Ebru YILMAZ YALÇINKAYA ,
Naime Evrim Karadağ SAYGI ,
Özden ÖZYEMİŞÇİ TAŞKIRAN ,
Özden ÖZYEMİŞÇİ TAŞKIRAN ,
Sehim KUTLAY ,
Birkan SONEL TUR ,
Özlem EL ,
Ece ÜNLÜ AKYÜZ ,
Süda TEKIN ,
Demet OFLUOĞLU ,
Pınar AKPINAR ,
MURAT ZİNNUROĞLU ,
Pınar AKPINAR ,
Tuğce ÖZEKLİ MISIRLIOĞLU ,
Berrin HÜNER ,
Hakan NUR ,
Sibel Çağlar OKUR ,
Melek SEZGİN ,
Canan TIKIZ ,
Kadriye ÖNEŞ ,
Afitap İÇAĞASIOĞLU ,
Resa AYDIN
Abstract: Spasticity is the most common motor disturbance in cerebral palsy (CP). Lockdown in the COVID-19 outbreak has profoundly changed daily routines, and similarly caused the suspension of spasticity treatment plans. Besides, the delay in botulinum toxin (BoNT) injection, which is important in the management of focal spasticity, led to some problems in children. This consensus report includes BoNT injection recommendations in the management of spasticity during the COVID-19 pandemic in children with CP. In order to develop the consensus report, physical medicine and rehabilitation (PMR) specialists experienced in the field of pediatric rehabilitation and BoNT injections were invited by Pediatric Rehabilitation Association. Items were prepared and adapted to the Delphi technique by PMR specialists. Then they were asked to the physicians experienced in BoNT injections (PMR specialist, pediatric orthopedists, and pediatric neurologists) or COVID-19 (pediatric infectious disease, adult infectious disease). In conclusion, the experts agree that conservative management approaches for spasticity may be the initial steps before BoNT injections. BoNT injections can be administered to children with CP with appropriate indications and with necessary precautions during the pandemic. Key words: Botulinum toxin, cerebral palsy, COVID-19, pandemic, spasticity
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Neurogenic heterotopic ossification (HO) is a complication of neurologic disorders which is characterized by formation of new extra osseous in soft tissue surrounding peripheral joints. HO can cause pain, progressive decrease in range of joint motion and a decline in functional capacity. We herein report a 52-year-old female patient with right hemiplegia due to ischemic stroke. She was admitted to the clinic with pain and limitation of movement in her right knee and shoulder for 6 months. Her imaging studies revealed HO. After 8 weeks of inpatient rehabilitation, shoulder range of motion improved but the contracture in the knee joint remained the same. HO is most commonly seen around the hip joint. However, in the presented case, it differs in that it is observed in the knee and shoulder. HO should be considered in the differential diagnosis of pain and joint limitation in patients with hemiplegia.
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objectives: The aim of the present study is to develop a Turkish version of the ABILHAND-Kids Survey, which evaluates upper extremity function in children with cerebral palsy (CP), and to carry out a validity and reliability study of the survey for Turkish CP patients.Materials and methods: Between November 2016 and March 2017, a total of 109 pediatric CP patients (62 males, 47 females; mean age 9.3±2.9 years; range, 6 to 15 years) followed in our outpatient clinic were included. The demographic characteristics and type of CP of the patients were recorded. A functional evaluation was made using the ABILHAND-Kids and Manual Ability Classification System (MACS) surveys. The reliability of the surveys was tested based on internal consistency (Cronbach’s α) and test-retest (intraclass correlation coefficient [ICC]) methods. The validity of the approach was evaluated using converted scores from an ABILHAND-Kids Rasch analysis and a correlation of the MACS levels.results: The ICC value for the test/retest reliability was 0.98 and internal consistency was 0.94. A strong negative correlation was found between the Turkish version of the ABILHAND-Kids and MACS surveys (r=-0.849; p<0.001). A Rasch analysis indicated good item fit, unidimensionality, and model fit.conclusion: The Turkish version of the ABILHAND-Kids survey is a reliable and valid scale for the assessment of manual ability in Turkish children with CP.
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