Robot yardımlı yürüme eğitiminin serebral palside motor performans üzerine etkisi: Pilot çalışma

Purpose: Children with Cerebral Palsy (CP) have significantly impaired motor performance. There are various rehabilitationmethods in rehabilitation in CP. Robot Assisted Gait Training (RAGT) is an alternative rehabilitation system in addition to othertherapies. This study aims to investigate effects of RAGT in children with CP.Methods: Seventeen patients with spastic type CP, mean age 12.83±5.41 years, participated in this study. Muscles’ tone wereassessed with “Modified Ashworth Scale”, motor developmental level was analysed by “Gross Motor Function Scale (GMFM)”,motor performance was assessed by “Gross Motor Performance Measure (GMPM)” balance and coordination was assessedwith “Paediatric Balance Scale (PBS)”. GEO robotic systems designed by Reha-Technology was used in treatment for 10 weeks(45 minutes-3 days a week), which was composed of treadmill and stair training.Results: The level of motor development, motor performance and balance has been detected to change positively at the end ofRAGT (p<0.05).Conclusion: Robotic rehabilitation method such as walking, climbing stairs has a positive effect on the motor performance andthe balance parameters in patients with CP. However, there is not a certain protocol in which to define the level and duration ofapplication of RAGT for these patients.Amaç: Serebral palsili (SP) çocukların motor performansları ciddi derecede bozulmuştur. Sp rehabilitasyonunda pek çok rehabilitasyon metodu kullanılmaktadır. Robot yardımlı yürüyüş eğitimi konvansiyonel rehabilitasyonlara ek olarak uygulanan alternatif bir rehabilitasyon sistemidir. Çalışmanın amacı Robot Yardımlı Yürüyüş Eğitiminin (RYYE) SP’li çocuklarda motor performans üzerine etkisini araştırmaktır. Yöntem: Spastik tip tanılı, 12.83±5.41 yıl yaş ortalamasında olan 17 hasta çalışmaya dahil edildi. Kas tonusu “Modifiye Ashworth Skalası” ile, motor gelişim seviyesi “Kaba Motor Fonksiyon Ölçütü” ile değerlendirildi, Motor performansı değerlendirmek için “Kaba Motor Performans Ölçütü”, denge ve koordinasyonu değerlendirmek amacıyla “Pediatrik Denge Skalası” kullanıldı. Düz zeminde yürüme ve merdiven çıkma olarak iki ayrı modda 10 hafta süreyle haftada 3 gün 45 dk olarak tedavi protokolü uygulandı. Eğitimlerde GEO robotik sistemi (Reha-Technology) kullanıldı. Bulgular: RYYE sonunda motor gelişim seviyesi, motor performans ve denge parametrelerinde anlamlı pozitif değişimler görüldü (p<0.05). Sonuç: Yürüme ve merdiven çıkma gibi aktiviteleri içeren robot destekli rehabilitasyonun motor performans ve denge üzerine olumlu etkileri vardır. Bununla birlikte RYYE’nin serebral palside uygulanabilirliği açısından, uygulamanın seviyesi veya durasyonu ile ilgili olarak belirli bir protokol veya görüş birliği bulunmamaktadır

The effect of leap motion controller based exergame therapy on hand function, cognitive function and quality of life in older adults. A randomised trial

Objective. To evaluate the effect of leap motion controller based exergame therapy (LMCBET) on hand function, cognitive function and quality of life (QoL) in older adults. Design. A parallel, double-blind trial with participants allocated (1:1) to one of two groups as the structured exercise (SE) and LMCBET. Setting. The study was conducted in “Barınyurt Nursing Home and Elderly Care Center” in Istanbul. Participants. Thirty-two older adults who had adequate hand function, ability to follow commands, 24 points or more in the mini mental state examination (MMSE) were included and 30 were analyzed. Interventions. SE Group performed a Structured Hand Exercise program while LMCBET group performed “ErgoActive’’ and “HandROM” exercise apps focusing on hand exercises and fine motor skills along 30-45 minute sessions, 2 days a week, over 8 weeks. Main outcome measures. Participants were evaluated with box and block test (BBT), Purdue Pegboard test (PPT), hand dynamometer, Duruöz hand index (DHI), stroop test (ST), digit span test (DST), and World Health Organization QoL instrument-older adults module (WHOQOL-OLD) at the beginning (T0), at 8 (T1), and 16 (T2) weeks after the study started. Results. There were significant differences in BBT, PPT, DHI, and WHOQOL-OLD in the SE group (p 0.05). Conclusions. SE and LMCBET were effective on hand function and QoL in healthy older adults.Nursing Home and Elderly Care Cente

Nörogelişimsel tedavinin serebral palsi’li çocuklarda fonksiyonellik ve kas ultrason parametrelerine etkisi

Purpose: This study aimed to evaluate the effectiveness of neurodevelopmental therapy (NDT) for improving lower extremity functions, ankle dorsiflexion range of motion (ROM), popliteal angle, medial gastrocnemius (GCM) muscle thickness (MT), and functionality of lower extremity on children with hemiparetic Cerebral Palsy (CP). Methods: Eighteen children with hemiparetic CP aged between 6-15 years were included in the study. Structured NDT (s-NDT) was applied 40 minutes per session, three times a week over 12 weeks. Children were evaluated with Gross Motor Function Measurement-88 (GMFM-88) for motor function level; with goniometer for ankle dorsiflexion ROM and popliteal angle; with ultrasound for medial GCM MT, and with ultrasound Lower Extremity Function Test (LEFT) for the functionality of lower extremity. Children were evaluated before and after the intervention. Results: After the treatment, statistically significant differences were obtained in mean values of GMFM-88, ankle dorsiflexion ROM, medial GCM MT, and LEFT (p0.05). Conclusion: In conclusion, it was observed that s-NDT might be effective on motor function level, ankle dorsiflexion, medial GCM MT, and lower extremity functionality in children with hemiparetic CP. These improvements will make significant positive contributions to the mobility of children.Amaç: Bu çalışmanın amacı; hemiparetik serebral palsi (SP)’li çocuklarda nörogelişimsel tedavinin (NGT) alt ekstremite fonksiyonları, ayak bileği dorsifleksiyon eklem hareket açıklığı (EHA), popliteal açı, medial gastroknemius (GCM) kas kalınlığı (MT) ve alt ekstremiye fonksiyonelliğini iyileştirmedeki etkinliğini değerlendirmekti. Yöntem: Çalışmaya yaşları 6-15 yıl aralığında on sekiz hemiparetik SP’li çocuk dahil edildi. Yapılandırılmış NGT haftada 3 seans, her seans 40 dakika olacak şekilde 12 hafta boyunca uygulandı. Çocukların motor fonksiyon seviyelerini değerlendirmek için Kaba Motor Fonksiyon Ölçütü-88 (KMFÖ-88), ayak bileği dorsifleksiyon açısı ve popliteal açının değerlendirmesi için universal gonyometre, medial gastroknemius kasının kalınlığı ölçmek için ultrasanografik ölçüm ve alt ekstremite fonksiyonlarını değerlendirmek için Alt Ekstremite Fonksiyon Testi (AEFT) kullanıldı. Sonuçlar: Tedavi sonrasında GMFM-88, ayak bileği dorsifleksiyon EHA, medial GCM MT ve AEFT değerlerinde istatistiksel olarak anlamlı gelişme olduğu belirlendi (p0,05). Tartışma: Sonuç olarak, hemiparetik SP'li çocuklarda yapılandırılmış NGT'nin motor fonksiyon düzeyi, ayak bileği dorsifleksiyonu, medial GCM- MT değerleri ve alt ekstremite fonksiyonelliği üzerine olumlu etkileri olabileceği gözlendi. Elde edilen bu gelişmeler çocukların mobilitesine önemli pozitif katkılar sağlayacaktır

Effect of custom design insole applications with 3D modelling on baropodometric parameters in individuals with pes planus

It was aimed to investigate the effect of custom made insoles on baropodometric analysis parameters in individuals with pes planus, using objective measurement and production methods. 100 individuals with pes planus, aged between 4-18 years in the study. Individuals who met the inclusion criteria and the medial longitudinal arch index were included in the study. Valgus angles of individuals, plantar measurements of the feet before the use of insoles and after 6 months of the use of insoles were evaluated with the Sensor Medica® device. When the measurement results of the ankle valgus angles of the individuals before and after the insoles were examined, it was observed that there was a statistical decrease in the mean results in both feet (p[removed]

A physiological signal database of children with different special needs for stress recognition

This study presents a new dataset AKTIVES for evaluating the methods for stress detection and game reaction using physiological signals. We collected data from 25 children with obstetric brachial plexus injury, dyslexia, and intellectual disabilities, and typically developed children during game therapy. A wristband was used to record physiological data (blood volume pulse (BVP), electrodermal activity (EDA), and skin temperature (ST)). Furthermore, the facial expressions of children were recorded. Three experts watched the children's videos, and physiological data is labeled "Stress/No Stress" and "Reaction/No Reaction", according to the videos. The technical validation supported high-quality signals and showed consistency between the experts.Scientific and Technological Research Council of Turkey Technology and Innovation Funding Programmes Directorat

Effects of Nintendo Wii-Fit((R)) video games on balance in children with mild cerebral palsy

WOS: 000387111100016PubMed ID: 26858013BackgroundThis study compared the effects of Nintendo Wii-Fit((R)) balance-based video games and conventional balance training in children with mild cerebral palsy (CP). MethodsThis randomized controlled trial involved 30 ambulatory pediatric patients (aged 5-18 years) with CP. Participants were randomized to either conventional balance training (control group) or to Wii-Fit balance-based video games training (Wii group). Both group received neuro-developmental treatment (NDT) during 24 sessions. In addition, while the control group received conventional balance training in each session, the Wii group played Nintendo Wii Fit games such as ski slalom, tightrope walk and soccer heading on balance board. Primary outcomes were Functional Reach Test (forward and sideways), Sit-to-Stand Test and Timed Get up and Go Test. Nintendo Wii Fit balance, age and game scores, 10 m walk test, 10-step climbing test and Wee-Functional Independence Measure (Wee FIM) were secondary outcomes. ResultsAfter the treatment, changes in balance scores and independence level in activities of daily living were significant (P < 0.05) in both groups. Statistically significant improvements were found in the Wii-based game group compared with the control group in all balance tests and total Wee FIM score (P < 0.05). ConclusionWii-fit balance-based video games are better at improving both static and performance-related balance parameters when combined with NDT treatment in children with mild CP

Video game-based therapy for the non-dominant hand improves manual skills and grip strength

The study was designed to investigate the effect of virtual reality-supported training on manual skills and grip strength in the non-dominant hand in healthy participants. Thirty participants were randomized into two groups: ErgoActive group (n = 15) and control group (n = 15). The ErgoActive study group received 8 weeks of training with leap motion controller-based virtual reality games. The training was done 1 day per week for 30 min. The participants' hand function was evaluated using the Jebsen Taylor Hand Function Test (JTHFT), while grip strength was evaluated with a Jamar Hand Dynamometer and Pinchmeter. After 8 weeks, the ErgoActive and control groups had significantly different JTHFT, Jamar and Pinchmeter results (P < 0.05). When leap motion controller-based virtual reality applications are used, healthy subjects have increased manual skills and grip strength in their non-dominant hand. These virtual reality games are an effective and fun way of improving patients' hand functions

Investigation of physical activity levels in disabled individuals with special needs education and their families

ÖZ Amaç: Çalışmamızın amacı; özel eğitim alan engelli bireylerin ve bakım verenlerinin fiziksel aktivite düzeylerini araştırmaktır. Gereç: Çalışmaya 5-18 yaşları arasında olan 15 bedensel engelli, 15 hafif mental retarde ve 15 otizm tanısı almış 45 engelli birey ve bakım vereni dahil edildi. Yöntem: Engelli bireylerde değerlendirme için Çocukluk ve Ergenlik Fiziksel Aktivite Biçimleri Anketi (ÇFA) ve pedometre kullanılırken bakım verenlerde Uluslararası Fiziksel Aktivite Anketi Kısa Formu (UFAA-KF), Cooper Anketi ve pedometre kullanıldı. Bulgular: Engelli bireylerde kullanılan ÇFA‟nın motor kısmında (1-8 arası kısım) grup içi değerlendirme sonuçları arasında anlamlı fark bulunmuştur (p=0,006). Engelli bireylerde gruplar arası pedometre sonuçları arasında anlamlı fark bulunmamıştır (p>0,05). Engelli bireylerde gruplar arası ÇFA‟nın motor kısmında (1-8 arası kısım) bedensel engelli bireylerle otizmli bireyler arasında anlamlı fark bulunmuştur (p=0,004). Bakım verenlerde kullanılan; UFAA-KF, pedometre, Cooper Anketinde grup içi ve gruplar arası sonuçlar arasında anlamlı fark bulunmamıştır (p>0,05). Sonuç: Çocukların aktif ve sosyal yaşamda daha bağımsız olmaları fiziksel aktivite ile mümkündür. Bakım verenler çeşitli faktörler nedeniyle inaktif durumdadır. Bu konu ile ilgili çeşitli seminerler düzenlenerek bilinç düzeyinin arttırılması gerektiği görüşündeyiz.ABSTRACT Purpose: The aim of this study is to investigate the physical activity levels of disabled individuals who take special education and caregivers. Materials and Methods: Between the ages of 5-18 who meet the inclusion criteria for our study; 45 handicapped individuals who had 15 bodily handicaps, 15 mild mental retardations and 15 autism and their care givers were taken. For the assessment of disabled individuals; the Childhood and Adolescent Physical Activity Forms Questionnaire (CPA) and pedometer were used. Caregivers were evaluated with; International Physical Activity Questionnaire Short Form (IPAQ-SF), Cooper Survey and pedometer. Results: İn the motor part of the CPA (1-8 part) used in disabled individuals, there was a significant difference between the scores of intra-group evaluation results in the CPA (p= 0.006). There was no significant difference between the inter-group pedometer results of disabled individuals (p>0.05). A significant difference found in the motor part of the CPA (1-8 part) between the inter-group evaluation results of individuals with physical disabilities and individuals with autism (p = 0.004). Used in caregivers; there was no significant difference intragroup and inter-group between IPAQ-SF, pedometer, Cooper Questionnaire (p> 0.05). Conclusion: İt is possible for children to be more independent in active and social life by physical activity. Caregivers are inactive because of several factors. We believe that the awareness level should be increased by organizing various seminars on this subject

Cross-cultural adaptation, validity and reliability of Turkish version of Oxford Ankle Foot Questionnaire for children with congenital talipes equinovarus & nbsp

Background: The purpose of the study was to evaluate the reliability and validity of the Turkish version of the Oxford Ankle Foot Questionnaire (OxAFQ) to provide cultural adaptation. Methods: This study involved translation, back translation, and cross-cultural adaptation. Forty-nine patients with congenital talipes equinovarus were evaluated using the Turkish version of OxAFQ. Turkish version of the Childhood Health Assessment Questionnaire (CHAQ) was used as a gold standard to validate the Turkish version of the OxAFQ. The validation was assessed with Spearman correlation analysis by using CHAQ. The reliability of the questionnaire was assessed with Cronbach alpha (internal consistency) and exploratory factor analysis. Results: High validity was found between OxAFQ and CHAQ (r =-0.422-0.292) (p < 0.01). Reliability analysis showed that OxAFQ had a high level of Cronbach alpha (alpha = 0.88-0.96) and internal consistency (ICC = 0.90-0.96). Conclusion: The Turkish version of OxAFQ is a valid, reliable and useful quality of life questionnaire in patients with congenital talipes equinovarus and it is proper for use by health professionals and researchers

Physiotherapy and rehabilitation In Escobar Syndrome: A case study

Amaç: Nadir görülen bir sendrom olarak Escobar'la ilgili literatürde rehabilitasyon uygulamaları konusunda yeterince çalışmaya rastlanmamaktadır. Bu çalışmada Escobar Sendromlu 5 aylık kız çocuk sunulmuş, klinik özellikleri ve yapılan fizyoterapi uygulamaları tartışılmıştır. Gereç ve Yöntem: Başını tutabilen hasta yüzüstü pozisyonda ön kolları üzerinde kendini destekleyemiyordu. Olgunun fizyoterapiye yönlendirilme sebebi motor gelişiminin yaşıtlarına göre daha yavaş olabileceği görüşü ve eklemlerdeki hareket kısıtlılıklarının kontraktürlere dönüşmeden önlenebilmesiydi. Olgu "Kaba Motor Fonksiyon Ölçümü Testi (GMFM ) ile değerlendirildi. Testin "yatma ve yuvarlanma" alt maddesinden 8 puan aldı. Ayrıca olguda alt ekstremitede ileri derecede olmak üzere omuz , dirsek, el bileği ve parmaklarda hareket kısıtlılıkları gonyometrik ölçümlerle belirlendi. Pasif omuz fleksiyonu sağda 120º, solda 115º; omuz abduksiyonu sağda 135º, solda 125º; dirsek ekstansiyonu sağda 170º, solda 170º; el bileği ekstansiyonu sağda 0º, solda 0º olarak ölçüldü. Hasta 9 ay haftanın 2 günü fizyoterapiye alındı. Motor gelişimini desteklemek amacıyla nörofizyolojik yaklaşımlar, üst ekstremite eklem hareket açıklığını koruma amaçlı eklem hareket açıklığı ve germe egzersizleri uygulandı. Sonuçlar: Sonuç ölçümleri alındığında 14 aylık olan olgu bağımsız olarak sırtüstünden yüzüstüne ve tersi yöne dönebilmekte, yüzükoyun ön kolları üzerinde yükselebilmekte, oturabilmekte, oturma pozisyonunda dengesi bozulduğunda kendini elleriyle destekleyebilmekte idi. GMFM'ye göre "yatma ve yuvarlanma" testinden 30, "oturma" testinden 8 puan aldı. Üst ekstremitede omuz fleksiyonu sağda 130º, solda 120º; omuz abduksiyonu sağda 150º, solda 140º; dirsek ekstansiyonu sağda 180º, solda 175º; el bileği ekstansiyonu sağda 10º, solda 10º'ye yükseldi. Tartışma: Escobar Sendromunda fizyoterapi ve rehabilitasyon uygulamalarının olumlu sonuçlar vereceğini düşünmekteyiz.Purpose: As a rare syndrome, there is limited information about rehabilitation approaches relation to Escobar Syndrome in literature. In this work, a five month old girl baby who has Escobar Syndrome was presented and her clinic characteristics and rehabilitation program were discussed. Material and Methods: She could hold her head but in facedown position she could not stand in balance with her arms. The reason of physiotherapy referral was delay in motor development and prevention of the joints from contracture expecially limited ones. The symptom was evaluated with the Gross Motor Function Measure Test (GMFM). She took 8 points from stay up and rolling test. Goniometric measurement results were as the the following; passive shoulder flexion (R)120&deg;, (L)115&deg; shoulder abduction (R)135&deg;, (L)125&deg;, elbow extension (R)170&deg;, (L)170&deg;, wrist extension (R)0&deg;, (L)0&deg;. The patient was taken to the physiotherapy two days of the week for 9 months. Neurophysiologic approaches were applied to support motor development. Upper extremity stretching exercises and range of motion exercises were the other exercises of the rehabilitation programme. Results: When the baby reached 14 months, she could turn from her back to facedown, she could lift her body on her forearms, she could sit free standing and when she losed her balance she could use her arms. According to GMFT her stay up and rolling point was 30 and sitting was 8 point. Upper extremity goniometrical results: shoulder flexion (R)150&deg;, (L) 140&deg;, elbow extension (R)180&deg;, (L)175&deg;, wrist extension (R)10&deg;, (L)10&deg;. Conclusion: In the direction of those findings, in Escobar Syndrome, physiotherapy and rehabilitation can be effective to cope with the symptoms causing disability