Turhan Kahraman

The Turkish validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery

BackgroundCognitive impairment may be seen in as many as 43–70% of patients with multiple sclerosis (MS) and may be observed in all MS subtypes. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS) battery may be used to evaluate cognition status. The purpose of the current study is to validate the BICAMS battery in Turkish.MethodsPatients with MS attending our clinic between September 2014 and April 2015 were invited to participate. Healthy control participants were matched in terms of age, gender and years of education.ResultsOne hundred seventy-three MS patients and 153 healthy control participants were enrolled in the study. MS patients performed significantly worse in all trials than the members of the healthy control group. In addition, cognitive dysfunction was identified in 78 of the 173 (45.1%) patients. In the MS with cognitive impairment group, 64 out of 151 (42.4%) subjects were RRMS patients, 12 out of 18 (66.7%) were secondary progressive MS patients, and 2 out of 4 (50%) were primer progressive MS patients.ConclusionsThe BICAMS has been proposed for assessing cognitive impairment in MS patients. This study shows that the battery is suitable for use in Turkey.

Developing a Reliable Core Stability Assessment Battery for Patients with Nonspecific Low Back Pain.

Study Design. Test-retest design. Objective. The objective was to examine the intrarater (test-retest) reliability of the core stability related tests and to develop a reliable core stability assessment battery. Summary of Background Data. Studies suggest that core stability exercises may improve function and decrease pain in patients with nonspecific low back pain (LBP). Reliable clinical tests are required to implement adequate rehabilitation and to evaluate results of these interventions. Methods. The study had a test-retest design. Thirty-three different tests that might relate to core stability were identified with their mostly used protocols. Five different components of core stability including endurance, flexibility, strength, functional performance, and motor control were assessed in 38 patients with nonspecific LBP. The same testing procedure was performed again after 48 to 72 hours. Intraclass correlation coefficients (ICCs), standard error of measurement, and minimal detectable change were calculated to assess the intrarater reliability. Results. The intrarater reliability of the tests ranged from little to very high (ICCu200a=u200a0.08–0.98). Partial curl-up (ICCu200a=u200a0.90), lateral bridge (ICCu200a=u200a0.95–0.96), trunk flexor endurance (ICCu200a=u200a0.97), sit and reach (ICCu200a=u200a0.98), single-legged hop (ICCu200a=u200a0.98–0.97), lateral step-down (ICCu200a=u200a0.93–0.92), eyes open right and left leg unilateral stance (ICCu200a=u200a0.97 and 0.91) tests had the highest intrarater reliability for each core stability component. Conclusion. The results indicated that the partial curl-up test (strength), side bridge and trunk flexor tests (endurance), sit-and-reach test (flexibility), single-legged hop, and lateral step-down (functional), unilateral stance test with eyes open (motor control) had very high intrarater reliability. A core stability assessment battery involving these tests can be used in patients with nonspecific LBP to assess all components of core stability. Level of Evidence: 3

Gender differences in postural control in people with nonspecific chronic low back pain

BACKGROUNDnMany studies have reported that there are several differences between genders which may result in altered neuromuscular control. Although the existing evidence suggests that low back pain (LBP) affects the ability to control posture, there is little evidence the gender differences in postural control in people with nonspecific chronic LBP.nnnRESEARCH QUESTIONnAre there any gender differences in postural control and correlations between postural control, pain, disability, and fear of movement in people with nonspecific chronic LBP?nnnMETHODSnStatic and dynamic postural control were evaluated using a computerized postural control assessment tool including assessments for limits of stability (LOS), unilateral stance, and modified clinical test of sensory interaction on balance. Pain intensity and fear of movement were assessed using a visual analogue scale and the Tampa Scale of Kinesiophobia, respectively.nnnRESULTSnThis cross-sectional study included 51 people (25 females and 26 males) with nonspecific chronic LBP. Mean reaction time in the LOS test was significantly less in male participants compared with females when adjusted for pain intensity and disability level, F(1,45)u202f=u202f4.596, pu202f=u202f.037, ηp2u202f=u202f0.093. There was no significant difference in the remaining LOS variables as well as unilateral stance, and modified clinical test of sensory interaction on balance variables between the genders (pu202f>u202f.05). Many correlations were observed between the LOS variables, pain intensity, and Tampa Scale of Kinesiophobia score in female participants (pu202f<u202f.05). The Tampa Scale of Kinesiophobia score was also correlated with the movement velocity and endpoint excursion in the LOS test in the male participants (pu202f<u202f.05).nnnSIGNIFICANCEnThis study suggests that there is no difference in most of the static and dynamic postural control variables between females and males; however, higher fear of movement, and pain intensity during activity are more associated with impaired dynamic balance in females with nonspecific chronic LBP.

Feasibility of a 6-Month Yoga Program to Improve the Physical and Psychosocial Status of Persons with Multiple Sclerosis and their Family Members

Context To the best of our knowledge, there has been no study on yoga that includes both persons with multiple sclerosis (MS) and their family members. Because yoga has therapeutic effects in both persons with MS and healthy persons, we hypothesized that it would be an effective method to improve not only the physical and psychosocial status but also the time persons with MS and their family members spend together. Objective To examine the feasibility of a 6‐month (long‐term) yoga program to improve the physical and psychosocial status of persons with MS and their family members. Design Uncontrolled clinical trial. Setting The protocol was developed at the Department of Neurology, Faculty of Medicine, and School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey. Participants Persons with MS and healthy family members. Main Outcome Measures Walking, balance, fatigue, health‐related quality of life, depression, pain, and kinesiophobia. Interventions Yoga training was given once a week (at least 1 h) for 6 months. The same assessors who assessed at baseline also performed the same assessments immediately after the end of the training (i.e., after 6 months). Results In total, 44 participants (27 persons with MS and 17 healthy family members) participated in the study. Twelve persons with MS and three healthy family members completed the 6‐month yoga intervention. The completion rate for persons with MS and healthy subjects was 44.4% and 17.6%, respectively. In persons with MS, the mental dimension of health‐related quality of life, walking speed, fatigue, and depression levels significantly improved after the yoga program (p < .05). However, there was no significant change in the self‐reported walking impact, balance, pain, physical dimension of health‐related quality of life, and kinesiophobia levels in the persons with MS (p > .05). This study suggests that a 6‐month yoga program can improve the mental dimension of health‐related quality of life, walking speed, fatigue, and depression in the persons with MS. However, the 6‐month yoga program does not appear to be a feasible method to increase the time that persons with MS spend together with their family members.

MULTİPL SKLEROZ HASTALARINDA ANKSİYETENİN MOTOR İMGELEME BECERİSİNE ETKİSİ

p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 26.0px Helvetica Neue} Amac: Motor imgeleme (MI), gercek bir hareket aciga cikmadan hareketin mental olarak dusunulmesi seklinde tanimlanmaktadir. Bu calismanin amaci, anksiyetenin multipl skleroz (MS) hastalarinin, MI becerileri uzerine olan etkilerini incelemekti. Yontem: Calismaya 27 MS hastasi ve 14 saglikli birey dahil edildi. MS hastalari Hastane Anksiyete ve Depresyon Olcegi’nin kesim degerine (≥8) gore anksiyetesi olan ve olmayan olarak iki gruba ayrildi. MI’nin netligi ve kinestetik yogunlugu Kinestetik ve Gorsel Imgeleme Anketi (KGIM)-kisa form ile degerlendirildi. Gercek ve imgelenen hareket arasindaki zamansal uyumu degerlendirmek amaci ile Zamanli Kalk Yuru Testi (ZKYT) kullanildi. ZKYT’nin MI suresi mental kronometre ile degerlendirildi. Gercek ZKYT suresi ile ZKYT’nin MI suresi arasindaki fark delta suresi olarak kayit edildi. Delta suresinin yuksekligi MI becerisindeki azalma olarak yorumlandi. Sonuclar: Hastane Anksiyete ve Depresyon Olcegi’ne gore MS hastalarinin 12’sinin anksiyetesi oldugu ve 15’inin ise anksiyetesinin olmadigi goruldu. MI olcumleri acisindan MS hastalari ve saglikli bireyler arasinda anlamli bir fark yoktu (p>0,05) ve farklarin etki buyuklukleri (EB) kucuktu (Cohen d 0,05), anksiyetesi olan hastalarda imgelemenin netligi ve kinestetik yogunlugu anksiyetesi olmayanlara gore orta ve kucuk EB ile daha dusuktu (sirasiyla, Cohen d=0,577 ve Cohen d=0,160). ZKYT delta suresinde gruplar arasinda anlamli bir fark (p>0,05) gozlenmemesine ragmen, orta etki buyuklugu ile (Cohen d=0,696) anksiyeteli bireylerde daha fazlaydi. Tartisma: Calismamizin sonuclari anksiyetenin MS hastalarinda MI beceresini etkileyebilecegi ile ilgili ip uclari vermektedir. Buradan yola cikarak, anksiyetesi olan MS hastalarinda MI egitimi sirasinda veya egitim oncesinde uygun modifikasyonlarin yapilmasinin yerinde bir secim olacagi dusunulmektedir.

Determinants of the 6-minute pegboard and ring test as an unsupported upper-extremity exercise capacity measure in older adults with chronic obstructive pulmonary disease

PurposeUpper extremities play an important role in performing of many activities of daily living. Physical and pathological changes limit upper extremity functions in older adults with chronic obstructive pulmonary disease (COPD). Although the 6-minute pegboard and ring test (6PBRT) is a reliable and commonly used method for the assessment of unsupported upper-extremity exercise capacity in patients with COPD, there is lack of evidence about the possible determinants of the 6PBRT score. The study aimed to investigate the possible determinants of the 6PBRT in older adults with COPD.MethodsFifty-two older adults (ageu2009≥u200965xa0years) with stable COPD and 23 age-matched healthy older adults participated in this study. Demographic characteristics, unsupported upper-extremity exercise capacity, pulmonary function, functional exercise capacity, disease related symptoms, peripheral and respiratory muscle strength were evaluated. Stepwise multiple linear regression analysis was used to investigate the possible determinants of the 6PBRT score.ResultsThe 6PBRT score was significantly higher in healthy participants compared with those with COPD (pu2009=u20090.024). In participants with COPD, shoulder flexor muscle strength, age and functional exercise capacity were significant and independent predictors of the unsupported upper-extremity exercise capacity with explaining 55.4% of the variance.ConclusionsThis study suggests that shoulder flexor muscle strength, age and functional exercise capacity are independent determinants of the unsupported upper-extremity exercise capacity assessed by the 6PBRT in older adults with COPD.

The multiple sclerosis work difficulties questionnaire: translation and cross-cultural adaptation to Turkish and assessment of validity and reliability

Abstract Purpose: To linguistically and culturally adapt the Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) for use in Turkey, and to examine its reliability and validity. Methods: Following standard forward-back translation of the MSWDQ-23, it was administered to 124 people with multiple sclerosis (MS). Validity was evaluated using related outcome measures including those related to employment status and expectations, disability level, fatigue, walking, and quality of life. Randomly selected participants were asked to complete the MSWDQ-23 again to assess test–retest reliability. Results: Confirmatory factor analysis on the MSWDQ-23 demonstrated a good fit for the data, and the internal consistency of each subscale was excellent. The test–retest reliability for the total score, psychological/cognitive barriers, physical barriers, and external barriers subscales were high. The MSWDQ-23 and its subscales were positively correlated with the employment, disability level, walking, and fatigue outcome measures. Conclusions: This study suggests that the Turkish version of MSWDQ-23 has high reliability and adequate validity, and it can be used to determine the difficulties faced by people with multiple sclerosis in workplace. Moreover, the study provides evidence about the test–retest reliability of the questionnaire. Implications for rehabilitation Multiple sclerosis affects young people of working age. Understanding work-related problems is crucial to enhance people with multiple sclerosis likelihood of maintaining their job. The Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) is a valid and reliable measure of perceived workplace difficulties in people with multiple sclerosis: we presented its validation to Turkish. Professionals working in the field of vocational rehabilitation may benefit from using the MSWDQ-23 to predict the current work outcomes and future employment expectations.

Validity and Reliability of the Turkish Version of the 8-Item Parkinson’s Disease Questionnaire

IntroductionnSymptomatic control and improvement of health-related quality of life (HRQoL) is a key feature of the management of patients with Parkinsons disease (PD). The 39-item Parkinsons Disease Questionnaire (PDQ) and its short version, PDQ-8, validated disease-specific patient-reported instruments, have been highly recommended to use for assessing HRQoL in patients with PD. The aim of this study was to assess the reliability and validity of the Turkish version of the PDQ-8.nnnMethodsnEighty-three patients with PD were recruited for this methodological and cross-sectional study. The PDQ-8 was repeated to assess the test-retest reliability after one-week interval. The participants completed the 36-Item Short Form Health Survey (SF-36) as a generic HRQoL previously validated in Turkey. The Hoehn & Yahr stages of the patients were also determined. The SF-36 and Hoehn & Yahr stages were used to assess the convergent validity of the PDQ-8.nnnResultsnThe Cronbachs alpha coefficient was 0.78 (95% CI: 0.70-0.84, p<0.001) for PDQ-8. The test-retest reliability was very high as the intra-class correlation coefficient was 0.97 (95% CI: 0.93-0.99, p<0.001). The PDQ-8 had significant correlations with the physical and mental component scores of SF-36 (ρ=-0.52, p<0.001 and ρ=-0.64, p<0.001, respectively) and Hoehn & Yahr stages (ρ=0.56, p<0.001). There was no evidence of floor or ceiling effects.nnnConclusionnThe results of this study suggest that the Turkish version of the PDQ-8 is a reliable, valid, less time-consuming, and brief disease-specific instrument to assess HRQoL in patients with Parkinsons disease.