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The aim this research, determine the level of influence of families with children with cerebral palsy in Northern Cyprus and to reveal the difference in being affected between parents. The study was carried out on 49 children with CP and 49 couples of parents. Pediatric Functional Independence Measure (WeeFIM) was used to evaluate the functional status of children, and the Impact of Family Scale (IFS) and the Quality of Life Scale (SF-36) were used to measure the influence of families. Those with WeeFIM total score between 18-90, the group requiring observation (CNO) (n = 34), and those between 91-126 were divided into independent group (IC) (n = 15). No relationship was found between IFS, SF-36 score of parents and functional level of their children. There was a positive correlation between mothers and fathers in IFS and SF-36 scores within groups (CNO IFS p: 0,021 r: 0,394; CNO SF-36 p: 0,001 r: 0,546; IC IFS p: 0,038 r: 0,602; IC SF-36 p: 0,001 r: 0,825). When the levels of influence and quality of life of the mothers and fathers within the groups were compared, it was observed that there was not a significant difference between the mothers and fathers in the group CNO and in the IC group (p>0.05). According to this study family influences of parents with children with cerebral palsy in Northern Cyprus are not affected by their functional levels. The fact that there was no difference between mothers and fathers in terms of quality of life and level of influence revealed the geographical cultural difference in favor of women. ©Author(s) 2022 by the authors.

Artificial neural network implementations in neurological rehabilitation, Nörolojik rehabilitasyonda yapay sinir ağı uygulamaları

BACKGROUND: Balance and mobility impairments, declined musculoskeletal strength and performance, limited range of motion, and poor flexibility are fairly common among older adults.

Purpose: The aim of this study was to examine the agreement between physiotherapists (PTS), patients and caregivers about the physiotherapy of patients with hemiparesis. Materials and methods: Fifty-two patients with hemiparesis (M = 24, F = 28), caregivers (N = 52) and PTs (N = 52) who applied for the physiotherapy programme were interviewed. Demographic and clinical characteristics of the patients were recorded. A questionnaire composed of six questions was used to describe the expectations of the PTs, caregivers and patients about the physiotherapy programme. Results: The Kappa calculator revealed a statistically moderate level of agreement between PTs and caregivers (K = 0.532, p = .0001), patients and caregivers (K = 0.496, p = .0001) and PTs and patients (K = 0.401, p = .0001) regarding the expectations of physiotherapy programme. Conclusion: Expectations of the patients and caregivers must be considered for rehabilitation; hence, participation in the therapy and efficacy of the physiotherapy programme will increase. Consequently, we believe that the expectations of the patients and caregivers should be considered by the PTs when preparing a treatment programme for patients with hemiparesis. C1 [Unal, Ayse; Altug, Filiz; Kara, Guzin; Cavlak, Ugur] Pamukkale Univ, Sch Phys Therapy & Rehabil, Denizli, Turkey. [Kilavuz, Gonul] Bilecik Seyh Edebali Univ, Sch Hlth, Bilecik, Turkey.

Background Rheumatoid arthritis (RA) is a chronic disease which affects the performance of the upper extremities. There is no method to evaluate the specific upper extremity endurance of individuals with this disease. The unsupported upper-limb exercise test (UULEX) is a performance test that evaluates upper extremity performance (functionality and endurance). Aim The aim of this study was to examine the reliability and validity of UULEX and the minimal detectable change (MDC) in individuals with RA. Methods and Materials The study included 71 patients (15 male, 56 female) with a mean age of 52.15 +/- 10.11 years. The intraclass correlation coefficient (ICC) was used to assess the reliability of UULEX. MDC estimates were calculated using baseline data. Correlations of UULEX with the Disability of Arm, Shoulder and Hand Questionnaire (DASH), Health Assessment Questionnaire (HAQ), 30-second push-up test and 6 pegboard ring test (6PBRT) were assessed for concurrent validity. Results The level, weight and duration scores of the UULEX test were found to be excellent for intra-rater reliability (ICC = 0.922, 0.960, 0.958). Intra-rater MDC values were determined to be 0.35, 2.04, and 0.80 seconds, respectively. Moderate-excellent correlations were found between UULEX and DASH, HAQ, 30-second push-up test and 6PBRT (P < .05). Conclusion The results of this study showed that UULEX test is a valid and reliable method for the assessment of upper extremity performance in individuals with RA. C1 [Cetin, Sebahat Yaprak] Akdeniz Univ, Fac Hlth Sci, Dept Physiotherapy & Rehabil, Antalya, Turkey. [Calik, Bilge Basakci] Pamukkale Univ, Sch Physiotherapy & Rehabil, Denizli, Turkey. [Ayan, Ayse] Antalya Res & Educ Hosp, Dept Rheumatol, Antalya, Turkey. [Cavlak, Ugur] Avrasya Univ, Fac Hlth Sci, Dept Physiotherapy & Rehabil, Trabzon, Turkey.

AIM: To compare patients with stroke and healthy controls in terms of balance ability and postural sway. METHODS: Twenty hemiparetic participants (mean age: 48.6±10.1 yr.) and 40 healthy controls (mean age: 44.05±7.77 yr.) were included and compared in this study. One single leg test (eyes open) and timed up & go test were used to assess balance ability. Postural sway of the participants was assessed by a kinesthetic ability trainer (SPORT-KAT 550) to determine postural sway in four directions. RESULTS: In all outcome measurements just used in this study, the hemiparetic participants showed lowest scores compared to the healthy controls (p

Objectives: To determine contributions of the gaze direction recognition exercise (GDRE) to improve pain intensity, balance, and disability level among patients with chronic neck pain. Methods: Eligible 40 patients were randomized to physical therapy program (Group I) or physical therapy plus GDRE (Group II) and were scheduled to receive a 3-week treatment, 5 sessions in a week. Pain Intensity was measured by a Visual Analog Scale (VAS). The Neck Disability Index (NDI) was used to determine disability level. To evaluate balance ability, four step square test (FSST) and single leg balance test (SLBT) with eyes opened and closed were used. All measurements were applied before and after a 3-week treatment program. Results: VAS scores of the two groups decreased after the treatment program (p0.05). Conclusions: The results of this study indicate that adding GDRE to the physical therapy program leads to much more improvements in balance ability and in disability level among patients with chronic neck pain. GDRE can have a positive impact on the treatment program.

Introduction/Background: This aim of this study was to determine environment safety status and risks of individuals with neurological disorders. Material and Methods: 83 participants living in Denizli with Cerebrovascular Disease (CVD; n=43), Parkinson’s disease (PH; n=10), Multiple Sclerosis (MS; n=16) or Spinal Cord Injury (SCI; n=14) were included in the study. Disability status was evaluated using by Modified Rankin Scale, Modified Hoehn Yahr Scale, Expanded Disability Status Scale or American Spinal Injury Association. Home safety status of the participants was evaluated using by Home Safety Check List (HSCL). The data in terms of living style and residential design of the participants were also recorded. Results: The mean age of the participants was 56.89±16.53 years and the duration of disabilities was 5.67±6.58 years. While 77 (93%) participants had ‘dangerous’ homes, 6 (7%) participants had ‘good’ homes according to the HSCL scores. Nobody had ‘perfect’ home in this study. When all participants were compared in terms of types of disability, education level, income status and home style, no significant differences according to their HSCL scores were found (p>0.05). When the participants using or not assistive ambulatory devices were compared, a significant difference was found (p

BACKGROUND AND OBJECTIVE: The aim of this study was to show the effects of an 8-week Neurodevelopmental Treatment based posture and balance training on postural control and balance in diparetic and hemiparetic Cerebral Palsied children (CPC).

Objectives: The aim of this randomized controlled study was to investigate the effect of proprioceptive training on balance in patients with chronic neck pain (CNP). Methods: Forty patients participating in the study were randomly divided into study and control groups. Both of the groups underwent conventional physical therapy; additionally, the study group was rehabilitated with gaze direction recognition exercise (GDRE) for proprioceptive training. Exercises were performed during 3 weeks with five sessions per week. Pain intensity [visual analog scale (VAS)], neck disability [Neck Disability Index (NDI)], and balance [four step square test (FSST), single leg balance test (SLBT) with eyes opened and closed] assessments were conducted in the patients before and after the treatment and 3 weeks after the last session. Results: No differences were observed between the groups in terms of pre-treatment measurements. There was a statistically significant decrease in VAS scores in both groups compared with pre-treatment conditions (p0.05). Conclusion: Proprioceptive training should be included in physiotherapy programs to improve balance; it decreases the disability level in patients with CNP.

Purpose: This study was planned to examine the effects of caregiving burden on strength, endurance, and flexibility of trunk muscles in caregivers of neurological patients. Methods: One-hundred and seven volunteer participants were included in this descriptive and cross-sectional study. After the median value of BAKAS Caregiving Impact Scale scores of all participants was calculated, they were divided into two groups as group with high caregiving burden (n=58, 36F, 22M) and group with low caregiving burden (n=49. 27F, 22M). Strength, endurance, and flexibility tests of trunk flexor, extensor, and lateral flexor muscles were used to evaluate trunk muscle strength, endurance, and flexibility between the groups. Results: The mean age of group with high caregiving burden was 46.93 +/- 14.95 years, and group with low caregiving burden was 42.00 +/- 14.55 years. The characteristics of groups including age, body mass index, gender, and diagnosis were similar (p>0.05). Trunk flexor and extensor muscle strength, and extension and lateral flexion flexibility of group with high caregiving burden were significantly worse than those of low caregiving burden (p0.05). Conclusion: Increase of caregiving burden may reduce strength and flexibility of trunk muscle, which contributes to development of structural and functional disturbance. It is, therefore, important to provide ergonomic education to caregivers and to make interventions in order to increase strength and flexibility of the trunk muscles with the aim of reducing the degenerative effects of the caregiving and enhancing the efficiency of caregiving process.

OBJECTIVE: The aim of this study was to compare the musculoskeletal pain distribution, quality of life, and the hopelessness level in mothers with disabled children in different ambulation levels.

Background and aims: Anterior Cruciate Ligament injury is a common orthopedic problem in young people who participated sport activities. In Anterior Cruciate Ligament injury, the first six weeks are accepted as an acute period. The primary goal in this period is to control acute pain and inflammation in the knee. The aim of this study was to determine of treatment preferences of physiotherapists’ for acute pain in Anterior Cruciate Ligament injury. Methods: In this study, total of ninety-three physiotherapists were participated who worked for one year or more and agreed to participate in the study were included in the study.The mean age was 28.52 ± 6.53 and mean working time 5.5±6.13 year. The scenario (21 years old male had a partial Anterior Cruciate Ligament rupture during play football) was given to physical therapist. Considering this scenario; they were asked which methods they preferred to treatment to acute pain more frequently. Results: The distribution treatment method preferences by physical therapists were electro physical agents 97.8%, cryotherapy 89.2%, manual therapy 78.5%, methods for pain and swelling stabilization and protection of knee 53.8%, exercise for keeping muscle performance and range of motion 49.5% and 12,9% alternative methods. Conclusion: The study results suggested that most chosen methods by physical therapists for treatment of acute pain in partial Anterior Cruciate Ligament injury was electro physical agents, cryotherapy, manual therapy and joint stabilization and protection.

Aim: To assess the effects of Modic changes on pain intensity, disability and quality of life. Method: 121 patients were included. Pain intensity was assessed using The McGill Pain Questionnaire, level of disability was assessed using The Oswestry Disability Index and quality of life was assessed using The SF-36 Health Survey. Modic changes were classified into ‘Type0’(no Modic changes), ‘Type1’(Type1 and 1/2) and ‘Type2’(Type2, 2/3 and 3). Results: 76(62.8%) patients had Modic changes. Of these 23(30,3%) had ‘Type1’ and 53(69,7%) had ‘Type2’. In The McGill Pain Rating Index, patients with Modic changes had worse score than patiens without Modic changes(p=0,006), there was no significant difference between Type1 and Type2(p>0.05). Patients with Modic changes had higher level of disability in The Oswestry Disability Index scores, compared to those without Modic changes (p=0,000), there was no significant difference between Type1 and Type2 (p>0.05). Patients with Modic changes had worse score in The SF-36’s dimensions of Physical Functioning (p=0.000), Physical Role Functioning(p=0,000), Bodily Pain(p=0,008), Emotional Role Functioning (p=0.023) and Social Functioning(p=0,002), compared to those who had no Modic changes. In these dimensions, there was significant difference between Type1 and Type2 (p>0.05) except Social Functioning(p=0,030). Modic changes have a negative effect on pain and level of disability but there is no difference between Type1 and Type2. Conclusion: Modic changes have a negative effect on quality of life in terms of dimensions of Physical Functioning, Physical Role Functioning, Bodily Pain, Emotional Role Functioning and Social Functioning. But there is no difference between Type1 and Type2 except Social Functioning.

Amaç: Ön çapraz bağ yaralanması, sportif aktivitelere katılan genç kişilerde sıklıkla görülen ortopedik bir problemdir. Ön çapraz bağ yırtıklarında ilk altı hafta akut dönem olarak kabul edilir. Bu dönemdeki temel amaç; öncelikle dizdeki akut ağrı ve inflamasyonun kontrol altına alınmasıdır. Bu çalışmanın amacı, ön çapraz bağ yaralanmasında fizyoterapistlerin akut ağrıya yönelik tercih ettikleri tedavi yöntemlerini belirlemektir. Gereç ve Yöntemler: Çalışmada 1 yıl ve daha uzun süredir çalışan ve araştırmaya katılmayı kabul eden toplam doksan üç fizyoterapist çalışma kapsamına alındı. Çalışmaya katılan fizyoterapistlerin yaş ortalamaları 28,52±6,53 yıl ve çalışma yıl ortalamaları 8,03±6,33 yıl idi. Fizyoterapistlere, ön çapraz bağ yaralanmasına ilişkin hayali bir senaryo (futbol oynarken parsiyel ön çapraz bağ rüptürü oluşan 21 yaşındaki erkek) verildi. Bu senaryo göz önüne alınarak; ağrıyı tedavi etmede hangi yöntemleri tercih ettiklerine dair açık uçlu sorular soruldu. Bulgular: Senaryoya göre fizyoterapistler tarafından tercih edilen tedavi yöntemlerinin dağılımı; ağrı ve şişlik için elektro-fiziksel ajanlar %97,8; soğuk uygulama %89,2; manuel tedavi teknikleri %78,5; dizin korunması ve stabilizasyon %53,8; kas performansı ve eklem hareket açıklığının korunması için egzersiz %49,5 ve alternatif metotlar %12,9 şeklinde idi. Sonuç: Parsiyel ön çapraz bağ yaralanmasında akut ağrının tedavisinde fizyoterapistler tarafından en çok tercih edilen yöntemler sırasıyla elektrofiziksel ajanlar, soğuk uygulama, manuel tedavi teknikleri, eklem koruma ve eklem stabilizasyon yöntemleridir.

Aim and Scope: The aim of this study was to determine how previous (year 2014) and present (year 2017) conditions influence the satisfaction level of the final year students and lecturers in School of Physical Therapy and Rehabilitation at Pamukkale University (SPTRPAU). Materials and Methods: The study was conducted interviewing face to face with final year physical therapy students (N: 143; mean age=23.1 +/- 1.4 yrs) and lecturers (N: 28; mean age=38.3 +/- 7.4 yrs.). The study completed in 2017. Demographics including gender, age, academic grade average, year of work experience belonging to students and lecturers were recorded. Previous results obtained in 2014 compared with present results obtained in 2017. The same questionnaires created by Erden and Cavlak just used in 2014 were also used in this study of 2017. Questionnaire I (18 suggestions; Cronbach alpha=0,90) consists of statements reflecting the feedback on the content of the education program, canteen-rest areas, training program content, etc. was used by both students and lecturers. Questionnaire II (20 suggestions; Cronbach alpha=0,91) is used by students to rated their lecturers. Results: Mean academic grade of the students was 3.1 +/- 0.37 / 4. Mean work experience of lecturers was 13.4 +/- 6.60 yrs. Questionnaire I showed that the level of satisfaction of students about education program content, grading system, counseling services, internship activities, occupational skills and overall satisfaction increased significantly compared to research 2014 aresults. On the other hand, no differences were found in terms of the other categories in Questionnaire I rated by the students. The lecturers reported improvements in canteens and resting areas only. According to the results of the research 2014, there were significant improvements in terms of satisfaction level of the students and the instructors in all fields except the contents of the training program and the equipment (p

BACKGROUND/AIM: This study was conducted to analyze the agreement between International Classification of Functioning, Disability, and Health (ICF) raters and to show its applicability in children with low vision. MATERIALS AND METHODS: Twenty children (mean age: 11.70 ± 1.92 years) were included. To evaluate the independency of the sample, the Northwick Park Activities Daily Living questionnaire was used. The Low Vision Quality of Life Scale was used to evaluate quality of life. An ICF core set was developed to be used in this study. The core set consisted of 13 items for body functions, 3 items for body structures, 36 items for activity and participation, and 12 items for environmental factors. RESULTS: High agreement was found between two raters in terms of subparameters of the ICF core set for activity and participation (r = 0.880, P = 0.000). CONCLUSION: The findings indicate that the raters showed strong agreement in terms of the ICF core set used in this study. This shows that the core set can be used to evaluate activity and participation of children with low vision.

OBJECTIVE: The aim of our study is to examine the relationship between kinesiophobia (fear of movement), physical activity level and quality of life.

Background/aim: This study was conducted to analyze the agreement between International Classification of Functioning, Disability, and Health (ICF) raters and to show its applicability in children with low vision. Materials and methods: Twenty children (mean age: 11.70 +/- 1.92 years) were included. To evaluate the independency of the sample, the Northwick Park Activities Daily Living questionnaire was used. The Low Vision Quality of Life Scale was used to evaluate quality of life. An ICF core set was developed to be used in this study. The core set consisted of 13 items for body functions, 3 items for body structures, 36 items for activity and participation, and 12 items for environmental factors. Results: High agreement was found between two raters in terms of subparameters of the ICF core set for activity and participation (r = 0.880, P = 0.000). Conclusion: The findings indicate that the raters showed strong agreement in terms of the ICF core set used in this study. This shows that the core set can be used to evaluate activity and participation of children with low vision.

OBJECTIVE: The aim of our study is to examine the relationship between kinesiophobia (fear of movement), physical activity level and quality of life. METHODS: In this study, we assessed 112 patients consulting for low back pain (LBP) of ≥ 3 month's duration. We used Visual Analog Scale (VAS) for pain intensity, the International Physical Activity Questionnaire (IPAQ) for physical activity level, Tampa Kinesiophobia Scale for perception of kinesiophobia, Oswestry Disability Index for disability status of low back. RESULTS: The results of this study, there was no statistically significant correlation between International Physical Activity Questionnaire, duration of pain, intensity of pain at rest and Tampa Kinesiophobia Scale (p> 0.05). It was found a statistically significant correlation between pain intensity at activity (p= 0.009), disability level (p= 0.000) and Tampa Kinesiophobia Scale. Tampa Kinesiophobia Scale were highly negative correlated with sub-scale of SF-36 Quality of Life Index (general health, physical function, social status, bodily pain, role limitations due to physical health) (p= 0.000). CONCLUSION: The kinesiophobia adversely affect the quality of life limiting the physical activity status of patients with chronic low back pain.

Pek çok insan altı aydan fazla süren ağrı olarak tanımlanan kronik ağrıdan (KA) yakınır. KA hafif şiddette olabildiği gibi ızdırap verici, devamlı veya ara sıra olabilir. Bireyi sadece rahatsız edebilir veya tamamen çaresiz duruma getirebilir. KA Muskuloskeletal Ağrı (KMSA) dünya genelinde oldukça sık karşılan bir sağlık problemidir. KMSA ile sinir sitemi aylar hatta yıllar bounca aktive edilir. Bu durum bireyin fiziksel ve emosyonel yapılarını olumsuz etkiler. KMSA sıklıkla fiziksel fonksiyon bozukluğuna, dizabiliteye ve azalmış yaşam kalitesine yol açar. Fizyoterapi ve Rehabilitasyon (F&R) KMSA'lı bireylerin yaşam kalitelerini artırmada hayati önem taşır. Fizyoterapistler elekrofiziksel ajanlar, maual teknikler ve davranış terapi odaklı egzersiz yaklaşımlarını kullanarak holistic bir bakış açısıyla (biyo-psiko-sosyal model) KMSA'lı hastalarıyla çalışırlar. F&R hastalara KMSA ile başa çıkma yöntemlerini öğretir ve yardımcı olur.

Objective: To determine the effect of lower extremity muscle strength training in healthy young adults on improvement of stability and performance. Methodology: In this study, 37 volunteers with mean age of 21.35 +/- 0.94 years were included and were randomly divided into 3 groups. Each group was trained for 3 days a week for 4 weeks. First group (group I) was trained with Russian stimulation to the knee extensors muscles, second group (group II) was trained by whole-body vibration (WBV) and third group (group Ill) was a control group and had no training. Balance was assessed with Portable Kinesthetic Ability Trainer (SPORTKAT 550). Quadriceps muscle strength was evaluated with Hand-Held dynamometer and lower extremity performance was measured with step-up test. Results: Muscle strength (p>0.05), step-up test (p0.05) and step-up test (p0.05) decreased. After training muscle strength, static balance, and step up test results of participants in group I and II did not increase significantly compared to group Ill. Conclusion: Although 4 weeks Russian stimulation and WBV methods improved the muscle strength in groups I and II compared to Group Ill, lower extremity endurance and the balance, there was no advantage relative to each other.

Amaç: Bu çalışma serebral palsi (SP) tanısı konmuş çocukların annelerinde bel ağrısı şiddeti ile ilişkili faktörlerin incelenmesi amacıyla planlandı. Gereç ve Yöntem: Bu çalışma Denizli ilinde özel eğitim ve rehabilitasyon merkezlerine devam eden serebral paralizili (SP) çocuk anneleri üzerinde gerçekleştirilmiştir. Bu çalışma bel ağrısı olan 67 anneyi içermektedir (yaş aralığı 22-49 yıl; ortalama yaş: 35.98 ±6.64 yıl). Ağrısı şiddeti Görsel Analog Skalası ile değerlendirildi (0-10 cm). Annelerin bel ağrısı şiddeti ile ilişkili parametreleri belirlemek için eğitim yılı, fiziksel sağlığı (Son 1 ayda fiziksel sağlığın iyi hissedilmediği gün sayısı), mental sağlığı (Son 1 ayda ruhsal sağlığın iyi hissedilmediği gün sayısı) ve umutsuzluk düzeyi (Beck Umutsuzluk Ölçeği) değerlendirildi. Sonuçlar: Bu çalışmanın sonuçları bel ağrısı şiddeti ile fiziksel sağlık, mental sağlık ve umutsuzluk düzeyi arasında anlamlı bir ilişki olduğunu gösterdi (p

OBJECTIVE: This study was planned to compare of pain, emotional status and disability level in patients with chronic neck pain and low back pain.

The aim of our study is to examine the effects of deep brain stimulation (DBS) surgery on severity of dystonia, mobility, emotional status, and health-related quality of life (QOL) in patient with dystonia. This study was carried out on a case of 41-year-old female with complaints of neck and arm pain, involuntary contraction for 30 years. GPI-DBS was applied to the patient bilaterally in 2010. Global Dystonia Scale (GDS) was used to assess the severity of the patient's dystonia, effects on body parts and functions. Beck Depression Inventory (BDI) was applied to detect emotional status. 12-Meter Walking Test (mobility) and Short Form-36 (SF-36) were used to evaluate quality of life. All assessments were repeated prior to surgery, after surgery 1st year and 3rd years. Prior to surgery, GDS was 112. Postoperative 1st and 3rd years, GDS was respectively 69/84. Prior to surgery, the total BDI score was 31. Postoperative 1st and 3rd years, GDS was respectively 28/40. 12-Meter Walking Test results were respectively 18/10/15 sec. for the prior to surgery, postoperative 1st. and 3rd years. General health status and physical function subscales of SF-36, respectively, prior to surgery were 30/75, postoperative 1st year was 60/85 and 3rd years were 20/35. GPI-DBS is a surgical procedure, which has positive effect on mobility, emotional status and QOL, in patient with dystonia.

Objective: To evaluate the patients with Spinal Cord Injuries (SCIs) seen at Pamukkale University Hospital between 2005-2013. Methodology: 489 (236 female, 253 male) patients with SCIs were evaluated retrospectively. Results: Their mean age was 48.20 +/- 18.95 years. SCIs were caused by trauma in 316(64.6%), spinal tumors in 119(24.3%) and congenital anomalies in 54(11%) patients. Injury levels were as follows: 155(31.7%) lumbar level, 144(29.4%) thoracic, 114(23.3%) cervical, 35 (7.2%) both thoracic and lumbar spine, 10(2%) both cervical and thoracic and 31(6.3%) in the other levels. Conclusion: The main reason for SCIs was trauma. Thus, public education is vital in order prevent to trauma.

[Purpose] The aim of this study was to show the impact of chronic musculoskeletal pain of the spinal column and lower extremities on physical functioning, emotional status, and independency in older adults. [Subjects] In this cross-sectional study, 258 older adults (mean age, 71.98 +/- 5.86 years, 50.8% males, 49.2% females) living in their own residences were evaluated. [Methods] Pain intensity was analyzed using a visual analogue scale. Physical functioning was evaluated with the Timed Up and Go Test (TUG) and a Six-Minute Walk Test. The Geriatric Depression Scale was used to determine emotional status. The independency in daily living of the participants was evaluated using the Lawton Brody IADL Scale. All participants were divided into two groups in accordance with the pain localization: the (1) spinal pain and (2) lower extremity pain groups. [Results] When the pain scores were compared, no significant differences between the two groups were found. The same results were found in terms of TUG scores. The spinal pain group had higher scores in terms of aerobic capacity than the lower extremity pain group. [Conclusion] The results indicate that chronic musculoskeletal pain in the lower extremities decreased aerobic capacity much more than spinal pain in older adults.

We report a case of 67 year-old man with Parkinson's disease who has gait disturbance for eight years. The Pedunculopontine Nucleus Deep Brain Stimulation (PPN-DBS) surgery was performed and gait parameters were evaluated by using foot print method. After opening the battery step length and stride length increased, the patienthas been walking the same distance with less number of steps. When the battery closed, the step length was 34.5 cm, following the battery opening it increased to 45.5 cm suggesting that PPN-DBS surgery was an effective treatment to improve gait ability. © 2014, Pakistan Medical Association. All rights reserved.

INTRODUCTION: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by tremor, rigidity and bradykinesia. Gait and postural difficulties supersede tremor, rigidity and bradykinesia as drivers of disease burden in patients with advanced PD. The aim of this study was to describe the effects of deep brain stimulation of the subthalamic nucleus on gait ability and balance performance in patients with PD. MATERIAL AND METHODS: We studied 19 consecutive patients who underwent bilateral stimulation of the subthalamic nucleus. Patients were evaluated preoperatively and at the 5(th) day and 6(th) month after surgery. Timed Up and Go Test, 12 m Walking Test, Chair Stand Test and Berg Balance Scale (BBS) were used to assess mobility and balance performance. Unified Parkinson's Disease Rating Scale (UPDRS III) and Hoehn and Yahr Scale were also used. RESULTS: All the patients' mobility ability and balance performance improved after surgery (p < 0.05). At the 6th month after surgery, the Timed Up and Go Test scores were decreased from 56.05 ±42.52 to 21.47 ±20.36, the 12 m Walking Test scores were decreased from 100.44 ±66.44 to 28.84 ±19.79, the Chair Stand Test scores were increased from 4.00 ±4.66 to 11.68 ±4.43 and the BBS score was increased from 12.84 ±6.89 to 38.89 ±8.79. UPDRS total scores were significantly improved 6 months after surgery (p < 0.001). UPDRS total scores were decreased from 98.26 ±37.69 to 39.36 ±18.85. The Hoehn and Yahr Scale score was significantly decreased after surgery (p < 0.05). CONCLUSIONS: Surgical therapy is an effective treatment to improve gait ability and balance performance in Parkinson's patients.

[Purpose] The aim of this study was to show the impact of chronic musculoskeletal pain of the spinal column and lower extremities on physical functioning, emotional status, and independency in older adults. [Subjects] In this cross-sectional study, 258 older adults (mean age, 71.98±5.86 years, 50.8% males, 49.2% females) living in their own residences were evaluated. [Methods] Pain intensity was analyzed using a visual analogue scale. Physical functioning was evaluated with the Timed Up and Go Test (TUG) and a Six-Minute Walk Test. The Geriatric Depression Scale was used to determine emotional status. The independency in daily living of the participants was evaluated using the Lawton Brody IADL Scale. All participants were divided into two groups in accordance with the pain localization: the (1) spinal pain and (2) lower extremity pain groups. [Results] When the pain scores were compared, no significant differences between the two groups were found. The same results were found in terms of TUG scores. The spinal pain group had higher scores in terms of aerobic capacity than the lower extremity pain group. [Conclusion] The results indicate that chronic musculoskeletal pain in the lower extremities decreased aerobic capacity much more than spinal pain in older adults.

Introduction: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by tremor, rigidity and bradykinesia. Gait and postural difficulties supersede tremor, rigidity and bradykinesia as drivers of disease burden in patients with advanced PD. The aim of this study was to describe the effects of deep brain stimulation of the subthalamic nucleus on gait ability and balance performance in patients with PD. Material and methods: We studied 19 consecutive patients who underwent bilateral stimulation of the subthalamic nucleus. Patients were evaluated preoperatively and at the 5th day and 6th month after surgery. Timed Up and Go Test, 12 m Walking Test, Chair Stand Test and Berg Balance Scale (BBS) were used to assess mobility and balance performance. Unified Parkinson's Disease Rating Scale (UPDRS Ill) and Hoehn and Yahr Scale were also used. Results: All the patients' mobility ability and balance performance improved after surgery (p < 0.05). At the 6th month after surgery, the Timed Up and Go Test scores were decreased from 56.05 +/- 42.52 to 21.47 +/- 20.36, the 12 m Walking Test scores were decreased from 100.44 +/- 66.44 to 28.84 +/- 19.79, the Chair Stand Test scores were increased from 4.00 +/- 4.66 to 11.68 +/- 4.43 and the BBS score was increased from 12.84 +/- 6.89 to 38.89 +/- 8.79. UPDRS total scores were significantly improved 6 months after surgery (p < 0.001). UPDRS total scores were decreased from 98.26 +/- 37.69 to 39.36 +/- 18.85. The Hoehn and Yahr Scale score was significantly decreased after surgery (p < 0.05). Conclusions: Surgical therapy is an effective treatment to improve gait ability and balance performance in Parkinson's patients.

[Purpose] The aim of this study was to examine the agreement between physiotherapists (PTs) and mothers (Ms) about the treatment of children with cerebral palsy (CP) who received treatment in special education and rehabilitation centers. [Subjects] Ms of 130 children with CP (75 boys, 55 girls) and 130 PTs who applied rehabilitation programs were interviewed. [Methods] Clinical types and gross motor function levels of the children were recorded. A questionnaire consisting of 6 open-ended questions was used to describe the expectations and views of the PTs and Ms about the physiotherapy and rehabilitation programs for the children. [Results] The mean age of the children was 89.80 +/- 52.05 months. The mean treatment period for the children was 73.62 +/- 42.11 months. The mean age of the mothers was 35.47 +/- 5.79 years, and the mean age of the PTs was 28.07 +/- 7.28 years. We found a statistically moderate level of agreement between the PTs and Ms regarding the appropriateness of the treatment provided to the children. There was statistically insignificant agreement regarding the applied treatment methods and the appropriateness of the applied rehabilitation programs. [Conclusion] We believe that the views and expectations of the Ms should be taken into account by the PTs when preparing a treatment program for children with CP.

[Purpose] The aim of this study was to examine the agreement between physiotherapists (PTs) and mothers (Ms) about the treatment of children with cerebral palsy (CP) who received treatment in special education and rehabilitation centers. [Subjects] Ms of 130 children with CP (75 boys, 55 girls) and 130 PTs who applied rehabilitation programs were interviewed. [Methods] Clinical types and gross motor function levels of the children were recorded. A questionnaire consisting of 6 open-ended questions was used to describe the expectations and views of the PTs and Ms about the physiotherapy and rehabilitation programs for the children. [Results] The mean age of the children was 89.80±52.05 months. The mean treatment period for the children was 73.62±42.11 months. The mean age of the mothers was 35.47±5.79 years, and the mean age of the PTs was 28.07±7.28 years. We found a statistically moderate level of agreement between the PTs and Ms regarding the appropriateness of the treatment provided to the children. There was statistically insignificant agreement regarding the applied treatment methods and the appropriateness of the applied rehabilitation programs. [Conclusion] We believe that the views and expectations of the Ms should be taken into account by the PTs when preparing a treatment program for children with CP.

[Purpose] The current study aimed to reveal the therapeutic effects of a pulsed electromagnetic field and swimming exercises on rats with experimental sciatic nerve injury, which was induced with crush-type neuropathy model damage, using electrophysiological methods. [Subjects] In the current study, the sample consisted of 28 adult male Wistar albino rats. [Methods] The rats were randomized into four groups (n=7). Swimming exercise and PEMF (2 Hz and 0.3 MT) were applied one hour a day, five days a week, for four weeks. Electroneuromyographic (ENMG) measurements were taken on day 7. [Results] When the data were evaluated, it was found that the 4 weeks of PEMF and swimming exercises led to an increase in motor conduction rates and a decrease in latency values, but the changes were not significant in comparison with the control and injury groups. The compound muscle action potential (CMAP) values of the left leg were lower in weeks 2, 3, and 4 in the swimming exercise group in comparison with the control group, although for the PEMF group, the CMAP values of the left leg reached the level observed in the control group beginning in week 3. [Conclusion] PEMF and swimming exercise made positive contributions to nerve regeneration after week 1, and regeneration was enhanced.

Amaç: Bu çalışmada, servikal disk patolojisi nedeniyle servikal disk protez cerrahisi uygulanan ve tek seviyede “peek cage” uygulaması yapılan hastaların erken dönemde ağrı şiddeti, özürlülük durumu ve yaşam kalitesi incelendi. Gereç ve Yöntem: Kronik boyun ağrısı nedeniyle tek seviyede servikal disk protez cerrahisi uygulanan 15 hasta ve “peek cage” uygulaması yapılan 15 hasta değerlendirildi. Demografik özelliklerin yanı sıra ağrı şiddeti Görsel Ağrı Skalası ile, özür durumu Boyun Özürlülük Göstergesi ve yaşam kalitesi SF-36 Yaşam Kalitesi Anketi ile değerlendirildi. Değerlendirmeler cerrahi öncesi ve cerrahi sonrasında 3. ayda tekrar edildi. Bulgular: Ağrı süresi ortalaması protez cerrahisi grubunda 41.00±35.15 ay ve “peek cage” grubunda 82.40±43.47 ay bulundu. İki grubun ağrı süresinde anlamlı farklılık bulundu (p=0.008). Cerrahi sonrası 3. ayda istirahat ağrı değerleri gruplar arasında karşılaştırıldığında protez uygulanan grup lehine istatistiksel olarak anlamlılık (p=0.010) bulundu. Boyun Özürlülük Göstergesi cerrahi öncesi değerleri gruplar arasında farklılık bulunmazken (p=0.076), cerrahi sonrasında Boyun Özürlülük Göstergesi puanları arasında anlamlı farklılıklar (p=0.008) bulundu. SF-36 Yaşam Kalite İndeksinin cerrahi sonrası değerleri gruplar arasında genel sağlık (p=0.014), ağrı (p=0.040) ve fiziksel fonksiyon değerlerinde (p=0.001) protez cerrahisi uygulanan grup lehine anlamlı farklılıklar bulundu. Sonuç: Servikal disk patolojilerinde servikal disk protez cerrahisi erken dönemde daha hızlı bir şekilde fonksiyonel olarak geri dönüşü sağlamaktadır.

Amaç: Bu çalışmada vücut farkındalık durumu ile ağrı, emosyonel durum ve yaşam kalitesi arasındaki ilişkinin in- celenmesi amaçlandı. Gereç ve Yöntem: Çalışmada herhangi bir hastalığı olmayan 20-40 yaş arası 100 sağlıklı ve gönüllü katılımcı değerlendi- rildi. Ağrı durumu Görsel Ağrı Skalası (GAS) ile, emosyonel durum Beck Depresyon Ölçeğiyle, vücut farkındalık durumu Vücut Farkındalık Anketi (VFA) ile ve yaşam kalitesi SF-36 an- keti ile değerlendirildi. Bulgular: Katılımcıların yaş ortalaması 36.88±10.45 yıl idi. GAS ortalama değeri 3.32±2.90, emosyonel durum ortala- ması 8.54±7.77 ve VFA ortalama skoru 94.77±13.97 bulundu. Vücut farkındalık durumu ile GAS skoru arasında negatif yön- lü bir ilişki bulundu. Vücut farkındalık durumu ile emosyonel durum arasında negatif yönlü bir ilişki bulundu; ancak Beck Depresyon skorunun minimal düzey depresif belirtileri gös- termesi sebebiyle ilişki anlamlı bulunmadı (p=0.264). Vücut farkındalık durumu ile yaşam kalitesi değerlendirmesi alt ka- tegorilerinden enerji-bitkinlik düzeyi (p=0.001) ve genel sağ- lık düzeyi arasında (p=0.023) pozitif yönlü bir ilişki bulundu. Sonuç: Çalışmanın sonuçları vücut farkındalığının yaşam kalitesini olumlu yönde etkilediğini göstermesi açısından önemlidir. Ağrı ve emosyonel durum vücut farkındalığını in- direk olarak etkilemesi yönüyle de önem teşkil eden diğer konulardır.

Objective: This study was conducted to determine the relationship between disability, pain intensity and quality of life in patients with chronic neck pain. Methodology. One hundred patients suffering from chronic neck pain for at least six months (71 female-29 male) were evaluated in this study. A Visual Analog Scale was used to describe pain intensity. The Neck Disability Index (NDI) was used to evaluate disability level. To determine the quality of life of the subjects, the SF-36 survey was used. Results. The mean age of the participants was 44.13±12.22 years. Mean of pain duration was 40.66±41.86 month. Mean pain intensity at rest 4.86±2.92, intensity of pain during activity 6.74±2.75, intensity of night pain 5.56±3.45.Mean NDI score was 42.20±18.29. The results of this study showed that the NDI scores were highly correlated with scores of the subscales of SF-36 (p

Aim and scop. The aim of this study was to compare the level of medial longitudinal arch drop, ankle joint range of motion and extension of the hallux in males and females and to correlate these values with body mass index. Material and Method. One hundred sixty-three medical faculty students, 74 female and 89 male, aged between 18 and 26 (20.37±1.432), were included in the study. Level of medial longitudinal arch drop, dorsiflexion and plantar flexion of the ankle and extension of the hallux were measured. Body mass index was assessed on the basis of World Health Organization (WHO) criteria. Results. The difference between males and females in terms of plantar flexion of the ankle (PFA), dorsiflexion of the ankle (DFA), extension of the hallux (EH) and level of navicular drop (ND), was statistically significant (pPFA=0.000, pDFA=0.003, pEH:0.043, pND=0.000). Medial arch drop was greater in individuals with a higher than normal weight in males and in total subjects (pmale ND= 0.007, ptotal ND= 0.001). Conclusion. Our determination of statistically significant differences between the sexes is important in revealing anatomical differences in terms of ankle, hallux and medial arch structures. Our conclusions show that body weight has a direct impact on the medial arch.

[Purpose] This study was conducted on university students with nonspecific low back pain in order to determine the independent variables that affect their pain. [Methods] A total of 514 students were included in this study. Pain was evaluated using a Visual Analogue Scale (VAS). A special form was prepared in order to evaluate the following independent variables: gender, weight, height, Body Mass Index (BMI), working periods sitting straight (television, computer, seminar, etc.), working periods bending at a table (reading, writing, etc.), using lumbar support while sitting, the mean duration of pain within the last one year, type of pain, time of the pain, faculty, class, physical activity habits and smoking. The collected data were evaluated using the CHAID (Chi-squared Automatic Interaction Detection) analysis method. [Results] The working hours bending at a table, physical activity, height, weight, BMI and educational departments were found not to affect the severity of the pain. The pain severity was affected by the duration of pain complaints within the last one year, the duration of working staying upright, smoking, classes, usage of lumbar support and age variables. [Conclusions] The results of this study show that nonspecific low back pain of university students is affected by many factors such as smoking, class, age, using a computer and lumbar support.

Amaç: Bu çalışmanın amacı Poliomiyelit Sekelli bireylerde ICF uygulamasında değerlendiriciler arasındaki uyumu incelemektir. Yöntemler: Bu çalışmaya 20 Poliomiyelit sekelli katılımcı dahil edilmiştir. Katılımcılar deneyimli iki fizyoterapist tarafından farklı zamanlarda değerlendirilmiştir. Değerlendirmede ICF kodlama sisteminin tüm alt bileşenleri kodlanmıştır: Vücut İşlevleri, Vücut Yapıları, Aktivite ve Katılım ve Çevresel Etmenler. Sonuçlar: Katılımcıların yaş ortalaması 37.10±1.84 yıl, eğitim süreleri ortalaması ise 11.35±0.94 yıl yıldır. Çalışmanın sonucunda her iki uygulayıcı arasında vücut yapıları ve aktivite katılım açısından çok yüksek düzeyde uyum saptanırken, vücut işlevleri ve çevresel etmenler açısından orta düzeyde uyum bulunmuştur (p=0.000). Tartışma: Bu çalışma sonuçları Poliomiyelit sekelli bireylerde ICF’nin bireyin bio-psiko-sosyal durumunu belirlemede uygulanabilir bir sistem olduğunu göstermiştir.

Objectives: To examine and compare the effects of massage and matrix rhythm therapy in young women on the peripheral blood circulation. Design: Randomized, double-blind, controlled trial. Setting: Pamukkale University in Denizli, Turkey. Patients: Fifteen healthy women age 19-23 years. Intervention: Matrix rhythm therapy was applied to the left lower extremity for a single 30-minute session. At least 1 week later, massage was applied to the left lower extremity for 30 minutes in a single session. The same physiotherapist applied both sessions. Outcome measures: The blood velocity (cm/s), artery diameter (mm), and blood flow (ml/min) of the popliteal and the posterior tibial arteries were measured with color Doppler ultrasonography. All images were evaluated by the same radiologist. Results: After matrix rhythm therapy and massage application, blood velocity, artery diameter, and blood flow in arteries increased. However, matrix rhythm therapy caused a more prominent increase in the amount of blood flow in the popliteal and in the posterior tibial artery than did massage. After matrix rhythm therapy application, the average increases in the blood flow rates in the popliteal and the posterior tibial arteries were 25.29%+/- 16.55% and 34.33%+/- 15.66%, respectively; after the massage, the increases were 17.84%+/- 17.23% and 16.07%+/- 10.28%, respectively. Conclusion: Matrix rhythm therapy and massage increased peripheral blood flow in young women. Matrix rhythm therapy method resulted in more prominent increases.

Purpose: To describe effects of urinary incontinence on depressive symptoms and quality of life (QoL) in women. Methods: Two hundred and sixty women with reproductive age were examined in this study. 61.5% (N= 160) had urinary incontinence. Beck Depression Inventory (BDI) was used to detect depressive symptoms. Short Form-36 (SF-36) was used to measure QoL. Results: Percentages of the incontinence types were found as 38.8% stress, 23.1% urge, 29.1% mixed, respectively. Incontinent women reported higher score in terms of depressive symptoms. Women with mixed urinary incontinence showed higher depressive symptoms. Incontinent women had also lower scores in terms of SF-36 survey results (p< 0.05). While women with stress urinary incontinence reported lower score in terms of physical functioning of the SF-36 survey, women with mixed type showed lower score in terms of role-emotional domain. Increased incontinence duration led to lower scores in mental health and general mental perception domains. Conclusion: Urinary incontinence had negative effects on depressive symptoms among incontinent women. This situation negatively affects QoL.

Regular walking is one of the most recommended and popular physical activity worldwide. This study (1) detected the effects of unsupervised regular walking on physical and cognitive functioning, emotional status, and quality of life in middle-aged and older adults and (2) compared the results with inactive controls. Forty middle-aged and older adults with a mean age of 56.30 +/- 4.85 years (range 40-70) walking for at least 1 year, at least three times a week, and at least 45 min a day and 40 inactive participants with a mean age of 55.15 +/- 5.64 years (range 40-70) participated. Before testing, sociodemographics of the participants were recorded. Body mass index and waist-hip ratio were calculated. The two groups were evaluated and compared in terms of physical functioning (handgrip strength, balance performance, cardio-vascular endurance, flexibility, muscular endurance and coordination), cognitive functioning (Mini Mental Test), emotional status (Beck Depression Inventory), and health related quality of life (CDC HRQOL- 4). The results obtained from this study showed that there were significant differences in terms of all outcome measurements between the groups ( < 0.05). The regular walking group had better scores in most parameters than the inactive controls. The results indicate that unsupervised regular walking improves health and is also a safe, cheap, and can easily be adapted into daily life. Therefore, it can be recommended to improve physical and cognitive functioning, emotional status, and quality of life of middle-aged and older adults.