Gul Sener

Demography and function of children with limb loss

This retrospective study was designed for the period 1982 – 2002 to collect the basic data on the demography, level and side of the amputation, involved limbs, age, gender, and prosthetic functional level in children with limb loss. A total of 232 children were assessed through their prosthetic records. Seventy-two percent (195 children) presented lower-limb involvement, and 28% (77 children) had upper-limb loss. The age of the children varied between 1 and 15 years with a mean age of 9.90 ± 2.32 years. Results of the study revealed that the leading amputation cause in children was congenital limb absence. The most frequent levels were determined as trans-tibial and trans-radial in lower and upper limbs, respectively. Findings showed that more boys (60%) were affected, and 84% of all amputations were found to be unilateral. It was also seen that right-side amputations (54%) were more common than left-side amputations (46%). The outcome of the study showed that 96% of children with lower-limb loss reached a functional gait pattern without any aids, while the percentage of independence in activities of daily living was found to be 88% in upper-limb loss.

Associations among Physical Activity, Comorbidity, Functional Capacity, Peripheral Muscle Strength and Depression in Breast Cancer Survivors

Physical inactivity may an important outcome in the prognosis of breast cancer. Physical activity levels decrease significantly for breast cancer patients following the treatment and remain low after oncology treatment is completed. The aim of this study was to determine physical activity levels and to examine associations among physical activity, comorbidity, functional capacity, peripheral muscle strength, and psychosocial status in breast cancer patients. Forty breast cancer survivors were included in this study. Demographic and clinical characteristics were recorded. Physical activity was assessed with a short form of the International Physical Activity Questionnaire (IPAQ). We defined comorbid diseases according to the Charlson Comorbidity Index (CCI). Functional capacity was evaluated with a six-minute walk test (6MWT). Peripheral muscle strength was measured for quadriceps femoris muscle with a hand-held dynamometer. Psychosocial status was measured with the Hospital Anxiety Depression Scale (HADS). Forty percent of patients were inactive. The IPAQ total score was significantly related with quadriceps muscle strength (r=0.492; p<0.001) and HADS depression score (r=0.341; p<0.05). Marked correlations were also observed between IPAQ walking score and quadriceps muscle strength (r=0.449; p<0.001), HADS depression score (r=0.341; p<0.05), and CCI (r=-0.433; p<0.001). The CCI score was also markedly associated with quadriceps muscle strength (r=-0.413; p<0.001). 6MWT distance was not significantly correlated with any of the parameters. Regression analyses revealed that psychosocial status and peripheral muscle strength were significant predictors of physical activity estimated with the IPAQ short form and when combined, they explained 35% of the variance. Comorbidities, peripheral muscle strength and psychosocial status partially explain the variability of physical activity level in breast cancer survivors. These results suggest that physical inactivity contributes to worsening health in breast cancer survivors.

Cross cultural adaptation and reliability of the Turkish version of Amputee Body Image Scale (ABIS)

OBJECTIVES The Amputee Body Image Scale (ABIS) is a self assessed questionnaire with 20 items created to measure body image perception of amputees. The questions assess how an individual perceives and feels about his or her body experience. But no Turkish version is available. The aim of this study was to cross-culturally adapt the ABIS for use with Turkish speaking lower limb amputees and to determine reliability. METHODS The sample consisted of 50 transtibial amputees. The mean age of the participants was 43.14, SD: 14.66. The ABIS has been filled by the patients for two times. RESULTS Internal consistency of the ABIS was very high (Cronbach alpha 0.834 for test and 0.842 for retest). The test-retest reliability was excellent for the ABIS (ICC = 0.939, 95% CI 0.895-0.965). CONCLUSIONS The Turkish version of the ABIS is a reliable instrument to assess body image in lower limb amputees.

Footwear suitability in Turkish preschool-aged children

Background: Unsuitable footwear worn in childhood may cause some foot problems by interfering normal development of foot. Objectives: To compare footwear suitability rate of indoor and outdoor footwear at all points in preschool children and investigate factors which could affect footwear suitability. Study design: A cross-sectional survey study. Methods: A total of 1000 healthy preschool children (4–6 years old) participated in this study. Indoor and outdoor footwear of children were evaluated through Turkish version of Footwear Assessment Score. Effect of factors like age, sex, number of siblings, educational and occupational situation of parents, and behavior of school management about selecting footwear was investigated. Results: Children got better footwear score for outdoor than indoor ones (p < 0.001). Boys got statistically better footwear score for both indoor and outdoor ones than girls (p < 0.001). Also significant difference in footwear score was found in favor of children who were going to schools that gave guidance about selecting footwear for both indoor and outdoor in comparison to children going to other schools (p < 0.001). Conclusions: For healthy foot development, parents need an education about suitable footwear for their children. Performing education programs and investigation of their effect with comprehensive follow-up studies in future is essential. Clinical relevance This study reflects footwear habits of Turkish preschool children and factors affecting this issue. Results may give way to education programs about suitable footwear worn in childhood for healthy foot development.

Outcome of activities of daily living in upper limb amputees

Activities of daily living were evaluated on 30 unilateral upper limb amputees. Although independence was more obvious in the amputees who have had distal amputations, all the amputees reached an adequate functional level in the activities of daily living. The treatment period for upper extremity amputees was shorter for distal than for more proximal amputations.

Evaluation Of Gait Symmetry In Amputees Who Use Below Knee Prosthesis With Dynamic Foot

Purpose: To assess inter limb symmetry while walking in unilateral transtibial amputees which use dynamic foot. Method: Gait velocity, cadence, step length, stance percentages and ambulation index results of amputees (n=20) were recorded. Comparison was made with control group. (n=21) Results: Gait velocity, cadence and ambulation index results were greater for control group. Cases had longer stance time on their intact limb than amputated side. Stance time difference between limbs were higher for amputee group than control group. Conclusion: Amputees had higher stance percentage on their intact limb than sound limb with regard to healthy people.

Neurodevelopmental Therapy: Sensory Integration and Vestibular Stimulation Intervention in Mentally Retarded Children

Mental retardation is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. Sensory integration is the brain’s organization of sensory input.