Serebral palsili çocuklarda duyu bütünleme terapisinin üst ekstremite fonksiyonları, gövde kontrolü ve denge üzerine etkisi
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Dosyalar
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bakırçay Üniversitesi Lisansüstü Eğitim Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Bu çalışmadaki amaç, serebral palsili çocuklarda duyu bütünleme terapisinin
üst ekstremite fonksiyonları, gövde kontrolü ve denge üzerine etkisini araştırmaktır.
GEREÇ-YÖNTEM: Çalışma randomize kontrollü tek kör olarak planlandı. Çalışmaya
serebral palsi (SP) tanısı almış çocuklar dahil edildi ve araştırma 10 çalışma grubu, 10 kontrol
grubu olmak üzere toplam 20 serebral palsili çocuk ile tamamlandı. Değerlendirmelerde üst
ekstremite fonksiyonları için Üst Ekstremite Beceri Kalitesi Ölçeği (ÜEBKÖ), gövde kontrolü
için Gövde Kontrol Ölçüm Skalası (GKÖS) ve denge için Pediatrik Denge Ölçeği (PDÖ)
kullanıldı. Değerlendirmeler gruplara kör bir fizyoterapist tarafından tedavi öncesi ve sonrası
yapıldı. Çalışma grubuna haftada bir gün 40 dakika duyu bütünleme terapisi ve haftada bir
gün 40 dakika konvansiyonel fizyoterapi olmak üzere toplam 8 hafta tedavi uygulanırken,
kontrol grubuna haftada 2 gün, 40’ar dakika olmak üzere 8 hafta konvansiyonel fizyoterapi
uygulandı. Elde edilen veriler SPSS 22.0 programı ile analiz edildi.
BULGULAR: Çalışma grubunun yaş ortalaması 9,3±3,92 yıl iken grubun %40’ı kız,
%60’ı erkek çocuktan oluşuyordu. Kontrol grubunun ise yaş ortalaması 8,4±5,13 yıl iken
%40’ı kız, %60’ı erkek çocuktan oluşuyordu. Çalışma grubunda tedavi öncesi ve tedavi
sonrası ÜEBKÖ değerleri karşılaştırıldığında disosiye hareketler alt skalasında anlamlı fark
bulunurken (p<0,05), kontrol grubunda ise hem disosiye hareketler hem de kavrama alt
skalasında anlamlı fark olduğu belirlendi (p<0,05). Kontrol grubunda ÜEBKÖ kavrama alt
skalası skorlarındaki değişim miktarları çalışma grubuna göre anlamlı düzeyde yüksekti.
Çalışma grubunda tedavi öncesi ve sonrası GKÖS toplam skorlarında anlamlı fark bulunmadı
(p>0,05). Dinamik uzanma alt skalasında ise çalışma grubunun tedavi öncesi ve tedavi sonrası skorlarında anlamlı fark bulundu (p>0,05). Hem çalışma grubu hem de kontrol grubunda PDÖ
skorlarında tedavi öncesi ve sonrası grup içi değerlendirmelerinde anlamlı fark bulunurken
(p<0,05), skorların gruplar arası değişim miktarlarında fark olmadığı belirlendi (p>0,05).
SONUÇ: Serebral palsili çocuklarda konvansiyonel fizyoterapiyle birlikte uygulanan
duyu bütünleme terapisinin, sadece konvansiyonel fizyoterapi uygulamasına göre üst
ekstremite fonksiyonları, gövde kontrolü ve denge üzerine toplam skorlarda bir katkısı
olmadığı belirlendi. Ancak duyu bütünleme terapisi alan grupta üst ekstremitenin disosiye
hareketleri, gövde kontrolünün dinamik uzanma alt skalasında ve dengede iyileşme olduğu
görüldü.
OBJECTIVE: The aim of this study is to investigate the effect of sensory integration therapy on upper extremity functions, trunk control and balance in children with cerebral palsy. MATERIAL-METHODS: The study was planned as randomized controlled single-blind. Children diagnosed with cerebral palsy (CP) were included in the study and the study was completed with a total of 20 children with cerebral palsy, 10 of which were in the study group and 10 in the control group. In the evaluations, Upper Extremity Skill Quality Scale (QUEST) was used for upper extremity functions, Trunk Control Measurement Scale (TCMS) for trunk control and Pediatric Balance Scale (PBS) was used for balance. Evaluations were made before and after treatment by a blinded physiotherapist. The study group received sensory integration therapy once a week and conventional physiotherapy once a week for a total of 8 weeks, while the control group received conventional physiotherapy 2 days a week for 8 weeks. The obtained data were analyzed with SPSS 22.0 program. RESULTS: While the mean age of the study group was 9.3±3.92 years, 40% of the group consisted of girls and 60% of boys. The mean age of the control group was 8.4±5.13 years, and it consisted of 40% girls and 60% boys. When the pre-treatment and post-treatment QUEST values were compared in the study group, there was a significant difference in the dissociated movements subscale (p<0.05), while in the control group, there was a significant difference in both dissociated movements and grasping subscales (p<0.05). The amount of change in the QUEST comprehension subscale scores in the control group was significantly higher than in the study group. There was no significant difference in the total scores of TCMS before and after treatment in the study group (p>0.05). In the dynamic reach subscale, a significant difference was found in the pre-treatment and post-treatment scores of the study group (p>0.05). While there was a significant difference in PBS scores before and after the treatment in both the study group and the control group (p<0.05), there was no difference in the amount of difference between the groups (p>0.05). CONCLUSION: It was determined that sensory integration therapy applied together with conventional physiotherapy in children with cerebral palsy did not contribute to the total scores on upper extremity functions, trunk control and balance compared to conventional physiotherapy alone. However, in the group receiving sensory integration therapy, dissociated movements of the upper extremity, improvement in the dynamic reaching lower scale of trunk control and balance were observed.
OBJECTIVE: The aim of this study is to investigate the effect of sensory integration therapy on upper extremity functions, trunk control and balance in children with cerebral palsy. MATERIAL-METHODS: The study was planned as randomized controlled single-blind. Children diagnosed with cerebral palsy (CP) were included in the study and the study was completed with a total of 20 children with cerebral palsy, 10 of which were in the study group and 10 in the control group. In the evaluations, Upper Extremity Skill Quality Scale (QUEST) was used for upper extremity functions, Trunk Control Measurement Scale (TCMS) for trunk control and Pediatric Balance Scale (PBS) was used for balance. Evaluations were made before and after treatment by a blinded physiotherapist. The study group received sensory integration therapy once a week and conventional physiotherapy once a week for a total of 8 weeks, while the control group received conventional physiotherapy 2 days a week for 8 weeks. The obtained data were analyzed with SPSS 22.0 program. RESULTS: While the mean age of the study group was 9.3±3.92 years, 40% of the group consisted of girls and 60% of boys. The mean age of the control group was 8.4±5.13 years, and it consisted of 40% girls and 60% boys. When the pre-treatment and post-treatment QUEST values were compared in the study group, there was a significant difference in the dissociated movements subscale (p<0.05), while in the control group, there was a significant difference in both dissociated movements and grasping subscales (p<0.05). The amount of change in the QUEST comprehension subscale scores in the control group was significantly higher than in the study group. There was no significant difference in the total scores of TCMS before and after treatment in the study group (p>0.05). In the dynamic reach subscale, a significant difference was found in the pre-treatment and post-treatment scores of the study group (p>0.05). While there was a significant difference in PBS scores before and after the treatment in both the study group and the control group (p<0.05), there was no difference in the amount of difference between the groups (p>0.05). CONCLUSION: It was determined that sensory integration therapy applied together with conventional physiotherapy in children with cerebral palsy did not contribute to the total scores on upper extremity functions, trunk control and balance compared to conventional physiotherapy alone. However, in the group receiving sensory integration therapy, dissociated movements of the upper extremity, improvement in the dynamic reaching lower scale of trunk control and balance were observed.
Açıklama
Anahtar Kelimeler
Serebral palsi, Duyu bütünleme, Fizyoterapi, Cerebral palsy, Sensory integration, Physiotherapy
