The Effects of Combined Virtual Reality Exercises and Robot Assisted Gait Training on Cognitive Functions, Daily Living Activities, and Quality of Life in High Functioning Individuals With Subacute Stroke

Stroke is a global health concern causing significant mortality. Survivors face physical, cognitive, and emotional challenges, affecting their life satisfaction and social participation. Robot-assisted gait training with virtual reality, like Lokomat, is a promising rehabilitation tool. We investigated its impact on cognitive status, activities of daily living, and quality of life in individuals with stroke. Between September 2022 and August 2023, we exposed 34 first stroke patients (8 women, 26 men; M age = 59.15, SD = 11.09; M height = 170.47, SD = 8.13 cm; M weight = 75.97; SD = 10.87 kg; M days since stroke = 70.44, SD = 33.65) in the subacute stage (3-6 months post-stroke) to Lokomat exercise. Participant exclusion criteria were Lokamat exercise inability, disabilities incompatible with intended measurements, and any cognitive limitations. The Control Group (CG) received conventional physiotherapy, while the Lokomat Group (LG) received both conventional physiotherapy and robot-assisted gait training with virtual reality, administered by an occupational therapist. Evaluations were conducted by a physiotherapist who was unaware of the participants' group assignments and included assessments with the Montreal Cognitive Assessment, Lawton Brody Instrumental Activities of Daily Living Scale, and Stroke Specific Quality of Life Scale (SS-QoL). Both groups demonstrated an improved quality of life, but the LG outperformed the CG with regard to SS-QoL (p = .01) on measures of Energy (p = .002) and Mobility (p = .005). Both groups showed improvements in cognitive functioning (p < .001) with no between-group difference, and in activities of daily living (p < .05) for which the LG was superior to the CG (p = .023). Thus, adding robot-assisted gait training with Lokomat and virtual reality improved self-reported quality of life and daily activities at levels beyond conventional physiotherapy for patients in the subacute stroke phase. An incremental impact on cognitive functions was not evident, possibly due to rapid cognitive recovery or this was undetected by limited cognitive testing.

Cross-Cultural Adaptation, Reliability, and Validity of the Turkish Sensory Responsiveness Questionnaire

IMPORTANCE

Sensory processing difficulties are commonly seen in people with mental disorders. However, no questionnaires specific to Turkish culture are available for people with mental disorders.

OBJECTIVE

To examine the cultural adaptation, reliability, and validity of the Turkish Sensory Responsiveness Questionnaire (SRQ).

DESIGN

Causal comparative groups design.

SETTING

Homes, clinics, hospitals, and therapy practices in Turkey.

PARTICIPANTS

A total of 913 participants, of whom 529 were participants ages 18-60 yr with mental disorders.

OUTCOMES AND MEASURES

The cross-cultural adaptation and translation procedures were conducted following Beaton's guidelines. Internal consistency was examined with Cronbach's α. Criterion-related validity of the SRQ was determined with the Adolescent/Adult Sensory Profile using construct validity and was examined by confirmatory factor analysis (CFA) using IBM SPSS Statistics (Version 23) and AMOS (Version 24.0).

RESULTS

In CFA, model fit indices showed an acceptable fit. Test-retest reliability was excellent for the hedonic and avoidance subfactor scores and for the total score (intraclass correlation coefficients = .973, .988, and .974, respectively). Internal consistency was high for the hedonic subfactor (.812) and the avoidance subfactor (.815). Participants with bipolar disorder had the highest scores on the hedonic subfactor, whereas those with schizophrenia had the highest scores on the avoidance subfactor.

CONCLUSIONS AND RELEVANCE

The 36-item SRQ is reliable and valid for analyzing the sensory processing abilities of adults in the Turkish population. Plain-Language Summary: People with mental disorders commonly have difficulties with sensory processing. No sensory responsiveness questionnaire specific to the Turkish population or culture is available for people with mental disorders. This study shows that the current form of the Turkish Sensory Responsiveness Questionnaire can contribute to understanding the sensory processing abilities of Turkish people with and without mental disorders.

The Resilience Scale for Parents of Children with Cancer: Scale development and psychometric evaluation

OBJECTIVE

This study aimed to develop a Resilience Scale for Parents of Children with Cancer (RSP-CC) designed specifically for parents of children with cancer and to evaluate its psychometric properties.

METHODS

Based on the Resilience Model for Families of Children with Cancer, items were created after an extensive literature review and evaluated through expert consultation and a pilot study. Psychometric evaluation was conducted with the parents of 601 children with cancer in the pediatric hematology oncology services of different hospitals in the Ankara and Kayseri provinces in Turkey.

RESULTS

A 4-factor structure was illustrated by exploratory factor analysis and confirmed by confirmatory factor analysis, explaining 62.192% of the total variance. In the reliability analysis of the scale, Interclass correlation = 0.993 and Cronbach's alpha = 0.994 were found for the scale. Robust correlation coefficients were found between test-retest, and the correlation between the two measurements was statistically significant (r = 0.990; p ˂ 0.001). As a result, the validity of a 24-item scale structure consisting of 4 dimensions was validated.

CONCLUSIONS

It may be said that the RSP-CC meets the necessary criteria to examine the resilience in parents of children aged 0-18 with a cancer diagnosis, and its psychometric properties are reasonable sufficient.

Translation, Psychometric and Concept Analysis of the Occupational Balance-Questionnaire Based on a Turkish Population

Occupational balance is a crucial concept in occupational therapy, accepted as a key component of health and well-being. The Occupational Balance-Questionnaire (OB-Quest) is designed as a standardized instrument to assess occupational balance. This study investigated the validity and reliability of the OB-Quest Turkish, which consisted of translation, cross-cultural adaptation, and analysis psychometric properties phases. The factor structure of the OB-Quest indicated a good model fit. The criterion-related validity showed a positive correlation with Beck Depression Inventory and a negative correlation with the 12-item Short Form Survey. The OB-Quest-Turkish showed questionable internal consistency and an excellent correlation between test-retest.Supplemental data for this article is available online at https://doi.org/10.1080/07380577.2021.2010160 .

Investigation of the relationship between feeding problems and cognitive functions in premature children

Children with a history of premature birth may show various problems in feeding, and these problems may continue at school age. It is necessary to examine the role of cognitive functions in children's feeding with more detailed studies.Comparison of feeding problems and cognitive functions of premature and full-term children and examining the relationship between them. The parents of 60 children aged 6-10 completed the The Screening Tool of Feeding Problems, and the cognitive functions of the children were evaluated with the Dynamic Occupational Therapy Cognitive Assessment. Results are compared and correlations betweeen feeding problems and cognitive functions were examıned. Feeding problems of premature children are statistically higher than those born at term; their cognitive functions were statistically weaker (p < 0.001). It was found that feeding problems and cognitive functions were statistically related in premature children (p < 0.05). Feeding problems seen in premature children may be related to their weaker cognitive functions compared to their peers. It is important to evaluate cognitive functions and include them in the intervention in rehabilitation programs to be prepared for premature children with feeding problems.

How Has the Occupational Performance and Participation Levels of Children with Cancer Changed during the COVID-19 Pandemic?

Aim: To examine how the occupational performance (OP) and participation levels of children with cancer changed during the COVID-19 pandemic.Methods: Sixty-seven children with cancer (aged 6-12 years) completed the Canadian Occupational Performance Measure by giving information about their OP and participation, and their parents completed the Child and Adolescent Scale of Participation via online interview techniques. Evaluations were repeated twice in April and September 2020 to determine the change in OP and participation levels of children with cancer due to the COVID-19.Results: OP of children with cancer decreased significantly (Z=-7.02, p < 0.001) during the pandemic period. The home participation of these children did not change significantly (Z=-0.98, p = 0.32) before and during the pandemic; and was limited in both periods. Community participation decreased significantly (Z=-4.84, p < 0.001) from limited level to very limited level.Conclusions: Findings emphasize the need to increase the levels of OP and participation levels of children with various types of cancer due to the ramifications of the COVID-19 pandemic.

Telehealth in paediatric occupational therapy: a scoping review

Background/Aims

This study reviewed the use of telehealth in paediatric occupational therapy practice and its clinical outcomes over the past 20 years.

Methods

A scoping review following Arksey and O'Malley's five stages was undertaken using six databases and Google Scholar. The scoping review covered articles from January 2000 to April 2020.

Results

A total of 22 articles were reviewed. Most studies indicated positive outcomes of using telehealth in paediatric occupational therapy practice. Although there is insufficient evidence, the results indicated that telehealth can be more effective than face-to-face interventions when there are mobility or travel challenges for children.

Conclusions

The use of telehealth in paediatric occupational therapy is an alternative service delivery model, facilitating access for children and their families to the rehabilitation services. Further research is needed to address the difficulties and potential solutions to expand the use of telehealth services to help children with disadvantages alongside their families.

The relationship between the sensory processing and occupational motor skills of children with autism spectrum disorder

Background/Aims

Motor skills difficulties may affect participation and communication in children with autism. Sensory processing problems are well-known problems in children with autism, so sensory processing could be important to predicate motor skills. The aim of this study was to examine the relationship between sensory processing and occupational motor skills and the ability to predict motor skill performances using sensory abilities.

Methods

A total of 31 children with autism participated in the study. The Sensory Profile questionnaire and Short Child Occupational Profile tool were used to assess the sensory ability and occupational motor skills of the children (boys=90.3%; mean age=5.45 years ± 1.73 years). The backward method of correlation coefficient analysis, multiple linear regression analysis, and multiple regressions were used for statistical analysis.

Results

There was a significant relationship between occupational motor skills and sensory processing capabilities of children. The regression prediction equation was statistically significant in all sections of sensory processing except for oral processing (F (6.24)=4.46, P=0.004), with a value of R2=0.527 and R2Adj=0.409. Modelling motor skills based on sensory processing capabilities of children showed that the regression prediction equation was statistically significant (F (2.28) =11.87, P<0.001); with the value of R2=0.459 and R2Adj=0.420. In the final model, the factors of auditory processing and multi-sensory were found effective in children's motor skills (P<0.05).

Conclusions

Sensory processing is related to occupational motor skills and can help to predict occupational motor skill issues of children with autism spectrum disorder. This could be helpful to develop appropriate treatments to improve the functional motor skills of children with autism.

Quality of life and occupational performance of children with cancer in the era of the COVID-19 pandemic in terms of rehabilitation

PURPOSE

This study was designed to determine the changes in the quality of life (QOL) and occupational performance of children with cancer and to examine their rehabilitation needs during the pandemic period in Turkey.

METHODS

60 children with cancer and their families participated in the study. The first and second assessments were carried out in April and September 2020, respectively. The pediatric quality of life inventory parent proxy-report was used to evaluate the QOL, and the Canadian occupational performance measurement was used to evaluate children's occupational performance and satisfaction. A qualitative interview was planned to determine the impact of the pandemic on children with cancer alongside their families and therefore determining the rehabilitation needs of the children.

RESULTS

While there is no statistically significant change in the pain-related conditions of the children in the first six months of the pandemic (p > 0.05), procedural and treatment anxieties of the children increased during the treatment. Their QOL including cognitive state, perceived physical appearance and communication skills also showed a statistically significant decrease (p < 0.05). Both the occupational performance and satisfaction scores decreased significantly, covering the pre-pandemic and pandemic era (p < 0.01). In the qualitative interview parents expressed their children's need for physical, psychological and social participation support. Also, they emphasized the need for time management.

CONCLUSIONS

During the COVID-19 pandemic, the QOL and occupational performance level of children with cancer decreased significantly. Holistic rehabilitation approaches complying with pandemic conditions are likely to benefit these children.

Effectiveness of a task-oriented training on occupational performance, functional independence, and fatigue in children with childhood cancer: a randomized-controlled trial

Abstract Objective The objective of the study is to explore the effectiveness of task-oriented training (TOT) on occupational performance, functional independence, and fatigue of children with cancer. Method Two hundred and thirteen children (101 females, 112 males) with cancer were randomized to experimental (n = 112; 9.53±2.23 years) or control (n = 101; 7.93±1.98 years) groups. The experimental group received a TOT together with a conventional occupational therapy (COT), while the control group received only a COT. Both groups received 20 sessions of therapy. The outcomes regarding occupational performance via the Canadian Occupational Performance Measure, functional independence via the Functional Independence Measure for Children and fatigue via the Visual Analog Scale were evaluated by the blind evaluators before and after the interventions in the hospital setting. Results The occupational performance and satisfaction (p<0.001) scores showed statistically significant differences in the experimental group compared to the control group (p<0.01). A statistically significant improvement was determined in functional independence for both groups (p< 0.001). The experimental group indicated a significant reduction in fatigue (p values for fatigue before, during, after activity, morning and evening: p< 0.001) and in the control group (P values for fatigue all situation: p< 0.05). Conclusion The TOT seems to ensure more beneficial effects in increasing occupational performance, improving functional independence in daily activities, and decreasing fatigue at the early phases of inpatient treatment of childhood cancer.

Sensory profile, ferritin and zinc levels in preschool-aged children with symptoms of attention deficit hyperactivity disorder

BACKGROUND

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders and has a big impact on the well-being of children. The disorder can lead to noticeable functional limitations for children and bio-ecological factors also contribute to symptoms of ADHD. We aimed to investigate the associations between ADHD symptoms and some related bio-ecological factors including serum ferritin, zinc levels and sensory processing in preschool-aged children.

METHODS

Twenty-two children who had been referred to the division of Developmental Pediatrics because of ADHD symptoms and 22 participants from the general pediatric outpatient clinics were included in the study. The symptoms of ADHD were evaluated with Conners` Parent Rating Scale-Revised Short form. Complete blood count, serum ferritin and zinc levels were also evaluated. A blind occupational therapist implemented sensory processing measurements. The characteristics of each participant such as prematurity, perinatal complications, developmental practices and sociodemographic data were also considered.

RESULTS

Sensory processing measurement analysis revealed that all Sensory Profile scores were significantly lower in the children with ADHD symptoms compared to the control group indicating that the child shows the behavior more than desired. The low level of zinc (p=0.026, OR=6.153, 95% CI= 1.247-30.362) and the presence of perinatal complications (p=0.045, OR=10.864, 95% CI=1.059-111.499) increased the risk of ADHD symptoms. We could not find an association for ferritin levels in our study.

CONCLUSIONS

The evaluation of zinc level and sensory profile parallel to other strategies can be recommended during the management of ADHD symptoms in preschool children.

Cognitive functions of children with brain tumor in the treatment process

Introduction

This study assesses the cognitive functions of children with brain tumor, including orientation, spatial perception, praxis, visuomotor constructions and thinking operations. The aim of the study was to assess the cognitive functions of children with brain tumor in the treatment process and the effects of different treatments on cognitive functionality.

Method

Cognitive functions of children with brain tumor ( n = 102) and children with typical development ( n = 90) were assessed with the Dynamic Occupational Therapy Assessment for Children. Children with brain tumor were divided into four subgroups according to the treatment they received. Multiple comparisons were analyzed using the Kruskal–Wallis test and binary comparisons were analyzed using the Mann–Whitney U test.

Results

Cognitive functions of children with brain tumor were weaker than children with typical development. Children who received chemotherapy, radiotherapy, surgery and both chemotherapy and radiotherapy had weaker cognitive functions.

Conclusions

Children with brain tumor whose treatment process is continuing are cognitively affected and their occupational performance in daily living tasks is weakened. In these children, cognitive- and occupation-based early intervention approaches should be developed and implemented. Especially when children start receiving radiotherapy, it may also be useful to start cognitive occupational therapy programs simultaneously for preserving children’s cognitive functionality.

Relationships between executive functions and occupational performance of children with medulloblastoma

Introduction

This study examines executive functions and occupational performances of children with medulloblastoma and children with typical development. The aim was to compare the executive function and occupational performance levels of children with medulloblastoma and children with typical development and to investigate the relationship between the executive function and occupational performance levels of children with medulloblastoma.

Method

Parents of 105 children (6–12 years) completed the Childhood Executive Function Inventory. A total of 105 children were administered the Canadian Occupational Performance Measurement to obtain information on occupational performance areas. Executive functions and occupational performance levels of children with medulloblastoma ( n = 52) and typical development ( n = 53) were compared. Correlation analysis was conducted between the executive functions and occupational performances of children with medulloblastoma.

Results

Executive function and occupational performance levels of children with medulloblastoma were lower than those with typical development. Significant relationships were found between the executive functions and occupational performances of children with medulloblastoma ( p < 0.05, p < 0.001).

Conclusion

It is clear that the executive functions of children with medulloblastoma significantly affect their occupational performance level. Client-centered, occupation-oriented cognitive therapy interventions prepared according to occupational therapy theories and models might be useful to increase the occupational performance level of children with medulloblastoma.

Investigation of the Relationship Between Sensory Processing and Motor Development in Preterm Infants

OBJECTIVE

The aim of this study was to analyze the correlation between sensory processing and motor development in preterm infants.

METHOD

We included 30 preterm and 30 term infants with corrected and chronological ages between 10 and 12 mo. We used the Test of Sensory Functions in Infants to evaluate sensory processing and the Alberta Infant Motor Scale to evaluate motor development.

RESULTS

The Spearman correlation test indicated a strong positive relationship between sensory processing and motor development in preterm infants (r = .63, p < .001).

CONCLUSION

Given the relationship between sensory processing and motor development in the preterm group, the evaluation of sensory processing and motor development in preterm infants was considered necessary for the effective implementation of physiotherapy assessment and interventions.

The Effect of Sensory Integration Therapy on Occupational Performance in Children With Autism

Sensory processing problems and related dysfunctions are among the most common conditions in children with autism spectrum disorder (ASD). This study examined the effect of sensory integration therapy (SIT) on different aspects of occupational performance in children with ASD. The study was conducted on an intervention group ( n = 16) receiving SIT and a control group ( n = 15) with 3- to 8-year-old children with ASD. The Short Child Occupational Profile (SCOPE) was used to compare the two groups in terms of the changes in their occupational performance and the Sensory Profile (SP) was used to assess sensory problems. The intervention group showed significantly greater improvement in all the SCOPE domains, as well as in all the SP domains, except for the "emotional reactions" and "emotional/social responses" domains, ( p < .05). The effectiveness of SIT in improving occupational performance in children with ASD as a health-related factor is supported by our findings.

Turkish version of body attitude test: Its reliability and validity

Introduction

Breast cancer (BC) may cause problems on body perception and awareness which can be perceived as a threat on body attitude among women with breast cancer.

Objectives

The Body Attitude Test (BAT) assesses subjective attitude toward women's own body.

Aim

The aim of the present study was to develop the Turkish version of the BAT and examine its reliability and validity.

Methods

The study group (SD) consisted of 72 women diagnosed with BC while 100 healthy women (HW). The women evaluated by BAT, Eating Disorder Inventory (EDI) and Self Esteem Inventory (SEI) in 7–10 days intervals. Internal consistency was determined with Cronbach's alpha coefficient. Factor analysis was conducted on BAT ratings given by control group.

Results

The mean age was 43.7 ± 8.76 of women with BC while 46.4 ± 10.84 in HW. Mean duration of cancer was 2.4 ± 0.7 years. Factor analysis showed BAT was composed of two factors as body dissatisfaction and lack of familiarity with one's body. The BAT demonstrates satisfactory level of internal reliability (α = 0.932). BAT was related with EDI subscales: drive for thinness (r = 0.741, P < 0.001), ineffectiveness (r = 0.736, P < 0.001) and body dissatisfaction (P = 0.718, P < 0.001) and SEI subscale: familial self-esteem (r = -0.629, P < 0.001).

Conclusion

The results support the validity and reliability of BAT which is able to differentiate the clinical and non-clinical form of subjective attitude toward women's own body. Turkish version of BAT could be used as an appropriate measure for assessing subjective attitude towards own body in women with and without breast cancer in Turkey.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Investigation of hand function among children diagnosed with autism spectrum disorder with upper extremity trauma history

BACKGROUND

The present study was designed to compare hand function in autistic children with history of upper extremity trauma with that of autistic children those who do not have history of trauma.

METHODS

The study group included total of 65 children diagnosed with autism spectrum disorder (ASD) and was divided into 2 groups: children with trauma history (Group I) and control group (Group II) (Group I: n=28; Group II: n=37). Hand function was evaluated with 9-Hole Peg Test and Jebsen Hand Function Test. Somatosensory function was evaluated using somatosensory subtests of Sensory Integration and Praxis Test. Results were analyzed with Student's t-test and Mann-Whitney U test using SPSS version 20 software.

RESULTS

Hand function and somatosensory perception test scores were statistically significantly better in children without upper extremity trauma history (p<0.05). When association between hand function tests and upper extremity somatosensory perception tests was taken into account, statistically significant correlations were found between all parameters of hand function tests and Manual Form Perception and Localization of Tactile Stimuli Test results (p<0.05).

CONCLUSION

Autistic children with upper extremity trauma history had poor somatosensory perception and hand function. It is important to raise awareness among emergency service staff and inform them about strong relationship between somatosensory perception, hand function, and upper extremity trauma in children with ASD in order to develop appropriate rehabilitation process and prevent further trauma.

BURNOUT AND OCCUPATIONAL PARTICIPATION AMONG TURKISH DENTAL STUDENTS

The aim of the present study was to investigate the prevalence of burnout and occupational participation limitation among dental students in a dental school in Turkey. Four hundred fifty-eight dental students (females=153; males=305) were included in the study. The age range varied from 17-to-38 years. Maslach Burnout Inventory-Student Version (MBI-SV) and Canadian Occupational Performance Measure (COPM) were used to gather data. Descriptive analyses, t-test, and Kruskall-Wallis test for independent groups were used for data analyses. The results indicated that 26% of all the students have burnout in terms of emotional exhaustion (25%), cynicism (18%), and academic efficacy (14%). The results showed that burnout is statistically significant in relation to demographics (p<0.05). Twenty-four percent of the students showed considerably decreased occupational performance and satisfaction scores, which suggested occupational participation limitations. Occupational performance and satisfaction scores were inversely correlated with emotional exhaustion and cynicism, while directly correlated with reduced academic efficacy (p<0.05). The results of the present study indicates that burnout and occupational participation limitation can be seen among dental students. Students with burnout may also have occupational participation limitation. Enriching dental education programs with different psychological strategies may be useful for education of healthy dentists and improve the quality of oral and dental health services.

Effects of occupational therapy on quality of life of patients with metastatic prostate cancer. A randomized controlled study

OBJECTIVES

To evaluate the efficiency of occupational therapy relative to a home program in improving quality of life (QoL) among men who were treated for metastatic prostate cancer (MPC).

METHODS

Fifty-five men were assigned randomly to either the 12-week cognitive behavioral therapy based occupational therapy (OT-CBSM) intervention (treatment group) or a home program (control group) between March 2012 and August 2014 in the Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey. The Canadian Occupational Performance Measure (COPM) was used to measure the occupational performance and identify difficulties in daily living activities. The QoL and symptom status were measured by The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 and its Prostate Cancer Module. A 12-week OT-CBSM intervention including client-centered training of daily living activities, recreational group activities, and cognitive behavioral stress management intervention were applied.

RESULTS

The COPM performance and satisfaction scores, which indicate occupational participation and QoL increased statistically in the treatment group in relation to men who were included in the home-program (p less than or equal to 0.05).

CONCLUSION

A 12-week OT-CBSM intervention was effective in improving QoL in men treated for MPC, and these changes were associated significantly with occupational performance.

DEVELOPMENT OF A TURKISH VERSION OF THE SENSORY PROFILE: TRANSLATION, CROSS-CULTURAL ADAPTATION, AND PSYCHOMETRIC VALIDATION

The purpose of this study was to translate and culturally adapt the Sensory Profile (SP), which is used to measure sensory processing abilities of children ages of 3-10 years, and test its reliability and validity for use with Turkish children with autism. A cross-cultural adaptation process was carried out by bilingual experts, following typical guidelines. The test-retest reliability, internal consistency, and construct validity studies of the Turkish SP were done for 144 children with autism. A comparison was also made between results of children with autism and 101 healthy children to test the validity of the Turkish SP. There were significant differences between results of autistic and healthy children on all subsections of the test. The Cronbach's as ranged from .63 to .97 for all subsections except I, J, and N, which had poor internal consistency reliability. Test-retest reliability over a one-week period was excellent (ICC > .90).