Effects of neuromuscular electrical stimulation of quadriceps on the quadriceps strength and functional performance in nursing home residents: A comparison of short and long stimulation periods.

AIM: To determine the effect of two neuromuscular electrical stimulation (NMES) periods on quadriceps strength (QS) and functional performance in nursing home residents. METHODS: A total of 53 older adults living in a nursing home were randomized into two groups: NMES with a short stimulation period and NMES with a long stimulation period. The quadriceps muscles were bilaterally stimulated three times a week for 6 weeks in both groups. Strength was measured with a digital handheld dynamometer and 30-s chair stand test. Functional performance was evaluated with the Berg balance scale, Timed Up and Go test and 6-min walking test. RESULTS: Analysis was carried out on 44 older adults, who completed the study protocol. The isometric QS did not change within groups or between groups. Interestingly, the 30-s chair stand test score increased for both groups, but the improvements were similar among groups. The Berg balance scale score, Timed Up and Go test time and 6-min walking test distance also improved in both groups. However, no difference in any of the functional outcome measures was observed between groups. CONCLUSIONS: The present findings showed that both NMES protocols might be an alternative to achieve an improvement in functional strength of the lower extremities and functional performance in nursing home residents, whereas neither of the two protocols seems effective for improving isometric QS. Both methods might contribute to maintaining isometric QS during the aging process. Geriatr Gerontol Int 2019; 19: 409-413.

Do adolescents with cerebral palsy agree with their caregivers on their participation and quality of life?

BACKGROUND: It is important to determine the quality of life (QoL) and level of participation in children with Cerebral Palsy (CP). Previous research has used reports from adolescents or caregivers, but there is no evidence that caregivers' reports accurately reflect the experiences of the adolescents they are interested in. OBJECTIVE/HYPOTHESIS: The aim of this study was to investigate whether a difference was present in the views of the adolescents and their caregivers regarding the participation and the quality of life of adolescents with CP, and to reveal the parameters creating such differences. METHODS: The participation levels and QoL of the adolescents were evaluated separately by the caregiver and the adolescent using the Pediatric Outcomes Data Collection Instrument (PODCI). RESULTS: A statistically significant difference was found in terms of caregivers and adolescents' scores of PODCI upper extremity (Z = -2,560, p = 0,008), transfer&basic mobility (Z = -3,839, p = 0,000), sports/physical functioning (Z = -3,103, p = 0,002), happiness (Z = -2,420, p = 0,016) and global functioning (Z = -3,639, p = 0,001). The children's scores were statistically significantly higher than caregivers'. It was found that there was a poor consistence in terms of caregivers and adolescents' scores of upper extremity (ICC = 0,373, p = 0,012), transfer/basic mobility (ICC = 0,289, p = 0,016), sport/physical functioning (ICC = 0,359, p = 0,009); moderate consistence in terms of those of global functioning (ICC = 0,421, p = 0,003). CONCLUSION: It was determined that caregivers and children's answers were not compatible with one another especially in terms of subjective assessments such as happiness and pain, which suggests that the consideration of caregivers or children in the assessment of subjective situations will change the results.

Impairments, activity limitations, and participation restrictions of the international classification of functioning, disability, and health model in children with ambulatory cerebral palsy.

OBJECTIVES: To examine the impairments, activity limitations, and participation restrictions in children with spastic unilateral and bilateral cerebral palsy (CP). We investigated the relationship between these factors according to the international classification of functioning, disability, and health (ICF) model. Methods: This prospective cross sectional study included 60 children aged between 4-18 years with spastic CP (30 unilateral, 30 bilateral involvement) classified as Levels I and II on the gross motor function classification system. Children had been referred to the Pediatric Rehabilitation Unit in the Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey between March 2014 and March 2015. The Physician Rating scale was used to assess body functions and structures. The Gillette Functional Assessment Questionnaire 22-item skill set, Pediatric Functional Independence Measure, and Pediatric Outcomes Data Collection Instrument were used to assess activity and participation levels. Results: There was a significant positive correlation between impairments and activity limitations (r=0.558; p=0.000), as well as between activity limitations and participation restrictions (r=0.354, p=0.005). Conclusion: These results show that activity limitations in children with unilateral and bilateral ambulatory CP may be related to their impairments and participation restrictions, although the sample size of our study is not large enough for generalizations. Overall, our study highlights the need for up-to-date, practical evaluation methods according to the ICF model.