Duchenne musküler distrofili çocuklarda fonksiyonel seviye ile gövde kontrolü ve solunum fonksiyonları arasındaki ilişki

Amaç: Bu çalışmada Duchenne Musküler Distrofi (DMD)’li çocukların alt ekstremite fonksiyonel seviyesi ile gövde kontrolü ve solunum fonksiyonları arasındaki ilişkinin incelenmesi amaçlandı.Yöntem: Çalışmamıza yaşları 6-16 yıl arasında, 23 Duchenne Musküler Distrofi’li çocuk dahil edildi. Çocukların alt ekstremite fonksiyonel seviyesi (Brooke Alt Ekstremite Fonksiyonel Sınıflandırması), gövde kontrolü, (Gövde Kontrol Ölçüm Skalası), kas kuvveti (manuel kuvvet ölçüm cihazı) ve solunum fonksiyonları (Solunum Fonksiyon Testi) değerlendirildi.Bulgular: Çalışmamızda Brooke Alt Ekstremite Fonksiyonel Sınıflandırması’nın, Gövde Kontrol Ölçüm Skalası’nın statik oturma dengesi, dinamik oturma dengesi, dinamik uzanma (denge reaksiyonları) alt başlıkları ve toplam puanı ve solunum fonksiyonlarının FVC ve PEF beklenen yüzde değerleri ile anlamlı düzeyde ilişkili olduğu (p<0,01) gösterildi. Alt ekstremite fonksiyonları ile gövde, boyun kas kuvveti ve solunum fonksiyonlarının FEV1 ve FEV1/FVC beklenen yüzde değerleri arasında anlamlı bir ilişki tespit edilemedi (p>0,05).Tartışma: Çalışmamızda Duchenne Musküler Distrofi’de, gövde kontrolü ve solunum fonksiyonlarının alt ekstremite fonksiyonel seviyesi üzerinde önemli rol oynadığı gösterildi. Bu sonuçlar çocukların fonksiyonel seviyesinin belirlenmesinde solunum parametreleriyle birlikte gövdenin de etkili olabileceğini ve Duchenne Musküler Distrofi’ye yönelik değerlendirme yaklaşımlarına erken dönemden itibaren gövde kontrolünün de eklenmesinin gerekliliğini düşündürdü.

Anahtar Kelimeler:

Duchenne musküler distrofi, Postüral denge, Ambulasyon, Solunum fonksiyon testi

The relationship between functional level, trunk control and pulmonary functions in children with Duchenne muscular dystrophy

Purpose: The aim of this study was to investigate the relationship between lower extremity functional level and trunk control and pulmonary functions in children with Duchenne Muscular Dystrophy.Methods: 23 children with Duchenne Muscular Dystrophy, between the ages of 6-16 years were included in the study. Functional classification of lower extremities in children (Brooke Lower Extremity Functional Classification), trunk control (Trunk Control Measurement Scale), muscle strength (handheld dynamometer) and respiratory functions (Respiratory Function Test) was evaluated.Results: In our study, it was shown that Brooke Lower Extremity Functional Classification was significantly associated with static sitting balance, dynamic sitting balance, dynamic reach (balance reactions) parameters and total score of Trunk Control Measurement Scale, and FVC and PEF expected percentage values (p <0.01). No significant relationship was found between lower extremity functions and trunk, neck muscle strength and FEV1 and FEV1 / FVC expected percentage values of respiratory functions (p> 0.05).Conclusion: In our study, it was shown that trunk control and pulmonary functions play an important role on lower extremity functional level in Duchenne Muscular Dystrophy. These results suggested that the trunk can be effective in determining the functional level of the children together with the respiratory parameters, and that trunk control should be added to the evaluation approaches for Duchenne Muscular Dystrophy from the early stage.

Keywords:

Duchenne muscular dystrophy, Postural balance, Ambulation, Respiratory function test,

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