-36 questionnaires. [Results] The test-retest reliability and inter-tester reliability of the Lymphedema Functioning, Disability and Health Questionnaire total score, physical function score, mental function score, household activities score, mobility activities score, life and social activities score were excellent. [Conclusion] The Turkish version of the Lymphoedema Functioning, Disability and Health Questionnaire was found to be valid and reliable for patients with breast cancer related lymphedema.

[Flexor tendoplasty with a tendon prosthesis for zone II flexor tendon injuries]. / Zone II fleksör tendon yaralanmalarinda tendon protezi ile fleksör tendoplasti uygulamalarimiz.

OBJECTIVES: We evaluated two-staged flexor tendoplasty with tendon prosthesis in patients with flexor tendon injuries in which conventional tendon grafting would fail to yield an acceptable result. METHODS: We performed flexor tendoplasty with tendon prosthesis in 37 hands of 31 patients (24 males, 7 females; mean age 23 years; range 4-46 years). Twenty-six patients had penetrating injuries, four had occupational injuries, and one patient had an electric burn. Preoperatively, all patients were evaluated according to the Boyes' classification. At the first stage, a silicone prosthesis, 4-6 mm in diameter was placed according to the patient's age and the recipient bed; after 3 to 5 months, silicone prosthesis was removed and flexor tendoplasty with a tendon graft was performed. The results were calculated according to the Strickland's formula. The mean follow-up period after the second operation was 37 months (range 12-80 months). RESULTS: The results were excellent in 11 hands (Strickland 75-100%), good in 15 hands (50-74%), moderate in nine hands (25-49%), and poor in two hands (0-24%), with a mean of 58%. Tenolysis was performed in seven patients at least four months after the second stage. Removal of the tendon prosthesis was required in one patient because of infection. CONCLUSION: Satisfactory results can be obtained with two-staged flexor tendoplasty with a tendon prosthesis in patients with joint injuries restricting finger movements, digital nerve injuries causing trophic changes in the finger, and multiple tissue injuries.