Evaluation of Informative Content on Cerebral Palsy in the Era of Artificial Intelligence: The Value of ChatGPT.

AIMS: In addition to the popular search engines on the Internet, ChatGPT may provide accurate and reliable health information. The aim of this study was to examine whether ChatGPT's responses to frequently asked questions concerning cerebral palsy (CP) by families were reliable and useful. METHODS: Google trends were used to find the most frequently searched keywords for CP. Five independent physiatrists assessed ChatGPT responses to 10 questions. Seven-point Likert-type scales were used to rate information reliability and usefulness based on whether the answer can be validated and is understandable. RESULTS: The median ratings for reliability of information for each question varied from 2 (very unsafe) to 5 (relatively very reliable). The median rating was 4 (reliable) for four questions. The median ratings for usefulness of information varied from 2 (very little useful) to 5 (moderately useful). The median rating was 4 (partly useful) for seven questions. CONCLUSION: Although ChatGPT appears promising as an additional tool for informing family members of individuals with CP about medical information, it should be emphasized that both consumers and health care providers should be aware of the limitations of artificial intelligence-generated information.

Inter-rater agreement of the Turkish version of the Neurobehavioral Rating Scale-Revised form.

OBJECTIVES: This study aims to adapt the Neurobehavioral Rating Scale-revised form (NBRS-R) for Turkish traumatic brain injury (TBI) patients and to investigate the inter-rater agreement of the Turkish revised scale. PATIENTS AND METHODS: A total of 45 patients (36 males, 9 females; mean age 31.1±13.0 years; range 18 to 60 years) with TBI were included in this study between September 2013 and August 2014. A semi-structured interview was set up for Turkish patients using a multidisciplinary approach (physiatrist, psychiatrist, neurologist and psychologist) with the participation of four rehabilitation centers. Questions were prepared for each of the 29 items, based on the recommendations of the original NBRS-R form. Four different interviewers from the four centers applied this form to a total of 45 TBI patients. RESULTS: The items evaluated by intra-class correlation coefficient showed satisfactory stability and the reliability of the items ranged from moderate to very good. CONCLUSION: The NBRS-R form can be suggested to provide a reliable and easily reproducible evaluation method of neurobehavioral deficits in TBI patients who speak Turkish.

Fever during rehabilitation in patients with traumatic spinal cord injury: analysis of 392 cases from a national rehabilitation hospital in Turkey.

OBJECTIVE: To determine the incidence and etiology of fever and the risk factors related to fever in adults with spinal cord injury (SCI) at the rehabilitation stage. DESIGN/SUBJECTS: A retrospective examination of records of 392 consecutive adult patients with traumatic SCI who received inpatient rehabilitation program. SETTING: A national rehabilitation center in Turkey. OUTCOME MEASURES: Incidence and etiology of fever, period of hospitalization (days). RESULTS: A total of 187 patients (47.7%) had fever at least once during their rehabilitation program. The most common etiology was urinary tract infection. The rate of fever occurrence was significantly higher in patients with complete SCI (P = 0.001). In patients with fever, the use of an indwelling catheter was significantly higher compared with clean intermittent catheterization and spontaneous voiding (P = 0.001). The hospitalization period of patients with fever was significantly longer than that of patients without fever (P = 0.006). CONCLUSIONS: A high rate of fever was seen in patients with SCI during rehabilitation. Fever was caused by various infections, of which urinary tract infection was the most common. Patients with motor complete injuries and those with permanent catheters constituted higher risk groups. Fever prolonged the length of rehabilitation stay and hindered active participation in the rehabilitation program.

Feeding and gastrointestinal problems in children with cerebral palsy.

The aim of our study was to identify feeding and gastrointestinal system (GIS) problems in children with cerebral palsy (CP), and to evaluate the relationship between these problems and the severity of CP. A total of 120 children with CP were enrolled consecutively into the study (67 males, 53 females; mean age: 6.0±2.4 years; range: 2-12 years). The children were classified according to the Swedish classification as diplegic, hemiplegic, or quadriplegic. Severity of CP was classified based on the Gross Motor Function Classification System. The amount of time that the caregiver allocated to mealtimes, modifications of the food, as well as feeding and GIS problems was evaluated. Feeding dysfunction was classified as mild, moderate, or severe. Comparisons of GIS and feeding disorders and the severity of CP were carried out using χ test. The results indicated lack of appetite in 46 of the 120 children (38.3%), sialorrhea in 37 (30.8%), constipation in 30 (25%), difficulty in swallowing in 23 (19.2%), and feeding dysfunction in 26 (21.7%). On the basis of the Gross Motor Function Classification System (GMFCS), the incidence of GIS problems and feeding dysfunction was found to be significantly higher in the children classified in the severe group. The time taken to consume meals was significantly longer among children with feeding dysfunction. Feeding and GIS problems are frequent in children with CP, and more marked in those with severe CP. Approximately one fourth of children with CP suffer from feeding dysfunction, and more time has to be allocated to consume meals.

Effects of ideomotor apraxia on functional outcomes in patients with right hemiplegia.

The aim of this study was to investigate the effect of ideomotor apraxia on activities of daily living and to determine if the presence of apraxia interferes with rehabilitation. This study was conducted on 47 patients with right hemiplegia. All the patients were assessed at their admission and discharge, respectively, for apraxia by Ideomotor Apraxia Test, for daily living activities by Functional Independence Measure (FIM, Santa Clara Valley Medical Center, San Jose, California, USA), for cognitive functions by Mini Mental State Examination (MMSE), and for language components by Gulhane Aphasia Test (GAT). The effects of apraxia presence and time course on FIM, MMSE, and GAT scores were investigated. Presence of apraxia was found to have significant effect on all test scores (P<0.05). Time course had the main significant effect on FIM, MMSE, and GAT scores (P<0.05). Interaction effect of both presence of apraxia and time course on the test scores was not significant either. In other words, apraxic and nonapraxic patients seemed to gain benefits from the neurological rehabilitation. However, mean FIM scores of apraxic patients during discharge have failed to reach the mean FIM scores of nonapraxic patients during admission. Apraxia is considered as an important determinant in the dependence of patients with stroke in their activities of daily living. For this reason, during the initial assessment of patients with right hemiplegia, apraxia should be tested, and the presence of apraxia as well as its severity should be determined.

Risk factors and clinical profiles in Turkish children with cerebral palsy: analysis of 625 cases.

The aim of the study was to investigate risk factors, clinical profiles and gross motor function levels of Turkish children with cerebral palsy (CP). A total of 625 consecutive children with CP, who were rehabilitated in the pediatrics rehabilitation clinic between 2000 and 2004 years, were included. Factors causing CP were investigated by interviewing the families and by scanning medical files. Risk factors were recorded as consanguineous marriage, maternal disorder, preterm birth, birth asphyxia, low birth weight, multiple pregnancy, neonatal convulsion, kernicterus, postnatal central nervous system infection and brain injury. Swedish classification was followed in CP typing. Of 625 children with CP, 370 (59.2%) were males and 255 (40.8%) were females, with ages ranging between 2 and 13 years (the mean age was 5.11+/-2.19 years). It was determined that 47.8% of the cases were spastic diplegic CP, 27.7% were spastic tetraplegic CP, 12.8% spastic hemiplegic CP and 11.7% were other types (ataxic, dyskinetic and mixed CP types). The most frequently encountered risk factors were low birth weight (45.1%), preterm birth (40.5%), birth asphyxia (34.6%) and consanguineous marriage (23.8%). Low birth weight, preterm birth, birth asphyxia and consanguineous marriage were top-ranked risk factors that were determined in Turkish children with CP. Compared with other countries, consanguineous marriage is still an important problem in Turkey.