Ayşe LİVANELİOĞLU, Akmer MUTLU, Özgün KARA KAYA, Mintaze Kerem GÜNEL

Beyin felci olan çocuklarda kaba motor işlevleri kazanma yaşının işlevsel motor bozukluk üzerine etkisi

Amaç: Bu çalışmanın amacı, beyin felci olan çocuklarda kaba motor işlevleri kazanma yaşının işlevsel motor bozukluk üzerine etkisinin araştırılmasıdır. Gereç ve Yöntem: Çalışmamıza çocuk nöroloğu tarafından tanısı konulmuş ve Hacettepe Üniveristesi, Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Serebral Paralizi Birimi’ne fizyoterapi rehabilitasyon programı almak için gönderilmiş 671 beyin felci olan çocuk alındı ve ailelerine çocukların kaba motor işlevleri kazanma yaşları soruldu. İşlevsel motor bozukluk, Kaba Motor Fonksiyon Sınıflandırma Sistemine göre belirlendi. Bulgular: Beyin felci olan olguların klinik tipleri 625’i spastik (%93,1), 32’si diskinetik (%4,8), 10’u ataksik (%1,5), dördü karışık tip (%0,6) olarak belirlendi. Kaba Motor Fonksiyon Sınıflandırma Sistemine göre seviye I’de 152 (%22,7), seviye II’de 102 (%15,2), seviye III’de 111 (%16,5), seviye IV’de 60 (%8,9), seviye V’de 246 (%36,7) olgu yer almaktaydı. Bağımsız oturma becerisi kazanma yaşı ortanca değeri seviye I’de dokuz ay, seviye II’de 12 ay, seviye III’de 24 aydı. Emekleme yeteneği kazanma yaşı ortanca değeri seviye I’de 12 ay, seviye II’de 18 ay, seviye III’de 48 aydı. Bağımsız yürüme yaşı ortanca değeri seviye I’de 18 ay, seviye II’de 33 aydı. Çalışma için Hacettepe Üniversitesi Tıp Fakültesi Etik Komitesinden onay alındı (No: HEK 09/60).Çıkarımlar: Bizim de beklediğimiz gibi, motor bozukluğun şiddeti arttıkça kaba motor işlevi kazanma yaşları giderek artmıştır. Bu çalışmanın sonuçlarının, beyin felci olan çocuğun kaba motor bozukluğunun seyri ile ilgili bilgi verebileceğini düşünmekteyiz.

Effect of acquisition ages of gross motor functions on functional motor impairment in children with cerebral palsy

Aim: This study aimed to investigate effect of the age of acquisition of gross motor functions on functional motor impairment in children with cerebral palsy. Material and Method: Six hundred seventy one children with cerebral palsy who were diagnosed by a pediatric neurologist and referred to Hacettepe University, Department of Physiotherapy and Rehabilitation, Cerebral Palsy Unit were included this study and acquisition ages of gross motor functions were asked to the parents. Functional motor impairment was determined with Gross Motor Function Classification System. Ethics committee approval was received by Hacettepe University Medical Faculty Ethics Committee, Faculty of Health Sciences (Number: HEK 06/60). Results: Clinical types of the patients with cerebral palsy included 625 (93.1%) spastic, 32 (4.8%) dyskinetic, 10 (1.5%) ataxic and four (0.6%) mixed type. According to Gross Motor Function Classification System 152 (22.7%) of the children were in level I, 102 (15.2%) were in level II, 111 (16.5%) were in level III, 60 (8.9%) were in level IV and 246 (36.7%) were in level V. The median age of acquisition of sitting independently was nine months in level I, 12 months in level II and 24 months in level III. The median age of acquisition of crawling was 12 months in level I, 18 months in level II and 48 months in level III. The median age of acquisition of walking independently was 18 months in level I and 33 months in level II. Conclusions: Age of acquisition of gross motor functions gradually increased as the severity of motor impairment increased, as we expected. We believe that the results of this study will provide information regarding prognosis of gross motor impairment in children with cerebral palsy.

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