Impact of stroke on people that receive rehabilitation and are living in Ankara, Turkey.

Background: Clinical guidelines for stroke rehabilitation and practices vary between high and low/middle-income countries (LMICs). Knowledge of the perceived impact of stroke in Turkey is limited. Understanding these perceptions can serve as a basis for developing rehabilitation. Design and methods: The aim was to investigate and compare the perceived impact of stroke in two groups of people living in Ankara. A cross-sectional study with 150 participants divided by stroke onset (Group I: stroke onset <12 months; Group II: >12 months) was conducted. The Barthel Index was used to describe the level of independence in daily living activities and stroke severity. The Stroke Impact Scale (SIS 3.0) was used to investigate the perceived impact of stroke. Results: The proportion of mild strokes was 78 and 82%, respectively, and 46% of participants in the total sample were moderately dependent. The impact of stroke was high; mean domain scores were below 50 in six of the eight SIS domains. Conclusions: Turkish stroke survivors perceived a higher impact of stroke regardless of the time passed since stroke onset, compared to survivors from other countries, including other LMICs. The high impact among survivors with mostly mild stroke indicates that Turkish survivors might not receive adequate rehabilitation. The content of rehabilitation services needs to be developed, and an evaluation of individually tailored interventions, preferably with a multidisciplinary approach, is warranted to find ways to decrease the perceived impact of stroke among Turkish stroke survivors.

Evaluation of psychometric properties of Turkish version of assessment of work performance among adults with mild intellectual disabilities.

BACKGROUND: Assessment of work performance (AWP) is a test for assessing work performance and can be utilised in matching person-work and applying effective interventions. It was aimed to adjust and to evaluate the validity and reliability of AWP in Turkish with individuals with mild intellectual disability (ID). METHODS: The study was conducted with 243 individuals with mild ID. Of the 243 participants, data gathered from 105 individuals was used to conduct exploratory factor analysis (EFA) and remaining data (138 individuals) was used to conduct confirmatory factor analysis. Internal consistency, construct validity, test-retest reliability, criterion-related validity and inter-rater reliability were analyzed. RESULTS: The AWP showed average to good reliability for individuals with mild ID. The construct validity and internal consistency of the AWP were confirmed with satisfying results; test-retest reliability (ICC >0.92) and inter-rater reliability (ICC >0.90) were excellent for all domains. The EFA resulted three factors, explaining 66.46% variance; and CFA resulted average fit. CONCLUSION: AWP is valid and reliable for evaluating the working performances of individuals with mild ID.

Where Exactly Is the Therapist in Virtual Reality and Game-Based Rehabilitation Applications? A Randomized Controlled Trial in Children with Specific Learning Disability.

Objective: Children with specific learning disability (SLD) experience problems in visual perception that influence academical skills and activities of daily living. Virtual reality and game-based rehabilitation applications are becoming increasingly popular in rehabilitation, including visual perception rehabilitation. However, the usage of commercially available and easily accessible games as intervention tools raises the question whether rehabilitation conducted with these games is really rehabilitation, or just casual gameplay. Therefore, we aimed to investigate the effects of a nonactively supervised (game-based intervention program [GIP]) and an actively supervised (therapist guided game-based intervention program [TGGIP]) on the visual perception skills of children with SLD. Materials and Methods: This study was designed as a single-blind randomized, controlled trial of a TGGIP on visual perception skills in children with SLD compared with the self-oriented, nonsupervised program (GIP). A total of 138 children with SLD participated in the study and were randomly divided into two groups (TGGIP and GIP). Children's visual perception skills were assessed with Motor-Free Visual Perception Test-3. Results: Both groups showed significant improvements in visual perception after the intervention programs (P < 0.05). However, the TGGIP (a supervised and structured intervention program) was significantly more effective in improving the visual perception skills compared with the GIP (a standard, nonsupervised, and unstructured intervention program) (P < 0.05). Conclusion: We think that the TGGIP methodology that we designed acts as a facilitator for therapists in using trademarked, commercially available, and easily accessible games for structured and supervised virtual reality and game-based rehabilitation applications.

Effects of vocational rehabilitation group intervention on motivation and occupational self-awareness in individuals with intellectual disabilities: A single blind, randomised control study.

BACKGROUND: The aim of this study was to investigate the effects of a vocational rehabilitation group intervention on motivation and occupational self-competence in individuals with intellectual disability. METHODS: A single-blind, randomised controlled study design was used. The intervention group (IG) received the group-based intervention alongside the individualised vocational rehabilitation (IVR) and the control group (CG) continued receiving only the IVR for 8 weeks. In order to assess motivation and occupational self-competence, Objective Achievement Motivation Test (OLMT) and Occupational Self-Assessment (OSA) were used. RESULTS: Forty-nine individuals were enrolled to the study and randomised into IG (n = 24) and CG (n = 25). Two groups were similar at baseline in terms of demographic qualities, OLMT and OSA scores (p > 0.05). After the intervention, the IG showed significant improvements in all assessments (p < 0.05), however the CG showed improvements only in OLMT sub-tests (p < 0.05). CONCLUSIONS: The group-based intervention program was effective in increasing occupational self-competence and motivation.

Vestibular activities and participation measure: Turkish validity and reliability.

BACKGROUND: International Classification of Functioning, Disability and Health (ICF) has an important role in rehabilitation in terms of assessments. In the field of vestibular rehabilitation, Vestibular Activities of Participation (VAP) measure is the first assessment developed in a perspective of ICF. OBJECTIVE: It was aimed to adapt cross-culturally and analyze psychometric properties of VAP into Turkish Language. METHODS: The VAP was translated into Turkish language by the authors and back translated by a blind native English speaker. The final version was applied to 310 participants. Internal consistency was analyzed with Cronbach's alpha and test-retest reliability analyzed with Intraclass Correlation coefficient (ICC). Validity of the scale investigated with Exploratory and Confirmatory Factor analysis (EFA and CFA). RESULTS: Cronbach's alpha reliability coefficient was found 0.94, and the reliability of the subscales ranged from 0.75 to 0.95; ICC was found 0.94. VAP resulted 8-factor structure and explained 88%of the total variance. In CFA (χ2) / df ratio shows good agreement with 2.472 and the goodness of fit indices of TLI (0.814), CFI (0.893) and RMSEA (0.075) showed acceptable fit. CONCLUSIONS: This study showed that VAP-Turkish version is valid and reliable in Turkish speaking populations, and might be used to determine impact of vestibular disorders on activities and participation.

Assessment of Participation within the International Classification of Functioning, Disability, and Health (ICF): The Turkish Validity and Reliability of the Participation Scale.

OBJECTIVE: The aim of the study was to investigate the reliability and validity of the Turkish version of the Participation Scale (P-Scale). METHODS: A total of 152 students, with a mean age of 20.27 ± 2.19, participated in the study. Sociodemographic information (age, gender, and family income) was recorded; all participants completed the P-Scale twice with a 15-day interval. Translation and cross-cultural adaptation were performed to analyze the validity and reliability of the P-Scale. Cronbach's alpha and McDonald's alpha were used for scale reliability statistics and explanatory (EFA) and confirmatory (CFA) factor analysis; Mardia's multivariate normality and assumption tests were used for the validity of the scale. The factor extraction methods were minimum rank factor analysis in EFA and weighted least squares mean and variance adjusted estimator polychoric correlation matrix in CFA. RESULTS: Internal consistency of the scale was found good with Cronbach's alpha (0.852) and excellent with McDonald's alpha (0.924). The EFA and CFA resulted in two-factored structure, with the explained variance found to be higher than 30%. CONCLUSIONS: Analysis demonstrated that the P-Scale had a satisfactory level of reliability and validity in Turkish university students.

Cross-Cultural Adaptation, Reliability, and Validity of a Turkish Version of the Work Rehabilitation Questionnaire (WORQ-Turkish).

Purpose The Work Rehabilitation Questionnaire (WORQ) is an instrument based on the International Classification of Functioning Vocational rehabilitation core set. The aim of this study was to analyze the validity, reliability and cross-cultural adaptation of the WORQ to Turkish and evaluate its psychometric properties. Methods The cross-cultural adaptation and translation procedures were conducted following Beaton's guidelines. The test-re-test reliability was examined by Spearman Brown Coefficient (split half analysis), internal consistency was examined by Cronbach's alpha. Criterion related validity of the WORQ was determined by Beck Depression Inventory using Pearson correlation coefficient and known group differences regarding age, gender, work and educational levels using one-way ANOVA and t test. Construct validity was examined by confirmatory factor analysis using AMOS. Results Two hundred and fifty-seven participants with disabilities were included to the study from seven different provinces of Turkey. The WORQ-Turkish showed excellent internal consistency (0.906), good test-retest reliability (0.811), and good construct validity (good model fit indices). Criterion related validity analysis showed medium correlations between WORQ and Beck Depression Inventory (p < 0.001), however there were no statistical significant differences regarding known group parameters (p > 0.05). Conclusions In this study, the cross-cultural adaptation, and validity and reliability of WORQ-Turkish self-reported version were examined and the results indicated that WORQ-Turkish was a valid and reliable scale for analyzing vocational rehabilitation process of people with disabilities.

The Effects of Virtual Reality on Motor Functions and Daily Life Activities in Unilateral Spastic Cerebral Palsy: A Single-Blind Randomized Controlled Trial.

Aim: This study was designed to investigate the effects of virtual reality (VR) through Kinect on both gross and fine motor functions and independence in daily living activities in children with unilateral spastic cerebral palsy (USCP). Materials and Methods: This study was designed as a single-blind, randomized, controlled trial. Sixty children with USCP were randomized and split equally between the VR intervention group (10 females and 20 males with a mean age of 10.5 ± 3.62 years) and the traditional occupational therapy (TOT) intervention group (13 females and 17 males with a mean age of 10.06 ± 3.24 years). Both groups were evaluated in terms of motor functioning via the Bruininks-Oseretsky Test of Motor Proficiency-Short Form (BOTMP-SF) and were assessed in accordance with independence in daily activities via the WeeFunctional Independence Measure (WeeFIM). Interventions were conducted for 8 weeks with the main objective of improving motor functions and independence in daily activities. Results: Total motor functions and total independence in daily lives in both groups improved after 8 weeks of intervention. A comparison between groups revealed significantly greater improvements in both gross and fine motor functions and daily activities in the VR group than in the TOT group (P < 0.001). Conclusion: The Kinect-based VR intervention approach is important to improving motor functions and independence in daily activities of children with USCP.

Effectiveness of the virtual reality on cognitive function of children with hemiplegic cerebral palsy: a single-blind randomized controlled trial.

Cerebral palsy is a term covering non-progressive motor and cognitive impairments caused by lesions of the brain. This study aims to evaluate the effectiveness of virtual reality-based rehabilitation program for children with hemiplegic cerebral palsy on cognitive functions. Ninety children (47 boys, 43 girls) with hemiplegic cerebral palsy were randomized to either study (n = 45; 11.18 ± 3.37 years) or control (n = 45; 11.06 ± 3.24 years) groups. The study group received virtual reality intervention in addition to Traditional Occupational Therapy intervention, and the control group received Traditional Occupational Therapy for 20 sessions. Both groups were evaluated by blinded assessors with Dynamic Occupational Therapy Cognitive Assessment for Children to collect information on cognitive functioning. Both groups' cognitive functions were improved after 10 weeks of interventions. The between-group comparison revealed significantly greater improvements in all subtest of cognitive functions in the virtual reality group than in the Traditional Occupational Therapy group (P < 0.001). Our results showed that 10 weeks of virtual reality-based rehabilitation enhanced cognitive functions in children with hemiplegic cerebral palsy. Using virtual reality applications in cognitive rehabilitation was recommended to improve spatial perception, praxis, visuomotor construction and thinking operations in children with cerebral palsy.

The effect of two different aerobic training modalities in a child with spinal muscular atrophy type II: a case report.

This study examined the effect of two different aerobic training modalities in a boy with spinal muscular atrophy type II. Motor functions were measured with Hammersmith Functional Motor Scale (HFMS) and Gross Motor Function Measure (GMFM). Spirometry was utilized for assessing pulmonary functions and PedsQL 3.0 Neuromuscular module was utilized for quality of life of child. Ergometer training was applied 3 times per week for the duration of 12 weeks. After 6 weeks of wash-out period, aquatherapy was applied for twice a week for the duration of 12 weeks. HFMS and GMFM scores, and pulmonary functions of the child and quality of life scores of his parents were improved during both modalities. These improvements were largely maintained during 1-year follow-up. This study showed that both modalities had similar effects on our case's pulmonary, motor functions and quality life of himself and parents. It will be a guide for researchers working in the area of children with neuromuscular disorders regarding plan and diversification of therapy program.

Cross-cultural adaptation, reliability, and validity of the Turkish version of the Cancer Fatigue Scale in patients with breast cancer

Background/aim: The Cancer Fatigue Scale (CFS) was developed to evaluate the severity of fatigue in patients with breast cancer. The aim of this study is to translate and culturally adapt a Turkish version and investigate the validity and reliability of the CFS in Turkish patients with fatigue symptoms. Materials and methods: Eighty participants completed the Turkish version of the CFS for breast cancer and the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire ″Core 30″ (EORTC QLQ-C30). Test-retest reliability was evaluated by repeating the CFS with a 7-day interval. Results: The CFS demonstrated high test-retest reliability (ICC = 0.95) and good internal consistency (Cronbach's alpha = 0.74) for all domains. The Kaiser-Meyer-Olkin measure of sampling adequacy was found to be 0.819, which is considered to be satisfactory (>0.5). Correlations between domains of CFS physical and EORTC physical (r: 0.77), CFS cognitive and EORTC cognitive (r: 0.70), and CFS physical and EORTC fatigue (r: 0.80) were found to be significant. Conclusion: The Turkish version of the CFS is a reliable and valid instrument to assess physical, effective, and cognitive dimensions of fatigue. The CFS may be used to evaluate the severity of fatigue in Turkish-speaking breast cancer patients.

Do hand outcome measures reflect cultural influences?

OBJECTIVE: The aim of this study was to compare the activities listed in DASH, MHQ, QuickDASH with the activities listed in Canadian Occupational Performance Measure (COPM) in a Turkish patient population with hand injury. METHODS: COPM questionnaire was administered to 163 participants (61 male and 102 female; mean age 40.72 ± 13.70 years). The activities that were stated in COPM were categorized and checked whether they were present in DASH-T, MHQ, QuickDASH. RESULTS: The highest rated stated activities were "carrying a heavy object" (39.2%), "cleaning the house" (25.7%) and "writing" (15.9%). DASH reflects 30% whereas MHQ and QuickDASH reflect 16.32% and 10.2% of the problematic activities, respectively. CONCLUSION: None of three questionnaires have satisfactory results for reflecting the problematic activities among hand injured Turkish people. Open ended interviews should be irrevocable part of assessment process in order to describe a person-center treatment program.