Examination of Physical Functions, Activity and Participation in Children with Juvenile Idiopathic Arthritis.

AIMS: To examine physical functions, activity, and participation level, and associated factors with participation in children with juvenile idiopathic arthritis (JIA) across the International Classification of Functioning Disability and Health-Children and Youth. METHODS: 49 children (Girl/Boy:28/21) aged between 7 and 18 years (Mean: 13.4 ± 3.3) were included. To evaluate body structure/functioning; pain, fatigue, disease activity, and motor functions were assessed. Childhood Health Assessment Questionnaire and Juvenile Arthritis Biopsychosocial and Clinical Questionnaire were used to determine activity level. Child and Adolescent Scale of Participation was used to assess participation. RESULTS: Mild level of pain (2.0 ± 2.3), disease activity (2.0 ± 2.3), and fatigue (4.1 ± 4.0) were recorded. Decrease in motor functions was determined in 75% of children, while 61% of whom had activity-related disability. There was mild to moderate participation restrictions, and participation was significantly associated with age (r = -0.29), pain severity (r = -0.31), disease activity (r = -0.39), motor functions (r = 0.33), and activity level (r = -0.43), (p Ë‚ 0.05). CONCLUSIONS: Majority of children with JIA have deteriorations in physical functions, activity, and participation. Age, pain, disease activity, motor functions and activity level were associated with participation level. Children with JIA should be regularly evaluated multi-directional and they should be referred to rehabilitation programs to increase functionality and participation.

Progressive relaxation training in patients with breast cancer receiving aromatase inhibitor therapy-randomized controlled trial.

BACKGROUND: Aromatase inhibitors have positive impacts on the disease-free life of patients with breast cancer. However, their side effects, especially arthralgia, may be experienced by many patients. This study sought to assess the efficacy of Progressive Relaxation Exercises on the prevalent side effects of Aromatase Inhibitors in patients with breast cancer. MATERIALS AND METHODS: This clinical trial was conducted with single-blind randomization at a physiotherapy department in a local hospital. Patients who received Aromatase Inhibitor were assigned at random to either the study or control group. The study group (n = 22) performed a Progressive Relaxation Exercises program four days a week for six weeks, while the control group (n = 22) received advice on relaxation for daily life. Data was collected before the intervention and after six weeks. The study's primary endpoint was the Brief Pain Inventory, which was used to measure pain severity. Secondary endpoints included assessments of quality of life and emotional status, which were measured using the Functional Assessment of Chronic Illness Therapy and Hospital Anxiety and Depression scales, respectively. RESULTS: The study group exhibited a significant reduction in Pain Severity (p = 0.001) and Pain Interference (p = 0.012) sub-scores. Reduction in Pain Severity (p<0.001) and Patient Pain Experience (p = 0.003) sub-scores was also noted between the groups. Quality of Life and Emotional Status showed no significant variation both within and between the groups (p>0.05). CONCLUSION: The study demonstrated that Progressive Relaxation Exercises caused a significant reduction in pain scores among Breast Cancer patients receiving Aromatase Inhibitors. While a decrease in pain during the 6-week period is valuable data, it is necessary to monitor the long-term effects of relaxation techniques.

Do Children with Attention Deficit and Hyperactivity Disorder Present with Different Spatio-Temporal Gait Parameters? An Evaluation of the Relationship Between Gait and Gross Motor Skills.

Objective: The aim of the current study was to compare the spatio-temporal parameters of gait and gross motor skills in children with attention deficit hyperactivity disorder-combined type with those of typically developing children and to search the effect of motor skills on gait parameters in children with attention deficit hyperactivity disorder-combined type. Methods: A total of 50 children (n = 25 attention deficit hyperactivity disorder-combined type, n = 25 typically developing children) aged 5-12 years were included. Gross motor skills were evaluated using the Bruininks-Oseretsky Test Second Edition-Short Form. Spatio-temporal parameters of gait were assessed with a GAITRite® computer-based system. Results: In the subtests of Bruininks-Oseretsky Test Second Edition-Short Form (bilateral coordination (P < .001), balance (P = .013), running speed and agility (P = .003)), lower scores were obtained by the children with attention deficit hyperactivity disorder-combined type. The swing phase of gait was found to be longer in children with attention deficit hyperactivity disorder-combined type (P = .01). Conclusion: The current study results show that gross motor skills are affected negatively and the swing phase is prolonged in children with attention deficit hyperactivity disorder-combined type. Upper limb coordination and balance were also seen to have an effect on the velocity, step, and stride length. It is important to include an objective gait assessment as well as gross motor skills in the comprehensive clinical evaluation of children with attention deficit hyperactivity disorder-combined type.

Motor Proficiency, Manual Dexterity, and Visual Perception in School-age Children With ADHD: Contribution of Different Comorbidities.

Attention-deficit/hyperactivity disorder (ADHD) is often comorbid with a number of other psychiatric conditions. The goal of this study was to investigate whether motor skills, manual dexterity, and visual perception differ in the presence of ADHD and comorbid psychiatric conditions in school-age boys by comparing them to a group of children with typical development (TD). We evaluated 81 boys 6 to 10 years of age in 5 groups: ADHD only (n=18); ADHD+specific learning disorders (ADHD+SLDs) (n=17); ADHD+oppositional defiant disorder (n=16); ADHD+anxiety disorders (n=15); and TD (n=15). The participants with ADHD only and those with ADHD+comorbidity had significantly lower scores than the participants in the TD group in every area we evaluated. The lowest scores were observed in the ADHD+SLD group in all motor skills domains except for the fine motor precision field. Furthermore, the group with ADHD+SLD had statistically significantly lower scores than the 3 other groups with ADHD+comorbidity in 3 areas: balance, upper extremity coordination, and speed and agility. Motor problems in patients with ADHD and comorbid conditions may not be a focus of attention in clinics. However, especially in the case of comorbid conditions accompanying ADHD, it is important to consider problems in motor skills, manual dexterity, and visual perception in evaluation and treatment to increase these children's quality of life.

Investigation of the validity and reliability of the Turkish version of the Functional Assessment of Cancer Therapy-Cognitive Function in cancer patients.

OBJECTIVE: The Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) is a questionnaire that is used to evaluate the quality of life and cognitive functions according to individual self-reports. The aim of this study was to investigate the validity and reliability of the Turkish version of the FACT-Cog. METHODS: Cancer patients who were treated with chemo or radiotherapy and had a score of 24/30 and more in Mini-Mental State Examination (MMSE) were included in this study. Cognitive functions assessed with the FACT-Cog and the European Organization of Research and Treatment of Cancer Quality of Life Core Questionnaire Core 30: Cognitive Function subscale (EORTC QLQ-CF). RESULTS: One hundred and forty cancer patients [female = 87 (62.1%), male = 53 (37.9%)] were included. The mean age of the participants was 47.93 ± 11.90 years. The Cronbach's α of the FACT-Cog scale was 0.82. Test-retest intraclass correlation coefficient values of the FACT-Cog questionnaire were varied from 0.855 to 0.954. There were found low correlations between the total score of the FACT-Cog and the MMSE (r = 0.26, p = 0.002), and moderate correlations between the EORTC QLQ-CF subscale and the FACT-Cog (r = -0.43; p < 0.001). SIGNIFICANCE OF RESULTS: It showed the validity and reliability of the Turkish version of the FACT-Cog questionnaire for cancer patients. It may be beneficial to use this questionnaire for the effects of cancer treatment.

Kinematic analysis of handwriting movements and pencil grip patterns in children with low vision.

PURPOSE: Handwriting skills are important for the academic life of children and the lack of visual-motor performance leads to writing problems in children with low vision. This study aims to reveal handwriting kinematics and pencil grip features in children with low vision by means of a novel method. MATERIALS AND METHODS: 18 children with low vision (mean age: 9.83 ± 1.54 years) and 18 children with typical development (mean age: 9.83 ± 1.62 years) were included in the study. Children performed a sentence writing task on a digitizer tablet. During the task, the writing hand of children was photographed to analyze pencil grip patterns. RESULTS: Children with low vision performed greater stroke size except for the vertical size, slower writing speed, more dysfluent movements, and less pen pressure than children with typical development. However, participants preferred mature pencil grip patterns and had high grip scores independent from the diagnosis. CONCLUSIONS: The findings indicate that children with low vision have difficulties in handwriting in terms of spatial and temporal features. These results would be important for interventions to develop specific programs on writing skills to support their educational life.

Validity and reliability of the Turkish version of the functional assessment of cancer therapy-bone marrow transplant (FACT-BMT) quality of life questionnaire in patients undergoing bone marrow transplantation.

OBJECTIVE: The Functional Assessment of Cancer Therapy-Bone Marrow Transplant Version 4 (FACT-BMT) is a widely used instrument to assess quality of life in individuals treated with bone marrow transplantation (BMT). Our aim was to determine the reliability and validity of the Turkish version of the FACT-BMT in patients undergoing BMT. METHOD: Patients between the age of 20 and 65 years and who had undergone BMT at least 3 months before the study were included. Validity was determined using exploratory and confirmatory factor analysis. To determine convergent validity, the European Cancer Research and Treatment Organization Quality of Life Questionnaire-Cancer30 (EORTC QLQ-C30), the Brief Fatigue Inventory (BFI), and the Eastern Cooperative Oncology Group (ECOG) performance score were used. Cronbach's alpha, intra-class correlation coefficient (ICC), and item-total correlation (ITC) values were calculated to assess the reliability of the FACT-BMT. RESULTS: Totally, 114 patients (F/M: 47/67) treated with BMT (mean age: 49.50 ± 12.50 years) were included. Confirmatory and exploratory factor analysis revealed that the FACT-BMT and the Bone Marrow Transplantation Subscale (BMTS) had sufficient fit. The FACT-BMT was moderately to strongly correlated with the EORTC QLQ-C30, the BFI, and the ECOG performance score (p < 0.001). Cronbach's alpha and ICC values of the FACT-BMT were acceptable (0.925 and 0.956, respectively). The ITC values of each item of the FACT-BMT were also acceptable (ranged from 0.296 to 0.737). Patients undergoing autologous BMT had a significantly higher BMTS score than those undergoing allogeneic BMT (p < 0.05). SIGNIFICANCE OF RESULTS: The Turkish version of the FACT-BMT is valid, reliable, and sensitive to changes in quality of life in patients undergoing BMT.

Motor and Basic Cognitive Functions in Children with Acute Lymphoblastic Leukemia Undergoing Induction or Consolidation Chemotherapy.

Children with acute leukemia (ALL) often suffer from several disease and treatment related side-effects during treatment. The aim of the present study was to determine the gross and fine motor functioning and basic cognitive performance of children (n = 25) with ALL who were undergoing induction or consolidation chemotherapy and to compare these characteristics to a normative group (n = 21) of age-matched typically developing children. We assessed the children's motor functions with the Bruininks-Oseretsky Test of Motor Proficiency Second Edition-Short Form and the Nine-hole Peg Test, and we used the Modified Mini-Mental State Exam (MMSE) to evaluate their cognitive performance. Compared to the normative group, children with ALL had lower scores on total motor proficiency and sub-tests scores of motor functions (p < .05), and on the Nine-hole Peg Test performance (p < .05); but their cognitive performance on the MMSE was not significantly different. Children with ALL would likely benefit from structured exercise and rehabilitative interventions during chemotherapy to prevent and/or ameliorate ALL-related motor dysfunction. We also suggest that their cognitive functioning should be further investigated with more extensive well-validated neurocognitive tests for children (e.g., the Wechsler intelligence scales).

Cross-cultural adaptation, validity and reliability of Turkish version of the Waterloo Handedness and Footedness Questionnaire-Revised.

This study investigated the validity and reliability of Turkish versions of the Waterloo Handedness and Footedness Questionnaire-Revised (WHQ-R and WFQ-R). Turkish versions of the WHQ-R and the WFQ-R, and other assessments (the Handedness Questionnaire and the Footedness Preference Test) were applied to 444 healthy participants aged between 18 and 65 years. The translation and cultural adaptation process of the WHQ-R and the WFQ-R was provided by the following proposed guideline. For test-retest reliability, translated versions were re-applied to 88 participants in a 7-day interval. Cronbach's alpha of the WHQ-R was 0.984 and that of the WFQ was 0.905. The test-retest intra-class correlation coefficients (ICC) of the WHQ-R varied from 0.741 to 0.933 and those of the WFQ-R from 0.649 to 0.814. There were moderate to strong correlations between the WHQ-R and the Handedness Questionnaire (r = -853, p < 0.001) and between the WFQ-R and the Footedness Preference Test (r = -0.687, p < 0.001). Confirmatory factor analysis revealed a two-factor structure of the WHQ-R and the WFQ-R. The results of this study demonstrated that Turkish versions of the WHQ-R and the WFQ-R are reliable and valid inventories for assessing handedness and footedness in this population.

Screening supportive care needs, compliance with exercise program, quality of life, and anxiety level during the COVID-19 pandemic in individuals treated with hematopoietic stem cell transplantation.

PURPOSE: The primary aim was to assess supportive care needs, compliance with home exercise program, quality of life level (QOL), and anxiety level during the COVID-19 pandemic in individuals treated with hematopoietic stem cell transplantation (HSCT). The secondary aim was to investigate demographic and medical factors associated with the recorded outcomes. METHODS: The present study included individuals treated with HSCT and previously referred to physical therapy. The data were collected by interviews with the participants on the phone. Supportive care needs were assessed using the Supportive Care Needs Survey-Short Form 29TR. Compliance with the exercise program was recorded as the number of patients regularly performed strengthening and stretching exercises and the ratio of the walking duration to the recommended duration. The European Cancer Research and Treatment Organization Quality of Life Questionnaire-Cancer30 was used to assess the QOL. The State-Trait Anxiety Inventory-I and the Visual Analogue Scale were used to assess anxiety level. RESULTS: The present study included 101 individuals treated with HSCT. The psychological and physical supportive care needs were predominant in participants. Compliance with exercise program was low. General anxiety level was low, yet anxiety about COVID-19 was moderate level in participants. Supportive care needs were related to female gender, performance level, time since HSCT, and QOL level (p Ë‚ 0.05). Anxiety level was correlated with supportive care needs, COVID-19-related anxiety, and QOL (p Ë‚ 0.05). Compliance with exercise program was associated with age, performance level, and QOL (p Ë‚ 0.05). CONCLUSION: Our results offer that supportive telehealth interventions should be considered during the COVID-19 pandemic for individuals treated with HSCT to decrease unmet supportive care needs and isolation-related physical inactivity.

An evaluation of participation restrictions and associated factors via the ICF-CY framework in children with acute lymphoblastic leukemia receiving maintenance chemotherapy.

Our aim was to determine impairments in physical functions, activity limitations, and participation restrictions with the International Classification of Functioning, Disability and Health version for Children and Youth (ICF-CY) framework in children with acute lymphoblastic leukemia (ALL) receiving treatment. Physical functions were assessed in terms of pain level, fatigue level, handgrip strength, and motor proficiency. Fine motor activities and lower extremity performance were assessed to determine activity limitations. Participation was assessed with a patient-reported questionnaire. Thirty children with ALL (mean age: 8.45 ± 3.33 years) were included. Pain and fatigue level were mild. Poor handgrip strength was found; their mean handgrip strength was 60% of the normative. Fifty-six percent of the children had below-average motor performance. Participation scores were considerably high, except for sport and physical functioning sub-score. Participation level was positively associated with bilateral coordination and duration after diagnosis, while negatively correlated with pain and fatigue level (p ˂ 0.05).Conclusion: The ICF-CY-based evaluation was useful to understand children's limitations in everyday life. Children with ALL need supportive interventions during treatments in terms of physical functioning and participation in activities. Children with ALL with higher pain and fatigue, poor bilateral coordination, and who were in earlier period after diagnosis had higher risk for participation restriction. What is Known: • Children with ALL had physical functioning limitations on treatments. • Participation restrictions were described in children with ALL off treatment. What is New: • The ICY-CY-based health and functioning evaluation allows health care professionals to globally determine limitations of everyday life in children with ALL on treatment. • Impairments in physical functions, pain severity, fatigue severity, and duration after diagnosis are associated with participation to everyday life in children with ALL on treatment.

Does ergonomics training have an effect on body posture during computer usage?

BACKGROUND: Computer users are at risk in terms of musculoskeletal disorders. It is known that ergonomics training prevents short-term injuries to the musculoskeletal system, but its long-term effect is unknown. OBJECTIVE: The aim of our study was to investigate the effect of receiving ergonomics training in undergraduate instruction on posture during computer usage. METHODS: The present study included 27 individuals who had received training previously and 58 individuals who had not received any training. Their posture was evaluated with Rapid Upper Limb Assessment (RULA) and Musculoskeletal Diseases in Computer Users Frequency and Risk Factors Screening Form (MCFRF). RESULTS: The percentage of pain experienced at least once in four weeks was much higher in the untrained than the trained group. The RULA scores were 3.7 ± 2.1 and 3.3 ± 0.8 points for the lower body and upper extremity for the trained group, and 4.2 ± 2.2 and 3.9 ± 0.9 points for the lower body and upper extremity, respectively, for the untrained group. The MCFRF scores were 1.9 ± 1.0 and 1.7 ± 1.0 points for the lower body and upper extremity, respectively, for the trained group, and 1.6 ± 1.3 and 1.6 ± 0.8 points for the lower body and upper extremity for the untrained group. CONCLUSIONS: According to RULA scores, training on ergonomics was effective in reducing the risk level of musculoskeletal disorders. MCFRF scores showed that ergonomics training had no effect on posture during computer usage. Nevertheless, MCFRF evaluates only posture and does not calculate approximate forces that body parts were exposed to. Thus, these areas of MCFRF required improvement. Our study emphasized the importance of the long-term effects of ergonomics training for preventive purposes before musculoskeletal problems manifest.

[Motor Proficiency in Children with Attention Deficit Hyperactivity Disorder: Associations with Cognitive Skills and Symptom Severity]. / Dikkat Eksikligi Hiperaktivite Bozuklugu Olan Çocuklarda Motor Yeterlilik: Bilissel Beceriler ve Belirti Siddeti ile Iliskisi.

OBJECTIVES: Of children with Attention Deficit Hyperactivity Disorder (ADHD), 45-70% have motor skill problems, which can adversely affect social competence, peer relations, and academic skills. The aim of this study is to assess motor skills in school-aged children with ADHD, and to elucidate if there are any relationships between ADHD symptoms and cognitive function. METHOD: Included in this study were 58 children (38 ADHD, 20 controls) between 8-11 years of age. Children were diagnosed with ADHD via the Schedule for Affective Disorders and Schizophrenia for School-Aged Children Present and Lifetime Version. The parents were asked to fill out the Conner's' Parent Rating Scale - Revised Short Turkish Form to determine the symptom domains and the symptom severity. The Wechsler Children's Intelligence Scale-IV was used to assess cognitive skills, and the Bruininks -Oseretsky Motor Proficiency Test was used to assess motor skills. RESULTS: Children with ADHD had impaired performance in many motor skill areas compared to the controls. Impairments in fine motor skills were correlated with problems in attention, working memory, and processing speed. In the ADHD group, age was not correlated with motor skills enhancement. CONCLUSION: The multistage clinical evaluation of ADHD should include screening for problems in motor skills. If deficiencies are found, the child should be clinically evaluated for motor proficiency and, if necessary, should be referred for appropriate objective assessment and intervention programs.

Effects of Nintendo Wii™ Training on Occupational Performance, Balance, and Daily Living Activities in Children with Spastic Hemiplegic Cerebral Palsy: A Single-Blind and Randomized Trial.

OBJECTIVE: This study aimed at assessing how the addition of Nintendo Wii™ (NW) system to the traditional therapy influences occupational performance, balance, and daily living activities in children with spastic hemiplegic Cerebral Palsy (CP). MATERIALS AND METHODS: The present study is a single-blind and randomized trial involving 24 children aged 6-14 years, classified as level I or II on the Gross Motor Function Classification System. The children were allocated into two groups: an intervention and a control group, and their families participated in the study. The activity performance analysis of the children was undertaken by using the Canadian Occupational Performance Measure (COPM), functional balance was measured with the Pediatric Balance Scale (PBS), and activities of daily living were assessed with Pediatric Evaluation of Disability Inventory (PEDI). Twenty-four children with CP were randomly divided into two groups: intervention (n = 12) and control group (n = 12). All children in both groups continued their traditional physiotherapy program twice a week, 45 minutes per session, whereas the participants in the intervention group, additionally, were trained with NW, two other days of the week for 12 weeks, with each session lasting for 30 minutes. RESULTS: Self-care, mobility, PEDI total, PBS, and performance of COPM scores increased in the NW group after intervention. Self-care, mobility, and total PEDI increased in the control group as well. However, there was no statistically significant difference found between the groups, except for PBS (P < 0.05). CONCLUSIONS: NW contributed to the implementation of occupational performance, daily living activities, and functional balance. We recommend that NW could be used in the rehabilitation program to engage play-based activities with fun.

Reliability and Validity of The Cerebral Palsy Quality of Life Questionnaire in The Turkish Population.

This study examined the psychometric properties of the Turkish version of the Cerebral Palsy Quality of Life Questionnaire (CP QOL). A total of 149 primary caregivers completed the final version of the CP QOL-Primary Caregivers and the Children Health Questionnaire (CHQ) for children 4-12 years old (M age = 7.6 yr., SD = 2.5); 58 children with CP ages 9 to 12 years completed the CP QOL-Child and Health-Related Quality of Life Questionnaire for Children (Kid-KINDL) questionnaire. The Gross Motor Function Classification System was also used for the classification of the children with CP. Internal consistency (Cronbach's α) ranged between .63 and .93 for primary caregivers and .61 to .92 for the children's self-reports. Intra-class correlation coefficients ranged between .88 and .97 for primary caregivers and .91 to .98 for children. It was concluded that the Turkish version of CP QOL questionnaire is a reliable and valid tool for assessing QOL in children with CP.

Development and reliability of a Turkish version of the Short Form-Joint Protection Behavior Assessment (JPBA-S).

STUDY DESIGN: Clinical measurement. PURPOSE: To adapt the original JPBA-S to a Turkish version (TUR-JPBA-S) and to investigate its reliability in assessing patients with rheumatoid arthritis (RA). METHODS: Twenty-two participants with RA and 21 healthy people were videotaped while performing tasks listed in the TUR-JPBA-S. Two raters scored the video recordings for to evaluate inter-rater reliability. One rater re-analyzed the recordings at a different time point for intra-rater reliability. Participants with RA were asked to perform the same tasks after three to four weeks which was also recorded to evaluate test-retest reliability. RESULTS: Internal consistency (Cronbach's α value) was found to be high (0.89) for participants with RA. Our results demonstrate excellent intra-rater (ICC: 0.99, SEM 1.2) inter-rater (ICC: 0.99, SEM 1.7) reliability, apart from excellent test-retest reliability (ICC: 0.96). CONCLUSION: The TUR-JPBA-S is a valid and reliable instrument for assessing JP behavior in patients with RA in Turkey. LEVEL OF EVIDENCE: Level 2.

The effects of Kinesio Taping on body functions and activity in unilateral spastic cerebral palsy: a single-blind randomized controlled trial.

AIM: The aim of this study was to investigate the effects of Kinesio Taping (KT) on the body functions and activity of children with unilateral spastic cerebral palsy (CP). METHOD: This study was designed as a single-blind, randomized, controlled trial. Thirty children with unilateral spastic CP were randomized and split equally between the KT group (eight males, seven females; mean age 9y [SD 2y 3mo] range 7-12y) and the control group (seven males, eight females; mean age 9y 7mo [SD 3y 4mo] range 7-14y) receiving usual care. All participants were evaluated with the Functional Independence Measure for Children (WeeFIM), the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), the Gross Motor Function Measure (GMFM), short-term muscle power, agility and functional muscle strength tests. Wilcoxon signed-rank and Mann-Whitney U tests were used to evaluate within and between-group differences respectively. The level of significance was accepted as p<0.05. RESULTS: There were significant differences in muscle power sprint (p=0.003), lateral step-up test right (p=0.016), sit to stand (p=0.018), attain stand through half knee right (p=0.003), BOTMP Gross scores (p=0.019), and WeeFIM total (p=0.003) and self-care scores (p=0.022) between the groups (p<0.05). INTERPRETATION: Kinesio Taping is a promising additional approach to increase proprioceptive feedback and improve physical fitness, gross motor function, and activities of daily living in children with CP.

Factors related to the impact of chronically disabled children on their families.

BACKGROUND: This study to investigated the effects of chronically disabled children (CDC) on their families. METHOD: The study included 655 CDD and their families from 45 cities located in Turkey representing the seven regions of the country. Sociodemographic characteristics, presence of mental retardation, primary care-giver, presence of social insurance, the number of other children and other family members living in the family, duration of the disorder, disabling conditions in the other children, time spent for care giving, and level of income were recorded. WeeFIM (Functional Independence for Children) and Impact on Family Scale (IPFAM) were administered to evaluate the level of functional independence and the overall burden on the families, respectively. RESULTS: IPFAM and WeeFIM scores were not different between geographical regions (P > 0.05). Functional independence level of the child and the level of education of the mothers were significant contributors to the disruption of social relations subscale of IPFAM (P < 0.05). WeeFIM score, presence of mental retardation, and income were significant contributors to general impact subscale. WeeFIM, mothers' level of education, and income were significant factors for the financial support subscale (P < 0.05). WeeFIM score, presence of mental retardation, mothers' level of education, and income also were found to contribute to the total impact subscale scores (P < 0.05). None of the evaluated factors were found to contribute to coping subscale of IPFAM (P > 0.05). CONCLUSION: Although some are expected, certain intriguing results, such as the impact of the mothers' literacy level, warrant further larger scale comprehensive studies to investigate the factors that contribute to the impact of CDC on their families. Also, policies that focus on family centered rehabilitation approaches should be encouraged in an effort to decrease the overall impact of CDC on families.

Relationship between writing skills and visual-motor control in low-vision students.

The purpose of this study was to investigate the relationship between handwriting skills and visual motor control among students with low vision and to compare this with the performance of their normal sighted peers. 42 students with low vision and 26 normal sighted peers participated. The Bruininks-Oseretsky Motor Proficiency Test-Short Form (BOTMP-SF), Jebsen Taylor Hand Function Test's writing subtest, and a legibility assessment were administered. Significant differences were found between groups for students' writing speed, legibility, and visual motor control. Visual motor control was correlated both writing speed and legibility. Students with low vision had poorer handwriting performance, with lower legibility and slower writing speed. Writing performance time was related to visual motor control in students with low vision.

Writing and reading training effects on font type and size preferences by students with low vision.

The effect of writing and reading training on preferred font type and size in low-vision students was evaluated in 35 children. An ophthalmologist confirmed low vision according to ICD-10-CM. Children identified the font type and size they could best read. The writing subtest of the Jebsen-Taylor Hand Function Test, read in 1 min., and legibility as measured by the number of readable written letters were used in evaluating the children. A writing and reading treatment program was conducted, beginning with the child's preferred font type and size, for 3 months, 2 days per week, for 45 min. per day at the child's school. Before treatment, the most preferred font type was Verdana; after treatment, the preferred font type and size changed. Students had gained reading and writing speed after training, but their writing legibility was not significantly better. Training might affect the preferred font type and size of students with low vision. Surprisingly, serif and sans-serif fonts were preferred about equally after treatment.