Spastik Kuadriparetik Serebral Palsili Çocuklarin Beslenme Davranişlari İle Beslenme Düzeyleri Arasindaki İlişkinin Araştırılması

Amaç: Spastik Kuadriparetik Serebral Palsi’li çocuklarda beslenme davranışlarının araştırılıp, bunların beslenme düzeyleri ve kaba motor fonksiyon seviyesiyle ilişkisinin belirlenmesidir. Gereç ve Yöntemler: Çalışmaya Spastik Kuadriparetik Serebral Palsi’li, 2-15 yaş aralığında 56 çocuk dahil edildi. Çocukların yaş, boy uzunluğu, vücut ağırlığı, vücut kütle indeksi (VKİ) ile doğum kilosu ve gestasyonel yaşları kaydedildi. Bireylerin beslenme davranışını değerlendirmek üzere Davranışsal Pediatrik Beslenme Değerlendirme Skalası uygulandı. Kaba motor fonksiyon seviyeleri, Kaba Motor Fonksiyon Sınıflandırma Sistemi’ne göre belirlendi. Beslenme düzeyleri ise; yaşa göre vücut kütle indeksi persentil eğrileri kullanılarak saptandı. Bulgular: Kaba motor fonksiyon seviyesine göre, 56 çocuktan 10’u seviye 3 (%17.9), 12’si seviye 4 (%21.4) ve 34’ü seviye 5’ti (%60.7). Yetersiz beslenme, normal beslenme, kilolu ve obez grupları arasında, beslenme davranışları ile ilgili olarak toplam sıklık skoru (p<0,0001) ve toplam problem skoru (p=0,0005) değerleri açısından anlamlı fark bulundu. Kaba motor fonksiyon seviyesine göre seviye 3, seviye 4 ve seviye 5 grupları arasında toplam sıklık skoru açısından anlamlı fark bulundu (p=0,004). Sonuç: Serebral Palsi’li çocuklarda davranış problemlerini inceleyen birçok çalışma olmakla birlikte bu çocukların beslenme davranışları üzerine oldukça az kanıt vardır. Çalışmamızda literatürle uyumlu olarak, Kuadriparetik Serebral Palsi’li çocukların kaba motor fonksiyon seviyesinin kötüleşmesinin beslenme davranış problemlerini artırdığı ve bu durumun bakım veren üzerinde stres oluşturduğu bulundu. Ayrıca çocukların beslenme davranışlarının beslenme düzeylerini de etkilediği görüldü. Yani sağlıklı bir büyüme gelişmenin temeli olan beslenme düzeyi, beslenme davranışı kötü olan bireylerde olumsuz etkilenebilmektedir.

Anahtar Kelimeler:

Beslenme davranışı, Beslenme düzeyi, Kaba motor fonksiyon seviyesi, Oral motor disfonksiyon, Serebral palsi

The Investigation of the Relationship between Nutritional Behaviors and Nutrition Levels of Spastic Quadriparetic Cerebral Palsy Children

Objectives: To investigate the relationship between feeding behavior and nutritional status of children with spastic quadriparetic cerebral palsy. Materials and Methods: 56 children between the ages of 2 to 15 years with spastic quadriparetic cerebral palsy participated in the study. The ages, heights, body weights, body mass indexes, birth weights and gestational ages of the children were recorded. Their feeding behavior was examined by using Behavioral Pediatrics Feeding Assessment Scale. Their gross motor function levels was designated based on the Gross Motor Function Classification System. Their nutritional status were estimated by using age for body mass indexes percentile curves. Results: Three groups were formed out of 56 children based on the Gross Motor Function Classification System, namely 10 children at level 3 (17.9%), 12 at level 4 (21.4%) and 34 at level 5 (60.7%). There was a significant difference found between inadequate nutrition, normal nutrition, overweight and obese groups according to total frequency score (p<0,0001) and total problem score (p=0,0005) of feeding behavior in these children. Moreover, there was a significant difference found between Gross Motor Function Classification System level 3, level 4, level 5 according to total frequency score (p=0,004). Conclusion: Along with many studies on behavior problems in children with cerebral palsy, there is little evidence on the feeding behavior of these children. In our study, we found that worsening of the gross motor function level of children with quadriparetic cerebral palsy increased feeding behavior problems and stressed on the family/caregiver in accordance with the literature. It was also observed that the feeding behavior of the children also affected the nutritional levels. Feeding behavior was worsened and increased stress of parents as Gross Motor Function Classification System levels increased. Besides, feeding behavior affected nutritional status. Feeding behavior of spastic quadriparetic cerebral palsy created stress on parents and affected their nutritional status.

Keywords:

Feeding behavior, Nutritional status, Gross motor function level, Oral motor disfunction, Serebral palsy.,

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