ÖzetAmaç: Bu çalışmanın amacı, Serebral Palsili (SP) çocukların bakıcılarının ev egzersiz programına uyumunu etkileyen faktörleri belirlemektir. Gereç ve Yöntemler: Yüz kırk yedi SP'li çocuğun bakıcısı çalışmaya dahil edildi. Bakıcıların egzersiz programına uyumları bir anket ile belirlendi. Çocukların ve bakıcılarının sosyo-demografik verileri, aile özellikleri, çocukların SP tipi ve Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS) seviyeleri, bakıcıların ruh sağlığı ve tükenmişlik ölçeklerine ait verilerin tümünün bakıcıların uyum durumu ile ilişkili olup olmadığı araştırıldı. Bulgular: Univariate testlerde istatistiksel olarak anlamlı verilerin [çocukların yaşı, ağırlığı, KMFSS seviyesi, bakıcıların yaşı ve Maslach emosyonel tükenme (EE) skoru] egzersiz programına uyumu tahmin gücünü belirlemek için lojistik regresyon modeli ile analiz edildi. Sonuç: Serebral palsili çocukların fonksiyonel limitasyonlarının ciddiyeti bakıcıların ev egzersiz programına uyumlarını arttırırken, bakıcıların tükenmişlikleri uyumu olumsuz etkilemektedir. Bu nedenle bakıcıların sosyal ve medikal olarak desteklenmeleri başarılı ev egzersiz programları için gereklidir. Anahtar Kelimeler: Egzersiz, serebral palsi, bakıcı, ruh sağlığı, tükenmişlik, özbildirim, uyum AbstractObjective: The objective of this study is to determine the factors that affect the adherence to home exercise programs among caregivers of children with cerebral palsy (CP). Methods: The caregivers of 147 children with CP were recruited for the study. The adherence status of the caregivers to an exercise program was assessed by a survey. The sociodemographic data of both children and caregivers; family characteristics, CP type, and Gross Motor Function Classification System (GMFCS) level of the disabled child; and inventories related to mental health and burnout of the caregivers were evaluated to determine whether these data were related with the adherence status or not. Results: Using statistically significant parameters in univariate tests [age, weight, and GMFCS level of the children and age and Maslach emotional exhaustion (EE) score of the caregiver], a logistic regression model was constructed to predict the adherence to exercise programs. GMFCS level and Maslach EE score were statistically significant independent factors that predicted the adherence to home exercise programs. Conclusion: The severity of the functional limitation of children with CP seems to enhance the adherence of caregivers to home exercise programs, while the burnout of caregivers has a negative impact. Caregivers should be supported socially and medically for a successful home exercise program.
Osteoporosis has recently been recognized as a major public health problem by some governments and health care providers. Despite significant progress in knowledge about osteoporosis, public awareness is required for effective management if precautions are to be taken. The aim of this study was to evaluate the educational status of osteoporotic individuals, and their awareness about the disease and sources of information. We also aimed to compare the variables between the geographical regions of the country, since significant differences exist in socioeconomic status and lifestyle within the same cultural context. This multicenter study was carried out in eight cities located in six different geographical regions between September 2001 and January 2002. To our knowledge, this is the first multicenter study in Turkey evaluating the relationship between awareness of osteoporotic patients and other variables such as educational level and economic factors. Ten centers took part in this study and consecutive patients with either femoral or lumbar T-scores below -2.5 SD were enrolled into the study group. Bone mineral density was measured using dual energy X-ray absorptiometry (DXA). Patients were interviewed using a questionnaire on past medical history, education, awareness about their disease and risk factors for osteoporosis. A total of 540 women (93.8%) and 36 men (6.3%) were included in the study. Fifty-four percent of patients declared that they were aware of osteoporosis. With regard to sources of information, 56.8% of patients reported physicians as the main source of information. Awareness of the patients was negatively correlated with age (P=0.025, r=-0,94) but positively correlated with education (P=0.0001, r=0.327), level of physical activity (P=0.001, r=143), calcium intake (P=0.005, r=119) and modern clothing style (P=0.0001, r=309). Educational status of the patients was negatively correlated with BMI (P=0.0001, r=-283) and positively correlated with physical activity (P=0.0001, r=268), modern clothing style (P=0.0001, r=600) and smoking (P=0.0001, r=273). Regional comparison of female patients demonstrated that significant differences exist in terms of educational status, clothing style, smoking, level of physical activity, calcium intake, and knowledge about osteoporosis. As a result, education has profound effects on awareness about osteoporosis and many aspects of human behavior, such as calcium intake, physical activity, clothing style and smoking. Significant disparities may be observed between the geographical regions of the same country.
The improvement in the median somatosensory evoked potentials following botulinum toxin A treatment suggests that central somatosensory patterns in hemiplegia can be modified by peripheral inputs.
This study failed to demonstrate any statistically significant difference in spasticity or in wrist PROM of both the volar and dorsal splint groups. These splints could be recommended as part of an integrative approach without expecting a major clinical effect rather than as an alternative to other treatment.
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