Association of Urinary Incontinence with Sensory-Motor Performance in Women with Multiple Sclerosis.

INTRODUCTION AND HYPOTHESIS: The relationship between somatosensory and motor components of urinary incontinence in individuals with MS has not been extensively addressed. The study was aimed at investigating the association of urinary incontinence severity with motor and sensory performance in women with multiple sclerosis (MS). METHODS: A cross-sectional single-center prospective study was conducted in 337 women with MS. The severity of MS symptoms was assessed using the SymptoMScreen questionnaire. The urinary incontinence status of the participants was evaluated using the Urinary Incontinence Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7). Physical performance was considered with the Timed Up and Go (TUG) test and the 5-Times Sit-to-Stand (5TSTS) test. In addition, the sensory performance of the individuals with MS was queried using the Somatosensory Amplification Scale (SSAS) and Sensory Sensitivity Scale (SeSS). RESULTS: The UDI-6 (r=0.685, p<0.05) and IIQ-7 (r=0.759, p<0.05) correlated highly with SymptoMScreen. Among the physical performance measures, TUG (r=0.012, p<0.05) and 5TSTS (r=0.096, p<0.05) were weakly associated with UDI-6, but not statistically significantly. Similarly, there was a low correlation between IIQ-7 and TUG (r=-0.005, p<0.05) and 5TSTS (r=0.068, p<0.05). UDI-6 (0.360, p<0.05) and IIQ-7 (0.378, p<0.05) correlated moderately with SASS. On the other hand, SeSS had a low correlation coefficient with UDI-6 (0.305, p<0.05) and IIQ-7 (0.272, p<0.05). CONCLUSIONS: The results revealed that sensory performance was more associated with urinary incontinence in women with MS than physical performance. The urinary incontinence severity was also related to MS symptoms (bladder control, walking, spasticity, stiffness cognitive function). Future studies should consider the potential impact of sensory performance on urinary incontinence and focus on explaining the mechanism behind this relationship.

Agreement between video-based clinician-rated tools and patient-reported outcomes on gait assessment in individuals with multiple sclerosis.

PURPOSE: To our knowledge, no studies compared the video-clinician-based tools and patient-reported questionnaires in assessing gait and balance in people with MS (pwMS). The present study investigated the correlation and agreement between video-clinician-based objective measurement tools and patient-reported outcome measures (PROMs) in gait and balance evaluation. METHODS: A prospective cross-sectional study was conducted with 55 pwMS. Video analysis-based gait was evaluated by the Tinetti Gait Assessment (TGA), Gait Assessment and Intervention Tool (GAIT), and Functional Ambulation Classification Scale (FACS) by the clinician. Participants' self-reported gait and balance were assessed with the Multiple Sclerosis Walking Scale-12 (MSWS-12) and Activity-Specific Balance Confidence Scale (ABC). RESULTS: There was a moderate positive correlation between ABC with TGA and FACS (r1: 0.552, r2: 0.510, p < 0.001). ABC was strongly correlated with GAIT (r: - 0.652, p < 0.001). A moderate positive correlation was observed between MSWS-12 with TGA and FACS (r1: - 0.575, r2: - 0.524, p < 0.001). In addition, there was a strong positive correlation between MSWS-12 and GAIT (r: - 0.652, p < 0.001). Clinician-rated tools and PROMs were within the agreement limits regarding the unstandardized beta values p < 0.001). CONCLUSIONS: Clinician-based gait and balance tools demonstrate consistent results with PROMs in pwMS. Considering the low cost and practical use of PROMs, in cases where video-based clinician-based measurements cannot be provided (time, space, and technical inadequacies), questionnaires can provide concordant results at moderate and severe levels compared with objective tools.

Investigation of urinary disorders, functional independence, and quality of life in children with cerebral palsy.

PURPOSE: The study aimed to investigate the relationship between voiding disorders, functional independence, and quality of life, according to the gross motor function classification system, in children with cerebral palsy (CP) aged 8-17. METHODS: A total of 102 individuals (aged 8-17) with CP were included in the study. The Gross Motor Function Classification System (GMFCS), Dysfunctional Voiding and Incontinence Scoring System (DVISS), Wee Functional Independence Measure for Children (WeeFIM), and Pediatric Quality of Life Inventory (PedsQL) were used to evaluate the clinical parameters. RESULTS: There is a statistically significant difference in DVISS (p = 0.010), WeeFIM (p = 0.001), and PedsQL (p = 0.001) scores of individuals with CP regarding GMFCS. According to the CP classification, there is a statistically significant difference between WeeFIM (p = 0.001) and PedsQL (p = 0.020) scores. Besides, there is a significant difference between DVISS (p = 0.048), WeeFIM (p = 0.001) and PedsQL (p = 0.001) according to the ambulation status of individuals with CP. On the other hand, there is a positive moderate, statistically significant correlation between WeeFIM and PedsQL scores (ρ = 0.306, r = 0.002). A moderately negative statistically significant relationship exists between PedsQL and DVISS (ρ = -0.266, r = 0.007). A negative, moderate, statistically significant correlation was shown between DVISS and WeeFIM scores (ρ = -0.323, r = 0.001). CONCLUSIONS: As the gross motor functional level of individuals with CP increased, voiding dysfunction increased; on the other hand, functional independence and quality of life decreased.

Psychometric Properties of the Turkish Version of the Fear of Falling Questionnaire-Revised (FFQ-R) in Nursing Home Residents with Mild Cognitive Decline.

BACKGROUND: The aim of the study was to investigate the validity and reliability of the Turkish version of the Fear of Falling Questionnaire-Revised (FFQ-R) in older adults with mild cognitive impairment (MCI) living in a nursing home. METHODS: The study was conducted with 107 (69 women) older adults. The participants were evaluated with the FFQ-R, the Falls Efficacy Scale (FES), the Mini-Mental State Examination (MMSE), the Barthel Index and Montgomery-Åsberg Depression Rating Scale (MADRS)". FFQ-R was refilled one month later for retesting. RESULTS: Cronbach's alpha value of the FFQ-R was 0.971. The global internal consistency was excellent (>0.80). Intraclass correlation coefficient of the FFQ-R was 0.962 (95% CI: 0.92-0.98), indicating excellent test-retest reliability. The Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) values of the FFQ-R was 0.80 and 2.21, respectively. The correlation between the total score of FFQ-R and the FES was excellent (r = 0.963, p < .001). The relationship between FFQ-R and MMSE was excellent (r = -0.821, p < .001). Besides, there was a moderate correlation between the FFQ-R with Barthel Index (r = -0.648, p < .001) and FFR-Q with MADRS (r = 0.568, p < .001). CONCLUSION: Turkish version of the FFQ-R is a valid and reliable tool to assess the fear of falling in nursing home residents.

Cross-cultural adaptation, validation, and the reliability of the Sleep-Related Behaviors Questionnaire in patients with multiple sclerosis.

PURPOSE: Examining sleep-related behavioral disorder strategies in detail for MS patients provides an essential assessment to address specific disease findings. The aim of the study was to demonstrate the reliability and validity of the Turkish Sleep-Related Behaviors Questionnaire in patients with multiple sclerosis (MS). METHODS: A total of 100 MS patients were filled Sleep-Related Behaviors Questionnaire (SRBQ), Beck Depression Inventory (BDI), Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI). One week later, 30 randomly selected patients were refilled the SRBQ. The test-retest reliability, internal consistency, and contruct validity were determined. RESULTS: The mean age of the individuals included in the study was 38.9 ± 11.0 years. The ICC value of the reproducibility of SRBQ was calculated as 0.877 (CI: 0.74-0.94). The test-retest reliability of the SRBQ was excellent (ICC > 0.80). Cronbach's alpha value of the SRBQ was 0.877, which indicates excellent consistency. The SRBQ had correlation coefficients of 0.573, 0.509, and 0.523 with ISI, PSQI, and BDI, respectively. The SRBQ had high validity (r > 0.50, p < 0.01). CONCLUSION: The Turkish SRBQ was found to be valid and reliable in patients with MS. Owing to the long but comprehensive nature of the SRBQ, a low-cost detailed measurement could be obtained in clinical practice.

The reliability and validity of the Turkish version of the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) and Telemedicine Patient Questionnaire (TPQ) in individuals with multiple sclerosis.

OBJECTIVE: The study was aimed to translate and adapt the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) and Telemedicine Patient Questionnaire (TPQ) into Turkish, thereafter to analyze the psychometric properties of both questionnaires. METHODS: A total of 149 multiple sclerosis (MS) patients were recruited in the study. For 4 years, all patients were supervised by a department clinician using telemedicine. Cronbach's alpha coefficient was used to assess internal consistency. By evaluating the scores of 41 retested patients 1 week later, the test-retest reliability was determined using the intraclass correlation coefficient (ICC). Pearson's correlation coefficient was used to assess the construct validity (r). RESULTS: A total of 149 patients (103 women, 46 men) with a mean age of 40.9±10.9 years were included in the study. MS duration of the patients was 9.15±6.24 years. Internal consistency of all items and the total score of the TSUQ were excellent (>0.80; ranged 0.971-0.974). On the other hand, the internal consistency of all items and total score of the TPQ was excellent, either (>0.80; ranged 0.878-0.890). The ICC of the TSUQ's and TPQ's total score was excellent (>0.80). The correlation between TSUQ and TPQ was strong (r=0.734, p<0.01). In addition, there was moderate relationship between the TSUQ and the Beck Depression Scale (BDS) (r=-0.363, p<0.01). On the other hand, there was low correlation between TPQ and BDS (r=-0.217, p<0.05). CONCLUSION: The Turkish version of the TSUQ and the TPQ is valid and reliable in individuals with MS.

Turkish Translation, Cultural Adaptation, Reliability, and Validity of the Exercise-Induced Leg Pain Questionnaire.

CONTEXT: Exercise-induced leg pain (EILP) is a chronic condition that generally arises in elite and recreational athletes' lower quarter of the legs. OBJECTIVES: The study aimed to translate and culturally adapt the EILP questionnaire into Turkish (T-EILP) and evaluate its reliability and validity. DESIGN: A cross-sectional study. METHODS: Established guidelines were preferred for translation and adaptation. T-EILP was filled twice with a 1-week interval. In the first assessment, patients were also evaluated with Short Form-36 and Visual Analog Scale, both for preexercise and postexercise. Test-retest reliability and internal consistency of the T-EILP were measured with the intraclass correlation coefficient and Cronbach α coefficient, respectively. The construct validity was demonstrated with the Pearson correlation coefficient (r). Further, the minimum detectable change and standard error of measurement with 95% confidence were calculated. RESULTS: A total of 121 participants (23.0 [3.59] y) were included in the study. The test-retest reliability was excellent and internal consistency was acceptable (intraclass correlation coefficient = .821, α = .808). T-EILP was highly correlated with the physical function subscore of the Short Form-36 (r = .509, P < .01). There was a moderate correlation between T-EILP with the bodily pain subscore of the Short Form-36 and Visual Analog Scale (postexercise; r1 = .436, r2 = -.355, P < .01). The standard error of measurement and minimum detectable change with 95% confidence were 3.54 and 9.81, respectively. CONCLUSION: T-EILP is a reliable and valid tool in Turkish-speaking participants. The minimum detectable change with 95% confidence of the T-EILP provides an essential reference for monitoring EILP.

The reliability and validity of the Turkish version of the multiple sclerosis impact scale-29.

BACKGROUND: The purpose of the study was to cross-culturally adapt the Multiple Sclerosis Impact Scale-29 (MSIS-29) into Turkish and evaluate its reliability and validity in patients with Multiple Sclerosis (MS). METHODS: A total of 119 individuals with MS were enrolled in the research. The neurologist classified the patients with Expanded Disability Status Scale (EDSS). In the initial evaluation, patients completed the Multiple Sclerosis Impact Scale-29 (MSIS-29), the Multiple Sclerosis International Quality of Life (MusiQoL), EuroQol-5D-3L (EQ-5D-3L), and Beck Depression Scale (BDS), respectively one week later, the MSIS-29 evaluation was repeated. Internal consistency, test-retest reliability, and construct validity were assessed, separately. RESULTS: The mean age of the total sample was 38.2 ± 10.6 years. The test-retest reliability of both subscores of the MSIS-29 was excellent (>0.80). Internal consistency of the MSIS-29 physical and psychological score was 0.968 and 0.914, respectively. Both of the subscores had excellent internal consistency (>0.80). There was a strong relationship between MSIS-29 physical score with MusiQoL, EQ-5D-3L (index), EQ-5D-3L (VAS), and BDS scores (p < 0.01, r > 0.50). MSIS-29 physical was moderately related to EDSS (p < 0.01, r = 0.381). MSIS-29 psychological score was strongly correlated with MusiQoL, EQ-5D-3L (index), EQ-5D-3L (VAS), and BDS scores (p < 0.01, r > 0.50). On the other hand, there was a weak correlation between MSIS-29 psychological score and EDSS (p < 0.01, r = 0.300). DISCUSSION: Turkish version of the MSIS-29 is a reliable and valid tool in individuals with MS.

Validation and cross-cultural adaptation of the Turkish version of the revised Leeds Disability Questionnaire in patients with ankylosing spondylitis.

BACKGROUND: The revised Leeds Disability Questionnaire (RLDQ) is a unique assessment tool for patients with ankylosing spondylitis (AS); its comprehensive structure includes posture and neck flexibility parameters. The aim of the study was to determine the psychometric properties of the Turkish RLDQ in patients with AS. METHODS: A total of 100 AS patients were enrolled in the study. In the first evaluation, patients filled out the Dougados Functional Index (DFI) and Bath Ankylosing Spondylitis Functional Index (BASFI), Stanford Health Assessment Questionnaire (HAQ) in addition to RLDQ. Then, patients were refilled the revised RLDQ in the second assessment. RESULTS: The mean age of the patients (40 women, 60 men) was 48.3 ± 12.6 years. The test-retest reliability and internal consistency of the RLDQ total score were excellent. ICC score and Cronbach's alpha score were calculated as 0.853 and 0.905, respectively. The SEM and MDC values calculated for the RLDQ total score were 2.74 and 7.60, respectively. RLDQ had degrees of correlation with DFI, HAQ, and BASFI of 0.814, 0.742, and 0.852, respectively. Construct validity was excellent (r > 0.50, p < 0.01). DISCUSSION: The Turkish version of the RLDQ was found to be valid and reliable in patients with AS. It should be emphasized that the RLDQ is a distinctive and valuable tool that focuses separately on neck, posture, or other mobility parameters in the clinical assessment of AS.

The reliability and validity of the Turkish version of the graded chronic pain scale in patients with chronic low back pain.

PURPOSE: To translate and cross-culturally adapt the Turkish version of the Graded Chronic Pain Scale-Revised (GCPS-R) and to evaluate its reliability and validity. METHODS: The prospective and cross-sectional study was performed with 102 low back pain patients (67 women, 35 men). Patients were asked to complete the GCPS-R twice, one week apart. Visual Analog Scale (VAS), Roland Morris Disability Questionnaire (RMDQ), Short Form-36 (SF-36), Fear Avoidance Beliefs Questionnaire (FABQ) were filled only in the first evaluation. Test-retest reliability was analyzed with intraclass correlation coefficient (ICC). Internal consistency was measured using Cronbach's α. The minimal detectable change (MDC95) was calculated based on the standard error of measurement (SEM95). The construct validity was analyzed using the Pearson correlation coefficient. Exploratory factor analysis was calculated to explore the factor structure of GCPS-R. RESULTS: The mean age of the patients was 45.2 ± 13.1 years. The internal consistency was acceptable, and test-retest reliability was excellent (α = 0.933, ICC = 0.972). SEM95 and MDC95 for the total score were 2.07 and 5.73, respectively. VAS measured for both rest and activity were strongly correlated with GCPS-R (r > 0.50). The correlation between the total score of GCPS-R and RMDQ was excellent (r = 0.677, p < 0.001). SF-36's; physical function, role physical, bodily pain and social function subscores were strongly correlated with GCPS-R (r > 0.50). There was moderate correlation between GCPS-R and the physical activity subscore of the FABQ (r = 0.494, p < 0.001). GCPS-R had a single factor structure as expected. CONCLUSION: The Turkish version of GCPS-R is a valid and reliable questionnaire in patients with chronic low back pain. Level of Evidence II (Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding).

Opinions, satisfaction and expectations of individuals with multiple sclerosis about telerehabilitation services.

OBJECTIVE: The opinions, satisfaction, and expectations of telemedicine can provide essential data for remote health services in individuals with Multiple Sclerosis (MS). The study aimed to demonstrate the views (barriers-benefits), satisfaction, and expectations of individuals with MS about telerehabilitation services. METHODS: A prospective cross-sectional was conducted with 82 individuals with MS who received telerehabilitation services for at least one year. The participants have completed SymptoMScreen, Beck Depression Inventory (BDI), Telehealth Usability Questionnaire (TUQ), Telemedicine Satisfaction Questionnaire (TSQ), Telehealth Barriers Questionnaire (TBaQ and Telehealth Benefits Questionnaire (TBeQ). RESULTS: As the age of individuals with MS increased, TUQ (r: -0.517, p < 0.001) and TBeQ (r: -0.383, p < 0.001) decreased, while TSQ (r: 0.405, p < 0.001) and TBaQ (r: 0.390, p < 0.001) increased. SymptoMScreen score (r: -0.288, p < 0.05) was weakly associated with TUQ. In addition, TUQ, TSQ, TBeQ, and TBaQ were strongly correlated (p < 0.001). CONCLUSION: In order to improve usability and satisfaction in telerehabilitation services, the age, symptom severity, and education levels of individuals with MS should be considered. Telehealth methods with high usability should be preferred to increase patient satisfaction.

Does backward gait require more proprioception and balance in older adults after total knee arthroplasty?

Objectives: Some basic and instrumental daily living activities include backward gait. There is a need to clarify which parameters should be focused more on to improve backward gait in older individuals. This research investigated the proprioception, and balance in forward-backward gait of older individuals with total knee arthroplasty (TKA). Methods: A prospective cross-sectional research was conducted with 105 older adults with TKA. Individuals' forward and backward gait performance was assessed with the Timed Up & Go Test (TUG) and 3 Meter Walk Back Test (3MBWT), respectively. Proprioception was measured with a mobile application-based inclinometer. Berg Balance Scale (BBS) and Activity Specific Balance Confidence Scale (ABC) were used to assess balance and balance confidence levels, respectively. A single clinician evaluated the individuals. Results: TUG was weakly and positively correlated with the Right and Left Leg Proprioception Test (RLPT and LLPT) (r1 = 0.386, r2 = 0.391, p < 0.01). Also, the 3MBWT was weakly and positively correlated with RLPT and LLPT, respectively (r1 = 0.293, r2 = 0.251, p < 0.01). In addition, TUG was strongly and negatively correlated with BBS and ABC, respectively (r1 = -0,693, r2 = -0.722, p < 0.01). Besides, 3MBWT was strongly and negatively correlated with BBS and ABC (r1 = -0.642, r2 = -0.645, p < 0.01). Conclusion: The study revealed that forward and backward walking were similarly associated with balance and proprioception in older adults with TKA. Clinicians should focus more on balance ability than proprioception to improve backward walking performance in older individuals with THA.

The effect of pelvic floor muscle training on urinary incontinence in patients with stroke: a systematic review and meta-analysis.

BACKGROUND: No other systematic review presented the effectiveness of pelvic floor muscle training (PFMT) in individual with stroke. AIMS: The purpose of this systematic review and meta-analysis was to demonstrate the effectiveness of PFMT for urinary incontinence in patients with stroke. METHODS: "Web of Science (WoS), Cochrane Library, PubMed and Scopus" databases were searched. "Revised Cochrane risk-of-bias tool randomized trials (RoB 2)" and "PEDro" were used to assess the risk of bias and methodological quality of the studies. Narrative synthesis and meta-analysis were conducted to present the results. RESULTS: A total of 8 articles were included in the review. Seven articles were classified as "good" level evidence. Four articles were considered to have "high risk" of bias for the overall score. Regarding two homogenous studies, PFMT-based rehabilitation was not superior standard urinary incontinence therapy on SF-36-Social Function score at 12-week follow-up (ES 0.47, 95% CI - 0.16-0.96). Data pooling of two studies did not provide an additional advantage of pelvic muscle training on 3 days voiding diary (night, total day) score at 12-week follow-up (ES 28, 95% CI - 0.61-0.48; ES 0.30, 95% CI - 0.23-0.95). On the other hand, low-quality evidence demonstrated that pelvic muscle training yielded better results on daytime voiding (ES 0.28, 95% CI 0.04-1.16). CONCLUSIONS: The results demonstrated that PFMT had positive effects in terms of daytime urination frequency and incontinence. Although some studies have reported positive effects on symptoms, function, strength, and endurance, the generalizability of these results is controversial. Further studies should assess the quality-of-life and function with urinary incontinence and stroke-specific tools.

The reliability and validity of the 30-second chair stand test and modified four square step test in persons with multiple sclerosis.

BACKGROUND: The 30-second Chair Stand Test (30s-CST) and Modified Four Square Step Test (mFSST) are used to determine the functional status of individuals with multiple sclerosis (MS). No other studies have demonstrated the reliability and validity of the 30s-CST and mFSST. PURPOSE: To identify the test-retest reliability, concurrent validity and the known-group validity of the 30s-CST and mFSST in persons with MS. METHODS: A total of 64 persons with MS were enrolled. 30s-CST, mFSST, Timed Up and Go Test (TUG) and Five Times Sit to Stand (FTST) tests were performed. 30s-CST and mFSST were conducted again one-hour later. RESULTS: The mean age of the persons with MS were 37.9±11.3 years. The test-retest reliability of the 30s-CST and mFSST were excellent (ICC30s-CST = 0.974, 95%CI: 0.95-0.98; ICCmFSST = 0.992, 95%CI: 0.98-0.99). The 30s-CST was strongly correlated with FTST and TUG (r1 = -0.871, p1 = 0.0001; r2 = -0.741,p2 = 0.0001). There was a strong relationship between mFSST with TUG and FTST (r1 = 0.781,p1 = 0.0001;r2 = 0.788,p2 = 0.0001). The SEM95 and MDC95 values of the 30s-CST and mFSST were 0.41/1.13 and 0.34/0.94, respectively. Besides, there were significant differences between the persons with or without fall history in 30s-CST (MD: 1.66, CI: 0.27 to 3.05, p = .019) and mFSST CST (MD:-2.70, CI: -4.73 to -0.67, p = .010) performances. CONCLUSION: The 30s-CST and mFSST are both valid and reliable in mildly-disabled individuals with MS.

Comparison of physical performance, gait, balance, falls efficacy, and step reaction time in individuals with multiple sclerosis.

OBJECTIVE: The study aimed to investigate the physical performance, gait, balance, falls efficacy, and step reaction time in individuals with MS. METHODS: A total of 60 individuals (30 individuals with MS and 30 age and sex-matched healthy controls) were enrolled. Individuals' physical performance was evaluated with the Timed Up and Go Test (TUG) and Five-Times-Sit-to-Stand Test (FTSTS). Activities-specific Balance Confidence (ABC) Scale, 12-item Multiple Sclerosis Walking Scale (MSWS-12v2) and Falls Efficacy Scale International (FES-I) were used to assess the balance, gait and fall efficacy of the participants. Individuals' step reaction time (SRT) was calculated with video-based software. The time between the step command and the first contact of the foot with the ground in the first step was recorded. RESULTS: The mean age of the individuals with MS and the control group was 38.5 ± 9.4 years and 33.9 ± 11.7 years, respectively. Significant differences existed between the groups in SRT, FES-I, ABC, and FTSTS (p < 0.05). There was no significant correlation between SRT with any other parameter (p > 0.05). TUG was moderately correlated with MSWS-12 and FES-I (r1 =0.426, r2 =0.495, p < 0.05). Besides, there was a moderate correlation between ABC with TUG and FTSTS (r1 =-0.605, r2 =-0.468, p < 0.05). A high degree correlation was found between MSWS-12 with FES-I and ABC (r1 =0.843, r2 =-0.834, p < 0.05). CONCLUSION: Individuals with MS have decreased SRTs. However, this condition was not found to be related to physical performance. Further studies should focus on the association of SRT with cognitive and psychosocial parameters.

Investigation of Motor Activity, Movement Kinematics and Forward-Backwards Gait in Children with Cerebral Palsy.

Our aim in this study was to examine relationships between the motor activity ability, sensor-based kinematics and forward-backwards gait characteristics of children with cerebral palsy (CP). In this prospective cross-sectional study we studied 40 children with CP. We used the Pediatric Motor Activity Log Revised (PMAL-R) to assess motor activity, evaluated motion kinematics (acceleration and angular velocity) with a sensor-based application, applied the Edinburgh Visual Gait Score (EVGS) and the Timed Up and Go Test (TUG) to observe gait performance, and used the Three Meter Backward Walk Test (3MBWT) to assess backward gait. We found moderately positive significant correlations (r1 = 0.416, r2 = 0.418, p < 0.05) between the chilidren's minimum angular velocity on PMAL-R motor activity frequency (how often) and quality (how well) scores, respectively. We also found moderately negative significant correlations (r1 = -0.529, r2 = -0.521, p < 0.05) between PMAL-R frequency (how often) and quality (how well) scores with TUG, respectively. There were moderately high positive correlations (r1 = 0.415, r2 = 0.726, p < 0.05) between EVGS scores and 3MBWT and TUG scores, respectively. We concluded that angular velocity ability was moderately related to children's motor activity and showed that physical performance tests (TUG and 3MBWT) could monitor gait function and upper extremity motor activity level, including both forward and backward walking tasks, in children with CP.

The investigation of cognition, proprioception, sensory and physical function in stroke patients with urinary incontinence.

PURPOSE: This study aimed to investigate cognition, proprioception, and sensory/physical function in stroke patients with urinary incontinence (UI). METHODS: A prospective cross-sectional study was conducted on 53 individuals with stroke (23 had UI and 21 matched controls). The Incontinence Impact Questionnaire Short Form (IIQ-7) and Urogenital Distress Inventory (UDI-6) were used to assess the patients' UI symptoms. Participants were also evaluated with Mini-Mental State Examination (MMSE), Barthel Index (BI), Fugl-Meyer Sensory Assessment (FMA-S), Five Times Sit to Stand Test (FTSST), Functional Reach Test (FRT) and Proprioception Test. RESULTS: FTSST, FRT and FMA-S were better in stroke subjects without UI (p < 0.05). There was a moderate correlation between IIQ-7 with FMA-S, FTSST and proprioception (left extremity) (r1: - 0.415, r2: 0.440, r3: 0.430, p < 0.05) and a low correlation with BI (r: - 0.356, p < 0.05). CONCLUSION: Individuals with UI had worse sensory/motor function and static balance. Stroke patients with UI were more dependent, had less sensory function, and had worse lower extremity muscle strength and proprioception as the level of urinary incontinence increased. To reduce urinary incontinence, emphasis on motor/sensory function, balance, and proprioception should be considered.

The effect of exercise and education combination via telerehabilitation in patients with chronic neck pain: A randomized controlled trial.

BACKGROUND: A limited number of studies have investigated the effect of telerehabilitation in individuals with chronic neck pain (CNP). OBJECTIVE: The study aimed to evaluate the effectiveness of holistic exercise and education combination via telerehabilitation on pain, disability, kinesiophobia, exercise adherence, quality of life and patient satisfaction in individuals with CNP. METHODS: A two-armed, randomized controlled study was conducted with 40 participants with CNP. Patients were randomized into two groups: Telerehabilitation (TR) (n = 20) and Standard Rehabilitation (SR) (n = 20). The TR group was provided with exercise and education videos online. The same protocol was given to the SR group in the clinical setting. Patients were evaluated at baseline and after eight weeks of intervention. Satisfaction and usability levels of the TR group were assessed at week 8. RESULTS: TR group demonstrated better improvement in function, quality of life (including bodily pain, general health, social function), kinesiophobia and exercise adherence. The TR group was not superior to the SR group in pain and other quality-of-life subscores. A vast majority of the TR group had high satisfaction and usability. CONCLUSION: Comprehensive rehabilitation via TR increases satisfaction and participation in patients with CNP. Besides, TR provides more positive effects on function and kinesiophobia. Further studies should focus on the impact of telerehabilitation on pain and quality of life in CNP with a long-term follow-up.

FLARE-RA in patients with rheumatoid arthritis: translation and cross-cultural adaptation into Turkish.

BACKGROUND: Flare Assessment in Rheumatoid Arthritis (FLARE-RA) is a patient-reported outcome measure (PROM) to evaluate the flare-related symptoms of individuals with Rheumatoid Arthritis (RA) in the last three months. OBJECTIVE: The present study aimed to demonstrate the translation, cultural adaptation and psychometric properties of the Turkish version of the FLARE-RA. METHODS: A cross-sectional psychometric analysis study was conducted with a total of 80 patients (61 Women, 19 Men; 49.6 ± 15.4 years). Patients filled-out the Global Health Assessment (GHA), Visual Analog Scale (VAS), Disease Activity Score-28 (DAS-28), Rheumatoid Arthritis Quality-of-Life Questionnaire (RAQoL), Health Assessment Questionnaire (HAQ) in addition to the Turkish FLARE-RA. In addition, participants' Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) were recorded. Thirty patients refilled the FLARE-RA again, one-week later. RESULTS: In the cross-cultural adaptation, translation procedures and pilot study, each item of the Turkish version of the FLARE-RA was found to be comprehensible. The ICC (two-way random-effect, single-measure model) and alpha values of the Turkish FLARE-RA were 0.97 and 0.96, respectively. The MDC95 values calculated for the FLARE-RA, FLARE-RA-arthritis, and FLARE-RA-symptoms scores were 2.01, 1.60, and 1.18, respectively. FLARE-RA, FLARE-RA-arthritis, and FLARE-RA-symptoms scores were highly correlated with VAS-rest, VAS-activity, DAS-28, RAQoL, and HAQ scores (r > 0.50). On the other hand, scores of FLARE-RA, FLARE-RA-arthritis, and FLARE-RA-symptoms were moderately correlated with the GHA-patient subscale, GHA-clinician subscale, ESR, and duration of morning stiffness (0.35 < r < 0.50). CONCLUSION: The present study results demonstrated the reliability and validity of the Turkish FLARE-RA. FLARE-RA is a practical tool to assess the flare of RA patients.