Tülin Düger

Validation of the Turkish Version of the Oswestry Disability Index for Patients With Low Back Pain

Study Design. Validation of a translated, culturally adapted questionnaire. Objectives. To translate and culturally adapt the Turkish version of the Oswestry Disability Index (ODI) (2.0), and to validate its use for assessing disability in Turkish patients with low back pain. Summary of Background Data. The ODI is a reliable evaluation instrument for disability, but no validated Turkish version is available. Methods. A total of 95 outpatients with low back pain were assessed by the ODI. Sixty-five of these patients were observed on a second occasion. Translation/retranslation of the English version of the ODI was done blindly and independently by four different individuals, and adapted by a team. Individuals were given the ODI and other scales (Visual Analog Scale, Schober Test, and the Roland-Morris Disability Questionnaire) on their first visit and a week later. Results. Scores of the two ODIs were 27.10 (SD 16.22) on day 1 and 22.88 (SD 13.94) on day 7, with an intraclass correlation coefficient of r = 0.938 (P < 0.001). Cronbach’s alpha was 0.918 (day 1) and 0.895 (day 7) in the validation. Concurrent validity, measured by comparing ODI responses with the results of Visual Analog Scale and Schober test, was r = 0.367 (P < 0.01), r = −0.068 (P = 0.591) for day 1, and r = 0.392 (P < 0.01), r = −0.041 (P = 0.745) for day 7, respectively. Construct validity, tested by determining the correlation between the Turkish ODI and the Turkish adaptation of the Roland-Morris Disability Questionnaire, yielded r = 0.815 (P < 0.001) on day 1 and r = 0.708 (P < 0.001) on day 7. Conclusion. The Turkish version of ODI has good comprehensibility, internal consistency, and validity and is an adequate and useful instrument for the assessment of disability in patients with low back pain.

The assessment of Bruininks-Oseretsky test of motor proficiency in children

OBJECTIVE The primary objective is to research the relationship between motor abilities and demographic characteristics such as age and sex, in healthy children aged 4-11 years. METHODS One hundred and twenty children in kindergarten (n = 30) and primary school (n = 90) were included in the study and evaluated by the Occupational Therapy Unit. All children were divided into four groups according to age, 4-5, 6-7, 8-9 and 10-11 years. The primary school children were classified according to academic learning, being successful or unsuccessful. In this study, Bruininks-Oseretsky test of motor proficiency was used to assess the gross motor skills and fine motor skills. These tests are running speed and agility (subtest 1/item 1), balance/walking forward heel-to-toe on walking line (subtest 2/item 6), bilateral coordination/tapping-foot and finger on same side synchronized (subtest 3/item 2), strength/standing broad jump (subtest 4/item 1), response speed (subtest 6/item 1), visual motor control/cutting out a circle with preferred hand (subtest 7/item 1), upper-limb speed and dexterity/pacing pennies in two boxes with both hands (subtest 8/item 2). RESULTS When the children were classified according to sex, there were significant differences in subtests 6 and 7. According to academic learning, there were significant differences in subtests 2 and 8. When the results were evaluated due to age, important differences were found in subtests 1, 2, 4 and 8. CONCLUSION It was seen that gross and fine motor skills in early childhood showed variety between age, sex and academic learning. The scores of motor abilities were better in successful children than unsuccessful children. The outcome of this study revealed that the Bruininks-Oseretsky test can be useful to investigate unexplored aspects of motor development.

The environmental barriers of children with Muscular Dystrophies and its effect on mother's low back pain

Purpose : The aim of this study is to determine the architectural barriers of children with Muscular Dystrophy at home according to their diminished functional capacity and its effect on their mothers back problem. Method : Twenty children with Muscular Dystrophy (11.1 - 4.14 years) were evaluated with Brooke Scale and WeeFIM. Quebec and Oswestry Disability Scales were used for determining physical disability of their mothers (38.65 - 5.91 years). The architectural barriers have been detected with attention to standard criterias of International Organizations for all countries around the world. Results : The heights of thresholds, switches of wall plugs, shelves, cupboards, mirrors, hangers, arm of windows and siphons were found to be higher than standard values. The relation between back disability questionnaire results of mothers and dependency level of children on Activity of Daily Living has showed negative correlation (p < 0.05). Conclusions : The protective back health programmes and home arrangements that are suitable for disabled children must be added to the neuromuscular rehabilitation programmes.

Visual perception training on social skills and activity performance in low-vision children

Abstract The aim of this study was to evaluate the effect of two different visual perception training programmes on the social skills and activity performance of low-vision children. Forty children (aged 7–14 years) were randomly assigned into two groups with regard to the visual perception training performed: Group 1: aided paper and pen, and Group 2: with computer. The participants were evaluated before and after treatment using the Motor-Free Visual Perception Tests, Social Skills Assessment Tool for Children with Visual Impairments, and Canadian Occupational Performance Measurement. The training programmes were performed in the school for three months (two days/week and 45 minutes/day). In both groups, results of the social skills questionnaire showed significant differences before and after treatment (p < 0.01). Likewise, the results of the activity performance test indicated significant differences between the performance and total activity scores (p < 0.01). Both treatment programmes failed to show a significant relationship in respect of the increase in visual perception (p > 0.05). Based on these results, neither of the programmes tested appears to be superior to the other in low-vision children.

Cognition in 4-11 year old children in Turkey

OBJECTIVES The purpose of this study was to determine the relationship among age, sex and academic performance with cognitive ability on healthy age groups. METHODS The subjects were 71 children, aged 4-11 years (x = 7.11). The children were divided into four age groups: 22 of the 71 children were at kindergarten and 49 children were in primary education. Thirty nine children were girls and 32 were boys. Twenty six children had good academic achievement and 23 did not. Each child was tested on the LOTCA battery by the Occupational Therapy Unit of Hacettepe University School of Physical Therapy and Rehabilitation. In this study, seven subtests were used from LOTCA (Loewenstein Occupational Therapy Cognitive Assessment). These are orientation for place, orientation for time, overlapping figures, praxis, reproduction of a two dimensional model, drawing a clock, and categorization. RESULTS Statistical analysis of the relationships demographic variables, academic achievement and performance on the battery revealed that age was significant, sex was insignificant and academic achievement was significant when correlated with cognitive abilities. CONCLUSIONS The results suggest that cognitive abilities tested show some differences. For this reason, in the school or other educational settings, children who have low academic achievement should be assessed also for cognitive abilities and then provided with occupational therapy.

Aerobic exercise improves oxidant-antioxidant balance in patients with rheumatoid arthritis.

[Purpose] Although oxidative stress is known to be present in rheumatoid arthritis (RA), the effects of exercise on oxidative parameters are unknown. The aim of this study was to investigate the effects of acute aerobic exercise on serum oxidant and antioxidant levels in patients with RA. [Subjects and Methods] Sixteen patients with RA and 10 age-matched healthy volunteers participated in this study. All participants wore polar telemeters and walked on a treadmill for 30 minutes at a speed eliciting 60–75% of maximal heart rates. Blood samples were obtained before, immediately and 24 hours after exercise and malondialdehyde (MDA) and total sulfhydrile group (RSH) levels were measured. [Results] Both groups had similar heart rates during the test but the treadmill speed of the RA patients was significantly lower than that of the healthy volunteers. Serum MDA levels were lower than in both groups immediately after exercise, with greater decrements in the RA patients than controls. MDA levels returned to baseline 24 hours after the exercise only in the controls; they remained low in the RA patients. There was a slight increase in serum RSH levels after exercise compared to baseline in both groups. [Conclusion] Moderate intensity treadmill exercise did not have any adverse effect on the oxidant-antioxidant balance. The results suggest that such an exercise may be safely added to the rehabilitation program of RA for additional antioxidant effects. Morever, this antioxidant environment is maintained longer in RA patients.

Two different back pain scales and their relation to pain intensity in women

People suffering from low back pain (LBP) fail in performing many daily living activities. The aim of this study was to compare two different back pain scales and to determine the relation between pain intensity and these scales on women with low back pain. Fifty-five women with chronic LBP (X ± SD: 37.76 ± 5.12 years) participated in this study. Their disabilities were determined by Quebec Back Pain Disability Scale (QBPDS) and Oswestry Low Back Disability Questionnaire Scale (OLBDQS). Pain intensity was measured by a visual analogue scale (VAS). Outcome of this study showed that the QBPDS and OLBDQS were highly correlated. Also, VAS scores were correlated with both scale scores but this correlation was less strong. These two disability measuring methods are comparable, but OLBDQS has the advantage of requiring shorter time. summary

The effect of independence level of the children with muscular dystrophies on the mother's low back pain

Abstract Introduction: Forward bending, rotation, lifting, carrying, pulling and pushing during bathroom activities, dressing, transferring, feeding, etc. increase stress on structures in the back and neck of mothers caring for disabled children. The aim of this study was to determine the effect of independence level of children with muscular dystrophies on their mothers low back pain. Methods: Thirty mothers who had children with muscular dystrophies were included in this study. They were divided two groups as mothers of nonambulatory (group 1) and ambulatory (group 2) disabled children. To investigate the activities of daily living the WeeFIM scale was used; to investigate the functional status the Broke Scale was used. Quebec Back Pain Disability Scale (QBPDS) was used to measure disability and a visual analogue scale (VAS) was used to measure pain in mothers. Results: The QBPDS scores of mothers were higher in group 1 (36.13 ± 17.9) than in group 2 (20.8 ± 14.87). There was positive correlation betwe...

Reliability and validity of Milliken Activities of Daily Living Scale (MAS) in measuring activity limitations of a Turkish population.

Abstract Aim: The Milliken Activities of Daily Living Scale (MAS) is a self-report scale to address limitation of ability to perform daily tasks in upper extremity injuries. It can address the necessity of each task, which makes MAS useful while planning individual treatment. The objective of this study was to perform cross-cultural adaptation of the MAS TURKISH and to evaluate its reliability and validity for Turkish-speaking patients with upper extremity conditions. Method: A total of 99 patients were asked to complete the adapted MAS and DASH at baseline and one week after the initial assessment. Also grip strength was evaluated with an interval of one week. Results: The reliability of the adapted version was good, with high internal consistency (Cronbachs alpha = 0.964) and test–retest reliability (interclass correlation coefficient (ICC) = 0.772) for the total score. A statistically significant correlation between MAS and DASH scores and grip strength scores of the injured side was obtained. Conclusion: The results of the study have shown that the Turkish version of MAS has excellent test–retest reliability and validity. It is a suitable assessment for evaluating function and giving an overview of activity limitations in many performance areas in a Turkish population.

Reliability and Validity of The Cerebral Palsy Quality of Life Questionnaire in The Turkish Population

This study examined the psychometric properties of the Turkish version of the Cerebral Palsy Quality of Life Questionnaire (CP QOL). A total of 149 primary caregivers completed the final version of the CP QOL–Primary Caregivers and the Children Health Questionnaire (CHQ) for children 4–12 years old (M age = 7.6 yr., SD = 2.5); 58 children with CP ages 9 to 12 years completed the CP QOL–Child and Health-Related Quality of Life Questionnaire for Children (Kid–KINDL) questionnaire. The Gross Motor Function Classification System was also used for the classification of the children with CP. Internal consistency (Cronbachs α) ranged between .63 and .93 for primary caregivers and .61 to .92 for the childrens self-reports. Intra-class correlation coefficients ranged between .88 and .97 for primary caregivers and .91 to .98 for children. It was concluded that the Turkish version of CP QOL questionnaire is a reliable and valid tool for assessing QOL in children with CP.