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Background: Recent studies revealed the connection between the endurance of neck muscles and pain, neck awareness, and fear of movement in patients with chronic neck pain in literature. Objectives: To investigate the association between cervical, scapular, trunk, and upper extremity muscles' endurance and neck pain, disability, neck awareness, and kinesiophobia in patients with chronic neck pain. Design: Cross-sectional, observational study. Methods: Thirty-six patients with chronic neck pain (aged 18–65 years) were included in the study. Endurance tests were performed for 9 muscles/muscle groups in the cervical and scapular region, upper limb, and trunk. Pain severity, neck disability, neck awareness, and fear of movement were measured by Visual Analog Scale (VAS), Neck Disability Index (NDI), Fremantle Neck Awareness Questionnaire (FreNAQ), and Tampa Scale of Kinesiophobia (TSK), respectively. Results: Negative, weak-to-moderate relations were found between VAS (at rest and during activity) and the endurance of muscles evaluated in the cervical and scapular regions, upper extremity, and trunk as well as between NDI and endurance of the same muscles, similar to the relations between FreNAQ scores and the endurance of the cervical flexor, anterior trunk flexor, and upper extremity muscles (p < 0.05). No relation was found between the endurance of the muscles and TSK (p > 0.05). Conclusions: Since the decrease in upper extremity, scapular region, and trunk muscles' endurance may contribute to neck pain and disability, and decrease neck awareness in patients with chronic neck pain; the evaluation of muscular endurance of upper body and trunk should also be considered. Clinical Trials: NCT05121467 [ABSTRACT FROM AUTHOR]

Duchenne Muscular Dystrophy (DMD) is a devastating neuromuscular disease of childhood which is characterized by progressive muscle weakness that limits the functional activities of daily life in course of time and result in decreased quality of life. The benefits of increasing the physical activity (PA) level and participation on general health status in children with DMD was previously mentioned in literature. Parents have been reported to have an important impact on their child's beliefs, attitudes, and behaviors in many dimensions of development throughout their lives. Studies showed that there was a significant correlation between parental impact and child's PA level and participation in healthy children. The aim of this study was to investigate the family impact on PA level, interest in PA, and participation level of their school-age children with Duchenne Muscular Dystrophy (DMD). This cross-sectional, observational study included a total of 30 ambulatory children between 8 and 18 years of age (mean: 8.70 ± 0.84). Physical Activity Questionnaire for Older Children (PAQ-C) and pedometer were used to assess PA level of children while International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to determine the PA level of parents. Children's Attraction to Physical Activity (CAPA), Pediatric Outcome Data Collection Instrument (PODCI), and Children's Physical Activity Correlates (CPAC) questionnaires were also used to evaluate interest in PA, participation level, and family impact on PA level of children, respectively. Low-to-moderate correlations were determined between family impact sub-score of CPAC and PAQ-C, CAPA and PODCI while moderate correlation was found between PAQ-C and parents' IPAQ-SF score (p < 0.05). This study revealed the importance of parents' support and encouragement as well as their own PA habit in shaping their child's behaviors and attitudes towards PA in an early-stage, school-aged DMD population. In order to achieve the goal of increasing PA level and participation of children with DMD, a family-centered rehabilitation approach may be more effective. Clinical Trial Registration Number NCT05209087; Date: 25.01.2022. Highlights: School-age children with DMD had moderate PA and participation levels as well as moderate interest in PA. Parents, especially the primary caregiver, had a significant impact on PA level and participation of DMD children. The PA levels of the parents had an impact on the PA level of children with DMD. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to investigate falls and the fear of falling (FOF) in children with Duchenne muscular dystrophy (DMD) and to determine the relationships between the FOF and physical performance, balance, and ambulation. Methods Thirty-eight ambulatory children with DMD were included in the study. The functional level, falling history, FOF, physical performance, balance, and ambulation were assessed by using Brooke Lower Extremity Functional Classification, History of Falls Questionnaire, Pediatric Fear of Falling Questionnaire (Ped-FOF), timed performance tests, Timed "Up and Go" (TUG) test, and North Star Ambulatory Assessment (NSAA), respectively. Results Of the 38 children (mean age: 9.00 ± 2.03 years) 97.4% had a history of serious fall last year and 62.2% were injured due to this fall. The Ped-FOF score was 13.79 ± 7.20. Weak to moderate relations were determined between Ped-FOF and functional level (r = 0.33), frequency of falls (r = 0.41), duration of climbing 4-steps (r = 0.38), TUG (r = 0.36), and NSAA (r = –0.32) (p < 0.05). Conclusion Ambulatory children with better performance scores had lower levels of FOF despite their history of serious falls and injuries. FOF tends to increase as the symptoms of the disease progresses. Investigating the history of falls and FOF from the earliest period will guide to take precautions and make necessary interventions on time in treatment programs. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to investigate whether trunk control is associated with the upper limb function of children with Duchenne Muscular Dystrophy (DMD). Methods: The children included in the study were divided into two groups according to the Trunk Control Measurement Scale total scores. Twenty-five children whose trunk control levels were lower than 30.5 points were included in Group 1 while 31 children who had good levels of trunk control between 30.5 and 58 points were included in Group 2. General functional levels, muscular strength, and function of the upper limb were assessed and compared between the groups. Results: According to the results of the assessments, children in Group 2 were found to have better upper limb function and muscular strength than Group 1 (p <.001). Conclusions: The current study demonstrated better upper limb functional performance of children with DMD that had good-level trunk control thus suggesting the possible association between trunk stability and upper limb function. The results reveal the need to improve and protect trunk muscle strength and stability as well as upper limb strength, and to optimize trunk stability during upper limb movement in rehabilitation programs. [ABSTRACT FROM AUTHOR]

This study was aimed to investigate the acute effects of kinesiology taping (KT) on physical performance, gait characteristics, and balance in early-stage Duchenne Muscular Dystrophy (DMD). Forty-five children at early functional level of DMD were included. 6-minute walk test (6MWT), and timed performance tests were performed; gait characteristics, and balance were assessed before and one hour after taping. KT was applied to bilateral quadriceps and tibialis anterior muscles. The comparison of assessments was performed by using Wilcoxon Signed Ranks test. Significant increase in the distance of 6MWT, decrease in the duration of descending 4 steps, and 10 m walk timed performance tests, improvements in all of the gait characteristics, and balance were determined after taping (p <.05). KT has positive acute effects on performance and gait of children with DMD at early functional level which encourages therapists to use KT as a complementary approach in rehabilitation programs. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to describe a school-aged Turkish cerebral palsy (CP) population in terms of gross motor function, mobility, independence, and participation, and to investigate parental stress. Methods: Mobility (Functional Mobility Scale (FMS)), independence (Barthel Index (BI)), motor function (Gross Motor Function Measurement (GMFM)), functional classification (Gross Motor Function Classification System (GMFCS)), participation (Pediatric Outcome Data Collection Instrument (PODCI)), and parents' stress (Parental Stress Scale (PSS)) of 100 school-aged children with CP aged 5–15 years old were evaluated. School-related difficulties and restrictions were also questioned. Results: Of the 100 children with GMFCS levels I–V, almost half had independent mobility on level or all surfaces according to the FMS, with a relatively high GMFM score (72.8%), and above average BI (12 from 20), and PODCI Global Functioning (62.8%) scores. Strong-to-very strong correlations were determined between all test batteries. A mean score of 42.3 ± 9.92 out of 90 was obtained for parental stress with a weak correlation to the GMFCS and the child's mobility distance according to family (p < 0.05). Conclusions: Turkish school-aged children with CP displayed functional abilities that are above average besides experiencing restrictions in the school environment. Parents' view on the physical condition of the school varied depending on functional and mobility levels of their children. [ABSTRACT FROM AUTHOR]

Patients with Duchenne Muscular Dystrophy (DMD) have gait disorders. Therefore, specific gait assessment tools are needed. The aim of this study was to develop a gait assessment instrument for DMD patients (DMD-GAS), and investigate its validity and reliability. The scale was developed considering the expert opinions which included 10 physiotherapists who had experience in the management of patients with DMD, and the Content Validity Index (CVI) was calculated. The final version of the DMD-GAS that was agreed upon the experts consisted of 10 items, and each item scored between 0 and 2. The intra-rater reliability was established by the video analysis of children with a 1-month interval and inter-rater reliability was determined by the scores of 3 physiotherapists. The study included 56 patients with DMD. The criterion validity was determined by investigating the relationship between the total score of the DMD-GAS and Motor Function Measure (MFM), 6 Minute Walk Test (6MWT), and the data obtained from GAITRite. The CVI of the DMD-GAS was 0.90 (p < 0.05). The construct validity and internal consistency of the DMD-GAS were excellent as well as the intra- and inter-rater reliability (>0.90). Moderate-to-very strong correlations were found between the total score of the DMD-GAS and the MFM-total score (r = 0.78), 6MWT (r = 0.71), gait speed (r = 0.50), stride length (r = 0.56), and base of support (r = −0.70) (p < 0.01). The results indicated that DMD-GAS was a reliable and valid instrument to determine gait characteristics of the patients with DMD in clinical settings. NCT05244395. • This study presents a new scale that can assess the kinetic properties of each part of the body during walking and the spatio-temporal characteristics of gait in a disease-specific manner. • DMD-GAS was a reliable, valid and practical assessment instrument for gait deviations. • DMD-GAS promises a practical assessment of gait deviations of children with DMD. [ABSTRACT FROM AUTHOR]

This study presented the Turkish translation of the Early Activity Scale for Endurance (T-EASE) which was developed to evaluate the endurance for physical activity of preschool children with Cerebral Palsy (CP), and its validity and reliability. Fifty-five children with CP aged between 2 and 5 years were included in the study. The Gross Motor Function Classification Scale (GMFCS) and Pediatric Outcomes Data Collection Instrument (PODCI) were used to determine motor function levels and quality of life of the study population. The T-EASE had good test-retest reliability (ICC = 0.996), internal consistency (α = 0.903), higher construct validity approved by confirmatory factor analysis, and criterion validity supported by the weak-to-strong correlations between T-EASE and GMFCS, and PODCI. The T-EASE scores were significantly different between GMFCS levels (p <.05). The T-EASE was found to be valid and reliable to determine the endurance for physical activity of Turkish pre-school children with CP with the sensitivity to changes in motor function levels. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of aerobic training adding to home-based exercise program on motor function and muscle architectural properties in children with Duchenne muscular dystrophy. Design: This is a prospective randomized controlled study. Setting: Pediatric neuromuscular clinic in a tertiary care center. Subjects: Children with Duchenne muscular dystrophy. Interventions: Children were randomly divided into two groups whereby 12-weeks aerobic training was additionally given in treatment group in contrast to the control group which received only home-based exercise program. Main Measures: Motor Function Measure and Six Minute Walk Test were used for clinical evaluation, and muscle architectural properties (thickness, pennation angle and fascicle length) were measured by ultrasound imaging. Both groups were assessed at baseline and after 12-weeks of training. Results: Median age of children was 7.9 years in the treatment group and 8.6 years in the control group (p > 0.05). Significant improvements were obtained for Motor Function Measure and Six Minute Walk Test from baseline to 12-weeks in the treatment group; Motor Function Measure total score changed from 83.2 (6.1) to 86.9 (4.0) vs. 82.3 (10.2) to 80.4 (9.4) points in the control group (p = 0.006) ; 6 Minute Walk Test distance changed from 395.3 (46.6) to 413.0 (52.3) vs. 421.7 (64.4) to 393.8 (68.2) meters in the control group (p < 0.001). However, muscle architectural parameters did not change during study period (p > 0.05). Conclusion: Aerobic training may be of additional value in improving motor function and performance with no remarkable effect on muscle architectural properties. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to describe a school-aged Turkish cerebral palsy (CP) population in terms of gross motor function, mobility, independence, and participation, and to investigate parental stress.Methods: Mobility (Functional Mobility Scale (FMS)), independence (Barthel Index (BI)), motor function (Gross Motor Function Measurement (GMFM)), functional classification (Gross Motor Function Classification System (GMFCS)), participation (Pediatric Outcome Data Collection Instrument (PODCI)), and parents' stress (Parental Stress Scale (PSS)) of 100 school-aged children with CP aged 5-15 years old were evaluated. School-related difficulties and restrictions were also questioned.Results: Of the 100 children with GMFCS levels I-V, almost half had independent mobility on level or all surfaces according to the FMS, with a relatively high GMFM score (72.8%), and above average BI (12 from 20), and PODCI Global Functioning (62.8%) scores. Strong-to-very strong correlations were determined between all test batteries. A mean score of 42.3 ± 9.92 out of 90 was obtained for parental stress with a weak correlation to the GMFCS and the child's mobility distance according to family (p < 0.05).Conclusions: Turkish school-aged children with CP displayed functional abilities that are above average besides experiencing restrictions in the school environment. Parents' view on the physical condition of the school varied depending on functional and mobility levels of their children. [ABSTRACT FROM AUTHOR]

• Pulmonary and upper limbs function start deteriorating in the early stages of Duchenne muscular dystrophy (DMD). • The decline in pulmonary function is more significant than the decline in upper limbs function in DMD. • Functional status can be followed by comparing healthy peers in each stage of DMD. Pulmonary and upper limbs function of children with Duchenne muscular dystrophy (DMD) are known to deteriorate throughout the disease process. However, there is a lack of information on the extent of impairments in the early stages of DMD when compared to healthy peers. To investigate to what extent pulmonary and upper limbs function of children with early stage DMD are impaired. Sixty-one children participated in the study: 31 with Grade 1 DMD (study group) according to the Brooke Upper and Lower Extremity Functional Classification Systems, and 30 age matched healthy peers (control group). Pulmonary function was determined with pulmonary function tests. The Performance of Upper Limb test was used to evaluate the upper limbs function. Study and control groups were homogenous in terms of physical characteristics (p > 0.05). Pulmonary and upper limbs function of children with DMD were about 85% and 93% of healthy peers, respectively. This study provides evidence for deterioration of pulmonary and upper limbs function in children with early stage DMD. Better knowledge of deterioration rate over time may help therapists to better plan and update their plan of care. [ABSTRACT FROM AUTHOR]

Few studies have examined the effect of intensive therapy on gross motor function and trunk control in children with cerebral palsy (CP). This study evaluated the effects of an intensive burst of therapy on the lower limbs and trunk by comparing qualitative functional and functional approaches. This study was designed as a quasi-randomized, controlled, and evaluator-blinded trial. Thirty-six children with bilateral spastic CP (mean age = 8 y 9 mo; Gross Motor Function Classification II and III) were randomized into functional (n = 12) and qualitative functional (n = 24) groups. The main outcome measures were the Gross Motor Function Measure (GMFM), the Quality Function Measure (QFM), and the Trunk Control Measurement Scale (TCMS). The results revealed significant time-by-approach interaction effects for all QFM attributes and the GMFM's standing dimension and total score. Post hoc tests showed immediate post-intervention gains with the qualitative functional approach for all QFM attributes, the GMFM's standing and walking/running/jumping dimension and total score, and the total TCMS score. The qualitative functional approach shows promising results with improvements in movement quality and gross motor function. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate validity, reliability and feasibility of the Four Square Step Test (FSST) in children with Duchenne Muscular Dystrophy (DMD). The study included 44 children with DMD aged 5–12 years. The functional level of the children was determined by using the Brooke Lower Extremity Functional Classification (BLEFC). The concurrent validity of the FSST, a dynamic balance assessment, was investigated by analyzing the association between FSST and Timed Up and Go Test (TUG), North Star Ambulatory Assessment (NSAA) and Six-Minute Walk Test (6MWT) distance. The intra- and inter-rater reliability of the FSST was determined by using the Intra Class Correlation Coefficient (ICC) while the feasibility of the test was determined by calculating the percentage of children who successfully completed the test in accordance with the test instructions. The FSST score of the children (mean age 9.25 ± 2.14 years) was 11.91 ± 3.43 and the BLEFC level ranged from Level 1 (65.9%) to Level 3 (9.1%). FSST had positive, moderate relation with BLEFC (r = 0.447; p =.002); positive, strong relation with TUG (rs = 0.623), and negative, moderate correlations with NSAA (rs = −0.529) and 6MWT distance (rs = −0.592) (p <.001). Intra-rater (ICC: 0.965) and inter-rater (ICC: 0.991) reliability was "excellent," and the test was feasible with successful performance of 88% children. The FSST is a valid, reliable and feasible instrument to assess dynamic balance as well as having the ability to reflect falling risk and different functional levels of children with DMD. [ABSTRACT FROM AUTHOR]

This study aims to investigate the feasibility and safety of short-term functional electrical stimulation (FES) training of the quadriceps femoris muscles in a child with facioscapulohumeral muscular dystrophy (FSHD). A 7-year-old child with FSHD received treatment due to a decrease in functional performance and difficulty climbing stairs. The child was followed up with a home-based exercise program. FES was applied twice a week during stair climbing for six weeks. Muscle activation of the quadriceps femoris was measured using superficial electromyography, muscle strength was measured with a hand-held dynamometer, and functional performance was assessed with the 6-Minute Walk and the Stair Climb Tests before and after the treatment period. At the end of the treatment, there was an improvement in muscle activation. While muscle strength increased in the quadriceps femoris muscle of the non-dominant side, it remained constant on the dominant side. Functional performance test results also improved. FES was a feasible and safe tool to use in our case, a child with FSHD. [ABSTRACT FROM AUTHOR]

While trunk control is essential for daily activities and motor function, there is currently sparse information regarding the psychometric properties of the outcome measures used for assessing trunk control in Duchenne muscular dystrophy (DMD), characterized by proximal muscle weakness. The Trunk Control Measurement Scale (TCMS) was developed to assess trunk control in children with cerebral palsy. We aimed to examine the reliability and validity of the Turkish version of the TCMS for children with DMD. We determined the functional level of 52 children with DMD (median age: 8.83 years) with the Vignos Scale, and we further evaluated them with the Motor Function Measure (MFM), a gold standard for determining the validity of the TCMS. Internal consistency of the Turkish TCMS was excellent with a Cronbach’s alpha of .95. Intraclass correlation coefficient (ICC) values for intra-rater reliability were between 0.90–0.96 and for inter-rater reliability were between 0.91–0.95. We reported positive moderate to strong correlations between the TCMS and trunk flexors strength (p < .001, r = 0.77), back extensors strength (p < .001, r = 0.68) and MFM (p < .001, r = 0.85). Thus, we found the Turkish version of TCMS to be a reliable and valid instrument for assessing trunk control of children with DMD in clinical and research settings. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were (a) to examine the surface electromyography (sEMG) amplitude values of the lower limb muscles during stair climbing both between different functional levels of Duchenne muscular dystrophy (DMD), in comparison with healthy children, and (b) to investigate the relationships between sEMG amplitudes and physical performance.Methods: sEMG amplitudes of the lower limbs of twenty-one children with DMD between levels I and III according to the Brooke Lower Extremity Functional Classification Scale and eleven healthy peers were evaluated by using sEMG during stair climbing task. Physical performance was evaluated by 6-min walk test and ascending 4-step timed performance test.Results: The lower limb sEMG amplitude values of children with DMD were statistically higher than healthy children (p < 0.001). sEMG amplitudes of the right (p = 0.01) and left (p = 0.003) biceps femoris, the right (p < 0.001) and left (p = 0.001) gastrocnemius medialis, and the right vastus lateralis (p = 0.02) muscles were higher in children with levels 2-3 than those in level 1. Moderate-to-strong relations were found between the gastrocnemius medialis and biceps femoris sEMG amplitudes and physical performance assessments (p < 0.05).Conclusion: Increased sEMG amplitude values in the lower limbs during stair climbing task are thought to be caused by the effort to compensate for progressive muscle weakness and are associated with lower physical performance in children with DMD. Further, sEMG amplitude values are determined to increase as the functional level deteriorates.Clinical Trial Registration Number and Url: NCT04287582 ( https://clinicaltrials.gov/ct2/show/NCT04287582?term=merve+bora&draw=2&rank=1 ). [ABSTRACT FROM AUTHOR]

Background: The General Movement Assessment (GMA) is a video analysis method developed by Heinz Prechtl that examines the infant's spontaneous movements. In recent years, although many studies have been performed in preterm infants by applying GMA, few studies have shown the effects of early intervention on GMA.Aims: Current study was planned to determine the acute effects of a single-session early physiotherapy approach on preterm infants' general spontaneous movements, and to reveal the change in Motor Optimality Scale (MOS) score including FMs.Study Design: Prospective, single-blind study.Subjects: Current study was carried out with 32 preterm infants at postterm 12-16 weeks.Outcome Measures: The infants included in the study were videotaped by a physiotherapist during 10-15 min before the physiotherapy session at postterm 12-16 weeks for GMA. After a single physiotherapy session, the same physiotherapist performed the same video footage second time. A blind evaluator assessed the videos taken before and after session and scored Motor Optimality Scale (MOS).Results and Conclusions: There was no statistically significant difference between MOS sub-category and total score of the infants before and after the session (p > 0.05). According to the results of present study, a single-session early physiotherapy intervention did not have an acute effect on the spontaneous movements of preterm infants at postterm 12-16 weeks. Future studies are needed to demonstrate the short and long-term effects of early physiotherapy approaches to risky infants. [ABSTRACT FROM AUTHOR]