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    Evaluation of daily and social participation of children with Cerebral Palsy across different age groups with a focus on the 'F?-words: Function, family, fitness, fun, friends and future
    (Pergamon-Elsevier Science Ltd, 2023) Kerem-Gunel, Mintaze; Arslan, Umut Ece; Seyhan-Biyik, Kubra; Ozal, Cemil; Numanoglu-Akbas, Ayse; Unes, Sefa; Tuncdemir, Merve
    Background: The impact of disability differs across cultures. This study aimed to determine the predictors of participation in children with cerebral palsy (CP) in Turkey, based on the six F -words. Methods: Cross-sectional study exploring participation profiles of 450 children with CP, aged between 2 and 18 years. Pediatric Evaluation of Disability Inventory (PEDI) evaluated functional skills, and Assessment of Life Habits (LIFE-H) version 3.0 assessed daily and social participation. Hierarchical linear regression models were done to determine the predictors of participation in daily activities (PDA) and social roles (PSR) in three age groups (2-4, 5-13 and 14-18 years) based on the 6 F-words (mobility of PEDI for 'fitness'; four classification systems and self-care of PEDI for 'functioning'; social functions of PEDI for 'friends'; demographic information by parents for 'family'; the recreation of LIFE-H for 'fun'; and different stages of development for 'future'). Results: The most important predictors for total PDA by age group were: self-care (p = 0.012) of PEDI in 2-4 y; self-care (p = 0.001) and mobility (p = 0.005) of PEDI in 5-13 y; GMFCS (p = 0.006) and mobility (p = 0.002) of PEDI in 14-18 y. Significant predictors for PSR differed by age group: self-care (p = 0.001) of PEDI in 2-4 y; self-care (p = 0.023) and mobility (p = 0.006) of PEDI in 5-13 y; and GMFCS (p = 0.004) and MACS (p = 0.003) in 14-18 y. Conclusions: Six F-words of function and fitness focussed on self-care in younger children with an increasing emphasis on mobility and ability levels according to age. Therefore, rehabilitation for different aspects of the functional levels is needed to improve participation in life across the six F -words framework; plus take into consideration context, age-differences, family's expectations, life requirements, environmental needs, and cultural differences.
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    Reliability and construct validity of the Turkish adaptation of the Assessment of Life Habits for children and adolescents with cerebral palsy
    (Marmara Univ, Fac Medicine, 2021) Akbas, Ayse Numanoglu; Ozal, Cemil; Cankaya, Ozge; Biyik, Kubra Seyhan; Unes, Sefa; Tuncdemir, Merve; Arslan, Umut Ece
    Objectives: The Assessment of Life Habits (LIFE-H) is a well-known questionnaire used to evaluate participation. The aim of this study was to determine the reliability and validity of the Turkish version of the LIFE-H in children with Cerebral Palsy (CP). Patients and Methods: The study included 450 children with CP between the ages of 2-18 years old. The internal consistency and test-retest reliability of the LIFE-H were calculated. The construct validity of the LIFE-H was determined with the Pediatric Evaluation of Disability Inventory (PEDI) domains and Pediatric Outcome Data Collection Instrument (PODCI) subscales. Results: The mean age of the children was 8.3715.13 years (42.4% female, 57.6% male). The internal consistency of the LIFE-H was determined to be acceptable for all categories (Cronbach alpha:0.794-0.999). The test-retest reliability values were found to be of good to excellent reliability (ICC:0.804-0.999). The correlation between the LIFE-H total scores, PODCI subscales and PEDI domains was determined as acceptable (rho between 0.538-0.894) except for the Pain/Comfort, happiness subscales of the PODCI (rho:0.24.0 - 0.479). Conclusions: It was determined that the Turkish LIFE-H had acceptable internal consistency, good test-retest reliability and satisfactory construct validity. Turkish LIFE-H is an appropriate tool to assess the participation of children and adolescents with CP.
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    The effects of fatigue, gross motor function, and gender on participation in life situations of school-aged children with cerebral palsy: A parental perspective
    (Elsevier France-Editions Scientifiques Medicales Elsevier, 2022) Seyhan-Biyik, Kubra; Arslan, Umut Ece; Ozal, Cemil; Cankaya, Ozge; Numanoglu-Akbas, Ayse; Unes, Sefa; Tuncdemir, Merve
    Objective: To investigate the effects of fatigue, gross motor function, and gender on participation in life situations of school-aged children with cerebral palsy (CP) from a parental perspective. Methods: The study included 209 children with CP aged between 5 and 13 years (mean age, 8.06 +/- 2.41 years; girls, 45.5%) and their parents. Fatigue, gross motor function, and participation status were evaluated with the Pediatric Quality of Life (PedsQL), Gross Motor Function Classification System (GMFCS), and the Assessment of Life Habits (Life-H) questionnaire, respectively. The effects of fatigue, gross motor function, and gender on participation were investigated with linear regression analysis. Results: According to parental reports, 79.9% of the children had fatigue. Children in all GMFCS levels experienced fatigue. Fatigue and GMFCS levels were dependent variables, and therefore only simple linear regression analyses were performed. Fatigue explained 38-43% of the variances in daily activities, social roles, and total Life-H scores, while gross motor function explained 48-65% of the variances in scores (p < 0.001). Gender had no effect on participation scores (p > 0.05). Conclusion: More than two thirds of the school-aged children with CP had fatigue. Fatigue and poor gross motor function had a negative effect on participation in daily activities and social roles. (c) 2022 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.