Serebral Palsi’de İnteraktif Video Oyunlarının Denge ve Performans Üzerine Akut Etkisi

Amaç: Serebral Palsi (SP)’li bireylerde video oyunları terapisi (VOT) ile nörogelişimsel terapinin (NGT) performans, denge üzerindeki akut etkilerini karşılaştırmaktır. Gereç ve Yöntem: Çalışmaya 6-18 yaşları arasında 20 SP’li birey dahil edildi. Fonksiyonel düzeyleri; Kaba Motor Fonksiyon Sınıflama Sistemi (KMFSS), spastisiteleri Modifiye Ashword Skalası (MAS), kaba motor fonksiyonları Kaba Motor Fonksiyon Ölçeği-88 (KMFÖ-88) D&E modüllerine göre, fiziksel performansları 10m yürüme, 5 basamak merdiven inme ve çıkma sürelerine (5BMİS-5MBÇS) göre; fonksiyonel denge performansları süreli kalk ve yürü testi (SKYT), sağ-sol tek ayak üzerinde durma süreleri (TAÜDS) ile değerlendirildi. Birer seans NGT ve Nintendo Wii oyun konsolunda, 4 standart oyundan oluşan VOT uygulandı. 45 dakika süren 2 müdahelede önce ve sonrasında değerlendirmeler yapıldı. Sonuçlar: Performans parametrelerinde, terapi seanslarında anlamlı gelişme elde edilemedi. Denge performanslarında; VOT’da SKYT ve sol TAÜDS’de anlamlı gelişme olduğu belirlenirken (Z=-2,576, p=0,01), NGT’de elde edilmedi (Z=-1,531, p=0,126). VOT’da Spastik Diplejik (SDİ) ve Hemiplejik (SHİ) bireyler karşılaştırıldığında, 5BMÇ’da SDİ lehine anlamlı gelişme elde edildi (p=0,01). VOT’da KMFSS alt grupları; (KMFSS I-II) karşılaştırıldığında, 5BMÇS (p=0,01) ve SKYT’de (p=0,035) KMFSS II’de anlamlı gelişme elde edildi. Tartışma: SP’li bireylerde denge, performans açısından standart tedaviye oyun terapisinin eklenmesinin daha fazla fayda sağlayacağı, SP’de hastanın klinik tablosuna uygun oyun seçiminin önemli olduğu sonuçlarına varılmıştır.

Anahtar Kelimeler:

Serebral palsi, Video oyunları, Sanal sistemler

Acute Impact on Balance and Performance of Interactive Video Games in Cerebral Palsy

Purpose: Purpose: Comparing acute effects of video game therapy (VOT) and neurodevelopmental therapy (NGT) in cerebral palsy (SP) in relation to performance, balance. Material and Methods: Between ages of 6-18, 20 SP individuals were included in the study. Functional levels; Gross Motor Function Classification System (GMFCS), physical performance; 10m walking, 5 stairs climbing up (5SCU), down (5SCD), spasticity; Modified Ashworth Scale, gross motor function; Gross Motor Function Measurement-88; functional balance performances were assessed by timed up & go test (TUG) and right-left single-leg raise (SLR). NGT and VOT (4 standard games, Nintendo Wii game console) were applied for 45 minutes. Evaluations were done before-after interventions. Results: Performance parameters; there is no significant improvement in both therapy sessions. Equilibrium performances; in VOT; there is significant improvement about TUG, left SLR (Z=-2,576, p=0.01), but not in NGT (Z=-1,531, p=0,126). Compared with Spastic Diplegic (SDI) and Hemiplegic (SHI) subjects in VOT, significant improvement obtained in 5SCU in favor of SDI (p=0,01). Comparing GMFCS subgroups (GMFCS I-II) in VOT; significant improvement observed in GMFCS II about 5SCU (p=0,01) and TUG (p=0,035). Discussion: In SP, the inclusion of game therapy in standard treatment will be beneficial in terms of balance and performance and it is important to select games appropriate to the clinical chart of the patient.

Keywords:

Cerebral palsy, Video games, Virtual systems,

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