Devrim Tarakci

Wii-based Balance Therapy to Improve Balance Function of Children with Cerebral Palsy: A Pilot Study.

[Purpose] Cerebral palsy is a sensorimotor disorder that affects the control of posture and movement. The Nintendo® Wii Fit offers an inexpensive, enjoyable, suitable alternative to more complex systems for children with cerebral palsy. The aim of this study was to investigate the efficacacy of Wii-based balance therapy for children with ambulatory cerebral palsy. [Subjects] This pilot study design included fourteen ambulatory patients with cerebral palsy (11 males, 3 females; mean age 12.07 ± 3.36 years). [Methods] Balance functions before and after treatment were evaluated using one leg standing, the functional reach test, the timed up and go test, and the 6-minute walking test. The physiotherapist prescribed the Wii Fit activities,and supervised and supported the patients during the therapy sessions. Exercises were performed in a standardized program 2 times a week for 12 weeks. [Results] Balance ability of every patient improved. Statistically significant improvements were found in all outcome measures after 12 weeks. [Conclusion] The results suggest that the Nintendo® Wii Fit provides a safe, enjoyable, suitable and effective method that can be added to conventional treatments to improve the static balance of patients with cerebral palsy; however, further work is required.

Effects of Nintendo Wii-Fit(®) video games on balance in children with mild cerebral palsy.

This study compared the effects of Nintendo Wii‐Fit® balance‐based video games and conventional balance training in children with mild cerebral palsy (CP).

Calcaneal quantitative ultrasound measurements in young male and female professional dancers.

The aim of this study was to assess the bone status of dancers using calcaneal quantitative ultrasound (QUS). Twenty-four male and 26 female dancers (aged 19–36 years) and 100 age-and sex-matched nonathletic controls were included in this study. QUS parameters (broadband ultrasound attenuation [BUA], speed of sound [SOS], quantitative ultrasound index [QUI], and estimated heel bone mineral density [eBMD]) were obtained for both heels in all subjects using a gel-coupled QUS device. Two-way analysis of variance, including the factors of dancing status and gender, revealed significant differences in all QUS parameters between the dancers and the controls (p < 0.001 for all), without a significant interaction with gender status. For each heel (right versus left), the mean QUI, BUA, SOS, and eBMD values of the male and female dancers were 22.0% vs. 20.9% and 16.6% vs. 16.0%; 21.6% vs. 24.1% and 13.2% vs. 14.3%; 2.3% vs. 2.0% and 1.7% vs. 1.7%; and 25.0% vs. 23.9% and 19.0% vs. 18.6% higher than those of the male and female controls, respectively. Analysis of covariance still revealed significant differences between the dancers and the controls after controlling for the influence of body mass index (p < 0.001). Furthermore, the finding that significant bilateral differences in BUA did exist in the controls but not in the dancers demonstrated site-specific effects of exercise on bone, indicating that it is the dance that improved bone properties. Calcaneal QUS, with a strong discriminative ability between those involved in professional dance and normally active individuals, emerges as an attractive technology for exploring the benefits of exercise on bone, which might be a challenge for those in the conditioning field, who need to identify those who need intervention in terms of bone status and promote participation in high-impact physical activity, such as dance, to enhance bone quality.

Disabled children's functionality and maternal quality of life and psychological status.

Physiotherapy is being provided for different disabled groups in pediatric rehabilitation centers. The quality of life (QOL) and psychological status of the mothers of these children is affecting their compliance in the rehabilitation period. The aim of this study was therefore to assess the relationship between disability level of individuals receiving rehabilitation and maternal QOL, psychological status and influencing factors.

The impact of epilepsy on preschool children and their families

This study investigated the possible presence of sensory-motor developmental impairments in preschool children with epilepsy and explored epilepsy impact on their activities and quality of life and on the stress load of their family. Study participants were children aged 2-6years diagnosed with epilepsy without any other comorbidities (epi-only children). The instruments used for assessment included the Neurological, Sensory, Motor, Developmental Assessment (NSMDA) scale for sensory-motor development, the Impact of Childhood Neurologic Disability Scale (ICNDS), and the Impact of Pediatric Epilepsy Scale (IPES) for disease impact on disability and Quality of Life (QoL), as well as the Pediatric Outcomes Data Collection Instrument (PODCI) for functional health status, and the Parental Stress Scale (PSS) for the family stress load. Required data were obtained from direct testing or observation of childrens activities and mother-supplied answers to questions. Eighty-two children were investigated. The NSMDA scores were in the normal development range 6-8. Significant moderate impact of the disease on disability and QoL was estimated with the ICNDS and IPES instruments. The PODCI scores were similar to healthy population levels except for the happiness dimension which was better for children with epilepsy. PSS were significantly above normal. The functional health and QoL of the children as well as their family stress were found to be positively correlated with increasing age. It is found that epilepsy does not degrade neuromotor development and functional health status of preschool epi-only children, though it has a significant impact on their neurological disability and QoL and the stress level of their families; this impact seems to decrease with age.

Turkish version of the Motor Function Measure Scale (MFM-32) forneuromuscular diseases: a cross-cultural adaptation, reliability, and validity study

Background/aim: The Motor Function Measure (MFM-32) is a classification system for ambulant and nonambulant patients with neuromuscular diseases (NMDs). We aimed to translate it into Turkish, culturally adapt it, and test its reliability and validity for Turkish patients with NMDs.Materials and methods: The translation of the 32 items assessing three functional areas: standing position and transfers (D1: 13), axial/proximal (D2: 12), and distal (D3: 7) motor functions was performed according to the established guidelines for cross-cultural adaptation. Totally 51 patients (12.56 ± 8.84 years; F/M 12/39) were tested. Vignos and Brooke scores for the lower and upper extremities, respectively, were used for the validity of the MFM-32-TR items, which were rated on a 4-point Likert scale. Results: The agreement coefficients for interrater reliability were excellent (0.72-0.93) for 10 items, good (0.58-0.77) for 16 items, and moderate (0.42-0.56) for 6 items of the MFM-32-TR. The intertester reliability varied from good to excellent and the intraclass correlation coefficient was 0.76-0.93. The MFM-32-TR positively correlated with Vignos and Brooke scores with coefficients 0.47 to 0.75, indicating concurrent validity.Conclusion: The MFM-32-TR is a reliable and valid outcome measure for the assessment of motor function of people with NMDs in our sociocultural context.

Examining the postural awareness and flexibility changes in physical therapy students who took clinical Pilates class

Objective: This study aimed to evaluate postural awareness and changes in posture and flexibility of students who took Clinical Pilates class as an elective course at the undergraduate level. Methods: The study conducted from 2013-2016 included 98 students who took Clinical Pilates class at the Department of Physical Therapy and Rehabilitation, School of Health Sciences, Istanbul Medipol University, Turkey. The flexibility levels of the study participants were measured before and after the Clinical Pilates education using finger-to-floor test and modified Schober’s test. Observational posture analysis and postural awareness were recorded using the scale prepared by the researchers. Results: The post-education evaluations showed that postural distortions were fixed, and a significant increase in the postural awareness of the students was observed compared with the pre-education period. The results of both modified Schober’s test and finger-to-floor test, which were used to measure the flexibility levels, showed a statistically significant increase in post-education scores compared with those of the pre-education period. Conclusion: This study showed that the Clinical Pilates course increased postural awareness and flexibility of physical therapy students and fixed postural distortions. Thus, the inclusion of Clinical Pilates class in the undergraduate education is considered to be important.

Escobar Sendromu’nda Fizyoterapi ve Rehabilitasyon: Olgu Sunumu

Amac: Nadir gorulen bir sendrom olarak Escobar’la ilgili literaturde rehabilitasyon uygulamalari konusunda yeterince calismaya rastlanmamaktadir. Bu calismada Escobar Sendromlu 5 aylik kiz cocuk sunulmus, klinik ozellikleri ve yapilan fizyoterapi uygulamalari tartisilmistir. Gerec ve Yontem: Basini tutabilen hasta yuzustu pozisyonda on kollari uzerinde kendini destekleyemiyordu. Olgunun fizyoterapiye yonlendirilme sebebi motor gelisiminin yasitlarina gore daha yavas olabilecegi gorusu ve eklemlerdeki hareket kisitliliklarinin kontrakturlere donusmeden onlenebilmesiydi. Olgu “Kaba Motor Fonksiyon Olcumu Testi (GMFM ) ile degerlendirildi. Testin “yatma ve yuvarlanma” alt maddesinden 8 puan aldi. Ayrica olguda alt ekstremitede ileri derecede olmak uzere omuz , dirsek, el bilegi ve parmaklarda hareket kisitliliklari gonyometrik olcumlerle belirlendi. Pasif omuz fleksiyonu sagda 120o, solda 115o; omuz abduksiyonu sagda 135o, solda 125o; dirsek ekstansiyonu sagda 170o, solda 170o; el bilegi ekstansiyonu sagda 0o, solda 0o olarak olculdu. Hasta 9 ay haftanin 2 gunu fizyoterapiye alindi. Motor gelisimini desteklemek amaciyla norofizyolojik yaklasimlar, ust ekstremite eklem hareket acikligini koruma amacli eklem hareket acikligi ve germe egzersizleri uygulandi. Sonuclar: Sonuc olcumleri alindiginda 14 aylik olan olgu bagimsiz olarak sirtustunden yuzustune ve tersi yone donebilmekte, yuzukoyun on kollari uzerinde yukselebilmekte, oturabilmekte, oturma pozisyonunda dengesi bozuldugunda kendini elleriyle destekleyebilmekte idi. GMFM’ye gore “yatma ve yuvarlanma” testinden 30, “oturma” testinden 8 puan aldi. Ust ekstremitede omuz fleksiyonu sagda 130o, solda 120o; omuz abduksiyonu sagda 150o, solda 140o; dirsek ekstansiyonu sagda 180o, solda 175o; el bilegi ekstansiyonu sagda 10o, solda 10o’ye yukseldi. Tartisma: Escobar Sendromunda fizyoterapi ve rehabilitasyon uygulamalarinin olumlu sonuclar verecegini dusunmekteyiz.

Genç Erişkinlerde Fiziksel Aktivite Düzeyi İle Vücut Kompozisyonu İlişkisi: Pilot Çalışma

Amac: Genc eriskinlerde fiziksel aktivite duzeyi ile vucut kompozisyonu ve cinsiyet arasindaki iliskiyi arastirmakti. Materyal ve Metod: Son 6 ay icinde kardiyopulmoner, ortopedik, romatizmal ya da metabolik hastalik hikayesi olmayan 62 ogrenci calismada yer aldi. Ogrencilerin demografik ve fiziksel ozellikleri kaydedildi. Fiziksel aktivite duzeyi FIT Skoru ile belirlendi, vucut kompozisyonunu degerlendirmesinde Beden Kutle Indeksi ile skinfold kaliper olcumlerinden elde edilen degerler kullanilarak hesaplanan vucut yag orani ve ideal vucut agirligi kullanildi. Bulgular: Katilimcilarin fiziksel aktivite ortalamasi 27,08±18,74 olarak bulundu. Fiziksel aktivite seviyesi cok iyi olan ogrenciye rastlanmadi. Kizlarin fiziksel aktiviteleri (26,53±19,73) ve erkeklerin fiziksel aktivite (27±18,55) ortalamalari arasinda fark bulunmadi (p=0,936). Erkeklerin beden kutle indeksi (24,92±3,15 kg/m2) kizlardan (21,23±3,18 kg/m2) yuksekti (p=0,004). Kizlarin vucut yag orani (%22,74±6,93) erkeklerin vucut yag oranindan (%16,60±5,46) yuksekti (p=0,003). Her iki cinsiyet arasinda fazla kilo yuzdesi bakimindan fark yoktu (kizlar:0,05±0,12 erkekler:0,06±0,11, p=0,804). Korelasyon analizinde kizlarda fiziksel aktivite ve beden kutle indeksi arasinda anlamli iliski saptanmadi (p=0,055) ancak erkeklerde fiziksel aktivite ile beden kutle indeksi (rs=0,662, p=0,007), vucut yag orani (rs=0,602, p=0,018), ideal vucut agirligi (rs=0,544, p=0,036) ve fazla kilo yuzdesi arasinda pozitif yonde anlamli iliski saptandi (rs=0,560, p=0,030).Sonuc: Katilimcilarin fiziksel aktivite duzeylerinin dusuk seviyede olup beden kutle indekslerinin ve yag oranlarinin normal sinirlar icerisinde olmasi calismanin genc populasyonda yapilmis olmasi ile aciklanabilir. Genclerin vucut kompozisyonlarinin saglikli olmasi sevindiricidir ancak ileride inaktiviteye bagli olarak ortaya cikabilecek sorunlari onlemek acisindan fiziksel aktiviteye daha fazla tesvik edilmesi gerektigi dusunulmektedir.

Klinik Pilates Eğitimi Alan Fizyoterapi Öğrencilerinin Vücut Farkındalığı ve Esnekliğin Değerlendirilmesi

AMAC: Klinik Pilates govdenin postural kaslarini dengeli calistiran ve omurgayi destekleyen bir egzersiz sistemidir. Fizyoterapistlere Pilates egitimi son yillarda mezuniyet sonrasi egitimlerle ogretilmektedir. Bu calismadaki amacimiz secmeli ders olarak Yoga-Pilates dersine katilan ogrencilerin vucut farkindaligi ve esneklik sonuclarini degerlendirmektir. GEREC YONTEM: Calismaya Istanbul Medipol Universitesi, Fizyoterapi ve Rehabilitasyon Bolumu, Yoga-Pilates dersine katilan 16 ogrenci alindi. Calismaya katilan ogrencilerin Pilates egitimi verilmeden once ve sonra esneklik olcumleri yapildi ve vucut algisi(farkindalik) kaydedildi. Istatistik analizi SPSS-20.00 programi ile yapildi. SONUCLAR: Pilates egitimi sonunda yapilan degerlendirmelere gore postur bozukluklarinda duzelmeler bulundu. Esneklik olcumlerinde ise hem modifiye shober testi hem de parmak zemin testi sonuclarina gore egitim sonrasi egitim oncesine gore istatistiksel olarak anlamli bir gelisme goruldu (p<0,05). Vucut farkindaligi sorgulandiginda ogrencilerin egitim oncesine gore vucut farkindaliklarinda onemli bir artis oldugu goruldu (p<0,05). TARTIŞMA: Verilen egitime gore Pilates dersi oncesi ve sonrasi fizyoterapi ogrencilerinin vucut farkindaligini ve esnekligi artirdigi, postur bozukluklarini onledigi gorulmektedir. Pilates egitimi sadece fizyoterapi ogrencileri uzerine bu duzeltmeyi saglamasi hastalarina ornek olmalari acisindan onemlidir. Bu amacla pilates egitimin lisans egitimde yer almasinin onemli oldugunu dusunmekteyiz. Ileride yapilacak benzer calismalarin daha fazla sayida olgu ile yapilmasinin gerekli oldugu sonucuna varilmistir. Anahtar kelimeler: Pilates, vucut farkindaligi, esneklik