Ayşe NUMANOĞLU AKBAŞ, Mintaze KEREM GÜNEL

317199

SPASTİK SEREBRAL PALSİLİ ÇOCUKLARDA BİREYSEL YAPILANDIRILMIŞ GÖVDE EĞİTİMİNİN VÜCUT YAPI VE FONKSİYONU ÜZERİNE ETKİSİ: TABAKALANDIRILMIŞ RANDOMİZE KONTROLLÜ ÇALIŞMA

Amaç: Bu çalışmanın amacı, spastik serebral palsili (SP) çocuklarda gövde eğitiminin; vücut yapılarıve fonksiyonları üzerindeki etkilerini araştırmaktı.Yöntem: Bu çalışmaya dahil edilen çocuklar Kaba Motor Fonksiyon Sınıflandırma Sistemi’ne(KMFSS) göre sınıflandırıldı; yaşlarına ve KMFSS seviyelerine göre tabakalı randomizasyon ile ikigruba ayrıldı. Gövde eğitimi grubuna 19 çocuk (4 kız, 15 erkek, yaş=8,81±3,92 yıl), kontrol grubuna17 çocuk (6 kız, 11 erkek, yaş=10,44±4,63 yıl) olmak üzere toplam 36 bilateral spastik SP tanılıçocuk dahil edildi. Üst ve alt ekstremite kaslarının kas tonusu Modifiye Tardieu Ölçeği (MTÖ) ile,gövde kaslarının kas aktivasyonu yüzey elektromiyografi ile dinlenme (sEMG minimum) ve ileridoğru uzanma aktivitesi (sEMG maksimum) sırasında değerlendirildi. Değerlendirmeler başlangıçtave sekiz hafta süren müdahaleden sonra yapıldı.Sonuçlar: Tedavinin etkisi ile meydana gelen değişimler incelendiğinde, her iki grupta da kastonusunda herhangi bir değişim olmadığı görüldü (p>0,05). Erektör spina kasları sEMG maksimumskorları gövde eğitimi grubunda iyileşme gösterdi (sağ için p=0,025 ve sol için p=0,006). Lumbalmultifidus, M. rectus abdominis, internal oblik-transversus abdominis, eksternal oblik ve M. gluteusmaximus kaslarının sEMG değerlerinde herhangi bir değişim yoktu (p>0.05).Tartışma: Bireysel yapılandırılmış gövde eğitimi gövde ekstansör kaslarının aktivasyonunuartırmak için umut verici bir yöntemdir. Bu müdahale, SP'li çocuklarda üst ve alt ekstremitelerdekas tonusunda artış riski olmaksızın güvenle kullanılabilir.
Anahtar Kelimeler:

Serebral Palsi, Çocuk, Egzersiz, Kaslar, Rehabilitasyon

EFFECTS OF INDIVIDUALLY STRUCTURED TRUNK TRAINING ON BODY FUNCTION AND STRUCTURES IN CHILDREN WITH SPASTIC CEREBRAL PALSY: A STRATIFIED RANDOMIZED CONTROLLED TRIAL

Purpose: This study aimed to investigate the effects of trunk training on body function andstructures of children with spastic cerebral palsy (CP).Methods: Children included in this study were classified according to the Gross Motor FunctionClassification System (GMFCS) and divided into two groups by stratified randomization basedon their GMFCS levels and ages. A total of 36 children with bilateral spastic CP were recruitedfor this study, and 19 children (4 females, 15 males, age=8.81±3.92 years) were included in thetrunk training group, and 17 children (6 females, 11 males, age=10.44±4.63 years) were includedin the control group. Muscle tone of upper and lower extremity muscles was assessed using theModified Tardieu Scale (MTS), and muscle activation of the trunk muscles was assessed usingSurface Electromyography during rest (sEMG minimum) and forward reaching (sEMG maximum) atbaseline and after an eight-week intervention.Results: When the therapy-induced changes were considered, it was seen that there was nodifference in muscle tone in both groups (p>0.05). The sEMG maximum scores for erector spinaemuscles (p=0.025 for right and p=0.006 for left) improved in the trunk training group. There was nochange in the sEMG scores of lumbar multifidus, M. rectus abdominis, internal oblique-transversusabdominis, external oblique, and M. gluteus maximus muscles (p>0.05).Conclusion: Individually-structured trunk training is a promising method to increase activation oftrunk extensors. This intervention can be used safely without the risk of increasing muscle tone ofupper and lower extremities in children with CP. 
Keywords:

Cerebral Palsy, Child, Exercise, Muscles, Rehabilitation,

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Türk Fizyoterapi ve Rehabilitasyon Dergisi-Cover
  • ISSN: 2651-4451
  • Başlangıç: 1974
  • Yayıncı: Türkiye Fizyoterapistler Derneği
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