Serebral Palsili Çocuklarda Bireyselleştirilmiş Ergoterapi Programının Motor Beceri ve Aktivite Performansı Üzerine Etkisi
Amaç: Çalışma, bireyselleştirilmiş ergoterapi programının (BEP) Serebral Palsi’li çocukların motor beceri ve aktivite performansı üzerine etkisini incelemek amacıyla planlandı. Gereç ve Yöntem: Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS)’ne göre seviye I-II arası yaş ortalaması 10,25 ± 2,45 yıl olan Hemiparetik Serebral Palsi (HSP)’li 12 çocuk (7 erkek; 5 kız) çalışmaya dahil edildi. BEP, 10 hafta boyunca haftada 2 seans 45 dakika olacak şekilde çocuklara uygulandı. Çocukların motor beceri düzeyleri Bruininks- Oseretsky Motor Yeterlilik Testi Kısa Formu (BOMYT-KF) ile ve aktivite performans seviyeleri ise Kanada Aktivite Performans Ölçeği (KAPÖ) ile değerlendirildi. İstatistiksel analiz için Wilcoxon işaretli sıra testi kullanıldı. Sonuçlar: Dahil edilen çocukların 9’u sağ ve 3’ü sol HSP idi. BOMYT-KF sonuçları incelendiğinde müdahale sonrası tüm alt test skorlarında istatistiksel olarak anlamlı artış olduğu tespit edildi(p
The Effect of Individualized Occupational Therapy Program on Motor Skills and Activity Performance in Children with Cerebral Palsy
Purpose: The study was designed to investigate the effect of individualized occupational therapy program (IOTP) on motor skills and activity performance of children with Cerebral Palsy (CP). Material and Methods: 12 children (7 boys; 5 girls) with hemiparetic cerebral palsy (HCP) who had a mean age of 10.25 ± 2.45 years were included in the study according to Gross Motor Function Classification System (GMFCS). IOTP was applied 2 times and 45 minutes per week for 10 weeks. The motor skill levels of the children were evaluated by the Bruininks- Oseretsky Motor Proficiency Test Short Form (BOMPT-KF) and activity performance levels were evaluated by the Canada Occupational Performance Measure (COPM). Wilcoxon signed rank test was used for statistical analysis. Results: Nine of the children were found to have right and 3 had left hemiparetic CP. It was a statistically significant increase in all sub-test scores BOMPT-SF(p
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- Aarts, P. B., Jongerius, P. H., Geerdink, Y. A., van Limbeek, J., & Geurts, A. C. (2011). Modified Constraint-Induced Movement Therapy combined with Bimanual Training (mCIMT–BiT) in children with unilateral spastic cerebral palsy: How are improvements in arm-hand use established? Res Dev Disabil, 32(1), 271-279.
- Anttila, H., Autti-Rämö, I., Suoranta, J., Mäkelä, M., & Malmivaara, A. (2008). Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review. BMC Pediatr, 8(1), 14.
- Ballı, Ö., & Gürsoy, F. (2012). The Study of Validity and Reliability of Bruininks-Oseretsky Motor Proficiency Test for five-six–years–old Turkish children. Hacettepe J Sport Scien, 23(3), 104-118.
- Baum, C. M., & Law, M. (1997). Occupational therapy practice: Focusing on occupational performance. Am J Occup Ther, 51(4), 277-288.
- Beckung, E., & Hagberg, G. (2002). Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol, 44(5), 309-316.
- Özal, C., & Günel, M. K. (2014). Spastik serebral palsili çocuklarda gövde kontrolü ile fonksiyonel mobilite ve denge arasındaki ilişkinin incelenmesi. J Exerc Rehabil, 1(1), 01-08.
- Croce, R. V., Horvat, M., & McCarthy, E. (2001). Reliability and concurrent validity of the movement assessment battery for children. Percept Mot Skills, 93(1), 275-280.
- Cup, E. H., Scholte op Reimer, W., Thijssen, M. C., & van Kuyk-Minis, M. (2003). Reliability and validity of the Canadian Occupational Performance Measure in stroke patients. Clin Rehabil, 17(4), 402-409.
- Dodd, K. J., Taylor, N. F., & Graham, H. K. (2003). A randomized clinical trial of strength training in young people with cerebral palsy. Dev Med Child Neurol, 45(10), 652-657.
- Druzbicki, M., Rusek, W., Snela, S., Dudek, J., Szczepanik, M., Zak, E., &et al. (2013). Functional effects of roboticassisted locomotor treadmill therapy in children with cerebral palsy. J Rehabil Med, 45(4), 358-363.
- Eliasson, A. C., Krumlinde-Sundholm, L., Gordon, A. M., Feys, H., Klingels, K., Aarts, P. B., &et al. (2014). Guidelines for future research in constraint-induced movement therapy for children with unilateral cerebral palsy: an expert consensus. Dev Med Child Neurol, 56(2), 125-137.
- Galli, M., Cimolin, V., Rigoldi, C., Tenore, N., & Albertini, G. (2010). Gait patterns in hemiplegic children with cerebral palsy: comparison of right and left hemiplegia. Res Dev Disabil, 31(6), 1340-1345.
- Hagsten, B., Svensson, O., & Gardulf, A. J. (2004). Early individualized postoperative occupational therapy training in 100 patients improves ADL after hip fracture. A randomized trial. Acta Orthop, 75(2), 177-183.
- Ketelaar, M., Vermeer, A., Hart, H. T., Van Petegem-van Beek, E., & Helders, P. J. (2001). Effects of a functional therapy program on motor abilities of children with cerebral palsy. Phys Ther, 81(9), 1534-1545.
- Kielhofner, G. (2009). Conceptual foundations of occupational therapy practice. In G. Kielhofner (Eds.), The Nature and Role of Conceptual Practice Models, (First Edition, pp.60- 67). Philadelphia: FA Davis.
- Köse, B. (2018). Bruininks-Oseretsky Motor Yeterlik Testi 2 Kısa Formunun Türkçe Uyarlaması ve Özgül Öğrenme Güçlüğü Olan Çocuklarda Geçerlilik ve Güvenilirliği (Yüksek Lisans Tezi). Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
- Law, M., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. (2014). Canadian Occupational Performance Measure (COPM): CAOT publications.
- Law, M., Baptiste, S., McColl, M., Opzoomer, A., Polatajko, H., & Pollock, N. (1990). The Canadian Occupational Performance Measure: an outcome measure for occupational therapy. Can J Occup Ther, 57(2), 82-87.
- Law, M., Steinwender, S., & Leclair, L. (1998). Occupation, health and well-being. Can J Occup Ther, 65(2), 81-91.
- Lucas, B. R., Latimer, J., Doney, R., Ferreira, M. L., Adams, R., Hawkes, G., & et al. (2013). The Bruininks-Oseretsky test of motor proficiency-short form is reliable in children living in remote Australian aboriginal communities. BMC Pediatr, 13(1), 135.
- Mayston, M. J. (2001). People with cerebral palsy: effects of and perspectives for therapy. Neural Plast, 8(1-2), 51-69.
- Moreau, N. G., Bodkin, A. W., Bjornson, K., Hobbs, A., Soileau, M., & Lahasky, K. (2016). Effectiveness of rehabilitation interventions to improve gait speed in children with cerebral palsy: systematic review and meta-analysis. Phys Ther, 96(12), 1938-1954.
- Morris, C., Kurinczuk, J. J., Fitzpatrick, R., & Rosenbaum, P. L. (2006). Do the abilities of children with cerebral palsy explain their activities and participation? Dev Med Child Neurol, 48(12), 954-961.
- Myklebust, G., Jahnsen, R., & Elkjær, S. (2009). Registration of interventions in children with cerebral palsy during three years-a population based study. Dev Med Child Neurol, 51(suppl 5), 65.
- World Health Organization. (2001). International Classification of Functioning, Disability and Health. Geneva, Switzerland: World Health Organization.
- Oskoui, M., Coutinho, F., Dykeman, J., Jetté, N., & Pringsheim, T. (2013). An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol, 55(6), 509-519.
- Østensjø, S., Carlberg, E. B., & Vøllestad, N. K. (2004). Motor impairments in young children with cerebral palsy: relationship to gross motor function and everyday activities. Dev Med Child Neurol, 46(9), 580-589.
- Palisano, R. J., Begnoche, D. M., Chiarello, L. A., Bartlett, D. J., McCoy, S. W., & Chang, H. (2012). Amount and focus of physical therapy and occupational therapy for young children with cerebral palsy. Phys Occup Ther Pediatr, 32(4), 368- 382.
- Palisano, R. J., & Murr, S. (2009). Intensity of therapy services: what are the considerations? Phys Occup Ther Pediatr, 29(2), 107-112.
- Pan, A. W., Chung, L., & Hsin-Hwei, G. (2003). Reliability and validity of the Canadian Occupational Performance Measure for clients with psychiatric disorders in Taiwan. Occup Ther Int, 10(4), 269-277.
- Peters, C., Chang, A., Morales, A., Barnes, K., & Allegretti, A. (2019). An integrative review of assessments used in occupational therapy interventions for children with cerebral palsy. Braz Jour Occup Ther, 27(1), 168-185.
- Reid, D. T. (2002). Benefits of a virtual play rehabilitation environment for children with cerebral palsy on perceptions of self-efficacy: a pilot study. J Pediatr Rehabil,5(3), 141-148.
- Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, D., et al. (2007). A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl, 109(suppl 109), 8-14.
- Sakzewski, L., Miller, L., Ziviani, J., Abbott, D. F., Rose, S., Macdonell, R. A., & et al. (2015). Randomized comparison trial of density and context of upper limb intensive group versus individualized occupational therapy for children with unilateral cerebral palsy. Dev Med Child Neurol, 57(6), 539-547.
- Semple, R. J., Lee, J., Rosa, D., & Miller, L. F. (2010). A randomized trial of mindfulness-based cognitive therapy for children: Promoting mindful attention to enhance social-emotional resiliency in children. J Child Fam Stud, 19(2), 218-229.
- Serdaroǧlu, A., Cansu, A., Özkan, S., & Tezcan, S. (2006). Prevalence of cerebral palsy in Turkish children between the ages of 2 and 16 years. Dev Med Child Neurol, 48(6), 413-416.
- Shimada, T., Nishi, A., Yoshida, T., Tanaka, S., & Kobayashi, M. (2016). Development of an individualized occupational therapy programme and its effects on the neurocognition, symptoms and social functioning of patients with schizophrenia. J Physiother Occup, 23(4), 425-435.
- Stamm, T. A., Cieza, A., Machold, K., Smolen, J. S., & Stucki, G. (2006). Exploration of the link between conceptual occupational therapy models and the International Classification of Functioning, Disability and Health. Aust Occup Ther J, 53(1), 9-17.
- Şahin, S., Köse, B., Demirok, T., & Huri, M. Hemiparatik serebral palsili çocukların ve bakım verenlerinin çocuklara yönelik aktivite tercihlerinin incelenmesi. Ergoterapi ve Rehabilitasyon Dergisi, 7(1), 41-46.
- Taylor, N. F., Dodd, K. J., Baker, R. J., Willoughby, K., Thomason, P., & Graham, H. K. (2013). Progressive resistance training and mobility-related function in young people with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol, 55(9), 806-812.
- Torpil, B. (2017). Multipl Skleroz’lu Bireylerde Kanada Aktivite Performans Ölçümü’nün Türkçe Kültürel Adaptasyonu, Geçerlilik ve Güvenilirliği (Yüksek Lisans Tezi). Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
- The Canadian Occupational Performance Measure, Using the COPM with Children 2019 [Available from: http://www.thecopm.ca/advanced/using-the-copmwith- children/.] (Erişim tarihi: 12.12.2018)
- Wright, F. V., Rosenbaum, P. L., Goldsmith, C. H., Law, M., & Fehlings, D. L. (2008). How do changes in body functions and structures, activity, and participation relate in children with cerebral palsy? Dev Med Child Neurol, 50(4), 283-289.
- Wuang, Y.-P., & Su, C. (2009). Reliability and responsiveness of the Bruininks–Oseretsky Test of Motor Proficiency-in children with intellectual disability. Res Dev Disabil, 30(5), 847-855.
- Yanardağ, M. (2017). Bireyselleştirilmiş fiziksel eğitim programı. M.Yanardağ, İ. Yılmaz (Ed), Özel Gereksinimli Çocuklar için Fiziksel Eğitim ve Spor, (1.Baskı,syf.252-285). Ankara: Pegem Akademi.