Deran Oskay

Cross-Cultural Adaptation, Validation, and Reliability Process of the Michigan Hand Outcomes Questionnaire in a Turkish Population

PURPOSE The Michigan Hand Outcomes Questionnaire (MHQ) is a domain-specific questionnaire that was developed to be used as a standardized instrument capable of measuring outcomes for patients with all types of hand disorders. The purpose of this study was to develop the Turkish version of the MHQ and to examine whether it is a valid and reliable tool for assessing the outcomes in hand disorders. METHODS Translation and back-translation of the MHQ were performed, according to published guidelines. A total of 70 patients with hand complaints completed the final version of the MHQ and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire Turkish version (DASH-T) twice, on their first visit and after an interval of 7 days. Visual analog scale (VAS) results for pain intensity and grip strength measurements of the individuals were also taken in both assessments consecutively. RESULTS Translation and back-translation revealed no major difficulties. The Turkish version of the MHQ met set criteria of reliability and validity. The intraclass correlation coefficient of the test-retest reliability for the 6 subscales ranged from 0.79 to 0.96. The internal consistency of the MHQ, estimated by Cronbachs alpha, ranged from 0.85 to 0.96 for all subscale scores. There were high to moderate correlations between MHQ and DASH scores and VAS and grip strength scores of the injured side. CONCLUSIONS The Turkish version of the MHQ has excellent test-retest reliability and validity, and it is an adequate and useful instrument for measuring functional disability in hand disorders of Turkish-speaking patients.

Quality of life in mothers of children with obstetrical brachial plexus palsy.

Background:  The aim of this study was to explore impairment in quality of life (QOL) of the mothers who were primarily responsible for taking care of children with obstetrical brachial plexus palsy (OBPP) and to state its association with the age, sex and functional status of the child with OBPP.

Impact of obstetrical brachial plexus injury on parents

The aim of this study was to describe the impact of obstetrical brachial plexus palsy (OBPP) on parents and to investigate the effect of the severity of OBPP and the age of the children on parents.

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.

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

Hand functions in systemic lupus erythematosus: a comparative study with rheumatoid arthritis patients and healthy subjects

Background/aim Systemic lupus erythematosus (SLE) frequently affects the small joints of the hand and may result in difficulty in activities of daily living. There are very few studies evaluating the problems encountered in the hands in patients with SLE. The aim of this study is to evaluate hand functions in patients with SLE and compare them with rheumatoid arthritis (RA) patients and healthy subjects. Materials and methods A total 46 female patients meeting the SLE classification criteria were recruited. Similarly, 51 female RA patients and 46 healthy female subjects served as the control groups. To assess the upper extremity disability level, the Disability Arm Shoulder and Hand Questionnaire (DASH) was used. Some functional performances such as hand grip and pinch strength were evaluated using a dynamometer and the Nine Hole Peg Test (NHPT), respectively. Results Hand functions were found to be impaired in both SLE and RA patients when compared to healthy controls. In addition, patients with SLE showed better performance in the NHPT, hand grip, and pinch strength than RA patients (P < 0.05). However, the patient-reported disability level was similar in both patient groups (P > 0.05). Conclusion Similar to patients with RA, hand functions are significantly impaired in patients with SLE in daily activities.

Proprioception After Hand and Wrist Injury, Surgery, and Rehabilitation

Several conditions may impair the proprioception and sensorimotor function of hand and wrist. Especially upper extremity conditions such as carpal tunnel syndrome, distal radius fracture, metacarpal fractures, dislocation, and complex regional pain syndrome are the common causes of the proprioception deficits. There is still a lack of consensus in the literature about a simple, clinically suitable, and reliable method to assess proprioception of hand or wrist. Although its reliability and validity are still criticized, using a goniometer to easily assess joint position sense of the hand and wrist seems to be the simple and reliable method. Detection of passive motion, joint position reproduction, and active movement extent discrimination are the main testing techniques reported in the literature for assessing proprioception of proximal joints and hand/wrist. Portable novel devices are also introduced in the literature to assess proprioception of the hand and wrist. Proprioceptive training to be applied to the wrist should be sustained in two phases: late and early phases post-injury. Proprioceptive exercises done in the early phase could prevent functional demands that may occur due to the prolonged immobilization, pain, edema, and degreased active range of motion. Late-phase rehabilitation methods are particularly used to increase muscle strength and joint stabilization. The factor that will shape the strengthening programs principally is tissue healing.

Fear of movement and its effects on hand function after tendon repair

After tendon injuries, it has been observed clinically that patient-reported disability is more severe than the patients actual performance. This is thought to result from a fear of movement (kinesiophobia) after surgery. The aim of this study was to investigate the presence of kinesiophobia in this patient population and its effects on the clinical outcomes. Patients (n=118) with tendon repairs were included. All the participants received early passive mobilization and were assessed at the end of the 8th week. Grip and pinch strengths were measured and the Nine-Hole Peg Test (9HPT) was conducted. Patients also filled out the Michigan Hand Outcomes Questionnaire (MHOQ) and Tampa Scale for Kinesiophobia (TSK). Patients were divided according to their kinesiophobia: Group 1 with low kinesiophobia (TSK<37) and Group 2 with high kinesiophobia (TSK≥37). The groups were compared on the assessed parameters. Fifty-nine percent of the patients had a high kinesiophobia level. The performance-based test results were similar between the groups (P>0.05). Patient-reported MHOQ and TSK scores were significantly lower in the high kinesiophobic group (P=0.001 and P=0.000, respectively). Patients with tendon repairs often develop kinesiophobia, which may contribute to difficulty when starting to re-use their hand in daily life. None of the objective results were affected by this fear of movement-only patient-reported disability. Clinicians should be aware that clinical outcomes may be affected by the patients kinesiophobic thinking and must be cautious during treatment.

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.

The presence and influence of posterior capsule tightness on different shoulder problems

BACKGROUND In the literature it has been shown that posterior capsule flexibility is a precursor to shoulder problems. However, no study thus far has shown the influence of the flexibility of posterior capsule in different shoulder pathologies. OBJECTIVE This study set about to compare the role of posterior capsule tightness in different shoulder problems. METHODS One-hundred-twenty-five patients diagnosed with shoulder subacromial impingement syndrome (n= 52), partial rotator cuff tear (n= 31) or frozen shoulder (n= 42) and 30 asymptomatic peers participated in the study. Horizontal adduction was assessed in side-lying position for posterior capsule tightness. Pain was measured via the visual analogue scale and shoulder range of motion and active total elevation was assessed with goniometer. Hand behind the back (HBB) test was assessed the active internal rotation by measuring the distance between T5 and the thumb. RESULTS It was found that the affected side of the posterior capsules of the patients with subacromial impingement syndrome (p< 0.001), partial rotator cuff tear (p< 0.001) and frozen shoulder (p< 0.001) was stiffer than their healthy side. There were significant differences among groups in the level of tightness in the posterior capsule between the affected and the healthy sides (p< 0.001). All range of motion of the shoulder including HBB test and the posterior capsule tightness of the affected side are found to be correlated (p< 0.05). CONCLUSIONS This study emphasized that the posterior capsules susceptibility to tightness is most evident in frozen shoulder among different shoulder problems.