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    Lower urinary tract symptoms in children with mild to moderate spastic cerebral palsy: Associations with functional level, trunk and respiratory parameters
    (Elsevier Sci Ltd, 2026) Nacar, Emine; Suner-Keklik, Sinem; Numanoglu-Akbas, Ayse
    Introduction and objective Lower urinary tract symptoms (LUTS) are common in children with cerebral palsy (CP). Increased severity of functional impairment and impairments in trunk-related structures may be associated with increased severity of LUTS. The aim of our study was to examine the distribution of LUTS in children with mild to moderate spastic type CP and to investigate the relationship between LUTS severity and functional level, trunk control, trunk muscle strength and endurance, respiratory functions and rib cage mobility. Methods Fifty-three children with spastic CP with Gross Motor Functional Classification System (GMFCS) levels I-II and III were included in the study. LUTS was assessed using Dysfunctional Voiding and Incontinence Scoring System (DVISS); functional levels were assessed using GMFCS; and trunk control was assessed using Trunk Control Measurement Scale (TCMS). Transversus Abdominis (TrA) muscle strength was measured with Stabilizer Compression Biofeedback Unit; trunk muscle strength was measured with Sit-ups and Modified Push-up test; trunk muscle endurance was measured with McGill's trunk flexion, trunk extension, lateral bridge tests and prone bridge test. Pulmonary function was assessed by Contec SP10 Spirometer and chest mobility was assessed by chest circumference measurement. Results There was statistically significant difference between GMFCS level I and level III mean DVISS scores (p = 0.002). There was moderate negative correlation between DVISS and TCMS score (p = 0.002; r =-0.416), moderate positive correlation between TrA muscle strength (p = 0.001; r = 0.482), modified push-up test (p = 0.025; r =-0.308), trunk extension test (p = 0.021; r =-0.316), prone bridge test (p = 0.008; r =-0.362), FEV1/FVC (p = 0.020; r =-0.320), FEV1 (p = 0.005; r =-0.384), PEF (p = 0.007; r =-0.367). Conclusion This study shows that LUTS is common in children with mild to moderate spastic CP and that the severity of these symptoms increases significantly as the severity of functional impairment increases. In addition, it was determined that the decrease in trunk control, trunk muscle strength and endurance, respiratory functions and chest mobility were associated with an increase in LUTS. These findings suggest that isolated pelvic floor training alone may not be sufficient to improve lower urinary tract health in children with CP, but instead, a holistic rehabilitation approach that supports motor function, trunk stability and respiratory capacity should be adopted.
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    The Validity and Reliability of the Turkish Version of the Telerehabilitation Acceptance Scale (Health Care Professionals' Form)
    (Mary Ann Liebert, Inc, 2024) Turan, Gizem Gul; Numanoglu-Akbas, Ayse
    Purpose: This study was conducted to examine the Turkish validity and reliability of the Telerehabilitation Acceptance Scale Health Care Professionals' Form (TRAS-HP).Methods: Health care professionals between the ages of 18 and 65 years were included. TRAS-HP was used to assess study participants' acceptance of telerehabilitation. Turkish translation of the scale was followed by confirmatory and explanatory factor analyses. Internal consistency and test-retest reliability were calculated.Results: Of the participants, 158 (65.83%) were female and 82 (34.17%) were male. Explanatory factor analysis revealed a three-factor structure explaining 71.87% of the total variation with one item removed. Confirmatory factor analysis determined that the model fit indices (the root mean square error of approximation = 0.080, adjusted goodness of fit index = 0.857, goodness of fit index = 0.899, and chi-square/degrees of freedom = 2.516) were satisfactory. The subdimensions' factor loads ranged from 0.78 to 0.82. After confirmatory and explanatory factor analysis, the 16-item TRAS-HP was reduced to 14 items. Internal consistency (cronbach alpha = 0.947) and test-retest reliability (intraclass correlation coefficient: 0.927) were extremely high.Conclusions: With this study, the Turkish validity and reliability of TRAS-HP were demonstrated, and it was revealed that they are a suitable tool for determining the acceptance and awareness of telerehabilitation of health care professionals working in rehabilitation.