The Relationship Between Fatigue and Quality of Life in the Turkish Mothers of Children with Autism Spectrum Disorder.

This study aimed to investigate the different effects of fatigue and health-related quality of life in the Turkish mothers of children with autism spectrum disorder (ASD) through comparisons with mothers of typically developing children, and to evaluate the relationship between different aspects of maternal fatigue, depression, and maternal health-related quality of life. The study included a total of 103 mothers, comprising 60 mothers of children with ASD and 43 mothers of typically developing children. The Nottingham Health Profile and Quality of Life in Autism Questionnaire-Parent Version were used to assess the health-related quality of life. Fatigue was assessed comprehensively with the Fatigue Impact Scale and the Fatigue Severity Scale. The Nottingham Health Profile total and physical mobility domain and the quality of life were the strongest factors, explaining with a variance of 66.7% the fatigue impact on cognitive function. The mothers' quality of life accounted for 64.8% of the variance in factors that explained fatigue. Physical mobility, social isolation and quality of life were associated with the physical impact of fatigue and were explained with a variance of 52.4%. Emotional reactions and quality of life were explained with a variance of 52.7% in the fatigue of psychosocial function. The current study has highlighted that the fatigue of Turkish mothers of children with ASD has a greater impact on cognitive, physical and psychosocial functions. Furthermore, the quality of life, physical mobility, social isolation, and emotional reactions of mothers have a significant impact on maternal fatigue.

Effectiveness of Power Exercises Compared to Traditional Strength Exercises on Motor Skills, Muscle Performance and Functional Muscle Strength of Children with Attention Deficit Hyperactivity Disorder: A Single-Blind Randomized Controlled Trial.

The aim of this study was to compare the impact of 8-weeks of power exercises compared to traditional strength exercises on motor abilities, muscle performance, and functional strength in children with ADHD. A total of 34 children with ADHD were randomized into two groups to receive functional power training (n = 17, M age: 121.2 ± 16.6 months) and traditional strength training (n = 17, M age: 116.1 ± 13.4 months). After the 8-week intervention, two-way ANOVA results with 95% confidence intervals showed no differences between the groups in motor skills, muscle power, or functional muscle strength. However, the functional power training group had larger effect sizes and greater increases in total motor composite score (10% vs 7%), body coordination (13.8% vs 4.9%) and bilateral coordination (38.8% vs 27.9%) than the traditional strength training group. The power training group also exhibited catch-up growth with typically developing peers. These findings suggest that power exercises may be more effective than strength exercises for rapid force generation in daily life, particularly for children with ADHD.

Occupational performance and participation in children with developmental coordination disorders before and during Covid-19.

INTRODUCTION: Developmental coordination disorder (DCD) is a neurodevelopmental disorder that affects children's occupational performance and participation. It is known that the Covid pandemic has adversely affected the whole world in many areas. We aim to investigate the occupational performance and participation of children with DCD before and during the COVID-19. METHODS: Sixty-five children aged 5-12 years included in the study were assessed by the Canadian Measure of Occupational Performance and the Participation and Environment Measure for Children and Youth. RESULTS: Statistically significant differences were detected in occupational performance and satisfaction scores (p < 0.01). Additionally, except for 'involvement in the home environment' (p > 0.05), there were statistically significant differences in all other areas of participation (p < 0.01). CONCLUSION: The occupational performance and participation of children with DCD are impacted during COVID-19. In addition, it is seen that the desire of families to change regarding participation has increased due to COVID-19. It would be beneficial to include strategies to improve these areas in the rehabilitation processes.

The long-term impact of the COVID-19 pandemic on children with ADHD in terms of participation, support, and barriers at home.

PURPOSE: The purpose of this study was to compare the long-term impact of the COVID-19 pandemic on participation, support, and barriers at home in children with attention deficit hyperactivity disorder (ADHD) and without ADHD. DESIGN AND METHODS: This study included a total of 227 participants with a mean age of 11.93 ± 2.96 years, comprising 116 children and adolescents with ADHD and 111 without ADHD. The parents or primary caregivers of all the children completed the Participation and Environment Measure for Children and Youth (PEM-CY), which was used to assess participation and environmental factors in the home. The Student's t-test was used to compare numeric data and Chi-square test to categorical data between children and adolescents with ADHD and those without ADHD in all three settings. RESULTS: The children with ADHD were determined to play computer and video games significantly more than children without ADHD (p < 0.001). The mean frequency of participation in arts, crafts, music, hobbies (p < 0.001), school preparation (<0.0001), and homework (<0.003) was significantly higher in children without ADHD. A moderate effect size (ϕ = 0.42) was determined in respect of cognitive demands making it more difficult for children with ADHD to participate in home activities than children without ADHD. CONCLUSIONS: Children with ADHD were negatively affected in terms of participating in home activities than their typically developing peers. In addition, cognitive demands prevented their participation and involvement in the home environment while cognitive demands were a support for non-ADHD children. PRACTICAL IMPLICATIONS: A highlight of this research was the comprehensive investigation of the long-term effect of the COVID-19 pandemic on participation in all activities at home, in addition to the support and barriers in the home environment for children with ADHD compared to typically developing peers.

The effects of power exercises on body structure and function, activity and participation in children with cerebral palsy: an ICF-based systematic review.

PURPOSE: To systematically review the literature for evidence of effectiveness of power exercises on physical, physiological, and functional outcomes in children and adolescents with cerebral palsy (CP). MATERIALS AND METHODS: Methodological quality and evidence synthesis were assessed with using the Cochrane Risk of Bias (RoB) Tools and Modified Bakker Scale. Using the International Classification of Functioning (ICF), outcome measures for muscle agriculture, gait, balance, motor function, aerobic/anaerobic fitness, daily living, mobility, and school participation were categorised. RESULTS: The overall RoB of four randomised clinical trials was low, one had some concerns and two were rated as high. Moderate evidence was found that power exercises increased walking speed, activities of daily living, muscle strength, and enhanced gross motor function more than a routine physical therapy program. CONCLUSIONS: The lack of stronger evidence for power training interventions to improve muscle architecture, muscle function, walking capacity, and mobility in children with CP might be explained by the differences in training protocols and degree to which these meet the physiological definition of power, different methods of measuring power, limited durations of training, and the relative effectiveness of control interventions. Future studies should include a stronger focus on child and family-centred participation goals.Implications For RehabilitationPower training can improve gross motor function, walking speed, muscle strength, and activities of daily living more than routine physical therapy.Results comparing power training versus traditional strength training were less pronounced likely because both are intensive and may have positive effects.More research is needed to investigate effects of power training on participation.

Investigating the compatibility, interchangeability, and clinical usability of BOT2-BF and BOT2-SF in primary school-aged children with and without developmental dyslexia.

The aim of our study was to determine the sensitivity and specificity levels of BOT2-BF and BOT2-SF tests applied to children with developmental dyslexia and to examine their clinical usability. This study was designed as a case-controlled study. 82 (study group 41, control group 41) 7-12 year children were included. The study occurred three stages. In the first place, the similarities and differences of BOT2-BF and BOT2-SF tests observed in clinical practices were examined by taking the feedback of experts and test correlations. In the second step, BOT2-BF and BOT2-SF tests were examined with reference to the Core Outcome Set (COS) evaluation criteria. In the last step, in order to examine the sensitivity and specificity levels of the tests, assessments were performed in two groups with 1-week intervals. According to the COS results, the BOT2-BF test was examined better than the BOT2-SF test under cross-cultural validity title. The sensitivity and specificity of BOT2-SF were 0.92 and 0.51, and for BOT2-BF were 0.92 and 0.41, respectively. This study will help clinicians working on children with developmental dyslexia to decide the type of test they will use to evaluate and easy access to materials motor proficiency.

The relationship of motor development with sensory processing among infants born very preterm: a prospective case-control study.

BACKGROUND: Little is known about the relationship between sensory processing and motor development in very preterm infants. The purpose of this study was to explore the relationship of motor development with sensory processing among such infants with developmental delay and those who had typical development at the ages of 8 and 12 months. METHODS: This prospective case-control study included 61 preterm infants (31 males, 30 females, mean gestational age: 29.1 weeks). The infants had a gestational age of 32 weeks or less and a current corrected age of 8 months, and they had spent at least 15 days in the neonatal intensive care unit. Motor development was assessed with the Neuro-sensory Motor Developmental Assessment (NSMDA), and sensory processing was evaluated with the Test of Sensory Functions in Infants (TSFI). RESULTS: There were very strong positive correlations between the gross and fine motor scores of the NSMDA and the TSFI`s subdomain scores and total scores (r=0.85-0.93, p < 0.001). There were also very strong negative correlations between the functional level according to the NSMDA and the subdomain scores and total scores of the TSFI (r=-0.89-0.94, p < 0.001). CONCLUSIONS: The results show that sensory processing and motor development are related parts of the development of very preterm infants. In the early rehabilitation process, therapists should comprehensively take motor and sensory development into consideration.

Neuromotor and sensory development in preterm infants: prospective study.

AIM: To investigate the relationship between motor and sensory development in the first 4 months of life in preterm infants born at 32 gestational weeks and below. MATERIAL AND METHODS: The study consisted of 56 high-risk infants with a corrected age of 1 month who were born at 32 gestational weeks and stayed in the neonatal intensive care unit for at least 15 days. Neuro Sensory Motor Developmental Assessment and Infant Sensory Profile-2 were used for evaluation. These assessments were applied to preterm infants at the 1st and 4th months. The results of assessments were analyzed using the Wilcoxon test. The relationship between the results of motor and sensory assessments was analyzed using Spearman's correlation test. RESULTS: The mean gestational age of the infants was 29.58±2.09 weeks, their birth weights were 1233.87±251.22 grams, and their duration of stay in the neonatal intensive care unit was 26.48±9.58 days. There was a statistically significant difference between the Neuro Sensory Motor Developmental Assessment and Infant Sensory Profile-2 scores between the 1st and 4th months (p<0.05). It was found that there was a risk in terms of sensory development in 86-91% of the preterm infants at the 1st month and in 69-85% at the 4th month. There was moderate-strong degree of significant relationship between motor and sensory development. CONCLUSION: Considering the findings of our study, preterm infants are at risk for motor and sensory development. There is, therefore, a need for future research to investigate the effect of early sensory-based intervention approaches on preterm infants.

Are general movements at 3-5 months correlated and compatible with the Bayley-III at 1,5-2 years age?

Since early intervention is important in risky infants, it is also important to identify developmental problem as early as possible. There are various assessment methods for this. One of them is the General movements assessment (GMs), and the other one is the Bayley Scales of Infants and Toddler Developmental, third edition (Bayley-III). The present study aimed to compare the neurodevelopmental outcomes and Bayley-III scores at the age of 1.5-2 years with fidgety GMs. One hundred and twenty-six infants (57 females, 69 males) were assessed by the GMs at the corrected 3-5 months and also by the Bayley-III at the age of 1.5-2 years. According to the GMs, 21 infants exhibited the absence of fidgety movements, six infants exhibited abnormal fidgety movements, and 99 infants exhibited normal fidgety movements. According to the Bayley-III, 19 infants` motor scores, 13 infants` language scores, and 18 infants` cognitive scores were low (-2SD). Various neurodevelopmental problems were identified in 25.4% of the infants. As a result, although in the present study the Bayley-III underestimates the rates of motor impairment, it was found to be moderately compatible with the GMs at 3-5 months (r= 0.4, p < 0.001). However, the GMs were better than the Bayley-III in predicting neurodevelopmental outcomes at the age of 1.5-2. Although the Bayley-III and GMs may be valuable tools for estimating the later outcomes of infants, care should be taken while interpreting their results.

Combined Effects of Mirror Therapy and Exercises on the Upper Extremities in Children with Unilateral Cerebral Palsy: A Randomized Controlled Trial.

Purpose: This study investigated the combined effects of mirror therapy involving power and strength exercises of the upper extremities in children with Unilateral Spastic Cerebral Palsy (USCP).Methods: Thirty children were included in either an experimental group or a control group. All participants were evaluated with the Quality of Upper Extremity Skill Test (QUEST), Canadian Occupational Performance Measure (COPM), and a handheld dynamometer to measure isometric muscle strength.Results: Compared to the control group, greater improvement was found in dissociated movements (p < .001, d = 1.82), grasp (p < .001, d = 1.38), weight bearing (p = .006, d = 0.91), and total scores (p = .001, d = 1.16) of QUEST; performance (p < .001, d = 2.9), satisfaction (p < .001, d = 1.91), and total scores (p < .001, d = 2.87) of COPM; and isometric muscle strength of the biceps brachii (p < .001, d = 1.27) and triceps brachii (p = .002, d = 2.22) of the affected upper limbs in the experimental group.Conclusions: Mirror therapy combined with power and strength exercises is a promising intervention approach to improve activity performance and upper-limb function in children with USCP.

Examination of touch-coordinate errors of adolescents with unilateral spastic cerebral palsy at an aiming-tapping task.

BACKGROUND/OBJECTIVE: This study aimed to investigate performance (touch-coordinate errors, inter-touch interval) of touch screen technology in adolescents with unilateral spastic cerebral palsy (USCP) and healthy peers. MATERIALS AND METHODS: This prospective case-control study included 31 adolescents. The participants consisted of 15 adolescents with CP in the USCP group and 16 age-matched healthy peers in the control group. All participants performed an aiming-tapping task with an Android tablet. Four sessions were randomly applied: visual feedback (VF) and no VF with the dominant hand's index finger (DHF), and VF and no VF with the non-dominant hand's index finger (NDHF). Inter-touch interval (ITI) and touch-coordinate errors (TCE) were calculated. RESULTS: There were significant differences between the groups for VF and no VF-NDHF TCE and ITI (respectively p= 0.001, p= 0.01, p= 0.001, p= 0.004) and VF and no VF-DHF TCE values (respectively p= 0.01, p= 0.008). When comparing the dominant and non-dominant hand in the USCP group, there was a significant difference on TCE with no VF (p= 0.01). CONCLUSION: This study provided insight into the touch screen performance of adolescents with USCP, who performed an aiming-tapping task with a tablet. Results showed that both affected and unaffected hand performance of touch screen tasks was impaired in adolescents with USCP.

Agreement between parents and clinicians on the communication function levels and relationship of classification systems of children with cerebral palsy.

BACKGROUND: Functional classification systems have generally been used by clinicians and recently by parents to classify various functions of children with cerebral palsy (CP). OBJECTIVE: This study evaluated the agreement between clinicians and parents when classifying the communication function of children with CP using the Communication Function Classification System (CFCS). In addition, the relationships between the Gross Motor Function Classification System - Expanded and Revised (GMFCS-E&R), the Manual Ability Classification System (MACS), and CFCS were investigated. METHODS: This study was a cross-sectional study and included 102 children aged 4-18 years with CP and their parents. The parents and clinician classified the communication of children by using the Turkish language version of CFCS. Furthermore GMFCS-E&R and MACS were used for classification only by the clinician. RESULTS: The weighted Kappa agreement between CFCS results of the parents and clinicians was 0.95 (95% CI 0.95-0.96, p < 0.001). GMFCS-E&R levels were highly correlated with CFCS levels (r = 0.78 (95%CI 0.68-0.84, p < 0.001)). MACS and CFCS results were also highly correlated (r = 0.73 (95%CI 0.63-0.81, p < 0.001). CONCLUSION: The child's communication was classified as indicating higher functioning by the parents compared with the clinicians. The excellent agreement between parents and clinicians with the Turkish language version of CFCS for children with CP indicated that parents and clinicians could use the same language while classifying the communication function of children.

Is there any difference between high-risk infants with different birth weight and gestational age in neurodevelopmental characters?

AIM: This study is aimed to investigate differences between cognitive, language and motor development of high-risk infants related to birth weight and gestational age. MATERIAL AND METHODS: One hundred sixty high-risk infants who were born 32 weeks, 1 500 gr and below included in this study. According to corrected age, 58 infants were 1 month, 72 were at 4 months, 82 were at 8 months and 65 were 12 months old. Infants were seperated two groups according to gestational age <30 weeks and 30-32 weeks and birth weight ≤1 000 gr and 1 001-1 500 gr. Infants motor development were assessed with Bayley-III Infant and Toddler Development Motor Scale (Bayley-III) and Neuro Sensory Motor Developmental Scale (NSMDA), cognitif and lanuage development were Bayley-III cognitive and Language scales. Assessments were applied by the same physiotherapist at 1 month, 4 months, 8 months and 12 months old infants in corrected age. Mann-Whitney U Test, 2 x 2 Chi-Square test ve Fisher's exact tests were used to compare group data. Statistical significance was determined p<0.05. RESULTS: Cognitive, motor and language developments were in normal ranges in all infants. There were no statistical differences in cognitive, language and motor development between groups (p>0.05). CONCLUSION: Results of this study showed that the motor, cognitive and language development were normal in all high risk infants and power gestational age and birth weight did not affect these parametes.

Agreement between parents and clinicians for the motor functional classification systems of children with cerebral palsy.

PURPOSE: This study aimed to evaluate whether parental ratings of expanded and revised Gross Motor Function Classification System (GMFCS E&R) and Manual Ability Classification System (MACS) had agreement with clinicians' ratings when classifying children with CP to these two well-known classifications of motor functioning and hereby to evaluate intertester reliability of the classification systems between clinicians and parents. METHOD: The process of study was designed to collect data from parents using the GMFCS E&R and MACS. The total participants consisted of 100 children with CP and their parents. The overall agreement between the parents and physiotherapist GMFCS and MACS scores was analysed using intraclass correlation coefficient (ICC). RESULTS: The ICC value between parents and physiotherapist was 0.96 (95% confidence interval [CI] 0.95-0.97) for GMFCS and 0.96 (95% CI 0.94-0.97) for MACS and indicated excellent agreement. CONCLUSIONS: The excellent agreement between parents and clinicians indicated that parents and clinicians can talk in the same language for the motor functional classification systems of children with CP if careful administrations are provided.

The results of early physiotherapy on a child with incontinentia pigmenti with encephalocele.

This study aimed to exhibit the effects of early physiotherapy and discusses post-treatment results on a patient with incontinentia pigmenti (IP) with encephalocele. Physiotherapy evaluations of the child included cognitive, fine and gross motor development assessed with the Bayley Scales of Infant and Toddler Development - Third Edition (Bayley-III), disability level with the gross motor function classification system, gross motor function with the gross motor function measurement (GMFM), and tonus evaluation with the Modified Ashworth Scale. The child was included in a physiotherapy and rehabilitation programme based on neurodevelopmental treatment three times a week. Although cognitive and motor development according to Bayley-III improved in the present case, motor and cognitive retardation became more apparent with growth. GMFM results indicated a large improvement from 5.88% to 47.73%. Presentation of this case shows the significance of early physiotherapy in this first study on physiotherapy for IP during the early rehabilitation process.

Do the physiotherapy results make us happy in a case with 'happy puppet' (Angelman) syndrome?

This study aimed to investigate the benefits of physiotherapy programme in a patient with Angelman syndrome (AS) during a follow-up of 3 years. Assessments included: disability level with gross motor function classification systems, gross motor function with gross motor function measurement (GMFM), balance with Berg Balance Scale, motor performance with gross motor performance measurement (GMPM) and tonus assessment with Modified Ashworth Scale. Physiotherapy programme was performed during 36 months, 3 days per week by physical therapist according to Neurodevelopmental Treatment approach. During the 36 months, GMFM increased from 11.46% to 70.82% and GMPM increased from 1.25% to 70.25%. This case report is the first study about the effectiveness of physiotherapy with medium-term follow-up in a child with AS. Physiotherapy results make us happy in this particular patient with 'happy puppet' syndrome.