Tülay Tarsuslu Şimşek

The effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acute stroke: a randomized controlled study

Objective: The aim of this study was to investigate the effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with subacute stroke. Methods: 42 adults with stroke (mean age (SD) = 58.04 (16.56) years and mean time since stroke (SD) = (55.2 ± 22.02 days (∼8 weeks)) were included in the study. Participants were enrolled from the rehabilitation department of a medical center (a single inpatient rehabilitation facility). Participants were randomly assigned to Nintendo Wii group (n = 20) or Bobath neurodevelopmental treatment (NDT) (n = 22). The treatments were applied for 10 weeks (45–60 minutes/day, 3 days/week) for both of two groups. Nintendo Wii group used five games selected from the Wii sports and Wii Fit packages for upper limb and balance training, respectively. The patients in Bobath NDT group were applied a therapy program included upper extremity activites, strength, balance gait and functional training. The functional independence in daily life activities and health-related quality of life was assessed with Functional Independence Measure (FIM) and Nottingham Health Profile (NHP), respectively. Participants treatment satisfaction was recorded by using Visual Analogue Scale. A second evaluation (FIM and NHP) occurred after 10 weeks at the end of rehabilitative treatment (post-training). Treatment satisfaction was measured after 10 sessions. Results: There were significant difference between FIM and NHP values in NDT and Nintendo Wii group (p < 0.05). However, a significant difference was not found between the groups with regard to FIM and NHP (p > 0.05). The patients in Nintendo Wii group were detected to be better satisfied from the therapy (p < 0.05). A significant difference was found between subparameters and total FIM score, all subparameters and total NHP score in both groups (p < 0.05). Conclusion: These findings suggested that the Nintendo Wii training was as effective as Bobath NDT on daily living functions and quality of life in subacute stroke patients.

Examination of the relation between body mass index, functional level and health-related quality of life in children with cerebral palsy

AIM The aim of this study was to examine the relation between body mass index (BMI) and functional level and health-related quality of life in children with cerebral palsy (CP). MATERIAL AND METHODS Two hundred seventy-eight children with CP aged between 2 and 18 years were included in the study. The sociodemographic properties of the children were recorded. Their functional independence levels were assessed with WeeFIM and their health-related quality of life levels were assessed with the Child Health Questionnaire-Parent Form (PF-50). Approval was obtained from the ethics committee of Abant İzzet Baysal University Medical Faculty for this study (Number: 2008/100-77). RESULTS When classified by body mass index, 26.3% of the children had a normal body weight, 5.4% were overweight, 11.5% were obese and 56.8% had a low body weight. The rate of low body weight was higher in children with moderate and severe CP (52.7% and 53.8%, respectively), while the rate of obesity was higher in children with mild CP who could walk (7.1%). A significant difference was found in children with CP with a normal body weight, overweight children with CP, obese children with CP and children with CP with a low body weight in terms of the total WeeFIM score and the variables of quality of life including physical functionality and role/social limitations because of physical health (p<0.05). In the correlation analysis, a positive correlation was found between WeeFIM and BMI and the subdimensions of role/social limitations because of emotional or behavioral difficulties, pain and discomfort and self-esteem (p<0.05). CONCLUSIONS Our results showed that BMI affected functional independence and health-related quality of life in children with CP and this was more prominent in children who had severe CP and low BMI values. More studies are needed in this area.

The Turkish version of the Family Impact of Assistive Technology Scale: A validity and reliability study

Abstract Objective: The purpose of the current study is to estimate the preliminary measurement properties of the Turkish version of Family Impact of Assistive Technology Scale (FIATS-tr). Method: The validity and reliability of the scale was performed in two phases. Phase I focused on construction of the Turkish version of the instrument and pilot testing. The scale was translated using the back-translation technique. The comprehensiveness and clarity of the scale was assessed with 20 participants. Phase II included psychometric assessment of the scale using a classical test theory approach. The final version of the scale was pretested with Turkish-speaking parents (46 mothers, four fathers and five caregivers) of 55 chronically disabled children. Results: Test–retest reliability was found to be ICC = 0.931 (95% CI 0.881–0.960) for FIATS-tr total. Cronbachs alpha for the overall FIATS-tr was 0.858. Individual alpha values for FIATS-tr subscales ranged from 0.199 to 0.838. The FIATS-tr total was moderately correlated with the Functional Independence Measure for Children (WeeFIM) total (r = 0.688, p < 0.001). Conclusions: This study showed that overall FIATS-tr appears to have acceptable levels of validity and reliability when used to measure the functional impact of assistive devices. Further study of the constructs and homogeneity of its total and subscales may further improve the internal consistency, validity, and other measurement properties of the FIATS-tr.

Examination of the relationship between body mass index (BMI) and functional independence level in children with spina bifida

Abstract Objective: The aim of this study is to examine the relationship between body mass index (BMI) and functional independence level in children with spina bifida (SB). Methods: The study included 116 children between 5 and 18 years. Subjects’ socio-demographic characteristics, BMI values and functional independence levels were recorded. Results: There was negative correlation between BMI and communication and social cognition in girls (p < 0.05). No correlation was found between BMI and WeeFIM in boys (p > 0.05). Conclusion: The results indicated that body weight in children with SB affected functional independency and that precautions to control weight important in these children.

The effect of foot plantar massage on balance and functional reach in patients with type II diabetes

ABSTRACT Objective: The aim of this study was to investigate the effect of manual foot plantar massage (classic and friction massage) on functional mobility level, balance, and functional reach in patients with type II diabetes mellitus (T2 DM). Methods: A total of 38 subjects diagnosed with T2 DM were included in the study. A healthy control group could not be formed in this study. After the subjects’ socio-demographic data were obtained, Timed Up & Go (TUG) Test, functional reach test (FRT), one-leg standing test with eyes open-closed, and Visual Analogue Scale (VAS) to measure foot pain intensity were performed. The results were also divided and assessed in three groups according to the ages of the individuals (40–54, 55–64, and 65 and over). Results: As a result of statistical analysis, a difference was found in the values obtained from TUG, FRT, and one-leg standing test with eyes open and closed (p < 0.05). Following the massage, TUG values significantly decreased comparison with those before the massage, whereas the values of FRT and one-leg standing test with eyes open and closed significantly increased compared with those before the massage (p > 0.05). According to age groups, there were statistical differences (p < 0.05) between the TUG, one-leg standing test with eyes open and closed test values of the individuals before and after the massage. Conclusions: The results of our study indicated that application of plantar massage to patients with T2 DM caused an improvement in balance, functional mobility, and functional reach values. An increase in body balance and functional mobility may explain the improvement in TUG. Foot massage to be added to rehabilitation exercise programs of DM patients will be important in improving balance and mobility of patients.

İNME HASTALARINDA NİNTENDO Wİİ OYUNLARININ DENGE VE ÜST EKSTREMİTE FONKSİYONLARINA ETKİSİ

Amac: Bu calismanin amaci, inme hastalarinda Nintendo Wii (N-Wii) oyunlarinin denge, ust ekstremite fonksiyonu ve sureli performans uzerine etkisini incelemektir. Yontemler: Calisma, yaslari 18-85 yil arasinda degisen 42 inmeli hasta ile gerceklestirildi. Calismaya dahil edilen hastalar N-Wii grubu (n=20) ve Bobath Norogelisimsel tedavi (NDT-n=22) grubu olmak uzere 2 gruba ayrildi. Hastalarin ust ekstremite fonksiyon degerlendirmesinde Fugl-Meyer Motor Fonksiyon Testi ve Kol, Omuz ve El Sorunlari Anketi (DASH), postural duzgunluk ve fonksiyonel denge degerlendirmesinde Postural degerlendirme Olcegi (PASS), Fonksiyonel Uzanma Testi (FUT), Sureli Kalk Yuru Testi (TUG) kullanildi. Ilk degerlendirmeleri yapilan hastalara 10 hafta boyunca duzenlenen tedavi programlari uygulandi. N-Wii grubundaki hastalara, N-Wii oyunlariyla 10 hafta, haftada 5 gun, 1 saatlik oyun sistemleri ile egitim verildi. Bobath NDT grubundaki hastalar icinde terapist esliginde 10 hafta, haftada 3 gun, 1 saat suren hastanin fonksiyonel ihtiyaclarina gore duzenlenmis egzersiz programi uygulandi. Sonuclar: Calismanin sonunda, her iki gruptaki hastalarin Fugl-Meyer, DASH, PASS, FUT, TUG testlerinde anlamli gelismeler kaydedildi (p 0.05). Tartisma: N-Wii uygulamalarinin Bobath NDT yaklasimlarina gore inmeli hastalarda kol aktiviteleri ve agirlik aktarma, uzanma, yer degistirme becerisini daha fazla arttirdigi gozlenmistir.

The effect of age and body mass index on plantar cutaneous sensation in healthy women

[Purpose] This study was conducted to examine the effects of age and body mass index on plantar cutaneous sensation in healthy women. [Subjects and Methods] Two hundred and three healthy female volunteers over the age of 20 were included in the study. The statistical analyses were performed by considering the age and body mass index values of the individuals. The individuals were divided according to their ages and body mass index values. Foot pain was measured with a visual analogue scale and plantar cutaneous sensation using Semmes-Weinstein monofilaments. [Results] Fifty-six (27.5%) of the participants had normal weights, 67 (33%) were overweight, and 80 (39%) were obese. Statistical analysis revealed that as age and body mass index values increased, plantar sensitivity decreased and the frequency and severity of pain increased. [Conclusion] It is possible that healthy women may experience a decrease in foot plantar sensation with increasing weight and age. If women do not have any health problems, proprioception and sensory training must be focused on in order to prevent balance and falling problems.

Desire to have other children in families with a chronically disabled child and its effect on the relationship of the parents

AIM The aim of this study was to examine the desire of the parents who had a chronically disabled child to have other children and to investigate the effect of having a disabled child on the relationship of the parents. MATERIAL AND METHODS The families of 145 chronically disabled children were included in the study. After the sociodemographic information belonging to the child and family were obtained, the prepared questionnaire form was used to interrogate if the parents lived together, the number of children in the family, if they wished to have other children and the relation of the disabled child with the household. Ethics committee approval was obtained from Dokuz Eylül University (date: 18.10.2012, decision number, 2012/34-13). The data obtained in the study were expressed as figures and percentages. RESULTS While 91.7% of the parents continued their relationship, 2.8% were divorced and 1.4% were left by their spouses. The rate of the parents who did not wish to have (or did not have) other children after a disabled child was found to be 65.2%. The major reason for the families not to wish to have other children was found to be the fact that they thought they could not spare enough time for their disabled child. While 35.1% of the parents stated that clemped together more tightly, 35.2% stated that their concerns about the future increased further. Fifty eight percent of the parents stated that social relations and community involvements were not affected, whereas others stated that they were affected in different ways. CONCLUSIONS Although the relationship between the parents was not affected to a great extent in families who had chronically disabled children, it was found that parents intensively experienced concern for the future. It was found that this also affected the desire of the parents who had a chronically disabled child to have other children with the concern that the child will be disabled.

Feeding Problems in Children with Cerebral Palsy and the Effect of Feeding Problems on Growth

Ozet Giris: Bu calismanin amaci, serebral palsili (SP) cocuklarda beslenme problemlerinin belirlenmesi ve beslenme problemlerinin buyume uzerine etkisinin incelenmesidir.