Objectives: Fear of falling is highly prevalent in Parkinson’s disease (PD) and contributes to reduced mobility, activity restriction, and diminished quality of life. The psychometric properties of the Turkish version of the Falls Efficacy Scale–International (FES-I) have not been specifically examined in individuals with PD. This study aimed to evaluate the reliability and construct validity of the Turkish FES-I in this population. Methods: A total of 131 patients with idiopathic PD were consecutively recruited from an outpatient rehabilitation clinic. The FES-I was administered twice with a 10–14-day interval. Internal consistency and test–retest reliability were assessed. Construct validity was examined using exploratory and confirmatory factor analyses, correlational analyses with clinical and functional measures, and known-groups comparisons across modified Hoehn and Yahr stages. Results: No missing data were observed. The mean FES-I total score was 34.0 ± 14.3, with minimal floor (2.3%) and ceiling (1.5%) effects. The scale demonstrated excellent internal consistency with Cronbach’s alpha = 0.976, and high test–retest reliability (ICC = 0.941–0.996). Sampling adequacy was confirmed (KMO = 0.962; Bartlett’s χ²(120) = 2443, p < 0.001). Factor analysis supported a single-factor structure explaining 74.1% of the variance. Higher FES-I scores were significantly associated with greater disease severity, freezing of gait, impaired balance and mobility, and poorer quality of life (p < 0.001). Conclusion: The Turkish FES-I demonstrates strong reliability and construct validity in patients with Parkinson’s disease and may serve as a clinically useful instrument for assessing fear of falling in this population. Keywords: Parkinson Disease, Accidental Falls, Psychometrics, Reproducibility of Results

Objectives:To determine whether the thickness of swallowing-related muscles measured by ultrasonography (US) differs according to dysphagia status in children with cerebral palsy (CP) and to identify muscle-specific associations between US measurements and swallowing symptoms. Methods:In this cross-sectional study, 66 children with CP aged 2-18 years were evaluated at a tertiary outpatient rehabilitation clinic. B-mode US was used to measure the thickness of swallowing-related muscles. Symptom-defined dysphagia was defined as a Pediatric Eating Assessment Tool-10 (Pedi-EAT-10) score of ≥ 4. Muscle thicknesses were compared between children with and without dysphagia. Associations between individual Pedi-EAT-10 items and muscle thickness measurements were explored using Spearman correlation and univariate linear regression analyses. Results:Of the 66 children, 27 (40.9%) met the criteria for dysphagia. US-measured muscle thickness did not differ significantly between children with and without dysphagia for the masseter (0.66 ± 0.12 vs. 0.68 ± 0.10 cm; p = 0.520), genioglossus (0.69 ± 0.15 vs. 0.64 ± 0.13 cm; p = 0.166), geniohyoid (0.60 ± 0.14 vs. 0.64 ± 0.13 cm; p = 0.208), anterior digastric (0.50 ± 0.12 vs. 0.50 ± 0.12 cm; p = 0.887), or mylohyoid muscles (0.15 ± 0.03 vs. 0.15 ± 0.05 cm; p = 0.959). Symptom-level analyses demonstrated inverse associations between selected swallowing complaints and specific muscle measurements, with the strongest association observed between "coughs while eating" and genioglossus thickness. Conclusions:Although swallowing-related muscle thickness did not differ between children with CP with and without dysphagia, US measurements were associated with specific caregiver-reported swallowing complaints. These findings suggest that US may provide complementary, symptom-oriented information in the clinical assessment of swallowing difficulties in children with CP.

Introduction: This retrospective cross-sectional study aimed to investigate the association between serum vitamin D levels and upper and lower extremity muscle thickness and muscle mass in patients with neuromuscular diseases (NMDs), as well as their relationship with nutritional status, handgrip strength, and fatigue.Methods: This retrospective cross-sectional study included 51 patients with a confirmed diagnosis of NMD for at least one year who were hospitalized for neuromuscular rehabilitation between January 2016 and January 2020. Demographic characteristics and laboratory parameters were obtained from medical records. Nutritional status was assessed using the Subjective Global Assessment, muscle strength using a Jamar dynamometer, and fatigue using the Fatigue Severity Scale. Muscle thickness was evaluated by ultrasonography of selected upper and lower extremity muscles on the dominant side.Results: The median serum vitamin D level was 19.82 ng/mL (9.01–39.82), and 62.7% of patients had normal nutritional status. No significant differences were observed among NMD subgroups regarding assessment parameters (p>0.05). Serum vitamin D levels were positively correlated with handgrip strength (r=0.651, p=0.001) and forearm flexor muscle thickness (r=0.693, p=0.001). Regression analysis demonstrated that handgrip strength and forearm flexor muscle thickness were independently associated with serum vitamin D levels. A one-unit increase in handgrip strength was associated with a 0.625-unit increase in serum vitamin D level, while a one-unit increase in forearm flexor muscle thickness was associated with a 1.459-unit increase in serum vitamin D level.Conclusion: In this inpatient NMD cohort, serum 25(OH)D levels were positively associated with handgrip strength and forearm flexor muscle thickness, while no clear associations were observed in other assessed muscle groups. Although causality cannot be inferred from this cross-sectional design, these findings suggest that vitamin D status may be linked to peripheral muscle function and morphology and should be considered when interpreting muscle-related outcomes in neuromuscular rehabilitation settings. Prospective, disease-specific studies with appropriate control groups are warranted.

ObjectiveIndividuals with stroke frequently experience limitations in activities of daily living, and compensation-based approaches have the potential to enhance functional adaptation. This study aimed to develop and evaluate the feasibility and preliminary effects of a novel intervention, Compensation-Based Problem-Solving Therapy (CBPST), on participation and activities of daily living in individuals with stroke.MethodsCBPST was developed by trained occupational therapists, emphasizing in Occupational Adaptation Model and compensatory strategies. The CBPST was delivered individually in five sessions weekly (during four week and approximately 40 min)and including identifying the problem, developing strategies, selecting strategy and implementing and evaluating the selected strategy. Participants were randomly assigned to intervention or control group. This study involved 50 individuals with stroke assigned to either an intervention (n = 24 and mean age 54.58 ± 7.86) or control group (n = 26 and mean age 54.56 ± 7.09). Outcomes were assessed at baseline and immediately post-intervention using the Functional Independence Measure (FIM), Lawton-Brody Instrumental Activities of Daily Living (Lawton-Brody IADL), Frenchay Activity Indeks (FAI) and the Canadian Occupational Performance Measure (COPM). Statistical analyses included Wilcoxon signed-rank, Mann-Whitney U tests and effect sizes.ResultsBoth groups showed significant improvements (p < 0.05) in participation and activities of daily living. Effect size estimates in the intervention group indicated moderate to large clinical effects across outcome measures (COPM performance and satisfaction: 0.62; FIM: 0.62; Lawton-Brody IADL: 0.53; FAI: 0.55), supporting the preliminary efficacy of CBPST.ConclusionCBPST appears to be a feasible and promising approach to enhance adaptive participation after stroke by integrating problem-solving and compensatory strategies. Larger studies are warranted to confirm its clinical effectiveness.

This study aimed to examine factors associated with self-efficacy in individuals with stroke within a multidimensional framework. A total of 152 individuals with stroke were included in this cross-sectional observational study. Self-efficacy was assessed using the Daily Living Self-Efficacy Scale, functional independence using the Functional Independence Measure, participation using the Frenchay Activity Index, and fatigue using the Fatigue Severity Scale. Demographic and clinical data were also collected. Bivariate correlations and theory-driven hierarchical multiple linear regression analyses were conducted. The final model explained 46.9% of the variance in self-efficacy. Sex, education level, fatigue severity, and functional independence were identified as the factors most closely associated with self-efficacy, while age, stroke duration, employment status, and participation were not independently associated with self-efficacy in the final model. These findings indicate that self-efficacy after stroke is particularly related to functional independence and fatigue, while also reflecting the role of contextual characteristics such as sex and education. Addressing these factors may help guide rehabilitation approaches aimed at supporting self-efficacy in individuals with stroke.

:Neuromuscular diseases (NMDs) are a heterogeneous group of diseases including motor neurone diseases (MND), muscle diseases (MD), neuropathies and neuromuscular junction diseases (NMJD). NMDs are characterized by a wide range of symptoms and findings, depending on different underlying issues. Therefore, the literature includes specific management and/or rehabilitation recommendations for each subgroup and even for some diseases within these subgroups. Currently, neither in our country nor globally is there a comprehensive recommendation study that thoroughly addresses all aspects of NMD rehabilitation developed by experienced and specialized multidisciplinary experts in the field. The recommendations in this paper have been created by a multidisciplinary team for all patients without age limitation under the headings of peripheral neuropathy/polyneuropathy, MND, MD and NMJD using the seven-step and 3 round modified Delphi method via e-mail. The strength of agreements (SOA) was calculated for each item (recommendation) using percentages (response of between 8 and 10

The Executive Function Performance Test (EFPT) is a performance-based test designed to assess parameters of executive function in instrumental activities of daily living. This study aimed to examine the validity and reliability of the Turkish EFPT in people with stroke. The present study was carried out on 72 individuals with stroke (32 female, 40 male) undergoing inpatient care at Etlik City Hospital. Analyses of internal consistency, inter-rater reliability, and convergent and divergent validity were carried out. The mean age of the participants was 62.81 ± 12.33 years and the mean time since stroke was 19.96 ± 39.81 months. According to the reliability analysis, the Cronbach's alpha level of the Turkish EFPT was found to be excellent (0.92). The inter-rater reliability analysis showed a very good agreement (0.99). A significant and high correlation was found between the MMSE (r = -0.732; p < .001) and Turkish EFPT in convergent validity analysis. In divergent validity analysis, significant but weaker correlations were found between the Turkish EFPT and the FIM (r = -0.499; p < .001) and SIS (r = -0.381; p < .031). This study may provide preliminary evidence for the validity and reliability of the Turkish EFPT in individuals with stroke. The EFPT appears to be able to facilitate effective assessment of executive function in stroke rehabilitation, to help determine the level of assistance required for functional activities, and to assist in planning suitable interventions.

Introduction: Neuromuscular diseases (NMDs) have a substantial burden on patients, their caregivers, and healthcare systems. The level of knowledge of Physical Medicine and Rehabilitation (PMR) specialists about NMD is of great importance for these patient groups. This study aimed to measure the level of knowledge and expectation of PMR specialists about NMD. Methods: We conducted a national, population-based, cross-sectional survey of PMR specialists caring for persons with NMD. An experience-based survey had three themes: clinician facing NMD, clinician’s NMD knowledge, and clinician’s expectations. Results: Of the 198 PMR specialists included in the study. Among the NMD subgroup diseases, Duchenne Muscular dystrophy was the most well-known disease (n=179, 90.4%), followed by Myasthenia Gravis (n=174, 87.9%) and Amyotrophic Lateral Sclerosis (ALS) (n=162, 81.8%). The subgroup with the least awareness was diabetic polyneuropathy (n=61, 30.8%). While most of the participants (n=192, 97%) thought that rehabilitation programs could be effective in NMD, almost half of them (n=83, 41.9%) thought that stretching and strengthening exercises were harmful. Conclusion: Despite the high potential and thousands of patients who might benefit, NMD rehabilitation awareness is inadequate among PMR specialists. Improving PMR specialists' knowledge of NMD may contribute to patient outcomes. We recommend future studies investigating patient outcomes based on increased PMR knowledge following educational interventions.

Dysphagia is a complication that may occur after thyroidectomy or other head and neck surgeries. This complaint is usually associated with inferior and superior laryngeal nerve dysfunction, but it can also occur without nerve damage. The aim of this study is to evaluate the frequency, severity, and clinical course of dysphagia developing in the early and late periods after thyroid and parathyroid surgeries, to determine its effects on patients’ postoperative quality of life, and to contribute to optimal management strategies. Between January 2016 and September 2017, a total of 76 patients were prospectively evaluated: 25 who underwent parathyroidectomy (Group 1), 26 who underwent total thyroidectomy with central neck dissection (Group 2), and 25 who underwent total thyroidectomy without central neck dissection (Group 3). Swallowing function and postoperative quality of life were assessed using fiberoptic endoscopic evaluation of swallowing (FEES), the Swallowing Quality of Life questionnaire (Swal-QoL), and the Eating Assessment Tool (EAT-10), applied preoperatively, at postoperative week 1 (early postoperative period, EPO), and at week 8 (late postoperative period, LPO). Early postoperative swallowing changes were observed in 16

Background/aim:The child oral and motor proficiency scale (ChOMPS) is a parent-reported assessment that evaluates a child's eating and drinking skills within the framework of all related motor functions. It has been found to be useful in research studies and recommended in reviews. The purpose of this study was to perform the translation and cultural adaptation of the English version of the ChOMPS to Turkish and conduct psychometric testing of the ChOMPS-Turkish version, including reliability and validity. Materials and methods:This study was conducted with 185 children. Cronbach's α, corrected item-to-total correlations, coefficient of variation, and Cronbach's α when one item was deleted were used to assess internal consistency. In addition, test-retest reliability was assessed. The functional oral intake scale (FOIS) and pediatric eating assessment tool-10 (Pedi-EAT-10) scales were used for convergent validity. Moreover, Pedi-EAT-10 score was used to perform the receiver operating characteristic (ROC) curve analysis and the sensitivity and specificity of ChOMPS-Turkish version were calculated. Results:It was found that the ChOMPS-Turkish version demonstrated acceptable validity and reliability. Cronbach's α levels were excellent (0.969 and 0.973), and test-retest reliability demonstrated very high agreement (0.997-0.999; p < 0.001). Significant good-to-excellent correlations were found between the validation scales. In addition, the total ChOMPS-Turkish version score for dysphagia risk as estimated using Pedi-EAT-10 had 94.74% sensitivity and 80.28% specificity. Conclusion:The ChOMPS-Turkish version demonstrates strong evidence of validity and reliability for use in clinical practice and research.

Karaahmet, Özgür Zeliha MD; Ayhan, Egemen MD; Tombak Yıldızkan, Yasemin MD; Umay, Ebru MD Author Information

PURPOSE:Regaining gait is the primary goal in stroke rehabilitation. In this study, we aimed to investigate the effect of premorbid features of acute stroke patients on the ambulatory level. METHODS:The study included 174 patients who applied to our rehabilitation clinic within the first month after the onset of stroke. Demographic characteristics of patients, pre-stroke symptoms, and stroke characteristics were questioned from patient files and historical data. The ambulation levels of patients before and after rehabilitation were evaluated with the functional ambulation category. The relationship between demographic characteristics, pre-stroke symptoms, stroke characteristics, and ambulation levels of patients before and after rehabilitation was examined. RESULTS:The presence of coronary heart diseases, atrial fibrillation, and nausea/vomiting before stroke were independent negative risk factors on both pre- and post-rehabilitation ambulation levels (P < 0.05). Additionally, advanced age, oxygen, and mechanical ventilation requirement were other negative independent risk factors on post-rehabilitation ambulation levels (P < 0.05). CONCLUSIONS:Knowing some of the pre-stroke characteristics of patients while applying rehabilitation programs may be useful in estimating the ambulatory levels on returning home.

Abstract Background Regular exercise is essential in the treatment of Ankylosing Spondylitis (AS), as the main goals of the treatment are to reduce pain, restore function, avoid disability and structural deterioration, and improve quality of life (QoL). The purpose of this study is to ascertain whether patients adhere to exercise recommendations and to evaluate the effects of consistent exercise on patients' pain, function, disease activity, mood, and quality of life. Many studies emphasize the need for exercise in treatment of AS, but none reveal whether patients follow prescribed practices and the results of doing so. Results Exercising group had significantly decreased pain, erythrocyte sedimentation rate and Bath ankylosing spondylitis functional index and Bath ankylosing spondylitis disease activity index (BASDAI) scores (p < 0.05). There was no significant difference between the two groups in morning stiffness, mood, spinal mobility, and QoL parameters (p > 0.05). Regular exercise was positively correlated with physiotherapy history. Regression analysis revealed that with an increase of 1 unit in visual analog scale and BASDAI, regular exercise decreased by 0.087 and 0.116 units, respectively. Conclusion Our study revealed how much the patients considers and follows the recommended exercises and concluded that regular exercise habits should be developed since they offer promising effects in treatment of AS, hence, patients should be educated in this area, and particular exercise routines should be developed to encourage them to exercise.

This study aimed to evaluate whether the Pediatric Dysphagia Risk Screening Instrument (PDRSI) was a suitable test for children with cerebral palsy (CP) and assess the instrument’s Turkish validity and reliability. One-hundred twenty-six children with CP participated in this study. “Cronbach’s alpha (ɑ),” “Cronbach’s ɑ when one item is deleted,” “inter-item correlation,” and “corrected item-to-total correlation” were used to assess internal consistency. In addition, inter-rater agreement tests (Cohen’s kappa coefficient) were conducted for reliability. Construct validity was used to assess the validity. Moreover, flexible fiberoptic endoscopic evaluation of the swallowing method was used to describe the receiver operating characteristic curve analysis and calculate the sensitivity and specificity of T-PDRSI. It was found that the PDRSI had adequate validity and reliability. The PDRSI can be used in children with CP as a valid and reliable instrument with high sensitivity and specificity.

Aim: Breast cancer patients who get certain chemotherapeutic agents are more likely to experience early menopause and to suffer osteoporotic fractures at a younger age. This study investigated the impact of breast cancer history on bone mineral density (BMD) levels in postmenopausal osteoporosis (OP) treatment. Materials and Methods: This is a retrospective case-control study analyzed 65 female cases diagnosed with OP, including 32 patients with stable breast cancer who had undergone chemotherapy and/or radiotherapy but not within the last 5 years, and 33 matched controls. Demographic characteristics, total lumbar and femoral neck BMD levels and biochemical parameters were recorded for both groups. Results: Before treatment, femoral neck T-score and serum Ca levels were lower in the patient group than in the control group (p=0.038, p=0.007, respectively). There was no difference between groups for the first year (p>0.05), but when the change within a group was examined, only the patient group showed a significant increase in femoral neck T-score and serum Ca levels (p=0.027, p=0.001, respectively). Patients who received radiotherapy had lower femoral neck BMD levels before and after treatment than those who did not receive radiotherapy (p=0.021, p=0.024, respectively), and the post-treatment recovery was not different (p>0.05). Conclusion: This study demonstrated the success of osteoporosis treatment in patients with a previous diagnosis of breast cancer. Patients with breast cancer must be screened for osteoporosis and treated accordingly.

Lupus induced by a tumor necrosis factor-alpha inhibitor, namely "Anti-TNF-α-Induced Lupus (ATIL)" is commonly seen in patients with Crohn's disease and Rheumatoid Arthritis; however, it is rarely seen in axial spondyloarthropathy (SpA).Here, four cases of ATIL in patients with axial SpA are presented and discussed in the light of literature data.The files of the patients who used anti-TNF-α drugs regularly for at least one year due to axial SpA were reviewed retrospectively, and four patients with ATIL were analysed.ATIL developed while the first case was using Adalimumab for 6 years, the second was using Infliximab for 5 years, the third was using Infliximab for 7 years, and the fourth was using Adalimumab for 16 years.In all cases, antinuclear antibodies (ANA) and antidouble stranded DNA (anti-dsDNA) values were positive, while none of the cases had hypocomplemen temia.ATIL symptoms were acute mesenteric thrombosis, fever and pleuritis in the first case, arthritis in the small joints of the hand i n the second case, deep vein thrombosis, fever, pleuritis and peritoneal fluid accumulation in the third case and malar rash in the fourth one.Anti-TNF-α medication was discontinued in all patients and prednisolone was started.Only in the third case was the switch to another anti-TNF-α agent.Although anti-TNF-α is an effective and common treatment option in patients wi th SpA, these patients should be carefully monitored for side effects such as ATIL.

ÖZET Amaç: Polimiyaljiya romatika (PMR), omuz ve kalça kuşağında ağrı ile karakterize romatizmal bir hastalıktır.Mevcut çalışmamızın amacı, PMR ile ilgili YouTube'da en çok izlenen videoların güvenirlik ve kalitesini araştırmaktır.Gereç ve Yöntemler: Videoları aramak amacıyla "polimiyalgia romatica" anahtar kelimesi kullanıldı.Arama sonuçlarına göre