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    An investigation of sensory processing skills in toddlers with joint hypermobility
    (Elsevier Ireland Ltd, 2024) Yildiz, Ayse; Yildiz, Ramazan; Burak, Mustafa; Zorlular, Rabia; Akkaya, Kamile Uzun; Elbasan, Bulent
    Background: Children with Generalized Joint Hypermobility (GJH) may have a motor developmental delay in the early period and subluxation, fatigue, autonomic dysfunction, and pain arising from ligaments and other soft tissues in advanced ages. Additionally, there is a loss of proprioceptive sensation in children and adults with GJH. Aims: This study aimed to evaluate sensory processing skills in toddlers with GJH. Study Design: A cross-sectional study. Subjects: Fifty-eight children aged between 12 and 14 months were included in the study. These children were divided into two groups: with and without GJH (31 with GJH and 27 without GJH). Outcome measures: The sensory processing skills of the children in the study were evaluated with the Test of Sensory Functions in Infants (TSFI). Results: The scores in the subtests of TSFI in response to tactile deep pressure, adaptive motor functions, visual- tactile integration, and response to vestibular stimuli were higher in favor of children without GJH (p p < 0.05). The total TSFI score was higher in the group without GJH (p < 0.05). Conclusions: Sensory processing problems were found in toddlers with GJH. Sensory motor development should be evaluated in children with GJH, and an appropriate early intervention program should be planned.
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    Relationship between sensory processing skills and motor skills in 12-month-old infants
    (Wiley, 2024) Yildiz, Ramazan; Yildiz, Ayse; Zorlular, Rabia; Elbasan, Bulent
    IntroductionIdentifying sensory processing problems of 12-month-old preterm and term children and defining their relationship with motor skills are essential for appropriate interventions and optimal sensory-motor development. This study aimed to determine sensory processing difficulties in 12-month-old babies and examine their relationship with motor skills.Methods:This cross-sectional study included 61 infants (28 preterm and 33 full-term, ages 12 months). The infants' sensory processing skills were evaluated using the Test of Sensory Functions in Infants (TSFI), and their gross and fine motor skills were assessed with the Peabody Developmental Motor Scales-2 (PDMS-2).Results:Sensory processing difficulties were more common in preterm babies. Multiple linear regression models indicated a significant positive association between PDMS-2 gross/fine motor scores and TFSI total scores, reactivity to tactile deep pressure, and ocular-motor control in the total sample. Furthermore, there was a relationship between gross motor and adaptive motor function, and fine motor scores were found to be associated with visual-tactile integration sensory scores.ConclusionsPreterm babies are more likely than their full-term peers to have sensory processing problems around the age of one, which can affect their motor skills. The results support the relationship between children's sensory and motor processing skills. Practitioners such as occupational and physical therapists should be alert to this relationship in infants with sensory processing and motor problems. Taking this relationship into consideration when planning intervention programs can be a guide for an effective intervention. There is a relationship between children's sensory processing skills and gross/fine motor skills. image
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    The Effect of Attention Focus Instructions on Strength and Balance in Subjects With Generalized Joint Hypermobility
    (Routledge Journals, Taylor & Francis Ltd, 2024) Zorlular, Ali; Zorlular, Rabia; Elbasan, Bulent; Guzel, Nevin Atalay
    This study aims to examine the effects of different attention focuses on muscle strength and balance performance in individuals with Generalized Joint Hypermobility (GJH). This randomized crossover trial included 32 individuals with GJH whose Beighton score was greater than 5. Subjects performed each task under external attentional focus, internal attentional focus, and neutral attentional focus condition. Knee extensor muscle strength was measured using the Isokinetic Dynamometer. Postural stability was evaluated using the Biodex Balance System, while dynamic balance was assessed using the Y Balance Test. The main effects of attentional focus on the outcomes were analyzed using repeated measures ANOVA and post-hoc corrections with a 95% confidence interval. Subjects produced significantly higher quadriceps peak torque during external focus instruction and internal focus instruction compared to neutral condition (p = .006). Postural stability performance were found to be better during external attention focus compared to the internal focus of attention and the neutral group (p = .008). In addition, an increase in Y balance composite score was observed during external condition compared to internal condition and neutral condition (p < .001). Whether internal or external, the use of attentional focus may be beneficial for optimal force production during training in individuals with GJH. External attention focus enabled better postural stability and dynamic balance performances.
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    The Gait Outcomes Assessment List (GOAL) questionnaire: Test-retest reliability and validity in children with cerebral palsy in Türkiye
    (Elsevier B.V., 2024) Apaydın, Umut; Narayanan, Unni; Zorlular, Rabia; Adıgüzel, Hatice; Yıldız, Ramazan; Yıldız, Ayşe; Erol, Erkan
    Background: Most questionnaires provide little information about children's or parents' views on functioning and do not attempt to understand their priorities or expectations. The Gait Outcomes Assessment List (GOAL) questionnaire was developed to fill this gap by identifying the most important goals of the patient and family for a gait intervention. Research question: To investigate the test-retest reliability and concurrent and discriminant validity of the GOAL questionnaire in children with cerebral palsy (CP) in Türkiye. Methods: In this study, we included 81 children with CP aged 5–18 years and their families. The parent and child version 5.0 of the GOAL was used. Standardized item, domain and total (across all domains) GOAL scores were calculated for each participant. Test-retest reliability was assessed with the intraclass correlation coefficient (ICC). The Gillette Functional Assessment Questionnaire (FAQ) was used for validation. Results: The mean age of the children was 10.4 ± 3.3 years (range 5–18), and 64.2 % were boys. The test–retest reliability was excellent for the GOAL-Child and GOAL-Parent total GOAL scores (ICC: 0.97 for the child and ICC: 0.96 for the parent). All standard errors of measurement (SEMs) for domain scores and total scores were fewer than 20 points. The children's total scores on the GOAL questionnaire showed a significant difference between the GMFCS levels (p <0.001). The parents’ total scores on the GOAL questionnaires also showed a significant difference between the GMFCS levels (p <0.001). There were moderate positive correlations between the GOAL child and parent questionnaire total scores and the FAQ walking level according to Spearman's rho (GOAL child and FAQ walking rho: 0.66, p<0.001; GOAL parent and FAQ walking rho: 0.58, p<0.001). Significance: The results demonstrate that the child and parent versions of the GOAL 5.0 are valid and reliable for the comprehensive assessment of Turkish children with CP. © 2024 Elsevier B.V.
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    The relationship between home environment affordances and motor development and sensory processing skills in premature infants
    (Elsevier Science Inc, 2024) Zorlular, Rabia; Akkaya, Kamile Uzun; Elbasan, Bulent
    The availability of stimulating materials in the home environment is of great importance to optimizing an infant's development. This study, which has a cross-sectional study design, was conducted to examine the relationship between home environment conditions and equipment support and the motor development and sensory processing skills of premature infants. Children born premature, aged 10-16 months, were included in the study. Motor development was evaluated with the Peabody Motor Development Scale-2, and sensory processing skills were evaluated with the Test of Sensory Function in Infants. The Affordances in the Home Environment for Motor Development-Infant Scale was used to evaluate the home environment. A total of 51 premature infants were included in the study. It was determined that there was a significant relationship between physical space, stimulus variety and fine motor toys in the home environment and Peabody Motor Development Scale-2 gross motor and fine motor development scores. It was also shown that there was a relationship between the tactile and total scores of the Test of Sensory Function in Infants Scale and the variety of stimuli in the home environment and gross motor toy scores. These findings show that the opportunities provided in the home environment of premature infants may be related to their motor development and sensory processing skills. Consequently, the home environment may be associated with experiencing movements and sensory experiences.