An investigation of sensory processing skills in toddlers with joint hypermobility.

BACKGROUND: Children with Generalized Joint Hypermobility (GJH) may have a motor developmental delay in the early period and subluxation, fatigue, autonomic dysfunction, and pain arising from ligaments and other soft tissues in advanced ages. Additionally, there is a loss of proprioceptive sensation in children and adults with GJH. AIMS: This study aimed to evaluate sensory processing skills in toddlers with GJH. STUDY DESIGN: A cross-sectional study. SUBJECTS: Fifty-eight children aged between 12 and 14 months were included in the study. These children were divided into two groups: with and without GJH (31 with GJH and 27 without GJH). OUTCOME MEASURES: The sensory processing skills of the children in the study were evaluated with the Test of Sensory Functions in Infants (TSFI). RESULTS: The scores in the subtests of TSFI in response to tactile deep pressure, adaptive motor functions, visual-tactile integration, and response to vestibular stimuli were higher in favor of children without GJH (p < 0.05). The total TSFI score was higher in the group without GJH (p < 0.05). CONCLUSIONS: Sensory processing problems were found in toddlers with GJH. Sensory motor development should be evaluated in children with GJH, and an appropriate early intervention program should be planned.

The relationship between home environment affordances and motor development and sensory processing skills in premature infants.

The availability of stimulating materials in the home environment is of great importance to optimizing an infant's development. This study, which has a cross-sectional study design, was conducted to examine the relationship between home environment conditions and equipment support and the motor development and sensory processing skills of premature infants. Children born premature, aged 10-16 months, were included in the study. Motor development was evaluated with the Peabody Motor Development Scale-2, and sensory processing skills were evaluated with the Test of Sensory Function in Infants. The Affordances in the Home Environment for Motor Development-Infant Scale was used to evaluate the home environment. A total of 51 premature infants were included in the study. It was determined that there was a significant relationship between physical space, stimulus variety and fine motor toys in the home environment and Peabody Motor Development Scale-2 gross motor and fine motor development scores. It was also shown that there was a relationship between the tactile and total scores of the Test of Sensory Function in Infants Scale and the variety of stimuli in the home environment and gross motor toy scores. These findings show that the opportunities provided in the home environment of premature infants may be related to their motor development and sensory processing skills. Consequently, the home environment may be associated with experiencing movements and sensory experiences.

An investigation of computer-game addiction, physical activity level, quality of life and sleep of children with a sibling with a chronic condition.

BACKGROUND: It is known that chronic condition also affects siblings without chronic illness. Healthy siblings of children with a chronic condition and aged 9-14 years and healthy children with a sibling without chronic illness and their parents were included in the study. AIM: The aim of our study was to examine the internet-game addiction, physical activity, quality of life and sleep in children with a sibling with chronic condition and compare them with their peers with a healthy sibling. METHODS: Computer game addiction, physical activity, sleep quality and quality of life were evaluated respectively by Computer Game Addiction Scale for Children, Child Physical Activity Questionnaire, Children's Sleep Disorder Scale and Children's Quality of Life Scale. RESULTS: While the mean age of 75 children with chronically ill siblings was 10.65 ± 1.59 years, the mean age of 75 healthy children with healthy siblings was 10.46 ± 2.09 years. It was observed that children with a sibling with a chronic condition were more tend to computer-game addiction, had lower sleep quality, lower quality of life in terms of school functionality and psychosocial health compared to children with a healthy sibling (p < 0.05). CONCLUSIONS: It was revealed that in families with children with a chronic condition, siblings with no health problems should also be evaluated in psychosocial terms and supported by appropriate approaches, such as to increase the level of physical activity.

Breaking barriers: exploring physiotherapists' willingness and challenges in embracing telerehabilitation in a developing country.

INTRODUCTION: Telerehabilitation (TR) is an innovative approach that can address the limited availability and restricted access to rehabilitation services, particularly during challenging times such as pandemics and natural disasters. This study focuses on understanding the desires, perceptions, and barriers that physiotherapists face when implementing TR in a developing country. METHOD: The study was conducted with 219 physiotherapists residing in a developing country using a web-based survey on Google Docs. RESULT: The findings revealed that a significant majority of physiotherapists (88.1%) recognized TR as a potential solution for individuals with physical problems during the pandemic. Additionally, 89.5% expressed satisfaction with the opportunity to receive consultations from different hospitals, indicating a positive perception of TR. However, the study also highlighted certain barriers that hindered the implementation of TR. Around 40.2% of physiotherapists reported having training deficiencies, suggesting a need for educational support in utilizing TR effectively. Furthermore, the analysis of demographic factors revealed interesting insights. It was noteworthy that the age and years of experience of physiotherapists had an impact on their willingness and adoption of TR. CONCLUSION: The study reveals that physiotherapists in the developing country exhibit a positive attitude towards TR and recognize its potential benefits. However, various barriers, such as training deficiencies, need to be addressed to facilitate a broader adoption of TR in their practices. Overcoming these barriers is anticipated to heighten physiotherapists' readiness to embrace TR, ultimately enhancing the accessibility and delivery of rehabilitation services.

Using the center of pressure movement analysis in evaluating spontaneous movements in infants: a comparative study with general movements assessment.

BACKGROUND: Researchers have attempted to automate the spontaneous movement assessment and have sought quantitative and objective methods over the past decade. The purpose of the study was to present a quantitative assessment method of spontaneous movement using center-of-pressure (COP) movement analysis. METHODS: A total of 101 infants were included in the study. The infants were placed in the supine position on the force plate with the cranial-caudal orientation. In this position, the recording of video and COP movement data were made simultaneously for 3 min. Video recordings were used to observe global and detailed general movement assessment (GMA), and COP time series data were used to obtain quantitative movement parameters. RESULTS: According to the global GMA, 13 infants displayed absent fidgety movements (FMs) and 88 infants displayed normal FMs. The binary logistic regression model indicated significant association between global GMA and COP movement parameters (chi-square = 20.817, p < 0.001). The sensitivity, specificity, and overall accuracy of this model were 85% (95% CI: 55-98), 83% (95% CI: 73-90), and 83% (95% CI: 74-90), respectively. The multiple linear regression model showed a significant association between detailed GMA (motor optimality score-revised/MOS-R) and COP movement parameters (F = 10.349, p < 0.001). The MOS-R total score was predicted with a standard error of approximately 1.8 points (6%). CONCLUSIONS: The present study demonstrated the possible avenues for using COP movement analysis to objectively detect the absent FMs and MOS-R total score in clinical settings. Although the method presented in this study requires further validation, it may complement observational GMA and be clinically useful for infant screening purposes, particularly in clinical settings where access to expertise in observational GMA is not available.

Validity and reliability of the Turkish version of the hand-use-at-home questionnaire for children with unilateral cerebral palsy and neonatal brachial plexus palsy.

PURPOSE: To translate the Hand-Use-at-Home questionnaire (HUH), assesses the amount of spontaneous use of the affected hand in children with 18 bimanual activities, into Turkish and examine its validity and reliability on children with neonatal brachial plexus palsy (NBPP) or unilateral cerebral palsy (UCP). MATERIALS AND METHODS: The HUH was translated and cross-culturally adapted to Turkish and administered to children with NBPP (n = 25) and UCP (n = 42) between 3 and 10 years. The psychometric analyses included reliability by internal consistency (Cronbach's alpha) and test/retest reliability (intraclass correlation coefficient, ICC) structural validity was evaluated with exploratory factor analysis, and construct validity was investigated by matching the HUH with the Pediatric Outcome Data Collection Instrument Upper Extremity Scale (PODCI) (NBPP only), and Children's Hand-Use Experience Questionnaire (CHEQ) (UCP only). RESULTS: HUH showed excellent test-retest reliability (ICC2,1 = 0.988 Cl (0.977-0.992)), excellent internal consistency (Cronbach's-α = 0.989), and moderate correlation with CHEQ (rs = 0.558) in UCP and high correlation with PODCI Scale (rs = 0.789) in NBPP group. The HUH had low and moderate correlation respectively lesion-extent levels (r=-0.457) in NBPP and 5 Manual Ability Classification System levels (r=-0.688) in the UCP group. CONCLUSION: The HUH is a valid and reliable tool to assess the amount of spontaneous use of the affected hand in Turkish children with NBPP and UCP.

The Hand-Use-at-Home (HUH) questionnaire is a reliable and good valid outcome measure to evaluate the amount of spontaneous use of the affected hand.We suggest the Turkish version of the HUH be used in the Turkish children to indicate small changes in the severity of disorder of children until a normal quality of life is achieved.The HUH can be used with high reliability and validity by experienced and inexperienced doctors and physiotherapists.

Short-term effects of SAFE early intervention approach in infants born preterm: A randomized controlled single-blinded study.

OBJECTIVE: Recent literature suggests that goal-oriented and family-based interventions in enriched environment have a beneficial effect on neuromotor and cognitive development. We aimed to examine the short-term effects of SAFE (Sensory strategies, Activity-based motor training, Family collaboration, and Environmental Enrichment) early intervention approach on motor, cognitive, speech and language, and sensory development in preterm infants. METHODS: The study's sample population consisted of 24 preterm infants with corrected ages between 9 and 10 months. Infants in the control group participated in the family training program in accordance with the neurodevelopmental therapy principles (NDT). Infants in the treatment group were included in the family training program according to the principles of the SAFE Early Intervention Approach. Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS), Test of Sensory Functions in Infants (TSFI), Canadian Occupational Performance Measure (COPM), and Bayley Scales of Infant and Toddler Development III (Bayley III) were used to evaluate infants in both groups before and after 10 weeks of treatment (AHEMD-IS). The Depression, Anxiety, Stress Scale Short Form was used to assess the parents' mental health (DASS-SF). RESULTS: The interaction effects (time × group) revealed significant differences for Bayley-III cognitive and language scores, TSFI total score, and AHEMD-IS total score in favor of the SAFE group (p < .05). However, there were no differences in Bayley-III motor composite score, COPM Performance score, and COPM Satisfaction score between the interaction effects (time × group) of the groups (p > .05). CONCLUSIONS: SAFE early intervention approach improved cognitive, speech and language, sensory outcomes and provide enriched home environment in all domains when compared to NDT-based home program. SAFE is a promising novel early intervention approach for preterm infants.

An investigation of motor development and sensory processing skills in infants with a history of hyperbilirubinemia.

BACKGROUND: Hyperbilirubinemia is a clinical picture frequently occurring in the neonatal period and may negatively affect the development of infants. AIMS: To evaluate term infants with hyperbilirubinemia in terms of both motor development and sensory processing skills and to compare them with their healthy peers without hyperbilirubinemia. STUDY DESIGN: A cross-sectional study. SUBJECTS: Children born at term, aged 10-18 months, with and without a history of hyperbilirubinemia were included in the study. OUTCOME MEASURES: After demographic information was recorded, motor development was evaluated with the Peabody Motor Development Scale-2 and sensory processing skills were evaluated with the Test of Sensory Function in Infant. RESULTS: A total of 42 children (mean ± SD age of the children 13.07 ± 1.47 months, 22 with hyperbilirubinemia and 20 without hyperbilirubinemia) were included in the study. A statistically significant difference was found in the gross motor (p = 0.02), fine motor (p = 0.03), and total motor (p = 0.017) development scores of the Peabody Motor Development Scale-2 and in the adaptive motor functions (p = 0.004), visual tactile integration (p < 0.001), and total scores (p = 0.004) of The Test of Sensory Function in Infant in favor of the control group. CONCLUSIONS: The motor and sensory processing skills of children born at term with hyperbilirubinemia may be negatively affected. Infants with hyperbilirubinemia should be evaluated from the early period not only in terms of motor but also sensory processing skills and should be supported with appropriate intervention programs.

Turkish validity and reliability of the level of sitting scale in children with cerebral palsy.

BACKGROUND: The Level of Sitting Scale (LSS) is a valid and reliable classification index that categorizes sitting ability. The aim of this study is to establish the Turkish validity and reliability of the LSS in children with cerebral palsy (CP). METHODS: In total, 165 children (75 girls and 90 boys) between the ages of 4 and 18 years who were diagnosed with CP were included in the study. All children were evaluated by two independent physiotherapists for the interrater reliability analysis of the LSS and were reevaluated 1 week later by the same physiotherapist for the intrarater reliability analysis. The Gross Motor Function Classification System (GMFCS) was used for validity analysis. RESULTS: The intrarater reliability analyses of the LSS showed an intraclass correlation coefficient of 0.999 (ICC 95% CI [0.999-1]),and the interrater reliability analyses showed an intraclass correlation coefficient of 0.998 (ICC 95% CI [0.998-0.999]). A statistically significant, negative, and strong correlation was found between the GMFCS and the LSS (p < 0.001, r = -0.770). DISCUSSION: The Turkish version of the LSS in children with CP is a valid and reliable scale. The Turkish LSS can be used by researchersand clinicians in research and to determine the sitting level of children with CP.

Validity and reliability of the Turkish version of the parent perceptions of physical activity scale.

BACKGROUND: The Parent Perceptions of Physical Activity Scale (PPPAS) is a scale developed to measure the physical activity perceptions of parents of children with neurodevelopmental disorders about their children. Turkish version of the PPPAS has yet to be established. The purpose of the present study is to examine the validity and reliability of the Turkish version of the PPPAS. METHODS: The study included 130 parents with neurodevelopmental children. In the validity analyses of PPPAS, language validity, content validity analysis, and confirmatory and explanatory factor analysis were performed for construct validity. In the reliability analyses, Cronbach alpha analysis was used for internal consistency analysis, and intraclass correlation (ICC) analysis was used for test retest. RESULTS: The validity index was calculated as 0.94. Since the factor loading of the three questions in the survey remained below 40%,these questions were removed. Construct validity was achieved for two primary subscales of the PPPAS. It was found that the ICC valuesfor the reliability analysis of the PPPAS showed a perfect fit at the level of 0.918 for the benefits of the physical activity subdimension, and the physical activity barriers subdimension showed a perfect fit at the level of 0.916 (p = 0.001). DISCUSSION: The Turkish PPPAS, which consists of two subscales, namely the benefits and barriers of physical activity, is valid and reliable. This tool can measure the physical activity perceptions of parents with preschool-age children with neurodevelopmental disorders in the Turkish population.

Examination of foot sensations in children with generalized joint hypermobility.

BACKGROUND: Generalized joint hypermobility (GJH) is a condition that can be observed in children and children with GJH may have problems such as clumsiness, proprioceptive sensory loss, balance and coordination disorders. AIMS: To evaluate foot and ankle senses in children with GJH and compare them with their healthy peers. STUDY DESIGN: A cross-sectional study. SUBJECTS: Children aged 5-14 years with and without GJH were included in the study. OUTCOME MEASURES: After assessing the joint hypermobility of the children with the Beighton Score, tactile, vibration, two-point discrimination, and proprioception senses were evaluated. RESULTS: A total of 40 children (15 females, 25 males, mean age 9.43 years, SD ± 2.98 years, 20 with GJH and 20 without GJH) were included in the study. In children with GJH, foot sole tactile sense and ankle dorsiflexion and plantar flexion joint position sense were deficient in comparison with healthy controls (p < 0.05). CONCLUSIONS: There were deficiencies in foot and ankle tactile and proprioceptive senses in children with GJH. Neurosensorimotor examination of balance and coordination should be performed and appropriate intervention programs should be planned accordingly in children with GJH.

Turkish Translation/Cultural Adaptation and Psychometric Analyses of the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS).

In this study we translated the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) into Turkish, adapted the instrument culturally, examined its psychometric properties within a Turkish population, and identified its limitations. We administered the AHEMD-IS to families of 65 premature or full-term Turkish infants and repeated this testing for 17 families after one-two weeks to establish test-retest reliability. We calculated the Intraclass Correlation Coefficient (ICC) and Cronbach alpha coefficient to assess reliability, and we evaluated test validity using the Spearman's correlation coefficient and correlations with the Bayley-III motor development score. The Cronbach Alpha coefficient of the questionnaire was 0.846, and, for test-retest reliability, the ICC score was 0.830. The Turkish AHEMD-IS total score was moderately correlated with the Bayley-III fine motor development score (r = 0.469, p < 0.001), the Bayley-III gross motor development score (r = 0.533, p < 0.001), and the Bayley-III total motor development score (r = 0.526, p < 0.001). The Turkish version of the AHEMD-IS was found to be valid and reliable for children born prematurely or at full-term. The use of this questionnaire in Turkey will facilitate the creation of a home environment that will support motor development in children between 3-18 months of age.

Investigation of the effectiveness of family collaborative physiotherapy programs applied to high-risk infants.

BACKGROUND: The inclusion of families in intervention programs for infants may be more effective in ensuring adherence and positive outcomes. Approaches that include natural and enriched environments that provide communication and family interaction are important in the rehabilitation of high-risk infants. OBJECTIVE: To compare the effectiveness of Family Collaborative Approach (FCA) and Neurodevelopmental Therapy (NDT)-based family training. METHODS: High-risk infants (n = 63) with a mean age of 32.60 ± 4.53 months received early intervention for 12 weeks. Prechtl's General movements (GMs) assessment, Hammersmith Neonatal Neurological Examination (HNNE), Hammersmith Infant Neurological Examination (HINE), BAYLEY-III Scales of Infant and Toddler Development, and Third Addition (BSID-III) were performed. RESULTS: Significant differences between groups were found in HINE scores at the 3rd, 6th, and 12th months (p ≤ .028), and in BSID-III scores at the 6th month (cognitive, language, and motor) (p < .001) and the 12th month (language) (p = .031). There was significant difference between NDT and control group in 3rd month HINE scores and Reflex&Reactions scores (p ≤ .021). FCA group and NDT group was significantly different from control group in 6th month HINE (p = .032) and 12th month HINE scores (p = .007). FCA group significantly different from NDT group (p ≤ .002) and control group (p < .001) in 6th month BSID-III cognitive, language, and motor scores. There was significant difference between FCA and control group in 12 month BSID-III language scores (p = .024). CONCLUSIONS: Early physiotherapy interventions were effective in high-risk infants and FCA program was superior to NDT.

Oropharyngeal Dysphagia in Children with Eosinophilic Esophagitis.

Dysphagia is the most troublesome symptom of eosinophilic esophagitis (EoE). This study aimed to investigate oropharyngeal dysphagia in children with EoE and possible related factors. Children with a definite diagnosis of EoE were included in the study. Medical and feeding histories were recorded. A disease control level was determined for each child. An oral structure examination, the Turkish version of the Mastication and Observation Evaluation (T-MOE), the Pediatric version of the Eating Assessment Tool-10 (PEDI-EAT-10) and the 3-oz water swallow test were applied in screening for oropharyngeal dysphagia. Fifty-two children participated in the study. Oropharyngeal dysphagia took the form of abnormal swallowing (PEDI-EAT-10 score ≥ 4) and increased aspiration risk (PEDI- EAT-10 score ≥ 13) in 51.9% and 25.0% of the children, respectively. Seven children failed the 3-oz water swallow test. Abnormal swallowing and aspiration risk were significantly higher in children with prolonged mealtimes, impaired chewing function, and uncontrolled disease (p < 0.05). Chewing function was the most important risk factor for abnormal swallowing and increased aspiration (R2 = 0.36, R2 = 0.52, p < 0.001, respectively). Oropharyngeal dysphagia is common in children with EoE and associated with increased aspiration risk in a subpopulation. Uncontrolled disease, prolonged mealtimes, and impaired chewing function may provide clues for oropharyngeal dysphagia in EoE.

The effects of different procedures on pain levels in preterm and term infants in neonatal intensive care unit: a cross-sectional survey of pain assessment in newborns.

BACKGROUND: Newborns show a series of behavioral and physiological reactions to painful stimuli. AIMS: The current study aimed to determine the effect of different procedures on the pain levels of newborns in the Neonatal Intensive Care Unit (NICU). METHODS: One hundred ninety-six newborns with gestational age (GA) of 23-40 weeks, birth weight (BW) between 2235 ± 911 g were included. Painful procedure (PP) (vascular access (VA), heel prick (HP), umbilical catheter (UC), orogastric catheter (OC), and intubation (I)) were recorded. Pain during the PP was evaluated with Neonatal Infant Pain Scale (NIPS). Pulse and O2 saturation were recorded before (BP), during (DP) and after (AP) procedure. RESULTS: NIPS total scores were found to be significantly higher with term infants (p < 0.05). When NIPS total scores were compared according to the type of PP, significant difference was observed between groups (p = 0.000). Positive correlation was found between birth week (p = 0.000, r = 0.364), BW of infants and NIPS total score (p = 0.000, r = 0.371), pulse values of DP and NIPS total score (p = 0.000, r = 0.386). Negative correlation was found between O2 saturation values DP and the NIPS total scores (p = 0.000, r = -0.405). CONCLUSIONS: It is concluded that as GA and BW increase, so do the pain responses of the infant, which showed that the pain thresholds of term-preterm infants are different, and decrease as GA and BW increase.

Effects of progressive functional ankle exercises in spastic cerebral palsy, plantarflexors versus dorsiflexors: a randomized trial.

Background/aim: Children with cerebral palsy (CP), even those who have very mild impairment, have lower muscle strength than their typically developing peers. The ankle dorsiflexors (DFs) and plantarflexors (PFs) of children with CP are especially weak. Weakness in the ankle muscles causes problems in functional skills, mobility, and balance in spastic CP (SCP). The aim of this study was to investigate the effects of progressive functional exercises (PFEs) on the DF, PF, or dorsi-plantar flexor (DPF) muscles in children with SCP, specifically, the functional mobility, balance, and maximum voluntary contraction (MVC), and compare the effects of strengthening these muscles individually or combined. Materials and methods: This randomized trial was conducted between December 1st, 2018, and May 15th, 2019, at Gazi University, Department of Physiotherapy and Rehabilitation. Randomly assigned into groups were 27 independently ambulant patients with unilateral/bilateral SCP, where PFEs were applied to the DF, PF, or DPF muscles. Muscle tone, balance, and functional mobility were assessed. The MVC was evaluated by surface electromyography. PFEs were performed 4 times a week, for 6 weeks. Results: The spasticity of the PF muscles decreased in all of the groups. PFE of the DF muscles led to an increase in ankle joint range of motion (ROM) and improved functional mobility (p < 0.05). PFE of the PF muscles resulted in improvements in balance and functional mobility (p < 0.05). PFE of the DPF muscles brought about improvements in balance but not in functional mobility (p < 0.05). No significant difference in the MVC was observed in any of the groups (p > 0.05). Conclusion: Gains are obtained according to the function of a muscle group. By training the DF muscles, it is possible to improve function and ROM. Furthermore, training the PF muscles led to improvements in balance and functional mobility, indicating that it is possible to bring about positive changes in spastic muscles. This study showed that muscle groups must be exercised according to the intended goal.

Rasch analysis, reliability, and validity of the Turkish version of the Lumbar Spine Instability Questionnaire.

Background/aim: Lumbar instability is an important condition that can be seen frequently in people with low back pain, affecting both the progression and the choice of appropriate exercise. The Lumbar Spine Instability Questionnaire (LSIQ) is a simple and low-cost tool for evaluating disturbed back stability in people with low back pain. The aim of this study is to develop the Turkish version of the LSIQ (LSIQ-T) and to evaluate its psychometric properties using the Rasch model. Materials and methods: One hundred participants with chronic low back pain completed the LSIQ-T. The LSIQ-T was repeated for 30 participants after 1 week to establish its test-retest reliability. While internal and external construct validity were investigated using Rasch analysis and the Spearman correlation coefficient, respectively, reliability was evaluated in terms of internal consistency by Cronbach's alpha and the Person Separation Index (PSI). Results: All items of the LSIQ-T were found to fit the Rasch model (chi-square: 34.07 (df = 15), p = 0.0033). The internal construct validity was good, the overall mean item fit residual was 0 (SD: 0.765), and the mean person fit residual was 0.322 (SD: 1.123). Internal consistency reliability was low with a PSI of 0.63 although Cronbach's alpha was acceptable (0.68). When the test-retest reliability was examined via differential item functioning (DIF) by time, none of the items showed DIF. Conclusion: The LSIQ-T is a valid unidimensional scale for the Turkish population. Although the LSIQ-T had low internal consistency, it demonstrated unidimensionality and is appropriate for use. Therefore, the LSIQ-T can be used in clinical practice and scientific research.

An investigation of body awareness, fatigue, physical fitness, and musculoskeletal problems in young adults with hypermobility spectrum disorder.

BACKGROUND AND OBJECTIVES: Hypermobility Spectrum Disorder (HSD) is associated with excessive joint range of motion and the presence of musculoskeletal symptoms. The objective of this study was to examine body awareness, physical fitness parameters, fatigue levels, and musculoskeletal disorders in young adults with HSD and compare them with those without HSD. METHODS: Young individuals in the age range of 18-24 years were included in the study. Joint hypermobility of individuals was determined by the Beighton Score. Evaluations were made using the Body Awareness Questionnaire, the Fatigue Severity Scale, the Eurofit Physical Fitness Test Battery, and the Cornell Musculoskeletal Discomfort Questionnaire. RESULTS: A total of 94 healthy individuals (74 females, 20 males, mean age 21.44 years, SD ± 1.19 years), 47 with HSD and 47 without HSD, were included in the study. It was concluded that body awareness and fatigue levels were similar in two groups (p > 0.05). When physical fitness parameters were examined, there was a significant difference between the two groups in Sit and Reach test and the dominant side grip strength (p < 0.05). There was a significant difference between the two groups in the neck, back, dominant wrist, and total musculoskeletal problems (p < 0.05). CONCLUSION: It was concluded that young individuals with HSD had more flexibility, lower grip strength, more pain especially in the neck and back region, and more musculoskeletal disorders in general. Joint hypermobility is a factor to be considered in evaluating functional performance in these individuals.

Reliability and validity of the Turkish version of Fullerton Advanced Balance Scale in cerebral palsy.

BACKGROUND: The Fullerton Advanced Balance Scale (FAB) is a multi-item balance assessment test designed to measure balance in relatively higher functioning individuals. The aim of this study was to examine the reliability and validity of the Turkish version of the FAB (FAB-T) in children with cerebral palsy (CP). RESEARCH QUESTION: Is the Turkish version of the Fullerton Advance Balance Scale valid and reliable in determining balance problems in children with cerebral palsy and determining the underlying cause of this condition? METHODS: Forty-six children with CP participated in this study. Rasch analysis was used to investigate item adherence. Internal consistency of the FAB-T was established using Cronbach's alpha coefficient. Test-retest reliability was also evaluated. In addition, to assess concurrent validity, FAB-T scores were compared with the Pediatric Balance Scale (PBS) using the Spearman correlation coefficient. RESULTS: The FAB-T showed satisfactory internal consistency (Cronbach's alpha value=0.94) and excellent test-retest reliability (ICC=0.99). The FAB and the PBS exhibited concurrent positive validity (r = 0.913; p < 0.001). All items of the FAB-T were found to fit the Rasch Model (Chi-square 16.01(df=20), p = 0.716). SIGNIFICANCE: The FAB-T is a reliable and valid tool that can be used to measure balance skills and to identify the source of the problem in children with CP.

The acute effects of different hamstring muscle stretching techniques on reducing muscle resistance to movement by ultrasound elastography.

OBJECTIVE: Many stretching methods are applied on the hamstring muscles for reducing muscle resistance on movement. The aim of our study to investigate the acute effects of static stretching and the Mulligan traction straight leg raise (TSLR) technique administered to the hamstring muscles on reducing its resistance to movement. METHODS: The study included 22 healthy male volunteers (19.5 ± 0.98 years). After the individuals were randomly divided into two groups, static stretching was administered to the hamstring muscles in the first group and the Mulligan TSLR technique was administered on the same muscle in the second group. Active knee extension angles of the individuals were evaluated by a digital goniometer and muscle strain was assessed by ultrasound elastography. RESULTS: While there was a significant difference in all parameters in both groups after the treatment, the changes in the active knee extension angle and the strain index value of the biceps femoris musculotendinous junction were higher in the Mulligan TSLR group compared to the static stretching group (p < 0.05). CONCLUSION: It was concluded that, static stretching and the Mulligan TSLR technique administered to the hamstring muscles are effective ways to increase the range of motion. The Mulligan TSLR technique, however, can be opted in healthy individuals and patients since it is painless and more effective in reducing muscle resistance to movement and range of motion.