Bulent Elbasan

Sensory integration and activities of daily living in children with developmental coordination disorder

ObjectiveThe aim of our study was to evaluate sensory integration and activities of daily living in children with developmental coordination disorderSubjects and methods37 cases with developmental coordination disorder and 35 healthy age-matched peers were included in this study. Ayres Southern California Sensory Integration Test was used for evaluating the sensory integration and Functional Independence Measure for Children (WeeFIM) was used for evaluating the activities of daily living.ResultsSignificant differences were found in the visual shape perception, position in space, and design copying (p < 0.05). According to the results of somatosensory perception tests, significant differences were found in kinesthesia, manual form perception, finger identification, figure-ground perception, localization of tactile stimuli, double tactile stimuli perception (p < 0.05). Control group was better in motor planning (p < 0.05). Comprehension, expression, social communication, problem solving, and memory skills were significant in favor of the control group (p < 0.05). Graphestesia and self-care domain was found to be correlated (r = 0,491, p = 0.002) between the groups.DiscussionSpecial education and rehabilitation programs including sensory integration therapy and motor performance will increase independence in the activities of daily living in children with developmental coordination disorder.

Effects of chest physiotherapy and aerobic exercise training on physical fitness in young children with cystic fibrosis

BackgroundCystic fibrosis is a multisystem disease where the main problems are existing in the respiratory system. Aerobic exercise programs are effective in increasing physical fitness and muscle endurance in addition to chest physiotherapy.ObjectiveThe aim of this study was to evaluate the effects of chest physiotherapy and aerobic exercise training on physical fitness in young children with cystic fibrosis.MethodsSixteen patients with cystic fibrosis, between the ages 5-13 years, were included in this study. All children were assessed at the beginning and at the end of 6 week of the training. Modified Bruce protocol was used for assessing the cardiovascular endurance. The sit-up test was used to evaluate the dynamic endurance of abdominal muscles, standing long jump was used to test power, sit and reach, trunk lateral flexion, trunk hyperextension, trunk rotation and forward bending tests were used to assess flexibility, 20 m shuttle run test and 10-step stair climbing tests were used to assess power and agility. All patients received chest physiotherapy and aerobic training, three days a week for six weeks. Active cycle of breathing technique and aerobic exercise training program on a treadmill were applied.ResultsBy evaluating the results of the training, positive progressions in all parameters except 20 m shuttle run and 10 stairs climbing tests were observed (p < 0.05). Active cycle of breathing techniques were used together with exercise training in clinically stable cystic fibrosis patients increases thoracic mobility (p < 0.05) and the physical fitness parameters such as muscle endurance, strength and speed (p < 0.05). Comparison of the results in sit and reach and forward bending tests were not significant (p > 0.05).ConclusionIt is thought that in addition to medical approaches to the systems affected, the active cycle of breathing techniques along with aerobic training helps to enhance the aerobic performance, thoracic mobility and improves physical fitness in children with cystic fibrosis.

Low back pain prevalence in healthcare professionals and identification of factors affecting low back pain

BACKGROUND Work-related musculoskeletal system diseases are commonly observed among nurses, physiotherapists, dentists, and dieticians. OBJECTIVE To assess working postures of nurses, physiotherapists, dentists and dieticians, to identify whether low back pain (LBP) is present, and to put forth the correlation between LBP, working posture, and other factors. METHODS Twenty seven physiotherapists, 34 nurses, 30 dentists, and 16 dieticians were included. Impairment ratings of cases with LBP were analysed with Quebec Back Pain Disability Scale (Quebec). Working postures were analysed with Owako Working Posture Analysis System. RESULTS LBP was observed in 70.09% of healthcare professionals. Of the individuals suffering from LBP, 57.2% were working with a risky posture. 40.63% of individuals without LBP were using risky working postures. Trunk and head posture distribution of individuals with and without LBP was found as different from each other (p < 0.05). LBP prevalence of dentists and nurses were higher compared to other groups (p < 0.05). Quebec scores of professionals with LBP were not different among occupations (p > 0.05). Quebec scores were observed as correlated with various factors in various occupation groups. CONCLUSIONS Considering that head-neck and trunk postures are changeable factors that are among the factors affecting LBP, correcting the working posture gains importance.

Nutritional status of children with cerebral palsy in Turkey.

Purpose: The aim of this study was to assess the nutritional status, and provide information regarding anthropometric measurements of cerebral-palsied children living in the city of Ankara, Turkey. Method: A total of 447 children with cerebral palsy (CP) were participated in this cross-sectional study. Participants were assessed for functional motor impairment by the gross motor function classification system (GMFCS). Assesment of nutritional status was based on the triceps skinfold thickness (TSF), arm fat area (AFA) estimates derived from TSF and mid-upper arm circumference measurements. TSF and AFA Z-scores were computed using reference data. Results: Cerebral-palsied children had lower TSF and AFA Z-scores compared to reference data from healthy children. The prevalence of underweight and overweight among boys was 8.3 and 9.5%, respectively, whereas it was 19.0 and 0.5% for girls. Underweight was more prevalent in the low functioning children than in moderate functioning children. Conclusions: The findings of this study indicate that cerebral-palsied children face nutritional challenges. Underweight is more prevalent than overweight among cerebral-palsied children. To optimize the outcomes of rehabilitation and prevention efforts, an understanding of the heterogeneity of nutritional status among children with CP is required. Implications for Rehabilitation Compared with their healthy peers, cerebral-palsied children, especially girls and those who are low functioning, frequently show poor growth. Growth and nutritional status should be monitored regularly as part of rehabilitation program for cerebral-palsied children.

Reliability and Validity of The Cerebral Palsy Quality of Life Questionnaire in The Turkish Population

This study examined the psychometric properties of the Turkish version of the Cerebral Palsy Quality of Life Questionnaire (CP QOL). A total of 149 primary caregivers completed the final version of the CP QOL–Primary Caregivers and the Children Health Questionnaire (CHQ) for children 4–12 years old (M age = 7.6 yr., SD = 2.5); 58 children with CP ages 9 to 12 years completed the CP QOL–Child and Health-Related Quality of Life Questionnaire for Children (Kid–KINDL) questionnaire. The Gross Motor Function Classification System was also used for the classification of the children with CP. Internal consistency (Cronbachs α) ranged between .63 and .93 for primary caregivers and .61 to .92 for the childrens self-reports. Intra-class correlation coefficients ranged between .88 and .97 for primary caregivers and .91 to .98 for children. It was concluded that the Turkish version of CP QOL questionnaire is a reliable and valid tool for assessing QOL in children with CP.

Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis

Background/aim: Our aim was to investigate the association of kinesiophobia with pain, quality of life, clinical measures, and depression in patients with ankylosing spondylitis (AS). Materials and methods: Patients with AS (n: 163) were enrolled in the study. Kinesiophobia was evaluated with the Tampa Scale of Kinesiophobia (TSK), pain with a visual analog scale (VAS), mobility with Bath Ankylosing Spondylitis Metrology Index (BASMI), disease activity with the Bath AS Disease Activity Index (BASDAI), functional status with the Bath AS Functional Index (BASFI), depression level with Becks Depression Inventory (BDI), and quality of life with the AS Quality of Life Questionnaire (ASQoL). Besides correlation analysis, outcome measures were compared between patients with (TSK ? 37) and without (TSK < 37) kinesiophobia. Results: Kinesiophobia was found to be common with a percentage of 66.6%. TSK scores were correlated with VAS, BASFI, ASQoL, and BDI scores (r = 0.259, r = 0.294, r = 0.392, and r = 0.398, respectively; P < 0.05 for each). There were no correlations between TSK and the BASDAI and BASMI scores (r = 0.142, r = 0.198, respectively; P > 0.05). Patients with kinesiophobia had more pain and poorer BASFI, ASQoL, and BDI scores than patients without kinesiophobia (P < 0.05).Conclusion: Our study is the first study that investigated the relationship between kinesiophobia and other clinical measures in AS patients. Pain and psychological status have an impact on fear of movement and thus functional status and quality of life.

Investigation of the Relationship Between Sensory Processing and Motor Development in Preterm Infants

OBJECTIVE. The aim of this study was to analyze the correlation between sensory processing and motor development in preterm infants. METHOD. We included 30 preterm and 30 term infants with corrected and chronological ages between 10 and 12 mo. We used the Test of Sensory Functions in Infants to evaluate sensory processing and the Alberta Infant Motor Scale to evaluate motor development. RESULTS. The Spearman correlation test indicated a strong positive relationship between sensory processing and motor development in preterm infants (r = .63, p < .001). CONCLUSION. Given the relationship between sensory processing and motor development in the preterm group, the evaluation of sensory processing and motor development in preterm infants was considered necessary for the effective implementation of physiotherapy assessment and interventions.

Rehabilitasyon merkezlerine yönlendirilen nörogelişimsel bozukluğu olan çocukların durumuna bir bakış: Pilot bir çalışma

Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce: Dr. Bülent Elbasan, Gazi Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon, Ankara, Türkiye E-pos ta: bulentelbasan@gmail.com Ge lifl Ta ri hi/Re cei ved: 20.12.2012 Ka bul Ta ri hi/Ac cep ted: 19.04.2013 Türk Pediatri Arşivi Dergisi, Galenos Yayınevi tarafından basılmıştır. / Turkish Archives of Pediatrics, published by Galenos Publishing Profile of children with neurodevelopmental disabilities who are referred to rehabilitation clinics: A pilot study Original Article

Effects of inspiratory muscle training in children with cerebral palsy: a randomized controlled trial

BACKGROUND Respiratory muscle weakness and its relation to other impairments in children with cerebral palsy (CP) have been shown in the latest studies. The effects of inspiratory muscle training (IMT) in this population have not been comprehensively investigated so far. OBJECTIVES To investigate the effects of IMT on trunk control, pulmonary functions, respiratory muscle strength, daily living activities, exercise capacity and quality of life in children with CP. METHODS This was a prospective-randomized controlled trial. Twenty-five children with CP were randomly assigned to the treatment (n=13) or the control group (n=12). The treatment group received IMT at 30% of maximal inspiratory pressure (MIP) and the control group received sham therapy (5% of MIP) for 6 weeks. Also, both groups received routine conventional physical therapy (stretching, strengthening, and functional exercises, etc.) for 6 weeks. The primary outcome measure was trunk control. Secondary outcome measures were pulmonary function, respiratory muscle strength, daily living activities, functional exercise capacity and quality of life. RESULTS The treatment group had better outcome for trunk control (3.87, 95% CI 3.72-4.02). Also, respiratory muscle strength, daily living activities, functional exercise capacity and quality of life were significantly improved in the treatment group compared with controls. No improvements were observed in the pulmonary function test scores between the groups. CONCLUSION Inspiratory muscle training improves trunk control, respiratory muscle strength, daily living activities, functional exercise capacity and quality of life in children with CP and it can be included in the physiotherapy and rehabilitation programs.

Effects of neuromuscular electrical stimulation and kinesio taping applications in children with cerebral palsy on postural control and sitting balance

BACKGROUND Neurodevelopmental treatment (NDT), neuromuscular electrical stimulation (NMES), and Kinesio Taping (KT) applications are separately used to improve postural control and sitting balance in children with cerebral palsy (CP). OBJECTIVE The aim of this study is to examine the combined effect of NDT, NMES and KT applications on postural control and sitting balance in children with CP. METHODS Forty five children, in 3 groups, between the ages 5-12 years were included in the study. Group 1 received NDT; group 2 received NDT + NMES; and the group 3 received NDT + NMES + KT for 6 weeks. Sitting function evaluated by the sitting section of the gross motor function measure (GMFM), and postural control assessed with the seated postural control measurement (SPCM). RESULTS Seating section of GMFM was improved significantly in all the groups; however, increases in the group 3 were higher than groups 1 and 2 (p= 0.001). While significant differences were observed in all groups in the SPCM posture (p< 0.001), function (p< 0.001), and the total scores (p< 0.001); the change in the third group was higher according to the comparison of the three groups within each other. CONCLUSIONS Implementation of the NMES, and KT additionally to NDT improve the sitting posture, postural control, seating function, and gross motor function in children with CP.