A. Karaduman

Prednisolone therapy in Duchenne muscular dystrophy prolongs ambulation and prevents scoliosis

Steroids may have a beneficial effect on the course of Duchenne muscular dystrophy (DMD). However, results vary in different studies. This study consisted of 66 DMD boys who were in the therapy group and 22 DMD boys in the control group. The mean ages were 6.8 ± 2.1 years (range 2.5–12.5) and 7.0 ± 1.3 years (range 5.0–9.0), respectively. We assessed muscle strength, 10‐m walking, ankle contracture, and loss of independent walking ability age and onset of scoliosis. Treatment regimen was oral prednisolone 0.75 mg/kg on alternate days, plus vitamin D 600–1200 units/day and a calcium‐enriched diet. After a follow‐up period of 2.75 ± 1.1 years (range 1.5–5) and when compared with controls, there was a statistically significant change in muscle strength between the two groups after 12 months (P < 0.05). Although 10‐m walking time decreased in therapy group (P < 0.05), there was not significance between the groups in the end. Boys in the control group developed significantly less ankle contractures (P < 0.05). None of the therapy group had scoliosis during the follow‐up period (mean age 10.8 ± 1.2 years), whereas seven boys of the control group had scoliosis at a mean age of 11.7 ± 2 years. Loss of walking ability age was statistically different between groups (P < 0.05). Our results indicate that, alternate‐day prednisolone regimen may prolong ambulation and scoliosis can be delayed or prevented.

The TREAT‐NMD Duchenne Muscular Dystrophy Registries: Conception, Design, and Utilization by Industry and Academia

Duchenne muscular dystrophy (DMD) is an X‐linked genetic disease, caused by the absence of the dystrophin protein. Although many novel therapies are under development for DMD, there is currently no cure and affected individuals are often confined to a wheelchair by their teens and die in their twenties/thirties. DMD is a rare disease (prevalence <5/10,000). Even the largest countries do not have enough affected patients to rigorously assess novel therapies, unravel genetic complexities, and determine patient outcomes. TREAT‐NMD is a worldwide network for neuromuscular diseases that provides an infrastructure to support the delivery of promising new therapies for patients. The harmonized implementation of national and ultimately global patient registries has been central to the success of TREAT‐NMD. For the DMD registries within TREAT‐NMD, individual countries have chosen to collect patient information in the form of standardized patient registries to increase the overall patient population on which clinical outcomes and new technologies can be assessed. The registries comprise more than 13,500 patients from 31 different countries. Here, we describe how the TREAT‐NMD national patient registries for DMD were established. We look at their continued growth and assess how successful they have been at fostering collaboration between academia, patient organizations, and industry.

The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: a Turkish version study.

Objectives. The aim of this study was to conduct the cross-cultural adaptation of Neck Disability Index (NDI) and investigate the validity and reliability of Turkish version in patients with neck pain. Summary of Background Data. The NDI is a reliable evaluation instrument for disability but there are no published Turkish version. Methods. Eighty-eight patients with neck pain for at least 3 months were included in the study. NDI, The Neck Pain and Disability Scale and Visual Analogue Scale (VAS) were completed by all subjects. Test-retest reliability was determined by using intraclass correlation coefficient and Pearson’s correlation analysis. For the determination of concurrent validity, the relation between NDI and VAS was examined by Pearson’s correlation analysis and for the determination of construct validity, the relation between NDI and Neck Pain and Disability Scale was investigated. Results. Intraclass correlation coefficient score for test-retest reliability was 0.979 (95%, confidence interval = 0.968–0.986). For concurrent validity, the relation between NDI and VAS was investigated, the r value for test and retest was 0.508 and 0.620, respectively (P < 0.0001). For construct validity, the relation between NDI and the Turkish version of NPDA was investigated, the r value for test and retest was 0.659 (P < 0.0001) and 0.728 (P < 0.0001), respectively. Conclusion. The Turkish version of NDI was found to be a valid and reliable method of measurement for evaluating disability, caused by problems of the neck region as it is easy to comprehend by the patients and the time needed to apply is short in clinics.

Different types of upper extremity exercise training in Duchenne muscular dystrophy: Effects on functional performance, strength, endurance, and ambulation

We investigated and compared the effects of 2 different types of upper extremity exercise training on upper extremity function, strength, endurance, and ambulation in patients with early‐stage Duchenne muscular dystrophy (DMD).

The environmental barriers of children with Muscular Dystrophies and its effect on mother's low back pain

Purpose : The aim of this study is to determine the architectural barriers of children with Muscular Dystrophy at home according to their diminished functional capacity and its effect on their mothers back problem. Method : Twenty children with Muscular Dystrophy (11.1 - 4.14 years) were evaluated with Brooke Scale and WeeFIM. Quebec and Oswestry Disability Scales were used for determining physical disability of their mothers (38.65 - 5.91 years). The architectural barriers have been detected with attention to standard criterias of International Organizations for all countries around the world. Results : The heights of thresholds, switches of wall plugs, shelves, cupboards, mirrors, hangers, arm of windows and siphons were found to be higher than standard values. The relation between back disability questionnaire results of mothers and dependency level of children on Activity of Daily Living has showed negative correlation (p < 0.05). Conclusions : The protective back health programmes and home arrangements that are suitable for disabled children must be added to the neuromuscular rehabilitation programmes.

Pressure pain thresholds in adolescent patients with chronic tension-type headache

AbstractThe pathophysiological mechanisms underlying chronic tension-type headache are still unclear. The aim of the present study was to investigate tenderness of pericranial muscles by examining pressure pain thresholds in adolescents suffering from chronic tension-type headache. A group of 35 patients with chronic tension-type headache was compared to 70 healthy controls in terms of pressure pain thresholds. A conventional hand-held algometer was used to measure the pressure pain thresholds in the upper trapezius, suboccipitalis, and frontalis muscles. Pressure pain thresholds were significantly lower in patients than in healthy controls. Pressure pain threshold values of bilateral trapezius muscles were significantly negatively correlated with the pain intensity. There was no correlation between the pressure pain threshold values and duration, or frequency of headache. Along with results obtained previously, the present data support the hypothesis that muscular factors may be an important factor for t...

Development of a new instrument for determining the level of chewing function in children

This study aimed to develop a chewing performance scale that classifies chewing from normal to severely impaired and to investigate its validity and reliability. The study included the developmental phase and reported the content, structural, criterion validity, interobserver and intra-observer reliability of the chewing performance scale, which was called the Karaduman Chewing Performance Scale (KCPS). A dysphagia literature review, other questionnaires and clinical experiences were used in the developmental phase. Seven experts assessed the steps for content validity over two Delphi rounds. To test structural, criterion validity, interobserver and intra-observer reliability, two swallowing therapists evaluated chewing videos of 144 children (Group I: 61 healthy children without chewing disorders, mean age of 42·38 ± 9·36 months; Group II: 83 children with cerebral palsy who have chewing disorders, mean age of 39·09 ± 22·95 months) using KCPS. The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was used for criterion validity. The KCPS steps arranged between 0-4 were found to be necessary. The content validity index was 0·885. The KCPS levels were found to be different between groups I and II (χ(2) = 123·286, P < 0·001). A moderately strong positive correlation was found between the KCPS and the subscales of the BPFAS (r = 0·444-0·773, P < 0·001). An excellent positive correlation was detected between two swallowing therapists and between two examinations of one swallowing therapist (r = 0·962, P < 0·001; r = 0·990, P < 0·001, respectively). The KCPS is a valid, reliable, quick and clinically easy-to-use functional instrument for determining the level of chewing function in children.

Effect of muscle weakness distribution on balance in neuromuscular disease.

To assess balance and identify the effects of muscle weakness distribution on balance in children with different neuromuscular diseases.

Two different back pain scales and their relation to pain intensity in women

People suffering from low back pain (LBP) fail in performing many daily living activities. The aim of this study was to compare two different back pain scales and to determine the relation between pain intensity and these scales on women with low back pain. Fifty-five women with chronic LBP (X ± SD: 37.76 ± 5.12 years) participated in this study. Their disabilities were determined by Quebec Back Pain Disability Scale (QBPDS) and Oswestry Low Back Disability Questionnaire Scale (OLBDQS). Pain intensity was measured by a visual analogue scale (VAS). Outcome of this study showed that the QBPDS and OLBDQS were highly correlated. Also, VAS scores were correlated with both scale scores but this correlation was less strong. These two disability measuring methods are comparable, but OLBDQS has the advantage of requiring shorter time. summary

The effect of independence level of the children with muscular dystrophies on the mother's low back pain

Abstract Introduction: Forward bending, rotation, lifting, carrying, pulling and pushing during bathroom activities, dressing, transferring, feeding, etc. increase stress on structures in the back and neck of mothers caring for disabled children. The aim of this study was to determine the effect of independence level of children with muscular dystrophies on their mothers low back pain. Methods: Thirty mothers who had children with muscular dystrophies were included in this study. They were divided two groups as mothers of nonambulatory (group 1) and ambulatory (group 2) disabled children. To investigate the activities of daily living the WeeFIM scale was used; to investigate the functional status the Broke Scale was used. Quebec Back Pain Disability Scale (QBPDS) was used to measure disability and a visual analogue scale (VAS) was used to measure pain in mothers. Results: The QBPDS scores of mothers were higher in group 1 (36.13 ± 17.9) than in group 2 (20.8 ± 14.87). There was positive correlation betwe...