Mintaze Kerem Günel

The effects of Kinesio Taping on body functions and activity in unilateral spastic cerebral palsy: a single‐blind randomized controlled trial

The aim of this study was to investigate the effects of Kinesio Taping (KT) on the body functions and activity of children with unilateral spastic cerebral palsy (CP).

Rehabilitation of children with cerebral palsy from a physiotherapist’s perspective

Pediatric rehabilitation requires a multidisciplinary team approach to disabilities or handicaps caused by physical, mental, sensory-perceptional, or cognitive disorders due to prenatal, natal, or postnatal causes. Cerebral palsy (CP) is defined as persistent but not progressive disorder of posture and movement system, associated with functional activity limitations and sensorial, cognitive, communication problems, epilepsy, and musculoskeletal system problems. Physiotherapy approaches in rehabilitation applications aim to normalize sensorial and motor functions, provide normal posture and independent functional activity, regulate muscle tone, improve visual and auditory reactions, support normal motor development and motor control, improve ambulation and endurance, increase the quality of the existing movements, prevent soft tissue, joint and postural disorders, support orthopedic and surgical procedures, and finally to prepare the child for the adolescent and adult periods. Setting realistic goals, determination of the priorities, informing the family and enhancing family participation in physiotherapy programs will increase the success of physiotherapy. This article reviews current rehabilitation approaches and physiotherapy applications for children with CP.Pediatric rehabilitation requires a multidisciplinary team approach to disabilities or handicaps caused by physical, mental, sensory-perceptional, or cognitive disorders due to prenatal, natal, or postnatal causes. Cerebral palsy (CP) is defined as persistent but not progressive disorder of posture and movement system, associated with functional activity limitations and sensorial, cognitive, communication problems, epilepsy, and musculoskeletal system problems. Physiotherapy approaches in rehabilitation applications aim to normalize sensorial and motor functions, provide normal posture and independent functional activity, regulate muscle tone, improve visual and auditory reactions, support normal motor development and motor control, improve ambulation and endurance, increase the quality of the existing movements, prevent soft tissue, joint and postural disorders, support orthopedic and surgical procedures, and finally to prepare the child for the adolescent and adult periods. Setting realistic goals, determination of the priorities, informing the family and enhancing family participation in physiotherapy programs will increase the success of physiotherapy. This article reviews current rehabilitation approaches and physiotherapy applications for children with CP.

Agreement between parents and clinicians for the motor functional classification systems of children with cerebral palsy

Purpose. This study aimed to evaluate whether parental ratings of expanded and revised Gross Motor Function Classification System (GMFCS E&R) and Manual Ability Classification System (MACS) had agreement with clinicians’ ratings when classifying children with CP to these two well-known classifications of motor functioning and hereby to evaluate intertester reliability of the classification systems between clinicians and parents. Method. The process of study was designed to collect data from parents using the GMFCS E&R and MACS. The total participants consisted of 100 children with CP and their parents. The overall agreement between the parents and physiotherapist GMFCS and MACS scores was analysed using intraclass correlation coefficient (ICC). Results. The ICC value between parents and physiotherapist was 0.96 (95%% confidence interval [CI] 0.95–0.97) for GMFCS and 0.96 (95%% CI 0.94–0.97) for MACS and indicated excellent agreement. Conclusions. The excellent agreement between parents and clinicians indicated that parents and clinicians can talk in the same language for the motor functional classification systems of children with CP if careful administrations are provided.

Effect of Connective Tissue Manipulation on Symptoms and Quality of Life in Patients With Chronic Constipation: A Randomized Controlled Trial

OBJECTIVE The purpose of this study was to examine the effects of connective tissue manipulation (CTM) on the severity of constipation and health-related quality of life in individuals diagnosed with chronic constipation. METHODS Fifty patients with a diagnosis of chronic constipation according to Rome III criteria were recruited and randomized to an intervention (n = 25) or control group (n = 25). The intervention group received CTM in addition to the lifestyle advice, whereas the control group was given only lifestyle advice for constipation. All assessments were performed at baseline and at the end of 4 weeks. The primary outcome measure was the Constipation Severity Instrument. Secondary outcomes included Patient Assessment of Constipation Quality of Life Questionnaire, Bristol Stool Scale, and 7-day bowel diary. Differences between groups were analyzed with t tests, Mann-Whitney U test and χ(2) test. RESULTS Compared with the control group, subjects in the intervention group reported significantly greater improvement in total and subscale scores of the Constipation Severity Instrument and Patient Assessment of Constipation Quality of Life Questionnaire (P < .05). Based on the results from bowel diaries, the improvements in the number of bowel movements, duration of defecation, stool consistency, and the feeling of incomplete evacuation in the intervention group were also significantly more than the control group (P < .05). CONCLUSION This study showed that CTM and lifestyle advice were superior to reducing symptoms of constipation and quality of life compared with lifestyle advice alone for patients with chronic constipation.

Early Childhood Intervention and Early Childhood Special Education in Turkey Within the Scope of the Developmental System Approach

The purpose of this article was to provide an overview of early childhood intervention and early childhood special education (ECI/ECSE) services and practices in Turkey by using the Developmental System Approach (M. J. Guralnick, 2001). After pointing out the history of early childhood and ECI/ECSE services and current legislations with regard to ECI/ECSE in Turkey, the article focuses on ECI/ECSE practices in Turkey. Although ECI/ECSE legislative acts have been in place since 1980s, there are critical issues regarding the provision of systematic ECI/ECSE both to young children with developmental delays or at risk for developmental delays and to their families. These issues include lack of a model system approach, lack of assessment tools and curricula, and lack of qualified personnel. Future recommendations for ECI/ECSE are provided.

Investigation of interobserver reliability of the Gillette Functional Assessment Questionnaire in children with spastic diparetic cerebral palsy

OBJECTIVES Information obtained from families is of particular importance in the evaluation of functional mobility skills of children with cerebral palsy (CP) after orthopedic interventions and long-term rehabilitation applications. This study was designed to evaluate the interobserver reliability of the Gillette Functional Assessment Questionnaire (FAQ) which was administered to the mothers and the physiotherapist for children with CP. METHODS The study included 52 spastic diparetic children with CP (22 girls, 30 boys; mean age 7.8+/-4.4 years; range 4 to 12 years) and their mothers. According to the Gross Motor Function Classification System (GMFCS), all the children were in level 1 to 3. The Gillette FAQ was administered to the mother and physiotherapist to determine the functional walking level of the child and the interobserver reliability of the FAQ was calculated. In addition, gross motor performance was evaluated by the standing and walking-running-jumping dimensions of the Gross Motor Performance Measure (GMPM), and functional independence level was evaluated by the transfer and locomotion dimensions of the Functional Independence Measure for Children (WeeFIM). Correlations were sought between the FAQ results of the physiotherapist and mothers and the GMFCS, GMPM, and WeeFIM. RESULTS The intraclass correlation coefficient for interobserver reliability of the Gillette FAQ was 0.94 (95% CI 0.898-0.966). A highly significant correlation was found between the responses of the mother and physiotherapist to the Gillette FAQ (r=0.882, p<0.01). The responses of the mother and physiotherapist to the Gillette FAQ showed a negative correlation with the GMFCS level, and positive correlations with the dimensions of the GMPM and WeeFIM studied (p<0.01). CONCLUSION The Gillette FAQ can be used by the physiotherapists to determine the functional changes in spastic diparetic children with CP and can help clinicians derive important information from the families about functional walking of their children.

The Cross-cultural Adaptation, Reliability, and Validity of the Copenhagen Neck Functional Disability Scale in Patients With Chronic Neck Pain: Turkish Version Study

Study Design. The study design was cross-cultural adaptation and investigation of reliability and validity of the Copenhagen Neck Functional Disability Scale (CNFDS). Objective. The aim of this study was to translate the CNFDS into Turkish language and assess its reliability and validity among patients with neck pain in Turkish population. Summary of Background Data. The CNFDS is a reliable and valid evaluation instrument for disability, but there is no published the Turkish version of the CNFDS. Methods. One hundred one subjects who had chronic neck pain were included in this study. The CNFDS, Neck Pain and Disability Scale, and visual analogue scale were administered to all subjects. Results. For investigating test-retest reliability, correlation between CNFDS scores, applied at 1-week interval, intraclass correlation coefficient score for test-retest reliability was 0.86 (95% confidence interval = 0.679–0.935). There was no difference between test-retest scores (P < 0.001). For investigating concurrent validity, correlation between total score of the CNFDS and the mean visual analogue scale was r = 0.73 (P < 0.001). Concurrent validity of the CNFDS was very good. For investigating construct validity, correlation between total score of the CNFDS and the Neck Pain and Disability Scale was r = 0.78 (P < 0.001). Construct validity of the CNFDS was also very good. Conclusion. Our results suggest that the Turkish version of the CNFDS is a reliable and valid instrument for Turkish people.

Mesenchymal stem cell application in children with subacute sclerosing panencephalitis

Subacute sclerosing panencephalitis (SSPE) is a serious, often fatal disease that responds poorly to current treatment modalities. Recently, the ability of mesenchymal stem cells (MSCs) to produce neurotrophic factors and inflammatory molecules has placed them among potential treatment agents for neurological conditions. We report the results of four patients treated with MSC for SSPE. The patients were followed up clinically, and by periodical laboratory evaluations, magnetic resonance imaging (MRI), and electroencephalography. One patient deteriorated to stage III of the disease, two patients remained in the same stage, and one died from disease progression and respiratory problems. Neurological findings and electroencephalography scores were consistent with the clinical course of the patient whereas MRI showed new inflammatory lesions in two patients. This is the first report of the application of MSC in SSPE. No benefit is demonstrated.

Are migraineur women really more vulnerable to stress and less able to cope

BackgroundIn this study, we aimed to investigate the differences between a sample of migraineurs and non-migraineurs with regard to their stress symptoms, tendency to stress, coping styles and life satisfaction.MethodsThis study was carried out on a migraineur group (n = 62, mean age: 37.5 ± 11.3, range: 18 to 61 years) and a non-migraineur group (n = 58, mean age: 32.0 ± 11.2, range: 18 to 61 years). Stress Audit (Symptoms), Stress Audit (Vulnerability), Turkish version of Ways of Coping Inventory Scales and Life Satisfaction were applied to the migraineur and non-migraineur groups.ResultsNo significant differences were found between the groups in the scores of the stress symptoms except in the sub scores of the sympathetic system. There was no significant difference between the groups in the tendency to stress and life satisfaction (p > .05). For scores of the coping styles, the mean scores of the seeking social support subscale was higher in the control group than that of the migraineur group. However, migraineur women had higher mean scores in the submissive and the optimistic subscales.ConclusionWe consider that, these outcomes may emphasize the necessity to be careful when using negative expressions about stress relating to migraineurs. Further comprehensive studies are required considering the multiple triggers of the disease in various cultural contexts.

Do the physiotherapy results make us happy in a case with ‘happy puppet’ (Angelman) syndrome?

This study aimed to investigate the benefits of physiotherapy programme in a patient with Angelman syndrome (AS) during a follow-up of 3 years. Assessments included: disability level with gross motor function classification systems, gross motor function with gross motor function measurement (GMFM), balance with Berg Balance Scale, motor performance with gross motor performance measurement (GMPM) and tonus assessment with Modified Ashworth Scale. Physiotherapy programme was performed during 36 months, 3 days per week by physical therapist according to Neurodevelopmental Treatment approach. During the 36 months, GMFM increased from 11.46% to 70.82% and GMPM increased from 1.25% to 70.25%. This case report is the first study about the effectiveness of physiotherapy with medium-term follow-up in a child with AS. Physiotherapy results make us happy in this particular patient with ‘happy puppet’ syndrome.