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To compare mothers' report on children's pain with patients' own reports and to explore the prevalence, intensity, localisation and the effect of pain on daily living activities of adolescents with CP.A total of 75 adolescent with CP (34 females and 41 males) and their mothers were included in this cross-sectional study. Demographical and clinical characteristics were recorded. The adolescent and the mother independently completed the pain questionnaire in a face-to-face interview administrated by a physiatrist.The prevalance of pain in the previous week was 28% by self report and was 40% by mothers' report. No significant difference was determined between mother's report and self report (Pain is a common condition in adolescents with CP and it affects quality of life negatively. While the self-report of pain is ideal, parent's reports in various situations is important for the assessment of pain.

Aim: The purpose of the study was to assess the musculoskeletal pain frequency and intensity, to pinpoint the factors affecting the pain and to research their effect on patients’ quality of life. Methods: 203 patients over 65 who came to our Physical Therapy and Rehabilitation clinic were included in the study. Intensity of comorbid diseases were calculated by using Cumulative Illness Rating Scale (CIRS). Geriatric Pain Measure-24 (GPM) was used to assess the pain intensity, Geriatric Depression Scale-15 (GDS) was used to detect the presence of depression and Short Form-36 (SF-36) was used to determine quality of life. Results: The median age of the patients was 72.9 ± 6.36 (65 - 92) years. 97% of patients complained of pain. GPM total value mean of the patients was 61.9 (0 - 99.9). GPM scores were significantly higher in patients who were female (p < 0.001), single (p < 0.015), lower education, housewife (p < 0.001), depressed (p < 0.001), and with a preexisting comorbidity. However, in multivariate linear regression analysis, only female sex and depression presence was found out to be the factors that significantly affect the GPM scores (p < 0.001). There was a significant positive correlation between GPM and GDS scores (p = 0.001, r = 0.545). There were significant negative correlations between all subgroup parameters of SF-36 and both GPM and GDS. Conclusions: Low education, being single, presence of comorbidities and being a housewife all relates to pain intensity, yet the most important factors are being female and presence of depression. Pain intensity is connected to low quality of life. We think this study will show a path to program geriatric population’s healthcare needs.

Objectives: This study aims to evaluate the cardiopulmonary functions and exercise performance of patients with ankylosing spondylitis (AS) and to investigate the relationship between these parameters and disease activity, spine mobility and quality of life (QoL). Patients and methods: Forty-five patients with AS (group 1; 33 males, 12 females; mean age 43.1±12.1 years; range 22 to 70 years) and 30 control subjects (group 2; 23 males, 7 females; mean age 42.8±10.0; range 23 to 70 years) were included in the study. Disease activity was assessed with the Bath Ankylosing Spondylitis Disease Activity Index and spinal mobility measures with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Ankylosing Spondylitis Quality of Life (ASQoL) Questionnaire and the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) were used. The pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET) were performed. Results: There was no significant difference between groups 1 and 2 in terms of mean age. The peak expiratory flow value in PFT was significantly lower in group 1 (p

Objectives: This study aims to evaluate the cardiopulmonary functions and exercise performance of patients with ankylosing spondylitis (AS) andto investigate the relationship between these parameters and disease activity, spine mobility and quality of life (QoL).Patients and methods: Forty-five patients with AS (group 1; 33 males, 12 females; mean age 43.1±12.1 years; range 22 to 70 years) and 30 controlsubjects (group 2; 23 males, 7 females; mean age 42.8±10.0; range 23 to 70 years) were included in the study. Disease activity was assessed with theBath Ankylosing Spondylitis Disease Activity Index and spinal mobility measures with the Bath Ankylosing Spondylitis Metrology Index (BASMI). TheAnkylosing Spondylitis Quality of Life (ASQoL) Questionnaire and the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) were used. Thepulmonary function test (PFT) and cardiopulmonary exercise testing (CPET) were performed.Results: There was no significant difference between groups 1 and 2 in terms of mean age. The peak expiratory flow value in PFT was significantlylower in group 1 (p

[Purpose] The aim of this study was to assess the effects of central poststroke pain on quality of life, functionality, and depression in stroke. [Subjects and Methods] Twenty-four patients with stroke having central poststroke pain (a mean age of 60.6±8.5 years; 14 males, 10 females; Group I) and 24 similar age-and gender-matched patients with stroke without central poststroke pain (Group II) were enrolled. Characteristics of pain were recorded in patients with stroke having central poststroke pain. The Visual Analogue Scale and Leeds Assessment of Neuropathic Symptoms and Signs pain scale were used to evaluate pain. The Functional Independence Measure was used to assess functionality, the 36-Item Short-Form Health Survey was used to assess quality of life (QoL), and the Beck Depression Inventory was used to assess depression. [Results] There were no significant differences in Functional Independence Measure and Beck Depression Inventory. Some of the 36-Item Short-Form Health Survey domains (physical role limitations, pain, and physical scores) in Group II were significantly higher than those in Group I. Additionally, we found that a unit increase in Leeds Assessment of Neuropathic Symptoms and Signs score led to 0.679 decrease in physical score and 0.387 decrease in mental score. [Conclusion] The physical component of the 36-Item Short-Form Health Survey is negatively affected in patient with central poststroke pain, but the mood and mental components of the scale unaffected.

Background and purpose: The clinical effects of Kinesio taping (KT) for somatosensory tinnitus have not been confirmed. The purpose of this study is to investigate the efficacy of KT applied to the sternocleidomastoid, upper trapezius, and levator scapulae muscles for somatosensory tinnitus associated with neck complaints. Materials and methods: Thirty-patients were randomly assigned to the KT group (n = 15) and the sham-taping (ST) group (n = 15). Tinnitus-severity was measured using a visual analog scale (tinnitus-VAS) as a primary outcome. Tinnitus Handicap Inventory (THI), cervical pain-VAS, and neck disability index (NDI) were used for the assessments of tinnitus handicap, neck pain, and disability. Results: Tinnitus-VAS, THI, cervical pain-VAS, and NDI improved significantly in the KT group after the intervention (all P ≤ 0.001). In the ST group, no significant differences in outcome measures were found in the fourth-week. Conclusion: KT is more effective than sham-taping in improving somatosensory tinnitus associated with neck complaints. The authors would like to thank all the participants of this study, and Ilkay Kocak for providing envelopes for the randomization. 2-s2.0-85078401638 PubMed: 32379629

Heterotopic ossification (HO) is a rare complication (0.5 to 1.2%) after stroke. Although there are few reports on ulnar neuropathy (UN) due to HO at the elbow after traumatic brain injury, thermal burn or upper limb trauma, there has been no case reported after stroke. Herein, we present a 32-year-old male patient with UN due to HO after stroke.

WOS: 000443738600001, PubMed ID: 30632540, Objectives: This study aims to report the assessment of the Turkish League Against Rheumatism (TLAR) expert panel on the compliance and adaptation of the European League Against Rheumatism (EULAR) 2016 recommendations for the management of rheumatoid arthritis (RA) in Turkey. Patients and methods: The EULAR 2016 recommendations for the treatment of RA were voted by 27 specialists experienced in this field with regard to participation rate for each recommendation and significance of items. Afterwards, each recommendation was brought forward for discussion and any alteration gaining >= 70% approval was accepted. Also, Turkish version of each item was rearranged. Last version of the recommendations was then revoted to determine the level of agreement. Levels of agreement of the two voting rounds were compared with Wilcoxon signed-rank test. In case of significant difference, the item with higher level of agreement was accepted. In case of no difference, the changed item was selected. Results: Four overarching principles and 12 recommendations were assessed among which three overarching principles and one recommendation were changed. The changed overarching principles emphasized the importance of physical medicine and rehabilitation specialists as well as rheumatologists for the care of RA patients in Turkey. An alteration was made in the eighth recommendation on treatment of active RA patients with unfavorable prognostic indicators after failure of three conventional disease modifying anti-rheumatic drugs. Remaining principles were accepted as the same although some alterations were suggested but could not find adequate support to reach significance. Conclusion: Expert opinion of the TLAR for the treatment of RA was composed for practices in Turkish rheumatology and/or physical medicine and rehabilitation clinics.

WOS: 000429930000001, PubMed ID: 29900976, Objectives: This study aims to update 2011 Turkish League Against Rheumatism SpondyloArthritis Recommendations, and to compose a national expert opinion on management of axial spondyloarthritis under guidance of current guidelines, and implantation and dissemination of these international guidelines into our clinical practice. Materials and methods: A scientific committee of 28 experts consisting of 14 rheumatologists and 14 physical medicine and rehabilitation specialists (one of them also has an immunology PhD) was formed. The recommendations, systematic reviews, and meta-analyses including pharmacologic and non-pharmacologic treatment were scrutinized paying special attention with convenient key words. The draft of Turkish League Against Rheumatism opinion whose roof consisted of international treatment recommendations, particularly the Assessment of SpondyloArthritis International Society/European League Against Rheumatism recommendations was composed. Assessment of level of agreement with opinions by task force members was established through the Delphi technique. Voting using a numerical rating scale assessed the strength of each recommendation. Results: Panel compromised on five basic principles and 13 recommendations including pharmacological and nonpharmacological methods. All of the recommendations had adequate strength. Conclusion: Turkish League Against Rheumatism expert opinion for the management of axial spondyloArthritis was developed based on scientific evidence. These recommendations will be updated regularly in accordance with current developments.

WOS:000435672000002, PubMed ID: 30207576, Objectives: This study aims to establish the first national treatment recommendations by the Turkish League Against Rheumatism (TLAR) for psoriatic arthritis (PsA) based on the current evidence. Materials and methods: A systematic literature review was performed regarding the management of PsA. The TLAR expert committee consisted of 13 rheumatologists and 12 physical medicine and rehabilitation specialists experienced in the treatment and care of patients with PsA from 22 centers. The TLAR recommendations were built on those of European League Against Rheumatism (EULAR) 2015. Levels of evidence and agreement were determined. Results: Recommendations included five overarching principles and 13 recommendations covering therapies for PsA, particularly focusing on musculoskeletal involvement. Level of agreement was greater than eight for each item. Conclusion: This is the first paper that summarizes the recommendations of TLAR as regards the treatment of PsA. We believe that this paper provides Turkish physicians dealing with PsA patients a practical guide in their routine clinical practice.

Objective. The aim of this study was to compare the effects of trospium chloride (TCL) and TCL + doxazosin (DXZ) combination to bladder capacity and residual urine volume (RUV) in spinal cord injury (SCI) patients with neurogenic bladder. Methods. The study included 120 patients with SCI. Urodynamic data of patients were reviewed retrospectively. Changes in maximum cystometric capacity (MCC) as well as RUV were determined in patients using 60-90 mg/day TCL (Group 1, n = 98) or 60-90 mg/day TCL + 4-6 mg/day DXZ (Group 2, n = 22). Results. There was statistically significant increase in both MCC and RUV values in both groups. There was no statistical difference in MCC and RUV values in Group 1 and Group 2 ( p = 0.111 and p = 0.664, respectively). There was a significant weak negative correlation between duration of injury and MCC values (r = 0.185; p = 0.043), meaning as the duration of injury increased, MCC decreased. There was no statistically significant correlation between medication usage duration with MCC and RUV (r = -0.129; p = 0.159 and r = -0.68; p = 0.462, respectively). Conclusions. Anticholinergic treatment is currently the mainstay conservative treatment of neurogenic detrusor overactivity. The impact of alfa blockers on neurogenic bladder has been less well evaluated. We consider that, adding DXZ to TCL has no additional benefit to increase bladder capacity and reduce RUV. Further studies are needed to determine the location of DXZ treatment in SCI patients with neurogenic bladder.

Objective: Osteoporosis (OP) and bone fractures that can result in pain, functional impairment and death are important public health problems for the elderly. The aim of our study was to asses the awareness and the information level about OP in the elderly. Materials and Methods: A total of 250 participants (203 were women, 47 were men) who were 65 years and older who presented to our outpatient clinic were included the study. Demographic data were recorded. A 26 item questionnaire was used in the assessment of information on the OP risk factors in 220 (88%) cases who reported that they are aware about OP. Questionnaires were filled with face-toface interview. Results: There was no significant difference between gender and age groups (

Objective: The aim of this study was to investigate the sociodemographic and clinical characteristics as well as rehabilitation methods of patients with multiple sclerosis (MS) undergoing an inpatient rehabilitation program. Material and Methods: A retrospective analysis of 104 patients with MS from 2007 to 2012 undergoing a rehabilitation program in a special rehabilitation unit was performed. Sociodemographic data were recorded. Disease-related characteristics such as disease duration, initial symptoms, the type of MS, medications, and the results of imaging methods were recorded. The examination findings of the neuromuscular system, body involvement, and functional level were determined. The ambulatory status was evaluated using Functional Ambulation Scale, activities of daily living were evaluated using Functional Independence Measure (FIM), and the neurologic status was determined using Kurtzke Expanded Disability Status Scale (EDSS). The orthosis and aid devices used for rehabilitation, applications for spasticity and neurogenic bladder status, and additional rehabilitation methods used were recorded. Results: The mean age was 40.53±9.40 years. Of a total of 104 patients, 68 (65.4%) were female and 36 (34.6%) were male. When the patients were grouped according to the score of GDDS, 40.4% were moderate and 59.6% were severely disabled. A one-unit increase in EDSS caused a 7.032 unit decrease in the FIM score (p=0.0001). A one-unit increase in EDSS caused a 0.017 unit increase in the duration of hospitalization (p=0.078). A oneunit increase in disease duration caused a 0.082 unit decrease in the FIM score (p=0.050). A one-unit increase in disease duration caused a 0.189 unit increase in the duration of hospitalization (p=0.0001). A one-unit increase in disease duration caused a 2.89 unit increase in number of hospitalizations (p=0.0001). Conclusion: Although MS is a progressive disease, rehabilitation applications play an enormous role in functional development. The course of rehabilitation should be planned individually for each patient.

Background The role of the selected prothesis on activities of daily living (ADL). Objective To evaluate the impact of prothesis on ADL in patients with lower-limb amputations. Methods The data of 500 patients with unilateral lower limb amputation were recorded. The activity level was defined based on the Medicare Functional Classification Level. Old and new prescribed prosthesis were recorded. Nottingham Extended Activities of daily living activities Daily Living Scale was used to evaluate ADL. Results Amputation levels were transfemoral (TF) in 268 (53.6%), transtibial (TT) in 178 (35.6%), knee disarticulation (KD) in 54 (10.8%). In patients with TF and KD amputation active vacuum system, pin modular system, hydraulic system and mechanical modular prosthesis were replaced with the swing stance phase microprocessor-controlled prostheses. In patients with TT amputation pin modular system, hydraulic system and mechanical modular prosthesis were converted to active vacuum system prostheses. Prescribed new prosthesis has caused a statistically significant increase in all amputation levels in ADL of patients (p≤ 0.05). Conclusions We observed that there was significant improvement in ADL when conventional prostheses replaced with advanced technology prostheses in unilateral lower extremity amputation patients.

OBJECTIVE: To evaluate gynecological risk factors in patients with and without osteoporosis who are older than 50 years of age.METHODS: One hundred and twenty seven patients with postmenopausal-senile osteoporosis and 53 non-osteoporotic volunteers were included. The subjects were examined in terms of age, body mass index (BMI), risk factors like age at menarche, age at menopause, number of births, numbers of miscarriage and curettage, and history of breast-feeding,RESULTS: The mean age was statistically higher and the mean BMI level was statistically lower in patients (p, AMAÇ: Bu çalışmada 50 yaş üzeri osteoporozu olan ve olmayan olgularda osteoporoz için jinekolojik risk faktörlerini değerlendirmek amaçlanmıştır.YÖNTEMLER: Çalışmaya postmenopozal-senil osteoporoz tanısı alan 127 hasta ve 53 osteoporozu olmayan gönüllü alındı. Katılımcılar yaş, vücut kitle indeksi (VKİ), menarş yaşı, menopoz yaşı, doğum sayısı, düşük-küretaj sayısı, emzirme hikayesi gibi jinekolojik risk faktörleri açısından sorgulandı.BULGULAR: Hastaların yaş ortalaması kontrollere göre daha yüksek, VKİ değerleri daha düşüktü (p

Lipoma arborescens is a rare, benign articular lesion characterized by villous lipomatous proliferation of the synovium caused by replacement of mature fat cells with subsynovial tissue. Although the knee is the most affected joint, lipoma arborescens has also been observed in other locations such as glenohumeral joint, subdeltoid/bicipital bursae, hip, elbow, wrist, and rarely elbow joints. In this article, we report a rare case of lipoma arborescens at the elbow joint in a 30-year-old female patient with cerebral palsy.

Systemic lupus erythematosus (SLE) is a multi-system chronic inflammatory disease with a broad spectrum of clinical and serological manifestations. Although clinical evidence of proximal skeletal muscle involvement is not rare in patients with SLE, there is no knowledge about the effects of SLE on the macroscopic structural parameters of the muscles. Therefore, in this study, we aimed to explore the muscle strength and structure of SLE patients using isokinetic testing and ultrasonographic imaging. Thirty-one SLE patients (5 men, 26 women) with a mean age of 38.61 +/- 10.68 years and mean disease duration of 3.71 +/- 3.23 years without any previous history of myositis and 31 age- and sex-matched healthy subjects were enrolled. Demographic and clinical characteristics of the patients were recorded. Ultrasonographic evaluations were performed with a 7- to 12-MHz linear probe from vastus lateralis and gastrocnemius muscles of the nondominant extremity. Measurements included muscle thickness, pennation angle, and fascicule length. Isokinetic nondominant knee muscle strength tests were performed at 60 and 180A degrees/s. We found that muscle thickness, pennation angle, and fascicle length of vastus lateralis muscles were increased in patients with SLE in comparison to control subjects (p < 0.001, p = 0.007, and p = 0.217, respectively). On the other hand, the measurements pertaining to the gastrocnemius muscles were found to be similar between the two groups. We observed that all isokinetic knee muscle strength values were decreased in SLE patients, and knee strength values were found to be negatively correlated with age and positively correlated with height (all p < 0.01). We found that the structural and strength changes were seen in the proximal muscles of SLE patients. Pathophysiology and clinical relevance of these changes need to be further investigated.

ObjectiveTo find whether strength deficits could be detected in shoulder rotational strength in patients with the subacromial impingement syndrome [SIS].MethodsStrength of the internal rotators and external rotators was tested isokinetically at 90° and 180°/s.ResultsThere were 22 symptomatic patients and 26 asymptomatic control subjects. In the patient group, the rotational strength of the involved side was weaker compared with their uninvolved counterparts and with those of the control group [P

Objectives: This study aims to compare the handgrip strength values of fibromyalgia (FM) patients and healthy individuals and to demonstrate the relationship between clinical factors and FM disease severity. Patients and methods: Twenty-five female patients (mean age 34±9.2 years; range 20 to 50 years) with FM and 23 age- and body mass index-similar healthy females (mean age 35.3±9.2 years; range 26 to 46) were included. Demographic characteristics of the subjects were recorded. Tender point count was noted in the patient group. Also; total myalgia score and fibromyalgia impact questionnaire scores were calculated. Handgrip strength was measured with Jamar® dynamometer. Patients who had fibromyalgia impact questionnaire scores ≥70 out of 100 were considered to have severe FM, while those who had scores

The aim of our study was to identify feeding and gastrointestinal system (GIS) problems in children with cerebral palsy (CP), and to evaluate the relationship between these problems and the severity of CP. A total of 120 children with CP were enrolled consecutively into the study (67 males, 53 females; mean age: 6.0±2.4 years; range: 2-12 years). The children were classified according to the Swedish classification as diplegic, hemiplegic, or quadriplegic. Severity of CP was classified based on the Gross Motor Function Classification System. The amount of time that the caregiver allocated to mealtimes, modifications of the food, as well as feeding and GIS problems was evaluated. Feeding dysfunction was classified as mild, moderate, or severe. Comparisons of GIS and feeding disorders and the severity of CP were carried out using χ test. The results indicated lack of appetite in 46 of the 120 children (38.3%), sialorrhea in 37 (30.8%), constipation in 30 (25%), difficulty in swallowing in 23 (19.2%), and feeding dysfunction in 26 (21.7%). On the basis of the Gross Motor Function Classification System (GMFCS), the incidence of GIS problems and feeding dysfunction was found to be significantly higher in the children classified in the severe group. The time taken to consume meals was significantly longer among children with feeding dysfunction. Feeding and GIS problems are frequent in children with CP, and more marked in those with severe CP. Approximately one fourth of children with CP suffer from feeding dysfunction, and more time has to be allocated to consume meals.

The objective of this study was to assess the possible causes of hemiplegic shoulder pain (HSP) in Turkish patients with stroke, to identify the correlation between HSP and clinical factors, and to review the effects of HSP on functional outcomes. A total of 187 consecutive patients with stroke were evaluated for the presence of HSP and for the possible causes. Each patient was evaluated by clinical, radiographic, and ultrasonographic examination. Daily living activities were assessed using the Functional Independence Measure at admission and at discharge. Patients were divided into two groups, one comprising patients with shoulder pain and the other comprising patients without shoulder pain. They were then compared with respect to clinical characteristics, radiologic findings, and Functional Independence Measure scores. Shoulder pain was present in 114 (61%) patients. Of the 114 patients with pain, 71 patients showed various grades of glenohumeral joint subluxation, 70 patients had complex regional pain syndrome-type I, 70 patients had impingement syndrome, 68 patients had spasticity, 49 patients had adhesive capsulitis, and 10 patients had thalamic pain. No correlation was found between shoulder pain and clinical factors (sex, hemiplegic side, hand dominance, etiologic cause, comorbidities). The relationship between shoulder pain and adhesive capsulitis was significant (P=0.01) and also complex regional pain syndrome-type I was statistically significant (P=0.001). The group without HSP showed significantly more improvement than the group with HSP in functional outcomes (P=0.01) and the hospitalization period was significantly shorter (P=0.03). Shoulder pain is a frequent problem in patients with stroke. It is, however, often difficult to isolate a specific cause and it causes a prolonged hospitalization period and can have a negative effect on functional outcomes.

Objective: The aim of this study was noninvasive evaluation of voiding function in children with cerebral palsy. Design: Sixty children with cerebral palsy were enrolled in the study. Urinary system symptoms were recorded. Uroflowmetric tests were carried out, and postvoid residual volume was measured immediately after voiding by using a portable ultrasonic device developed for children. The expected age-related bladder capacity was calculated and compared with the observed bladder capacity. Uroflowmetric curves were evaluated and classified as normal (bell-shaped) and abnormal. Results: Thirty-three of the children (55%) were symptomatic. In 1 7 (28.3%) of the children, postvoid residual urine was observed. There was a statistically significant difference between the expected bladder capacity (271.6 ± 38.3 ml) and the observed bladder capacity (154.5 ± 111.8 ml) (P < 0.001). Observed bladder capacity was lower than the expected bladder capacity in 56 (93.3%) of the children. In the evaluation of the uroflowmetric charts, 22 (36.7%) children had abnormal curves. Conclusions: Bladder capacity is decreased in most children with cerebral palsy, and postvoid residue is present in an important proportion. Uroflowmetry and portable ultrasonic device combination is a noninvasive, well-tolerated, and efficient method in the first line evaluation of lower urinary tract function in children with cerebral palsy.

To evaluate the WeeFIM instrument's reliability and internal construct validity for the Turkish child population.License was taken from UDSmr to use the WeeFIM instrument. For the reliability and validity studies of the Turkish translation of the WeeFIM instrument, 573 Turkish nondisabled children were included in the study. The reliability of the instrument was assessed by Cronbach's alpha coefficient, intraclass correlation coefficient (ICC), and test-retest reliability. Internal construct validity was assessed by both using Rasch unidimensional measurement model and testing for differential item functioning for age and gender.Cronbach alpha value was 0.99 for motor WeeFIM rating and 0.99 for cognitive WeeFIM rating. ICC was 0.81 for motor WeeFIM rating and 0.92 for cognitive WeeFIM rating. The internal construct validity of the Turkish translation of the WeeFIM instrument was confirmed by excellent fit to the Rasch measurement model. Two subscales were found from the principal component analysis of standardized residual correlation for items. Among the items, bowel management, bladder management, eating, and comprehension showed considerable levels of misfit.The Turkish translation of the WeeFIM instrument is valid, reliable, and practical for the Turkish child population. Further studies are required to determine the cross-cultural validity of the instrument.

To investigate the validity and reliability of the Turkish translation of the original Pediatric Evaluation of Disability Inventory (PEDI).On May 2003, we received permission from Boston University to translate and use the PEDI for Research purposes. PEDI Functional Skills scale and Caregiver Assistance scale was administered by physiatrists to 573 healthy Turkish children (295 males and 278 females; the age range: 7 months to 7(1/2) years) in two different healthcare centres in Ankara. The Turkish translation of the PEDI was again administered to 102 children after five days in order to assess test-retest reliability. Intraclass correlation coefficients (ICC) and Cronbach's alphas (alpha) were calculated. The test-retest reliability was assessed by Spearman's correlation coefficient. Internal construct validity was assessed by using Rasch unidimensional measurement model.High Cronbach's alpha coefficients (or =0.98), high ICC values (or =0.96) and high Spearman correlation coefficients (or =0.86) were found. The internal construct validity was confirmed by good fit to the Rasch measurement model. The fit statistics conducted in the study was acceptable, except for some items.The Turkish translation of the PEDI is valid and reliable for the Turkish child population. We believe that PEDI is a detailed and useful instrument for the evaluation of efficiency of pediatric rehabilitation programme.

In this study, we aimed to determine gastrointestinal problems associated with neurogenic bowel dysfunction in spinal cord injury patients and to assess the efficacy of bowel program on gastrointestinal problems and the severity of neurogenic bowel dysfunction. Fifty-five spinal cord injury patients were included in this study. A bowel program according to the characteristics of neurogenic bowel dysfunction was performed for each patient. Before and after bowel program, gastrointestinal problems (constipation, difficult intestinal evacuation, incontinence, abdominal pain, abdominal distension, loss of appetite, hemorrhoids, rectal bleeding and gastrointestinal induced autonomic dysreflexia) and bowel evacuation methods (digital stimulation, oral medication, suppositories, abdominal massage, Valsalva maneuver and manual evacuation) were determined. Neurogenic bowel dysfunction score was used to assess the severity of neurogenic bowel dysfunction. At least one gastrointestinal problem was identified in 44 (80%) of the 55 patients before bowel program. Constipation (56%, 31/55) and incontinence (42%, 23/55) were the most common gastrointestinal problems. Digital rectal stimulation was the most common method for bowel evacuation, both before (76%, 42/55) and after (73%, 40/55) bowel program. Oral medication, enema and manual evacuation application rates were significantly decreased and constipation, difficult intestinal evacuation, abdominal distention, and abdominal pain rates were significantly reduced after bowel program. In addition, mean neurogenic bowel dysfunction score was decreased after bowel program. An effective bowel program decreases the severity of neurogenic bowel dysfunction and reduces associated gastrointestinal problems in patients with spinal cord injury.

Objective: This aim of this study was to determine the reliability and validity of an established ideomotor apraxia test when applied to a Turkish stroke patient population and to healthy controls. Subjects: The study group comprised 50 patients with right hemiplegia and 36 with left hemiplegia, who had developed the condition as a result of a cerebrovascular accident, and 33 agematched healthy subjects. Methods: The subjects were evaluated for apraxia using an established ideomotor apraxia test. The cut-off value of the test and the reliability coefficient between observers were determined. Results: Apraxia was found in 54% patients with right hemiplegia (most being severe) and in 25% of left hemiplegic patients (most being mild). The apraxia scores for patients with right hemiplegia were found to be significantly lower than for those with left hemiplegia and for healthy subjects. There was no statistically significant difference between patients with left hemiplegia and healthy subjects. Conclusion: It was shown that the ideomotor apraxia test could distinguish apraxic from non-apraxic subjects. The reliability coefficient among observers in the study was high and a reliability study of the ideomotor apraxia test was therefore performed.

Therapeutic proteins, such as infliximab, have revolutionized the treatment of many diseases during the last decade and more than 80 therapeutic proteins are currently approved for clinical use. However, all exogenous proteins have the potential to cause antibody formation. In order to ensure patient safety and the efficacy of therapeutic proteins, careful monitoring of the immunogenicity of therapeutic proteins is therefore necessary not only during preclinical trials, but also during the treatment of patients. Here, we report a clear-cut demonstration of the induction of anti-infliximab antibodies during the treatment of a patient with ankylosing spondylitis ( AS). Assessment of anti-infliximab antibodies in sera obtained at various time periods were performed using a highly specific double antigen assay system developed in our laboratory. Immunoreactivity was found to be solely specific for infliximab. Because all sera obtained from the patient were found to be negative for the presence of human anti-mouse antibody ( HAMA) and anti-human antibodies. The loss of effect of infliximab, as judged by observing the relapse of signs and symptoms of disease in the patient, seemed to be related with the appearance of antibodies. This study clearly demonstrates that monitoring for the induction of specific antibodies during clinical trials is an important issue for therapeutic proteins.