Hemiparetik ve kuadriparetik serebral palsili çocukların erken motor repertuarlarının karşılaştırılması

Amaç: Serebral palsili (SP) çocukların motor performansı, etkilenim şiddetine bağlı olarak farklı derecelerde bozulmaktadır. Bu çalışmanın amacı hemiparetik ve kuadriparetik SP’li çocukların erken motor repertuarlarını karşılaştırmaktı. Yöntem: Çalışmada 10 hemiparetik, 22 kuadriparetik SP’li çocuğun düzeltilmiş 3-5 aylık yaşlarda çekilmiş videoları geriye dönük olarak fidgety hareketler, yaşına uygun hareket repertuarı, hareket paternleri, postüral paternler ve hareket karakteri açısından ayrıntılı General Movements analizi ile değerlendirildi. Bu değerlendirmenin sonucunda Motor Optimalite Skorları (MOS) hesaplandı. Bulgular: Hemiparetik SP grubu doğum kiloları 1055-3140 gram, doğum yaşları 25-39 hafta arasında değişen 5 kız ve 5 erkekten oluştu. Kuadriparetik SP grubu doğum kiloları 660-3570 gram, doğum yaşları 25-40 hafta arasında değişen 14 kız ve 8 erkekten oluştu. Bebeklerin hiçbiri normal fidgety harekete sahip değildi. Hemiparetik SP’li çocukların MOS’ları kuadriparetik SP’li çocuklardan daha yüksekti (p=0.036). Sonuç: Hemiparetik SP’li çocuklar erken motor repertuar açısından kuadriparetik çocuklara göre daha iyi durumdadır. MOS vücut etkilenimi açısından farklı SP tiplerini tahmin etmede etkin bir değerlendirme yöntemi olabilir.

Anahtar Kelimeler:

İnfant, Motor aktivite, Serebral palsi

Comparison of early motor repertoires of children with hemiparetic and quadriparetic cerebral palsy

Purpose: The motor performance of children with cerebral palsy (CP) is impaired to varying degrees depending on the severity of the disorder. The aim of this study was to compare the early motor repertoire of children with hemiparetic and quadriparetic CP. Methods: In the study, videos of 10 hemiparetic and 22 quadriparetic children with CP at corrected 3-5 months of age were evaluated retrospectively with detailed General Movements analysis in terms of fidgety movements, age-appropriate movement repertoire, movement patterns, postural patterns and movement character. As a result, Motor Optimality Scores (MOS) were calculated. Results: The group of infants with hemiparetic CP consisted 5 girls and 5 boys who changed with birth weights between 1055-3140 grams and gestational ages between 25-39 weeks. The group of infants with quadriparetic CP consisted 14 girls and 8 boys who changed with birth weights between 660-3570 grams and gestational ages between 25-40 weeks. None of the infants had normal fidgety movements. The MOS of children with hemiparetic CP were higher than children with quadriparetic CP (p=0.036). Conclusion: Children with hemiparetic CP are better in terms of motor repertoire than quadriparetic children. MOS can be an effective evaluation method to predict different types of CP in terms of body involvement.

Keywords:

Infant, Motor activity, Cerebral palsy,

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Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8-14.
Morris C. Definition and classification of cerebral palsy: a historical perspective. Dev Med Child Neurol. 2007;49:3-5.
Lüchinger AB, Hadders-Algra M, van Kan CM, et al. Fetal onset of general movements. Pediatr Res. 2008;63:191-195.
Einspieler C, Prechtl HF, Ferrari F, et al. The qualitative assessment of general movements in preterm, term and young infants--review of the methodology. Early Hum Dev. 1997;50:47-60.
Prechtl HF, Einspieler C, Cioni G, et al. An early marker for neurological deficits after perinatal brain lesions. Lancet 1997;349:1361-1363.
Einspieler C, Peharz R, Marschik PB. Fidgety movements—tiny in appearance but huge in impact. J Pediatr. 2016;92:64-70.
Einspieler C, Bos AF, Krieber-Tomantschger M, et al. Cerebral Palsy: Early Markers of Clinical Phenotype and Functional Outcome. J Clin Med. 2019;8:1616.
Spittle AJ, Brown NC, Doyle LW, et al. Quality of general movements is related to white matter pathology in very preterm infants. Pediatrics 2008;121:1184-1189.
Spittle AJ, Doyle LW, Anderson PJ, et al. Reduced cerebellar diameter in very preterm infants with abnormal general movements. Early Hum Dev. 2010;86:1-5.
Ferrari F, Todeschini A, Guidotti I, et al. General movements in full-term infants with perinatal asphyxia are related to basal ganglia and thalamic lesions. J Pediatr. 2011;158:904-911.
Kwong AKL, Olsen JE, Eeles AL, et al. Occurrence and temporal trends in fidgety general movements in infants born extremely preterm/extremely low birthweight and term-born controls. Early Hum Dev. 2019;135:11-15.
Bruggink JLM, Cioni G, Einspieler C, et al. Early motor repertoire is related to level of self-mobility in children with cerebral palsy at school age. Dev Med Child Neurol. 2009;51:878-885.
Prechtl HF. General movement assessment as a method of developmental neurology: new paradigms and their consequences. The 1999 Ronnie MacKeith lecture. Dev Med Child Neurol. 2001;43:836-842.
Einspieler C, Prechtl HF. Prechtl's assessment of general movements: a diagnostic tool for the functional assessment of the young nervous system. Ment Retard Dev Disabil Res Rev. 2005;11:61-67.
Kolb B, Mychasiuk R, Williams P, et al. Brain plasticity and recovery from early cortical injury. Dev Med Child Neurol. 2011;53:4-8.
Kolb B, Mychasiuk R, Muhammad A, et al. Brain plasticity in the developing brain. Prog Brain Res. 2013;207:35-64.
Novak I, Morgan C, Adde L, et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017;171:897-907.
Morgan C, Darrah J, Gordon AM, et al. Effectiveness of motor interventions in infants with cerebral palsy: a systematic review. Dev Med Child Neurol. 2016;58:900-909.