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BACKGROUND: To assess treatment effect of lower limb botulinum toxin type A (BTX-A) in combination with physiotherapy approaches on gross motor functions in children with cerebral palsy compared with only physiotherapy treatment.

BACKGROUND AND OBJECTIVE: Cerebral palsied children may have difficulties in acting as senders and/or receivers in the communication process. The aim of this study is examining that which maternal and child-related factors affect the communication skills of cerebral palsied children.

BACKGROUND AND OBJECTIVE: The aim of this study is to examine the relationship between quality of life, activity-participation and environmental factors in adolescents with cerebral palsy. METHODS: Seventy-five adolescents (M:45, F:30) ages between 14-18 yrs (mean: 15.52±1.60 yrs) were included in the study. Participants were divided into three groups: Level I, Level II and Level III according to the Gross Motor Function Classification System. Gross Motor Function Classification System, Gross Motor Function Measure, Functional Independence Scale, Manuel Ability Classification System, Pediatric Quality of Life Inventory and International Classification of Functioning, Disability and Health Child-Youth version Short Form (ICF-CY) (14-18 yrs) were used for assessments. RESULTS: It is found that there is a moderate and high level of correlation between quality of life and activity participation and body functions; moderate and high level of correlation between quality of life and activity participation and body functions with the gross motor function levels; moderate and low level correlation between environmental factors and gross motor function levels (p < 0,05). CONCLUSIONS: The fact that the ICF-CY short form used for cerebral palsied children is compatible with other assessment scales suggests that the use of ICF-CY short forms may be useful in assessing the health status of individuals.

BACKGROUND: To assess treatment effect of lower limb botulinum toxin type A (BTX-A) in combination with physiotherapy approaches on gross motor functions in children with cerebral palsy compared with only physiotherapy treatment. OBJECTIVE: The purpose of this review was to analyze the efficacy botulinum toxin a lower limb injections in addition to physiotherapy approaches in children with cerebral palsy. METHODS: A literature search was conducted in the following databases: Cochrane, PEDro, PubMed, MEDLINE, AMED and EMBASE. The searches were limited to the period from July 2009 to July 2015. The intervention had to contain BTX-A into the lower limb plus physiotherapy approaches and be compared with only physiotherapy. The methodological quality and clinical relevance were independently assessed by the authors. RESULTS: The database search resulted in a total of 1521 studies, of which 4 (Level II of evidence) trials were included in this review. The population represented by were age between from 11 month to 15 years. Overall there were 153 children all diagnosed with CP (87 Male, 66 Female). CONCLUSIONS: The use of BTX-A injections in addition to physiotherapy approaches seems to have positive effect on spasticity and ROM. However, the question of whether the treatment of BTX-A plus physiotherapy has a greater improvement on functional capacity, such as gross motor function or gait parameter than only physiotherapy treatments, was inconclusive. Further investigation by rigorous studies is required.

BACKGROUND: To assess treatment effect of lower limb botulinum toxin type A (BTX-A) in combination with physiotherapy approaches on gross motor functions in children with cerebral palsy compared with only physiotherapy treatment. OBJECTIVE: The purpose of this review was to analyze the efficacy botulinum toxin a lower limb injections in addition to physiotherapy approaches in children with cerebral palsy. METHODS: A literature search was conducted in the following databases: Cochrane, PEDro, PubMed, MEDLINE, AMED and EMBASE. The searches were limited to the period from July 2009 to July 2015. The intervention had to contain BTX-A into the lower limb plus physiotherapy approaches and be compared with only physiotherapy. The methodological quality and clinical relevance were independently assessed by the authors. RESULTS: The database search resulted in a total of 1521 studies, of which 4 (Level II of evidence) trials were included in this review. The population represented by were age between from 11 month to 15 years. Overall there were 153 children all diagnosed with CP (87 Male, 66 Female). CONCLUSIONS: The use of BTX-A injections in addition to physiotherapy approaches seems to have positive effect on spasticity and ROM. However, the question of whether the treatment of BTX-A plus physiotherapy has a greater improvement on functional capacity, such as gross motor function or gait parameter than only physiotherapy treatments, was inconclusive. Further investigation by rigorous studies is required. © 2019 - IOS Press and the authors. All rights reserved.

BACKGROUND AND OBJECTIVE: The aim of this study is to examine the relationship between quality of life, activity-participation and environmental factors in adolescents with cerebral palsy.

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).

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

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.

OBJECTIVE: The objective of this study is to investigate musculoskeletal system problems and quality of life of mothers of children with cerebral palsy with different levels of disability.

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.

Amaç: Her yıl kliniğimize farklı yaş, cinsiyet ve tanılarda hastalar başvurmaktadır. Bu hastaların bir kısmı kliniğimizde tedavi edilirken, bir kısmına da sadece ev programı verilmektedir. Bu çalışmanın amacı 2001-2015 yılları arası Pamukkale Üniversitesi Hastaneleri Pediatrik Rehabilitasyon Ünitesi’ne başvuran hastaların çeşitli yönlerden profilini çıkarmaktır. Gereç ve Yöntem: Araştırmaya 2001-2015 yılları arasında kliniğimize başvurmuş olan 261 farklı hastaya ait kayıt formları dahil edildi. Kayıt formlarında hastalara ait yaş, cinsiyet, tanı, başvuru yılı ve alınan tedavi tipi (ev programı veya fizyoterapi seansları) gibi bilgiler yer almaktaydı. Sonuçlar: Araştırmaya dahil edilen toplam 261 hastanın 109’u kız, 152’si erkekti. Kızların yaş ortalaması 39.70±4.01 ay iken erkeklerinki 42.78±3.61 ay idi. Benzer olanları gruplandırıldıktan sonra toplam 32 farklı çeşit tanı tespit edildi. 220 hasta (%84.4) klinikte toplamda 5076, ortalama 22.86±1.37 seans tedavi alırken, 41 hastaya (%15.6) da ev programı verildiği görüldü. Hastaların 104’ünün (%39.5) tanısı Serebral Palsi (SP) iken 157’sinin (%60.5) farklı tanılar idi. Bu SP vakalarının ekstremite tutulumları 47 (%45.2) diparezi, 34 (%32.7) quadriparezi, 19 (%18.2) hemiparezi, 4 (%3.9) mikst tip şeklindeydi. 15 yıl içinde en sık görülen 3 tanı sırasıyla; SP (%39.5), hipotoni (%9.1), motor gelişim geriliği (%5.7), en az görülen 3 tanı sırasıyla; yanık (%0.4), SVO (%0.8), tümöral hastalıklar (%0.8) idi. Tartışma: 15 yıl içinde kliniğimize başvuran hastalar arasında erkeklerin kızlardan daha fazla olduğu, 32 farklı tanı içinde en az karşılaşılan hastalığın yanık, en sık karşılaşılan hastalığın SP olduğu ve SP vakaları içinde de ekstremite dağılımı bakımından en az mikst tip en sık da diparezi tipiyle karşılaşıldığı görülmüştür.

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.

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.

[Purpose] The aim of this study was to determine the functional differences between total knee arthroplasty (TKA) patients who were treated with supervised physiotherapy or a standardized home program and perform a cost analysis. [Subjects and Methods] Patients who received total knee arthroplasty between January 2009 and June 2011 were enrolled in this study; those with mean ages of 64.25 +/- 3.86 (60-68) years (n=18) and 68.08 +/- 6.25 (61-79) years (n=16) were placed in the supervised physiotherapy and standardized home program groups, respectively. All patients were evaluated by the same researcher before and after surgery, and the therapy programs were applied by another physiotherapist. All patients were evaluated for joint range of motion (ROM), pain, functional status (WOMAC), overall quality of life (SF-36), and depressive symptoms (BECK Depression Scale). [Results] A significant clinical improvement was observed in postoperative assessments. A statistically significant difference could not be found between ROM and functional levels of the patients in both groups. [Conclusion] No difference was found between the patients performing supervised or standardized home program with respect to the effects on functional status. A home exercise program can be used in the rehabilitation of patients with TKA, and implementation of home exercise programs can also reduce health-care spending.

[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.

Background: Connective Tissue Massage (CTM) or Manipulation is a bodywork technique which lies at the interface between alternative approaches. The autonomic balancing responses to CTM can be useful in the treatment of anxiety. Aim: This study was planned to investigate the effects of connective tissue mobilization (CTM) on quality of life and emotional status in healthy subjects. Design; Prospective trial, Setting; Treatment and Population. The study was conducted on 100 volunteers (students). Students in second class were in CTM group (20,49 +/- 1,37 years) and students (19,50 +/- 1,15 years) educating in class 1 were in control group. Methods: Participants were assessed before and after CTM according to flexibility of trunk flexion, hamstring muscles, trunk hyperextension and lateral flexion. It was used The SF-36 Health-Related Quality of Life Inventory (SF-36) to assess general health status and Beck Depression Scale was used for assessing emotional status. Results: It was observed a significant increase at lateral flexion to the right of trunk (p=0,03) in CTM group after application. It was found a significant difference (p=0,009) in emotional status between groups. It was found differences at general health level (p=0,001), limitations in emotional role (p=0,016) in SF-36. It was some differences in depression status and some subscales of SF-36 (general health, social status, emotional well-being, pain and energy levels) in favour of control group before application. It was no difference between groups after application. Conclusion: CTM could be used for minimizing depressive symptoms, improving quality of life in healthy young subjects.

[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.

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

OBJECTIVE: To investigate the effects of tetanic faradic stimulation in an antagonist muscle (tibialis anterior) on agonist muscles (gastro-soleus). In addition, to show the effects of maintaining agonist muscle strength on antagonist spastic muscle group to improve gait parameters in children with spastic hemiplegia. METHODS: We carried out the study at Pamukkale University, School of Physical Therapy, Denizli, Turkey between June 2001 and December 2002. We included 16 ambulant cerebral palsied children with a mean of age 6.25 +/- 2.89 years in the study. Each subject practiced a 20-minute electrical stimulation session plus neurodevelopmental approach (Bobath Technique) once a day, 4 days a week for 5 weeks. We performed faradic tetanic stimulation to stimulate and strengthen the tibialis anterior (antagonist muscle). We performed all tests, including goniometric measurement, the Modified Ashworth Scale, and gait analysis at the start of the treatment program, after the program, and one month after first follow up. RESULTS: After treatment, we found significant improvements in goniometric measurements and Modified Ashworth Scale in comparison with the baseline measurements (p0.05). The results of the gait analysis showed only a significant difference concerning step width (p>0.05). CONCLUSION: The results suggest that tetanic faradic stimulation was effective in improving aspects of ankle function, decreasing muscle tone and increasing range of motion in children with hemiplegic cerebral palsy during a physical therapy program.