Factors associated with balance ability in Duchenne and Becker muscular dystrophies.

BACKGROUND: Problems such as progressive muscle function loss, postural deteriorations, and contractures seen in patients with Duchenne and Becker muscular dystrophies (D/BMD) may affect children's balance ability, and impaired balance ability may lead to limitations in children's functional level. RESEARCH QUESTION: What factors are associated with balance ability in children with D/BMD? METHODS: Twenty participants with D/BMD were included in the study. Participants' ages were asked; height, body weight, and body mass index (BMI) were recorded. Children's functional level was assessed with the Motor Function Measurement-32 (MFM-32), Brooke and Vignos Scales. Muscle strength of hip flexion and extension, knee flexion and extension, and ankle dorsiflexion was measured with a handheld dynamometer. Balance measurements were performed using the Balance Master System. The relationship between balance and continuous independent variables was determined using Spearman's test. RESULTS: The mean age of the participants was 8.57 ± 3.27 years. The balance abilities of children with BMD were better than those of children with DMD (p < 0.05). The balance diminished with age (p < 0.05), while there was a positive correlation between balance and weight, height, BMI (p < 0.05). There was a positive correlation between the balance and the MFM-32 total and subsection scores. Muscle strength was positively related to balance (p < 0.05). SIGNIFICANCE: The results showed the balance ability in children with D/BMD was affected by age, height, weight, BMI, functional level, and muscle strength. Based on the results of this study, balance and strength training should be an integral part of the rehabilitation of children with D/BMD.

Functional level and its relationship to upper extremity function, pain, and muscle stiffness in children with Duchenne muscular dystrophy.

BACKGROUND: The progressive symptoms of Duchenne muscular dystrophy (DMD) negatively affect upper extremity skills, and this may have an effect that reduces the independence of daily life. AIMS: The purpose of this study is to investigate the relationship between functional level and upper extremity function, pain, and stiffness in children with DMD. METHODS: A total of 38 children with DMD were participated. The functional level of the upper and lower extremities was assessed using Brooke scale and Vignos scale. Upper extremity function, pain and stiffness were assessed using Upper Limb Short Questionnaire (ULSQ). The correlation between ULSQ and Brooke and Vignos scales was calculated. RESULTS: A moderate positive correlation was calculated between ULSQ total scores and Vignos scale (r = 0.52, p < 0.001) and Brooke scale (r = 0.65, p < 0.001). There was a moderate positive correlation between Vignos scale scores and ULSQ subscores of function (r = 0.42, p < 0.05) and stiffness (r = 0.56, p < 0.001); no significant correlation was found between pain scores and Vignos scale (p = 0.053). There was a moderate positive correlation between the function (r = 0.54, p < 0.001), pain (r = 0.40, p < 0.05), and stiffness (r = 0.62, p < 0.001) subscores of the ULSQ with the Brooke scale. CONCLUSION: In our study, there was a significant relationship between the functional level of patients with DMD and upper extremity function, pain, and muscle stiffness.

PLANTAR SENSATION AND BALANCE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH AND WITHOUT PERIPHERAL NEUROPATHY.

The aim of the study was to investigate the effect of diabetes on plantar sense and balance in patients with type 2 diabetes mellitus (T2DM). The study included 300 subjects divided into three groups: 100 T2DM patients with diabetic peripheral neuropathy (group 1); 100 T2DM patients without peripheral neuropathy (group 2); and 100 subjects without DM (group 3). Berg Balance Scale (BBS), Timed Up and Go test (TUG), single leg test with eyes open and closed, and plantar sensory tests were applied in the subjects. Study results showed significant differences in plantar sensory tests, BBS, TUG and single leg test among the three groups (p<0.05). In addition, duration of DM and medication were negatively correlated with single leg test both with eyes open and closed, but showed positive correlation with plantar sense and TUG test. Furthermore, the length of insulin therapy showed positive correlation with plantar sense and TUG test and negative correlation with BBS (p<0.05). In conclusion, DM has an effect on plantar sense and balance, and there is a relation between the duration of DM and balance problems. Balance problems are observed more often in patients with neuropathy.

Motivation and motivation-related factors in children with disabilities.

PURPOSE: Assessing motivation and motivation-related factors will contribute to a better understanding of motivation and the development of optimal rehabilitation conditions. The purpose of this study was to determine the motivation level and investigate the relationship of motivation level with socio-demographic characteristics (i.e., age, gender, comorbidities), functional level, and family satisfaction with rehabilitation centers in children with disabilities. METHODS: Sixty-two children with disabilities were included in the study, and the socio-demographic characteristics were recorded. Children were assessed by the Pediatric Motivation Scale (PMOT) and the Pediatric Functional Independence Measure (WeeFIM). Also, parents were asked to complete a questionnaire titled, "A patient satisfaction instrument for outpatient physical therapy clinics." RESULTS: The mean age of the children was 12.16 ± 3.19 years. Total PMOT and WeeFIM scores were found to be 93.71 ± 9.66 and 108.23 ± 22.14, respectively. There was a positive correlation between children's PMOT score and the satisfaction score of their families that was statistically significant (r= 0.602, p< 0.05). CONCLUSION: The level of family satisfaction with rehabilitation centers was found to be positively correlated with the motivation level of children. Improving family satisfaction with rehabilitation centers, potentially through modifying the physical conditions of rehabilitation centers and focusing on the interest of the family, may increase the motivation level of children, and thus may improve rehabilitation outcomes.

Exploring the Relationship of Pain, Balance, Gait Function, and Quality of Life in Older Adults with Hip and Knee Pain.

BACKGROUND: Musculoskeletal pain is a common problem in older adults and can result in disability and suffering. Uncontrolled pain leads to diminished quality of life (QoL) and places a great financial burden on the healthcare system. AIMS: The aim of this study was to explore the relationship of pain, balance, gait function, and QoL in older adults with hip and knee pain. DESIGN: This was a descriptive, correlational, and cross-sectional study. METHODS: The study included 111 older adults. Knee and hip pain was evaluated with a visual analog scale (VAS). Balance and gait functions were evaluated using the Timed Up-and-Go Test (TUG) and the Tinetti Balance and Gait Test (TBGT). Health-related QoL was evaluated with the Nottingham Health Profile (NHP). RESULTS: The TUG, pain, physical activity, and total NHP scores showed statistically significant differences between those with and without complaints of hip and knee pain (p < .05). Social isolation was more frequent in the older adults with knee pain (p < .05). Lower levels of performance were recorded in the TBGT for subjects with hip pain compared with those without hip pain (p < .05). CONCLUSIONS: Pain in the lower extremities can play an important role in the deterioration of QoL and loss of balance and gait function. Knee pain may affect gait performance and QoL more than hip pain. Nurses and physical therapists in nursing homes should have good knowledge of pain and regularly monitor undiagnosed pain conditions in the lower extremities of older adults.

Pain in adults with cerebral palsy: A systematic review and meta-analysis of individual participant data.

BACKGROUND: There is little focus on adults with cerebral palsy (CP) in research and health care and insufficient knowledge on how to identify and manage pain in this population. OBJECTIVES: This systematic review and meta-analysis aimed to determine whether pain prevalence in adults with CP is high and to explore variations in pain prevalence of subgroups, pain locations, pain severity and pain interference. METHODS: Potential datasets were identified by experts in the field and literature searches in Embase, MEDLINE, and Cochrane, from January 2000 to October 2016. Included studies had a representative sample of ≥25 adults with CP and ≥1 pain outcomes. Methodological quality assessment, pain prevalence estimates and logistic regression models for subgroup effects on pain prevalence were conducted. RESULTS: In total, 17 eligible studies were identified from 4584 publications. A meta-analysis was performed with individual participant data from 15 studies totalling 1243 participants (mean [SD] age 34.3 [12.6] years). Overall mean pain prevalence was 70% (95% CI 62-78). Women were more likely to have pain than men (P<0.001). The odds of pain was increased in adults with gross motor function level II (odds ratio [OR] 1.92, 95% CI 1.22-3.12) and IV (OR 1.77, 95% CI 1.03-4.29). Participants with pain reported pain predominantly in the legs (76%, 95% CI 66-84), and mean pain severity was 3.7/10 (95% CI 2.7-4.7) and pain interference 3.5/10 (95% CI 2.5-4.5). CONCLUSIONS: This meta-analysis provides the first reliable pain prevalence estimate in a large international sample of adults with CP. The high prevalence of pain, 70%, suggests that adults with CP should be routinely screened for pain and treated accordingly. The range of measurement instruments used by the included studies emphasizes using common outcome measures specific to pain internationally.

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

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

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

THE EFFECT OF BODY AWARENESS THERAPY AND AEROBIC EXERCISES ON PAIN AND QUALITY OF LIFE IN THE PATIENTS WITH TENSION TYPE HEADACHE.

BACKGROUND: This study is to investigate the effect of Body Awareness Therapy (BAT) and Aerobic Exercises on pain and quality of life in patients with Tension-Type Headache (TTH). MATERIALS AND METHOD: Sixty individuals with TTH diagnosis who referred Neurologist were incorporated into study. The individuals were randomly grouped into 3 as BAT (n=20), aerobic exercise (n=20) and control group (n=20). Pain severity of the individuals was evaluated by Visual Analog Scale (VAS) and pain diary, disability with ache; by Pain Disability Index (PDI) and Headache Impact Tests (HIT) and quality of life was evaluated by SF-36. Subsequent to first assessments, 3 sessions of 60 minutes per week throughout 6 weeks totally. RESULTS: When the groups were compared at the end of the study, a significant decrease was observed in VAS, PDI and HIT values in the individuals in the BAT and aerobic exercise groups. With the individuals in group BAT and aerobic exercise all parameters of quality of life were observed to be increased significantly. CONCLUSION: BAT and aerobic exercise programs to be applied on TTH patients were concluded to be important in decreasing the pain, in increasing the quality of life and in reducing pain-related daily constraints of the individuals.

The effect of foot plantar massage on balance and functional reach in patients with type II diabetes.

OBJECTIVE: The aim of this study was to investigate the effect of manual foot plantar massage (classic and friction massage) on functional mobility level, balance, and functional reach in patients with type II diabetes mellitus (T2 DM). METHODS: A total of 38 subjects diagnosed with T2 DM were included in the study. A healthy control group could not be formed in this study. After the subjects' socio-demographic data were obtained, Timed Up & Go (TUG) Test, functional reach test (FRT), one-leg standing test with eyes open-closed, and Visual Analogue Scale (VAS) to measure foot pain intensity were performed. The results were also divided and assessed in three groups according to the ages of the individuals (40-54, 55-64, and 65 and over). RESULTS: As a result of statistical analysis, a difference was found in the values obtained from TUG, FRT, and one-leg standing test with eyes open and closed (p < 0.05). Following the massage, TUG values significantly decreased comparison with those before the massage, whereas the values of FRT and one-leg standing test with eyes open and closed significantly increased compared with those before the massage (p > 0.05). According to age groups, there were statistical differences (p < 0.05) between the TUG, one-leg standing test with eyes open and closed test values of the individuals before and after the massage. CONCLUSIONS: The results of our study indicated that application of plantar massage to patients with T2 DM caused an improvement in balance, functional mobility, and functional reach values. An increase in body balance and functional mobility may explain the improvement in TUG. Foot massage to be added to rehabilitation exercise programs of DM patients will be important in improving balance and mobility of patients.

The effect of age and body mass index on plantar cutaneous sensation in healthy women.

[Purpose] This study was conducted to examine the effects of age and body mass index on plantar cutaneous sensation in healthy women. [Subjects and Methods] Two hundred and three healthy female volunteers over the age of 20 were included in the study. The statistical analyses were performed by considering the age and body mass index values of the individuals. The individuals were divided according to their ages and body mass index values. Foot pain was measured with a visual analogue scale and plantar cutaneous sensation using Semmes-Weinstein monofilaments. [Results] Fifty-six (27.5%) of the participants had normal weights, 67 (33%) were overweight, and 80 (39%) were obese. Statistical analysis revealed that as age and body mass index values increased, plantar sensitivity decreased and the frequency and severity of pain increased. [Conclusion] It is possible that healthy women may experience a decrease in foot plantar sensation with increasing weight and age. If women do not have any health problems, proprioception and sensory training must be focused on in order to prevent balance and falling problems.

The effects of Nintendo Wii(TM)-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acute stroke: a randomized controlled study.

OBJECTIVE: The aim of this study was to investigate the effects of Nintendo Wii(TM)-based balance and upper extremity training on activities of daily living and quality of life in patients with subacute stroke. METHODS: 42 adults with stroke (mean age (SD) = 58.04 (16.56) years and mean time since stroke (SD) = (55.2 ± 22.02 days (∼8 weeks)) were included in the study. Participants were enrolled from the rehabilitation department of a medical center (a single inpatient rehabilitation facility). Participants were randomly assigned to Nintendo Wii group (n = 20) or Bobath neurodevelopmental treatment (NDT) (n = 22). The treatments were applied for 10 weeks (45-60 minutes/day, 3 days/week) for both of two groups. Nintendo Wii group used five games selected from the Wii sports and Wii Fit packages for upper limb and balance training, respectively. The patients in Bobath NDT group were applied a therapy program included upper extremity activites, strength, balance gait and functional training. The functional independence in daily life activities and health-related quality of life was assessed with Functional Independence Measure (FIM) and Nottingham Health Profile (NHP), respectively. Participant's treatment satisfaction was recorded by using Visual Analogue Scale. A second evaluation (FIM and NHP) occurred after 10 weeks at the end of rehabilitative treatment (post-training). Treatment satisfaction was measured after 10 sessions. RESULTS: There were significant difference between FIM and NHP values in NDT and Nintendo Wii group (p < 0.05). However, a significant difference was not found between the groups with regard to FIM and NHP (p > 0.05). The patients in Nintendo Wii group were detected to be better satisfied from the therapy (p < 0.05). A significant difference was found between subparameters and total FIM score, all subparameters and total NHP score in both groups (p < 0.05). CONCLUSION: These findings suggested that the Nintendo Wii training was as effective as Bobath NDT on daily living functions and quality of life in subacute stroke patients.

Desire to have other children in families with a chronically disabled child and its effect on the relationship of the parents.

AIM: The aim of this study was to examine the desire of the parents who had a chronically disabled child to have other children and to investigate the effect of having a disabled child on the relationship of the parents. MATERIAL AND METHODS: The families of 145 chronically disabled children were included in the study. After the sociodemographic information belonging to the child and family were obtained, the prepared questionnaire form was used to interrogate if the parents lived together, the number of children in the family, if they wished to have other children and the relation of the disabled child with the household. Ethics committee approval was obtained from Dokuz Eylül University (date: 18.10.2012, decision number, 2012/34-13). The data obtained in the study were expressed as figures and percentages. RESULTS: While 91.7% of the parents continued their relationship, 2.8% were divorced and 1.4% were left by their spouses. The rate of the parents who did not wish to have (or did not have) other children after a disabled child was found to be 65.2%. The major reason for the families not to wish to have other children was found to be the fact that they thought they could not spare enough time for their disabled child. While 35.1% of the parents stated that clemped together more tightly, 35.2% stated that their concerns about the future increased further. Fifty eight percent of the parents stated that social relations and community involvements were not affected, whereas others stated that they were affected in different ways. CONCLUSIONS: Although the relationship between the parents was not affected to a great extent in families who had chronically disabled children, it was found that parents intensively experienced concern for the future. It was found that this also affected the desire of the parents who had a chronically disabled child to have other children with the concern that the child will be disabled.

Examination of the relationship between body mass index (BMI) and functional independence level in children with spina bifida.

OBJECTIVE: The aim of this study is to examine the relationship between body mass index (BMI) and functional independence level in children with spina bifida (SB). METHODS: The study included 116 children between 5 and 18 years. Subjects' socio-demographic characteristics, BMI values and functional independence levels were recorded. RESULTS: There was negative correlation between BMI and communication and social cognition in girls (p < 0.05). No correlation was found between BMI and WeeFIM in boys (p > 0.05). CONCLUSION: The results indicated that body weight in children with SB affected functional independency and that precautions to control weight important in these children.

Factors related to the impact of chronically disabled children on their families.

BACKGROUND: This study to investigated the effects of chronically disabled children (CDC) on their families. METHOD: The study included 655 CDD and their families from 45 cities located in Turkey representing the seven regions of the country. Sociodemographic characteristics, presence of mental retardation, primary care-giver, presence of social insurance, the number of other children and other family members living in the family, duration of the disorder, disabling conditions in the other children, time spent for care giving, and level of income were recorded. WeeFIM (Functional Independence for Children) and Impact on Family Scale (IPFAM) were administered to evaluate the level of functional independence and the overall burden on the families, respectively. RESULTS: IPFAM and WeeFIM scores were not different between geographical regions (P > 0.05). Functional independence level of the child and the level of education of the mothers were significant contributors to the disruption of social relations subscale of IPFAM (P < 0.05). WeeFIM score, presence of mental retardation, and income were significant contributors to general impact subscale. WeeFIM, mothers' level of education, and income were significant factors for the financial support subscale (P < 0.05). WeeFIM score, presence of mental retardation, mothers' level of education, and income also were found to contribute to the total impact subscale scores (P < 0.05). None of the evaluated factors were found to contribute to coping subscale of IPFAM (P > 0.05). CONCLUSION: Although some are expected, certain intriguing results, such as the impact of the mothers' literacy level, warrant further larger scale comprehensive studies to investigate the factors that contribute to the impact of CDC on their families. Also, policies that focus on family centered rehabilitation approaches should be encouraged in an effort to decrease the overall impact of CDC on families.

Examination of the relation between body mass index, functional level and health-related quality of life in children with cerebral palsy.

AIM: The aim of this study was to examine the relation between body mass index (BMI) and functional level and health-related quality of life in children with cerebral palsy (CP). MATERIAL AND METHODS: Two hundred seventy-eight children with CP aged between 2 and 18 years were included in the study. The sociodemographic properties of the children were recorded. Their functional independence levels were assessed with WeeFIM and their health-related quality of life levels were assessed with the Child Health Questionnaire-Parent Form (PF-50). Approval was obtained from the ethics committee of Abant Izzet Baysal University Medical Faculty for this study (Number: 2008/100-77). RESULTS: When classified by body mass index, 26.3% of the children had a normal body weight, 5.4% were overweight, 11.5% were obese and 56.8% had a low body weight. The rate of low body weight was higher in children with moderate and severe CP (52.7% and 53.8%, respectively), while the rate of obesity was higher in children with mild CP who could walk (7.1%). A significant difference was found in children with CP with a normal body weight, overweight children with CP, obese children with CP and children with CP with a low body weight in terms of the total WeeFIM score and the variables of quality of life including physical functionality and role/social limitations because of physical health (p<0.05). In the correlation analysis, a positive correlation was found between WeeFIM and BMI and the subdimensions of role/social limitations because of emotional or behavioral difficulties, pain and discomfort and self-esteem (p<0.05). CONCLUSIONS: Our results showed that BMI affected functional independence and health-related quality of life in children with CP and this was more prominent in children who had severe CP and low BMI values. More studies are needed in this area.

Comparison of Health-Related Quality of Life between children with cerebral palsy and spina bifida.

This study has two aims-the first is to compare the Health Related Quality of Life (HRQoL) between children with cerebral palsy (CP) and children with spina bifida (SB); the second is to investigate the relationship between HRQoL and age, sex, body mass index (BMI), level of ambulation, cooperation, family income and the mother's education level in both groups of children. The study included 96 children with CP and 70 children with SB (aged 5-18) who attended a physiotherapy and rehabilitation program at an institute of special training and rehabilitation. Socio-demographic information was obtained within the study. The Child Health Questionnaire (CHQ-PF50) was used to evaluate HRQoL. A significant difference was found in terms of age and BMI between children with CP and SB (p<0.05). HRQoL was lower for children with CP. There was a significant difference between the two groups in terms of role/social limitations - emotional behavioral, behavior, global behavior, parental impact-emotional and parental impact-time (p<0.05). A positive correlation was found between BMI and self-esteem in children with SB, unlike children with CP. The HRQoL of children with CP was lower than children with SB. The parameters of behavior and parental impact were particularly affected in the children with CP. Minimizing behavioral problems (which can improve with advancing age) of the children with CP and reducing parental impact are important for improving the HRQoL of both the child and parents. There is a need for further studies on this issue.

The Turkish version of the family impact of assistive technology scale: a validity and reliability study.

OBJECTIVE: The purpose of the current study is to estimate the preliminary measurement properties of the Turkish version of Family Impact of assistive technology scale (FIATS-tr). METHOD: The validity and reliability of the scale was performed in two phases. Phase I focused on construction of the Turkish version of the instrument and pilot testing. The scale was translated using the back-translation technique. The comprehensiveness and clarity of the scale was assessed with 20 participants. Phase II included psychometric assessment of the scale using a classical test theory approach. The final version of the scale was pretested with Turkish-speaking parents (46 mothers, four fathers and five caregivers) of 55 chronically disabled children. RESULTS: Test-retest reliability was found to be ICC = 0.931 (95% CI 0.881-0.960) for FIATS-tr total. Cronbach's alpha for the overall FIATS-tr was 0.858. Individual alpha values for FIATS-tr subscales ranged from 0.199 to 0.838. The FIATS-tr total was moderately correlated with the functional independence measure for children (WeeFIM) total (r = 0.688, p < 0.001). CONCLUSIONS: This study showed that overall FIATS-tr appears to have acceptable levels of validity and reliability when used to measure the functional impact of assistive devices. Further study of the constructs and homogeneity of its total and subscales may further improve the internal consistency, validity, and other measurement properties of the FIATS-tr.

The effects of Kinesio® taping on sitting posture, functional independence and gross motor function in children with cerebral palsy.

PURPOSE: The aim of this study was to investigate the effects of Kinesio® tape (KT) application on sitting posture, gross motor function and the level of functional independence. METHOD: The study included 31 cerebral palsied children scored as level III, IV or V according to gross motor functional classification system (GMFCS). Children were randomly separated into two groups as study (n = 15, receiving KT and physiotherapy) and control (n = 15, receiving only physiotherapy). KT application was carried out for 12 weeks. Gross motor function measure (GMFM), functional independence measure for children (WeeFIM) and Sitting Assessment Scale (SAS) were used to evaluate gross motor function, independency in the activities of daily living and sitting posture, respectively. RESULTS: Compared to initial assessments, both groups showed a significant difference in parameters of GMFCS sitting subscale, GMFCS total score and SAS scores (p < 0.05). At the end of 12 weeks, only SAS scores were significantly different in favour of the study group when the groups were compared (p < 0.05). Also, post-intervention WeeFIM scores of the study group were significantly higher compared to initial assessment (p < 0.05), however, no difference was detected in the control group (p > 0.05). CONCLUSIONS: No direct effects of KT were observed on gross motor function and functional independence, though sitting posture (head, neck, foot position and arm, hand function) was affected positively. These results may imply that in clinical settings KT may be a beneficial assistive treatment approach when combined with physiotherapy.

The relationship between physical, functional capacity and quality of life (QoL) among elderly people with a chronic disease.

The aim of this study was to evaluate the relationship between physical and functional capacity and quality of life (QoL) among elderly people who have a chronic disease. The study included 100 elderly individuals aged 65 years and older, who have a chronic disease. The study examined the marital and educational status, social security status, kind of chronic disease, number of chronic diseases and whether participants use assistive devices for walking. The Nottingham health profile (NHP) was used to evaluate QoL related to health; the physical mobility scale (PMS) was used to evaluate mobility in daily life and the functional independent measure (FIM) was used to evaluate functional independence in daily activities. In both female and male individuals, a statistically significant difference was found between the number of chronic diseases, kind of chronic disease, educational status, marital status, total FIM, PMS and NHP values (p<0.05). In males, there was a correlation between number of chronic illnesses and total NHP, FIM (p<0.05), but in females, there were no correlation between number of chronic illnesses and total NHP, FIM (p>0.05). There were no correlations between kind of chronic disease and PMS, NHP, FIM (p>0.05) in either of genders. It was found that there are differences among elderly female and male individuals with a chronic disease in terms of the number of chronic diseases, types of chronic disease, mobility level, functional status and QoL; and mobility level is related to functional capacity and QoL in females. It is thought that the rehabilitation programs to improve physical and functional capacity in elderly people and applications that increase participation in activities and reduce pain may improve QoL.

The effect of functional mobility and balance on health-related quality of life (HRQoL) among elderly people living at home and those living in nursing home.

The present study examined the effect of functional mobility and balance on HRQoL among elderly people living at home and those living in nursing homes. The study included 122 elderly people aged 65 and over. With regard to the individuals whose socio-demographic data were collected in the scope of the study, balance and functional mobility levels were evaluated using the timed up and go test (TUG) and Berg balance scale (BBS); HRQoL was evaluated using the Nottingham health profile (NHP); physical independence in daily activities was evaluated using the Barthel index (BI); and basic mobility in daily life was evaluated using the Rivermead mobility index (RMI). Statistically significant differences were found between the TUG, BBS and NHP values of the elderly people living in a home environment and those living in nursing homes (p<0.05). However, no statistically significant difference could be found between the BI and RMI values (p>0.05). A statistically significant relationship was found between the NHP and TUG, RMI, BI and the use of assistive devices in daily life activities (p<0.05). It is thought that the inclusion of functional mobility and balance training in elderly care and rehabilitation programs would be useful for the elderly people to develop functional independence and in increasing their HRQoL.