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Purpose: The aim of this study is to investigate the validity and reliability of the Selective Control of Upper Extremity Scale (SCUES) in patients with stroke. Materials and Methods: Forty-two patients with stroke aged 18–75 years, were included in the study. Patients were video-recorded while SCUES was administered. The videos were scored to determine the intrarater and inter-rater reliability. Fugl Meyer Assessment of Upper Extremity (FMA-UE), Box and Block test (BBT) and Brunnstrom Stages of Motor Recovery were measured to evaluate validity of SCUES. Spearman correlation analysis was used to assess the validity of SCUES. Intraclass correlation coefficient (ICC), Kappa (κ) and weighted Kappa (κw) were calculated to determine intrarater and inter-rater reliability. Results: There were significant positive high correlations between SCUES and FMA-UE and BBT and Brunnstrom upper extremity proximal and distal values (rho = 0.944, p = 0.01; rho = 0,875, p = 0.01; rho = 0.84, p = 0.01, rho = 0.82, p = 0.01; respectively) showing validity of SCUES. The ICC value of inter-rater reliability of SCUES was 0,99 (%95 CI: 0,989-0,997, p = 0,001) showing excellent reliability. κ and κ w values for inter-rater and intrarater reliability of individual SCUES items were above 0.7 indicating excellent reliability. ICC of SCUES and FMA-UE indicated excellent intrarater reliability (ICC = 0,99; %95 CI: 0,989–0,997, p = 0,001; ICC = 0.943; %95 CI: 0.9–0.97, p = 0,0001, consecutively). Conclusions: SCUES showed similar validity and reliability with FMA-UE and SCUES can be used in the evaluation of upper extremity selective motor control in patients with stroke. IMPLICATIONS FOR REHABILITATION: The Selective Control of Upper Extremity Scale (SCUES) stands out from existing outcome assessment tools for upper extremity motor control in stroke patients by enabling the evaluation of various quantifiers of selective motor function. SCUES assesses not only the accompanying movements of the trunk or additional joints beyond the targeted joint but also the presence of mirror movements, along with assessing the limited dynamic range of motion. SCUES appears valid and reliable in patients with stroke, indicating its potential use in evaluating upper extremity selective motor control and assessing the outcomes of interventions aimed at enhancing selective motor control. [ABSTRACT FROM AUTHOR]

An editorial is presented that focuses on the integration of ultrasound technology into pediatric rehabilitation medicine, particularly its role in diagnosing and treating musculoskeletal disorders in children. It highlights the transformative impact of US in guiding therapeutic interventions such as botulinum toxin injections and nerve blocks, as well as its utility in assessing nerve injuries, joint conditions, and musculoskeletal problems commonly encountered in pediatric rehabilitation.

Objectives: The aim of this study was to investigate the caregiver burden (CB) of informal caregivers for stroke survivors with and without dysphagia and to assess the relationship between the CB levels of informal caregivers for stroke survivors with dysphagia, patients’ swallowing-related quality of life (QoL), and patients’ stroke-specific QoL. Patients and methods: This multi-center, prospective, cross-sectional study included a total of 120 stroke patients (76 males, 44 females; mean age: 61.1±12.3 years; range, 19 to 86 years) between October 2019 and 2020. Of the patients, 57 had dysphagia and 63 had no dysphagia. The Functional Oral Intake Scale (FOIS) was used to classify the degree of functional dietary limitation caused by each patient’s swallowing impairment. Patients and caregivers completed the Eating Assessment Tool (EAT-10), Swallowing Quality of Life (SWQoL) questionnaire, Stroke Impact Scale (SIS), and the Zarit Caregiver Burden Interview (ZBI). Results: The CB levels were higher in those caring for stroke patients with dysphagia than in those caring for stroke patients without dysphagia. Caregiver burden was found to be associated with patients’ swallowing-related QoL and stroke-related QoL. Significant predictors of high CB scores (F=2.55, R2=0.59; p=0.007) were being an employed caregiver (B=17.48, p=0.003), being a caregiver with high school (B=-19.6, p=0.03), and secondary school (B=-16.28, p=0.02) educational status, being son, daughter (B=30.63, p=0.007) or other relative of the patient (B=20.06, p=0.01), lower FOIS stage (B=-3.14, p=0.011), lower SWQoL (B=0.52, p=0.009) and lower SIS (B=-0.37, p=0.04) scores. Conclusion: Caregivers of stroke patients with dysphagia suffer from a higher CB than those without dysphagia. In stroke patients with dysphagia, swallowing-related QoL is associated with the QoL levels of stroke patients and the CB levels of their caregivers. Employment status, educational status of caregiver, caregiver’s relativity to the patient, FOIS stage, swallowing and stroke related QoL of the patients are factors related to burden levels of caregivers of stroke patients with dysphagia. These results may help health professionals to understand dysphagia as an essential source of CB and consider it, while planning treatments. [ABSTRACT FROM AUTHOR]

BACKGROUND: Delayed radiation-induced motor neuron syndrome (DRIMNS) is an atypical motor neuron disorder that develops months or years after radiation therapy. In this study we present a case of DRIMNS that developed forty years after radiotherapy and to discuss differential diagnoses. CASE PRESENTATION: A 56-year-old male patient was admitted to our clinic with complaints of increasing difficulty in walking for the past year. He had a history of operation and radiotherapy due to testicular tumor. Electroneuromyography (ENMG) and thoracic, lumbosacral, plexus and pelvic magnetic resonance imaging (MRI) were performed considering radiculopathy, plexopathy and motor neuron disease in the differential diagnosis. MRIs revealed no abnormality. Needle EMG of lower extremity and lumbar paraspinal muscles revealed fibrillation and positive sharp waves concomitant with fasciculations and reduced recruitment suggesting anterior horn cell/root involvement. DRIMNS was considered rather than motor neuron disease based on the long duration of symptoms with slow progressive course and history of radiotherapy to the pelvic region. CONCLUSION: DRIMNS is a rare entity that should be considered in the differential diagnosis of lower extremity muscle weakness in a patient with a history of malignancy and radiotherapy. EMG findings are very valuable in making the diagnosis together with the clinical picture. [ABSTRACT FROM AUTHOR]

Ultrasound (US)‐guided suprascapular nerve block (SSNB) is a widely used procedure and while describing the US‐guided SSNB in the suprascapular notch, the suprascapular fossa is often visualized and injection is performed in that location. Although it can be done in both location, to inject the right area, the terminology should be settled and the visualization of these areas which are unclear and confusing in the literature should be clarified. In this sense, we showed the course of the nerve on a cadaver and briefly describe a protocol to correctly visualize the suprascapular notch with US. [ABSTRACT FROM AUTHOR]

BACKGROUND: Various tools have been created to measure physical function during intensive care unit (ICU) stay and after ICU discharge, but those have not been validated in coronavirus 2019 (COVID-19) patients. There is a need for a reliable, valid and feasible tool to define the rehabilitation needs of post-ICU COVID-19 patients entering the acute wards and then rehabilitation clinics. OBJECTIVE: This study aims to investigate the validity, inter-rater reliability and feasibility of Chelsea Physical Assessment Tool (CPAx) in assessing the functional status of COVID-19 patients after discharge from the ICU. METHODS: Demographic and clinical characteristics of the patients were recorded. Patients were evaluated using the modified Medical Research Council (MRC) dyspnea scale, Functional Oral Intake Scale, Glasgow Coma Scale, CPAx, Barthel Index, Katz Index and MRC sum score, measurements of grip strength obtained by dynamometer, the 5 time sit-to-stand test and 30 seconds and sit-to-stand test. CPAx and the other functional assessment tools were administered to 16 patients within 48 hours following ICU discharge. For inter-rater reliability, another physiatrist independently re-assessed the patients. MRC sum score, Barthel and Katz indexes were used to assess construct validity of CPAx. The discriminative validity of CPAx was determined by its ability to differentiate between patients with and without ICU acquired muscle weakness based on MRC sum score. The intra-class correlation coefficients (ICC) were calculated to determine inter-rater reliability for total scores of the functional assessment tools. Cohen's Kappa (κ) coefficient and weighed Kappa (κ w) were calculated to determine inter-rater reliability of individual CPAx items. Ceiling and flooring effects were calculated by percentage frequency of lowest or highest possible score achieved. The number and percentages of the patients who were able to complete each tool were calculated to assess feasibility. The CPAx score was strongly correlated with MRC sum score (rho: 0.83), Barthel Index (rho: 0.87) and Katz Index (rho: 0.89) (p < 0.001) showing construct validity. Area under the ROC curve demonstrated that cut off score for CPAx was ⩽ 12 to discriminate patients with MRC sum score < 48, with a sensitivity and a specificity of 100% and 63%, respectively (AUC = 0.859, p < 0.001). ICC was high for CPAx, MRC sum score, Barthel and Katz indexes, Glasgow Coma Scale, and hand grip strength measurement, with the highest value observed for CPAx (ICC, 0.96; 95% confidence interval (CI), 0.71–0.98). κ and κ w analysis showed good to excellent inter-rater reliability for individual CPAx items. No floor or ceiling effect was observed at CPAx while floor effect was observed at Barthel Index scores (25%) and Katz Index scores (37.5%). All patients could be evaluated using CPAx while less were physically able to complete the 5 time sit-to-stand, 30 seconds sit-to-stand tests (n = 4) and MRC sum score (n = 14). CONCLUSION: CPAx is a valid, reliable, and feasible tool to assess the physical functional state in COVID-19 patients following discharge from the ICU. [ABSTRACT FROM AUTHOR]

BACKGROUND: Following the first COVID-19 cases in Turkey, face-to-face education was ceased after March 16, 2020 until the end of the educational year (i.e. June 19, 2020) and education was substituted remotely due to confinement. OBJECTIVE: This study aims to investigate the frequency of musculoskeletal complaints in school-age children and associated risk factors including reduced physical activity, increased screen time and poor ergonomics conditions in school-age children during the pandemic. METHODS: This cross-sectional study included parents or guardians of 960 students aged between 6–13 years old with a non-randomized sampling. A survey was administered consisting of 65 items related with sociodemographic characteristics of the children and family, online education hours, technological device(s) used, screen time, type of physical activity, presence of musculoskeletal problems and poor ergonomics conditions such as incorrect sitting posture. RESULTS: Logistic regression results demonstrated that age, excess weight gain, total daily screen time, smartphone use, incorrect sitting posture were associated with musculoskeletal complaints. CONCLUSION: The long-term closure of schools due to the pandemic may have led to an increase in musculoskeletal complaints in 6–13 years old children, based on the factors identified in this study, which were excess weight gain, increased screen time and incorrect sitting posture. These findings might help education and health authorities to develop strategies to improve musculoskeletal health of children especially in emergencies such as the pandemic. [ABSTRACT FROM AUTHOR]

BACKGROUND: When a patient with a prior history of malignancy and radiotherapy develops progressive weakness as a presentation of plexus involvement, the differential diagnosis usually rests between radiation-induced plexopathy and invasion from recurrent tumor. The presence of myokymic discharges is helpful in differentiating radiation-induced from neoplastic plexopathy. OBJECTIVE: To present a case report of a patient with chordoma, a locally aggressive tumor, who was diagnosed with recurrent tumor accompanied by the occurrence of myokymia in needle electromyographic examination. METHOD: A 55-year-old male patient with a history of chordoma and radiotherapy presented to our outpatient clinic with complaints of foot drop, and impaired walking for two months. His latest magnetic resonance imaging (MRI) which was performed three months earlier did not show recurrence. Upon electromyographic evaluation, myokymia, the pathognomic electromyography abnormal wave for radiation plexopathy was detected supporting a diagnosis of radiation plexitis rather than recurrent neoplastic invasion. One month later he presented with more severe pain and was re-evaluated by an MRI, on which a mass was detected indicating relapse. CONCLUSION: With this case report, we would like to emphasize that the behaviour of the tumor should be considered and imaging should be repeated when tumors display aggressive or recurrent behaviour. [ABSTRACT FROM AUTHOR]

BACKGROUND: When a patient with a prior history of malignancy and radiotherapy develops progressive weakness as a presentation of plexus involvement, the differential diagnosis usually rests between radiation-induced plexopathy and invasion from recurrent tumor. The presence of myokymic discharges is helpful in differentiating radiation-induced from neoplastic plexopathy. OBJECTIVE: To present a case report of a patient with chordoma, a locally aggressive tumor, who was diagnosed with recurrent tumor accompanied by the occurrence of myokymia in needle electromyographic examination. METHOD: A 55-year-old male patient with a history of chordoma and radiotherapy presented to our outpatient clinic with complaints of foot drop, and impaired walking for two months. His latest magnetic resonance imaging (MRI) which was performed three months earlier did not show recurrence. Upon electromyographic evaluation, myokymia, the pathognomic electromyography abnormal wave for radiation plexopathy was detected supporting a diagnosis of radiation plexitis rather than recurrent neoplastic invasion. One month later he presented with more severe pain and was re-evaluated by an MRI, on which a mass was detected indicating relapse. CONCLUSION: With this case report, we would like to emphasize that the behaviour of the tumor should be considered and imaging should be repeated when tumors display aggressive or recurrent behaviour. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the validity of the Physical Activity Scale for the Elderly in stroke patients by comparing its scores with activity data derived from an accelerometer. Materials and Method: Twenty-five patients with stroke who walked independently or with an assistive device were included in the study. An accelerometer was held on participants’ non-paretic hips on Monday–Friday, and data were collected during three valid weekdays: Tuesday, Wednesday and Thursday. To evaluate validity, accelerometer-derived physical activity data and the Stroke Impact Scale were used. Results: A statistically significant moderate correlation was found between the Physical Activity Scale for Elderly and activity counts during moderate physical activity (Spearman correlation rho = 0.43, p = 0.03), energy expenditure during moderate activity, and total step count (rho = 0.41, p = 0.04; rho = 0.45, p = 0.03; rho = 0.45, p = 0.03; consecutively), while no significant correlations were found between Physical Activity Scale for Elderly score and total activity counts and activity counts during sedentary, light activity, or total energy expenditure (p >0.05). There was a moderately positive, statistically significant correlation between PASE and Stroke Impact Scale scores (rho = 0.49, p = 0.01) showing convergent validity. Conclusions: There is uncertainty about the validity of the Physical Activity Scale for Elderly for specifically reflecting total, light, and sedentary activity. Physical Activity Scale for Elderly was not designed to be used to measure and evaluate different physical activity levels. Accelerometers enabled an assessment of the amount and intensity of physical activity. The findings of this study support the use of accelerometers for assessing physical activity in patients with stroke rather than Physical Activity Scale if these factors are importantly considered. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate cross-sectional area of the amputated-limb rectus femoris compared to the intact-limb and controls and to determine its correlation with functional strength and walking tests in prosthesis users with transtibial amputation. Patients and methods: Between October 2018 and April 2019, a total of 14 prosthesis users (12 males, 2 females; mean age: 47.1±16.2 years; range, 26 to 73 years) who met the inclusion criteria, and 14 age-, sex-, and dominancy-matched able-bodied controls (12 males, 2 females; mean age: 47.1±16.2 years; range, 26 to 73 years) were included in this case-control study. Cross-sectional area of rectus femoris (CSA-RF) was evaluated bilaterally by two independent examiners. Knee extension strength was measured bilaterally by using a handheld dynamometer. Functional strength and walking were assessed by Step-Up-Over and Walk-Across tests of the NeuroCom Balance Master® device. Results: The CSA-RF was found to be reduced in amputated-limb compared to the intact-limb and able-bodied controls (p<0.01). In the prosthesis users, the cross-sectional area difference between both limbs rectus femoris muscles was shown to be correlated with actual and functional knee extension strength, step length, and walking speed (p<0.05). Intra- and inter-observer reliability of CSA-RF on both sides were found to be good to excellent (intraclass correlation coefficient: 0.856-0.936). Conclusion: Ultrasonographic measurement of CSA-RF is a valid and reliable tool to assess the functional strength and walking in the prosthesis users with unilateral transtibial amputation. [ABSTRACT FROM AUTHOR]

Background: To describe and understand the experiences and beliefs of caregivers of children with cerebral palsy following botulinum toxin injection. Methods: A descriptive case study approach with focus group interviews was employed. A semi‐structured questionnaire was conducted to collect data. Twenty‐one caregivers of children (3–13 years old) with cerebral palsy were recruited with a maximum variation sampling strategy to gain insight through different perspectives. Qualitative analysis with verbatim transcripts was analysed using a thematic approach. Findings Four themes emerged from qualitative analyses: acceptance of diagnosis, perceptions about treatment, caregivers' experiences with the health environment, and feelings and thoughts after the treatment. Conclusions: This study highlights caregivers' requests for information about the possible long‐term effect of botulinum toxin, as well as information and support to provide the best rehabilitation programme immediately after injection. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess psychosocial functioning in relation to lesion level and ambulatory status in children with spina bifida (SB) and compare them to their peers. Patients and methods: Between March 2013 and May 2013, a total of 31 patients with SB (11 males, 20 females; mean age: 9.4 years; range, 6 to 14.7 years) and 36 typically developing peers (16 males, 20 females; mean age: 9.8 years; range, 6.5 to 14.8 years) were included in the study. All participants were assessed using a semi-structured psychiatric diagnostic interview via the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL), Wechsler Intelligence Scale for Children-Revised (WISC-R), Behavioral Rating Inventory of Executive Functions (BRIEF) parent form, Social Responsiveness Scale (SRS), and Aberrant Behavior Checklist (ABC). Results: In the SB group, the rate of psychiatric disorders was significantly higher (p=0.001) and the SRS scores and the planning and organizational components of the executive function were higher than their peers (p=0.02 and p=0.007, respectively). The psychiatric diagnosis rate, BRIEF, and SRS total scores did not significantly differ according to lesion level and ambulatory status. The BRIEF initiate and organization of materials subtest scores and ABC scores were significantly lower at high lesion levels (p=0.02, p=0.02, and p=0.02, respectively) and non-community walkers (p=0.002, p=0.03, and p=0.003, respectively). Conclusion: Psychiatric disorders, impairment in social responsiveness, and planning and organization components of the executive function are prevalent in children with SB with no intellectual disabilities, compared to their peers. Therefore, psychosocial counseling and multidisciplinary follow-up for SB patients seem to be beneficial. [ABSTRACT FROM AUTHOR]

Introduction:  Pectus carinatum (PC) is a congenital chest wall deformity which is characterized by the protrusion of the sternum and costal cartilages. Although orthotic and exercise therapies are commonly offered by physicians for PC treatment, there is a lack of evidence on the benefits of exercises and how long the orthosis should be worn. The aim of this study is to investigate the effects and feasibility of custom-made compression orthosis and exercises in the treatment of PC.Materials and Methods:  Patients with PC aged 7 to 17 years old were randomized into three groups: compression orthosis 23 hours, compression orthosis 8 hours, and control group. All groups received exercises for 1 hour a day for 3 weeks. Additionally, compression orthosis 23 hours group wore the orthosis for 23 hours a day, while compression orthosis 8 hours group wore the orthosis for 8 hours a day. PC protrusion, pressure of correction, thorax lateral and anteroposterior parameters, external chest wall measurements, and Nuss Questionnaire were evaluated before and after the treatment. Also, adverse effects, retention, and compliance were assessed. Feasibility was evaluated by calculating the percentages of recruitment, retention, and safety.Results:  The compression orthosis 23 hours group showed greater improvements than the other groups. After treatment, all groups showed significant changes in protrusion, pressure of correction, and external chest wall measurements. Adverse events occurred with similar frequency across groups. Retention percentages did not differ among groups.Conclusion:  Compression orthosis use for 23 hours can be recommended rather than its use for 8 hours because 23 hours of orthosis use has better correction and similar adverse effects. [ABSTRACT FROM AUTHOR]

In the article, the authors present their report on the publications from Turkey regarding physical medicine and rehabilitation (PMR). Also cited are the 2020 Scientific and Technological Research Council of Turkey (TUBITAK) field-based competency analysis report on the research performances of universities, and the topics covered by the research like rehabilitation, rheumatology, and orthopedics.

BACKGROUND AND OBJECTIVE: Jumping stump is an uncommon movement disorder characterized by involuntary movements and severe neuropathic pain in the stump. The pathophysiology and etiology of this phenomenon have not yet been clearly elucidated, and unfortunately, no proven treatment with successful recovery exists. This report aims to describe a severe painful jumping stump, possibly due to neuromas, in a traumatic transradial amputee. MATERIALS AND METHOD: We performed ultrasound examination of the painful stump depicted neuroma. Electromyographic evaluation of the stump revealed arrhythmic motor unit action potentials (MUAPs) with normal duration and amplitude; other movement disorders, such as myokymia and fasciculations, were excluded. Ultrasound should be preferred to magnetic resonance imaging (MRI) for evaluation of stumps in patients with painful stump because MRI may not be helpful due to motion artefacts. The involuntary movements ceased after surgical excision of the neuroma following failure of conservative treatments. CONCLUSION: This report confirms that neuromas are clearly associated with jumping stump. Ultrasonographic and electromyographic assessments are necessary to reveal the features of this pathology for treatment planning. [ABSTRACT FROM AUTHOR]

Dynamic lycra splints are proposed to modify hypertonicity due to their characteristics – neutral warmth, circumferential pressure, and creating a low-intensity prolonged stretch on hypertonic muscles – to contribute to increased sensory awareness of the involved limb. The aim of this study was to investigate the effects of dynamic lycra orthosis as an adjunct to botulinum toxin-A injection and rehabilitation of the upper-limb in adults following stroke. Patients who had suffered a stroke more than three months previously were randomized into two groups: lycra sleeve plus rehabilitation (n = 10) and only-rehabilitation group (n = 10). After botulinum toxin injection, both groups underwent an upper-limb rehabilitation program. The intervention group wore a lycra sleeve for eight hours a day, five days a week for three weeks in addition to the rehabilitation program. Fugl Meyer upper-limb motor score, Motricity index, Modified Ashworth scale, Box and Block test, Stroke Impact Scale and change in touch-detection thresholds of the fingers measured via Semmes-Weinstein monofilaments were assessed by blinded investigators at before treatment, post-treatment (at 3 weeks) and three months post-treatment. This trial is registered with Clinicaltrials.gov, number NCT03546959. There were no differences between groups in terms of Fugl Meyer upper-limb motor score, Motricity Index, Modified Ashworth scale, Box and Block test, Stroke Impact Scale and change in light touch threshold at any follow-up time points. Using lycra splints as an adjunct to an upper-limb rehabilitation program after stroke did not provide additional benefit in spasticity, upper-limb motor function, light touch threshold of fingers or stroke-specific quality-of-life. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of vest type dynamic elastomeric fabric orthosis on posture and balance during sitting and gross manual dexterity and to compare the efficacy of daily wearing time of 2 h versus 6 h. Method: Twenty-four children with cerebral palsy (CP) aged 3–9 years with GMFCS levels III and IV were randomised to either of three groups: (i) a control group who received only conventional exercise therapy, (ii) dynamic elastomeric fabric orthosis 2 h group who wore the orthosis for 2 h during therapy and dynamic elastomeric fabric orthosis 6 h group who wore the orthosis for 4 h in addition to the 2 h of wear along with therapy during hospital inpatient stay for 2 weeks. Children continued to use dynamic elastomeric fabric orthosis during the post-discharge period. The primary outcome measure was the Sitting Assessment Scale. The secondary outcome measurements were the sitting dimension of Gross Motor Function Measure, Box and Block Test and Parent Satisfaction Survey. Assessments were made before treatment, at post-treatment, at 1-month post-treatment, and at 3-months post-treatment. Sitting Assessment Scale and Box and Block Test were also assessed when immediately after wearing the orthosis. This trial is registered with Clinicaltrials.gov, under number NCT03191552. Results: All groups showed similar improvements except the control group which showed less improvement in Sitting Assessment Scale scores compared to the dynamic elastomeric fabric orthosis groups. Dynamic elastomeric fabric orthosis groups showed greater improvements compared to the control group in the Sitting Assessment Scale but not in the sitting dimension of Gross Motor Function Measure and Box and Block Test at post-treatment, at 1-month post-treatment and at 3-months post-treatment. When the dynamic elastomeric fabric orthosis groups (2 h versus 6 h) were compared, there were no significant differences in any of the assessments. The Sitting Assessment Scale and Box and Block Test scores also improved immediately after the patients put on the orthosis. At 1-month post-treatment, parents of children in the control group reported less satisfaction than parents of the children in dynamic elastomeric fabric orthosis groups. Conclusions: Dynamic elastomeric fabric orthosis vest has an immediate effect on the sitting balance and gross manual dexterity. It also provides improvements in posture and balance during sitting. Wearing dynamic elastomeric fabric orthosis vest for 2 h during therapy is as much effective as wearing it for 6 h in children with CP in addition to therapy to improve sitting balance. Dynamic elastomeric fabric orthosis vest provides improvements in sitting balance when used in addition to conventional therapy in children with cerebral palsy. Wearing dynamic elastomeric fabric orthosis for 2 h and wearing dynamic elastomeric fabric orthosis vest for 6 h resulted in similar clinical outcomes. Dynamic elastomeric fabric orthosis vest has an immediate effect on sitting balance and gross manual dexterity in children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate knowledge and awareness of a sample of young researcher physicians about reporting guidelines and the EQUATOR network. Materials and Methods: One hundred young researcher physicians were enrolled for the study and evaluated using a questionnaire which assessed the level of usage and knowledge of reporting guidelines and the EQUATOR network. Results: Thirty-eight percent of the participants were aware of the EQUATOR network. The most recognized reporting guidelines were CONSORT (32%), PRISMA (35%), and the least recognized ones were ARRIVE (12%) GRRAS (12%). The percentage of participants who were aware of the EQUATOR network and reporting guidelines were deficient. Seventy-three percent of the participants declared that they requested more information about reporting guidelines when they were asked whether they wished to be informed about reporting guidelines. There were statistically significant differences between specialists and residents regarding the level of knowledge on reporting guidelines and reporting guideline use except for PRISMA and SAMPL guidelines and their level of the desire to be informed about guidelines were similar. When participants whose publication number was above and below the mean of publications of all participants were compared, the level of reporting guidelines usage and knowledge of PRISMA, GRRAS were similar and both groups showed equal levels of desire to be informed about guidelines. Conclusion: The use and awareness of the EQUATOR network and reporting guidelines are low among young researcher physicians. To improve the quality of manuscript writing and the acceptance rates, knowledge and awareness of the EQUATOR network and reporting guidelines should be increased among young physicians doing research. [ABSTRACT FROM AUTHOR]

Despite sore throat exists in the product characteristics of abobotulinum toxin A as one of the side effects, no available reports of sore throat after abobotulinum toxin A injection for adult upper limb spasticity could be found in the literature to guide physicians for the management. Herein, we report a case of poststroke spasticity who develop sore throat immediately after abobotulinum toxin A (Dysport®) injection of forearm muscles which completely resolved after observation for eight hours. This case report highlights a rare side effect of abobotulinum toxin A and provides information regarding the follow-up process of side effects which would guide physicians for the management. [ABSTRACT FROM AUTHOR]

Aim: To find out whether obesity or injection level have an impact on the amount of radiation exposure during fluoroscopy-guided lumbosacral transforaminal epidural steroid injections (TFESIs). Material and Methods: Patients aged 19-65 years who underwent lumbosacral transforaminal epidural steroid injection were retrospectively reviewed. Eighty-three patients with a mean age of 42.7±13.2 (19-65) years with signs and symptoms of unilateral lumbar radicular pain due to single level disc herniation were included. Subjects were categorized as normal weighted (18.5≤body mass index (BMI) ≤ 24.9), overweighed (25≤BMI<30) and obese (BMI≥30) according to World Health Organization BMI criteria. All patients were given unilateral TFESIs, including39 (47%) L5, and 44 (53%) S1 level. Radiation exposure dose and procedure time was automatically measured by fluoroscope. Results: Radiation dosage increased significantly with increasing BMI (p=0.0001). No statistically significant differences were found when three groups' procedure durations and NRS scores were compared (>0.05). The radiation dosages and procedure durations between the two different injection levels (L5 and S1) were not found to be statistically significant (>0.05). Conclusion: Obesity is associated with increased radiation exposure independent of procedure duration and the injection level. [ABSTRACT FROM AUTHOR]

Background: Subcutaneous echogenicity grade (SEG) and subcutaneous echo-free space (SEFS) grade allow semiquantitation of nonspecific subcutaneous tissue inflammation and fluid accumulation in breast cancer-related lymphedema. However, inter- and intrarater reliability of SEG and SEFS is yet to be reported. The objective of this study is to assess inter-rater and intrarater reliability of SEG and SEFS in patients with breast cancer-related lymphedema. Methods and Results: Two physiatrists performed SEG and SEFS grade to determine inter-rater and intrarater reliability. Inter-rater reliability for SEG and SEFS was excellent (Kappa [K] = 0.836, weighted Kappa [Kw] = 0.85; K = 0.884, Kw = 0.92). K and Kw values of SEG and SEFS grading systems indicated excellent intrarater reliability (K = 0.81, Kw = 0.83; K = 0.798, Kw = 0.82). This trial is registered with Clinicaltrials.gov, under number NCT03559296. Conclusions: Based on the findings of this study, SEG and SEFS demonstrated acceptable reliability. SEG and SEFS appear to be reliable and useful grading systems for the assessment of breast cancer-related lymphedema. [ABSTRACT FROM AUTHOR]

Background: Lateral epicondylitis is a common musculoskeletal condition presenting with pain and tenderness over the lateral epicondyle and dorsal forearm, pain and weakness in gripping and limitations in daily activities. It is proposed that kinesiotaping, a new application of adhesive taping, reduces pain and improves muscle function.Objective: To compare efficacy of kinesiotaping, sham taping, or exercises only in the treatment of lateral epicondylitis.Design: Double-blind, randomized, controlled trial.Setting: Tertiary medical center, university hospital.Participants: Thirty patients with lateral epicondylitis for less than 12 weeks.Methods or Interventions: Patients were randomized into three groups: kinesiotaping plus exercises (n = 10), sham taping plus exercises (n = 10), and control (exercises only) (n = 10) groups. All recipients were provided a home exercise program including strengthening and stretching exercises. In kinesiotaping and sham taping groups, tapings were performed and changed every 3-4 d for 2 weeks.Main Outcome Measure(s): The primary outcome was the patient-rated tennis elbow evaluation (PRTEE). Pain visual analogue scale (VAS), grip strength, and the disabilities of the arm, shoulder and hand (QuickDASH) scales were secondary outcomes. Evaluations were done at baseline, posttreatment, and at 4 weeks after treatment. The immediate effect was also assessed by VAS and grip strength immediately after real and sham tapings.Results: PRTEE total scores at posttreatment and at 4 weeks after treatment were statistically significantly lower in kinesiotaping plus exercises group compared to sham taping plus exercises group and exercises only group. The effects of kinesiotaping were larger than sham taping and only exercises at posttreatment (d = -1.21, d = -1.33) and at 4 weeks after treatment (d = -1.39, d = -1.34). Repeated-measures anova showed a significant interaction between the time and the groups (F 2950 = 4849; P = .006). Significant between-group differences were found in QuickDASH score and VAS at rest at 4 weeks after treatment, VAS at daily activity at posttreatment and 4 weeks after treatment when kinesiotaping plus exercises and sham taping plus exercises groups and kinesiotaping plus exercises and exercises only groups were compared. Real taping but not sham taping immediately led to an increase in grip strength, decrease in VAS at rest and VAS at daily activity (P = .0017, P = .041, P = .028; respectively).Conclusions: Kinesiotaping in addition to exercises is more effective than sham taping and exercises only in improving pain in daily activities and arm disability due to lateral epicondylitis.Level Of Evidence: I. [ABSTRACT FROM AUTHOR]

Progressive pseudorheumotoid dysplasia (PPD) is a rare hereditary musculoskeletal disorder which is usually misdiagnosed due to its clinical resemblance to juvenile idiopathic arthritis. It has a high incidence in the Middle East, Gulf States, and countries of Mediterranean basin. Herein, we present four cases of PPD from Turkey (two siblings pair from the same kindred who are far paternal cousins) showing different disease courses. The progression of disease was particularly aggressive in the male sibling who suffered from severe scoliosis with more crippling joint disease. These four cases of PPD support the clinical heterogeneity and variable expressivity of PPD. In this article, we draw attention to the effects of patient education and early rehabilitation which helped to slow progression of range of motion loss. [ABSTRACT FROM AUTHOR]

Objective: The aim the study is to assess relationships between caregiver burden, quality of life, arm disability, grip strength, and lymphedema symptoms in women with postmastectomy lymphedema. Materials and Methods: Fifty-two patients with postmastectomy lymphedema were recruited. Burden Interview, Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-30 and EORTC QLQ BRE-23) were used for the assessments of caregiver burden, arm disability, and quality of life. Lymphedema symptoms were questioned by Visual Analogue Scale (VAS) for pain, heaviness, and tension. Grip strength and arm volumes of the affected and unaffected sides were measured. Results: Statistically significant positive correlations were detected between Burden Interview scores and DASH scores, VAS for pain and EORTC QLO-30 symptom scores. There were statistically negative correlations between Burden Interview and grip strength of affected side and unaffected side and lymphedema duration. Multiple linear regression was calculated to predict Burden Interview and EORTC QLO-30 functional and symptom scores based on age, DASH, stage, and duration of lymphedema. DASH score was significant predictors of Burden Interview while DASH score and Burden Interview scores were significant predictors of quality of life. Conclusion: Arm disability indicates caregiver burden and quality of life in patients with postmastectomy lymphedema while caregiver burden predicts the quality of life. These findings have implications for the management of lymphedema. We suggest that arm disability should be diagnosed and treated to improve caregiver burden and quality of life. [ABSTRACT FROM AUTHOR]

Ankylosing spondylitis (AS) is a chronic inflammatory disease which is characterized by the primary involvement of axial spine and sacroiliac joints and also extraarticular involvements including ophthalmological, cardiac, pulmonary, or neurological effects. Cardiac involvement in patients with AS has been reported to be 2 to 10%. Ventricular dysfunctions have been previously reported in patients with AS. However, there is only one case report describing primary cardiomyopathy due to AS and management with better control of inflammation and medications. Herein, we present a case of cardiomyopathy in AS in whom ejection fraction and New York Heart Association (NYHA) functional class improved and disease activity decreased after cardiac rehabilitation program. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to identify the relationship between balance and sagittal spinopelvic alignment (SSA) in ankylosing spondylitis (AS) and compare patients with or without lumbopelvic mismatch in terms of balance. Patients and methods: We enrolled 41 patients (22 males, 19 females; mean age 41.3±8.9 years; range 21 to 57 years) into the study. SSA was evaluated measuring thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt and pelvic incidence on lateral standing X-rays of the whole spine including the femoral heads. Patients were grouped according to presence of lumbopelvic mismatch (lumbar lordosis-pelvic incidence >10o). Clinical parameters including age, body mass index, pain (Visual Analog Scale), disease activity (Bath Ankylosing Spondylitis Disease Activity Index), and disease duration were recorded. Posture was evaluated measuring tragus-to-wall distance, modified Schober's test and chest expansion. A computerized pressure plate system (NeuroCom Balance Master®) was used for evaluating static and dynamic balance. Correlations between SSA parameters and balance were analyzed. Patients with or without lumbopelvic mismatch were compared in terms of balance. Results: Patients took shorter steps, as thoracic kyphosis increased and sacral slope decreased (r= -0.391, p=0.012; r=0.344, p=0.028). Patients with lumbopelvic mismatch had significantly higher sway velocity on firm base with eyes closed and on foam base when the eyes open and closed. They also walked more slowly compared to patients without lumbopelvic mismatch (p>0.05). Conclusion: Lumbopelvic mismatch impaired both static and dynamic balance, while increased thoracic kyphosis and decreased sacral slope impaired only the dynamic balance in patients with AS. Further studies with larger sample size and longer follow-ups need to be conducted to identify the mechanism of spinal deformities and balance disorders in patients with AS. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this review to evaluate the clinical aspects and effectiveness of suit therapy for patients with cerebral palsy (CP). Materials and methods: A literature search was performed in the PubMed, SCOPUS, Web of Science, and PEDro databases within the period from the establishment of the relevant database to July 2018. The articles were categorized according to their study design. We included studies published in peer-review journals focusing on the efficacy of suit therapies for CP and excluded review articles, duplications, non-related articles. A narrative synthesis approach was used, as it was not possible to classify extracted and analyzed data, and the overall effect size was unable to be calculated. Data regarding study subjects (number, age, CP type, Gross Motor Function Classification System [GMFCS] level), suit type, intervention including dose of suit therapy, outcome measurements, outcomes, adverse effects, and funding were extracted. The method introduced by Furlan, Pennick, Bombardier, and van Tulder was used to evaluate the risk of bias for the assessment of methodological quality of randomized-controlled trials (RCTs). Results: A total of 29 studies were included of which 10 were Class I, eight were Class II-III, and 11 were Class IV studies. Studies were heterogenous in design, sample size, study population, and outcomes measured. The methodological quality score of RCTs varied between 4 and 10. The results of the high-quality RCTs showed that wearing the suit along with conventional therapy improved proximal stability, gross motor function, and gait. The Class II-III and IV studies supported the findings of the Class I studies. Conclusion: The major improvements from the RCTs were seen in proximal stability, gross motor function and gait, although grading was unable to be done due to the heterogeneity of included studies. In order to obtain gains in the function, it is important to carefully consider intended use, patient selection criteria, and suit type. [ABSTRACT FROM AUTHOR]

Chelsea physical assessment tool for evaluating functioning in post-intensive care unit COVID-19 patients Keywords: coronavirus; COVID-19; hospitals; intensive care units; physical functional performance; rehabilitation EN coronavirus COVID-19 hospitals intensive care units physical functional performance rehabilitation 2620 2622 3 04/03/21 20210501 NES 210501 By this letter, we aimed to address the need of an adequate assessment of functional status in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients. Taken together, our considerations suggested that CPAx might be a potential cornerstone in functional assessment of COVID-19 patients, thus facilitating PRM physician to plan an appropriate patient-tailored rehabilitation in post-ICU COVID-19 patients. [Extracted from the article]

Mechanical compression at any point along the lateral femoral cutaneous nerve (LFCN) may result in meralgia paresthetica (MP). A 54-year-old male patient presented with pain and tingling on the anterolateral side of thigh. After excluding other causes of pain radiating to legs, he was diagnosed with MP. Inguinal lymphadenopathy which caused the compression of LFCN was found on ultrasonographic examination. Tinea pedis infection was also identified during the detailed investigation for lymphadenopathy. Associated MP symptoms partially resolved immediately after ultrasound-guided LFCN block and a complete recovery was achieved after the treatment of tinea pedis. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate pain in children with cerebral palsy (CP), to investigate its association with dependency level, verbal abilities, and the quality of life (QoL) of children and sociodemographic status, depression levels, and QoL of their caregivers. Patients and methods: Between February 2016 and April 2016, a total of 85 children (56 males, 29 females; mean age 7.1±2.5 years; range, 4 to 12 years) with CP were included. Their sociodemographic data, gross motor functional levels, verbal abilities (verbal and nonverbal) were evaluated. The children were categorized as independent (Gross Motor Function Classification System [GMFCS] 1), partially dependent (GMFCS 2,3), and totally dependent (GMFCS 4,5). The Non-Communicating Children’s Pain Checklist - Revised (NCCPC-R), the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD), the Nottingham Health Profile (NHP), and the Beck Depression Inventory (BDI) were used for the evaluation. Results: A total of 50 (58.8%) of the children were verbal, while 35 (41.2%) were non-verbal. Of the patients, 47.1% were totally dependent, 37.6% were partially dependent, and 15.3% were independent. Pain was less frequent in the independent group, compared to the partially and totally dependent groups (p=0.04; p=0.013). There were no statistically significant difference in perceived pain according to the CPCHILD and NCCPC-R scores, when low and high socioeconomic status were compared (p>0.05). The QoL scores of children who were totally dependent and non-verbal were statistically significantly lower than those of the other children (p=0.0001, p=0.0001). A statistically significantly negative correlation between increased totally dependent children’s QoL scores and decreased QoL scores of the caregivers was observed (r=-0.429 p=0.006). The children with pain had a decreased QoL (p=0.03). The QoL of caregivers decreased and the depression scores of caregivers increased, as the pain scores of the children increased (r=0.291, p=0.007; r=-0.455, p=0.0001). Conclusion: Our study results show that pain is more frequent in children with CP who are dependent and non-verbal, and it negatively affects the QoL of both caregivers and children. Evaluation of pain and the identification of CP patients who are at high risk of experiencing pain is worthwhile, as these individuals have difficulty in verbalizing pain due to their cognitive problems, although they are at risk of experiencing pain due to chronic physical problems, such as spasticity and contracture, as well as interventions for complicated medical problems. [ABSTRACT FROM AUTHOR]