Publication: Doğumsal brakial pleksus lezyonlu çocuklarda vojta tedavisinin etkinliği
Abstract
Marmara Üniversitesi Fiziksel Tıp ve Rehabilitasyon nda 2000-2003 tarihleri arasında yürütülen bu çalışmanın amacı doğumsal brakial pleksus lezyonlu çocuklarda Vojta tedavisinin etkinliğini araştırmaktır. Çalışmaya 0-12 ay arasındaki doğumsal brakial pleksus lezyonlu 19 hasta dahil edildi. Hastalar eşlemeli olarak iki gruba ayrıldı. Tedavi grubunu oluşturan 10 çocuk pediatrik rehabilitasyon ünitesinde Vojta yöntemi ile rehabilitasyon programına alındı. Kontrol grubundaki 9 çocuğun ailelerine ev eklinde konvansiyonel egzersiz gösterildi. Tüm hastaların ailelerine egzersizler öğretilip uygulamaları kontrol edildi. Tüm hastaların tedavinin başlangıcı, 3.ay ve 6.ayında çevre ve uzunluk ölçümleri, gonyometrik ölçümleri, kas testi ve fonksiyonel değerlendirmeleri yapıldı ve lagerreaksiyonları değerlendirildi. Grupların tedavinin başlangıcı, 3.ay ve 6.aydaki değerlendirmeleri karşılaştırıldı, hiçbirinde istatistiksel olarak anlamlı fark bulunmadı, ancak her iki grubun da tedavi ile ilerleme kaydettikleri gözlendi. Tedavi sonunda tüm hastaların omuz fleksiyonu, abduksiyonu, dirsek fleksiyonu, ön kol supinasyonu ve bilek ekstansiyonunda istatistiksel olarak anlamlı iyileşme gözlendi. Çalışma sonucunda doğumsal brakial lezyonlu çocuklarda Vojta tedavisinin üstünlüğü kanıtlanamadı. Doğumsal brakial pleksus lezyonlu çocuklarda erken başlayan ve düzenli yapılan tedavi çok önemlidir, Vojta yöntemi ile konvansiyonel egzersizlerin kombine şekilde uygulanabileceği ve faydalı olacağı düşünülmektedir.
This study was carried out in Marmara University Faculty of Medicine, Physical Rehabilitation and Medicine Department between 2000-2003. The aim of our study was to investigate the efficacy of Vojta method in treatment of children with obstetrical brachial plexus palsy. Nineteen patients aged 0-12 months with obstetrical brachial plexus palsy were included in the study. Patients were divided into two matched groups. Ten patients were in the treatment group. A rehabilitation program with Vojta method was carried out with this group in the pediatric rehabilitation unit. There were 9 patients in the control group. A home exercise program was given to the family. Baseline, third and sixth month arm circumference and length measurements, muscle testing, goniometric measurements were recorded, functional improvement and lagerreactions were evaluated. Groups were compared according to baseline, third month, sixth month values, no statistically significant difference was detected. Improvement was seen with treatment in both groups. At the end of treatment we observed statistically significant improvement in shoulder flexion, abduction, elbow flexion, forearm supination and wrist extension in all patients. At the end of the study superiority of Vojta method in the treatment of obstetrical brachial plexus palsy was not proven. Early and regular treatment is important in the treatment of obstetrical brachial plexus palsy. We think that a combination of Vojta method and conventional exercise program is applicable and beneficial in the rehabilitation of children with obstetrical brachial plexus palsy.
This study was carried out in Marmara University Faculty of Medicine, Physical Rehabilitation and Medicine Department between 2000-2003. The aim of our study was to investigate the efficacy of Vojta method in treatment of children with obstetrical brachial plexus palsy. Nineteen patients aged 0-12 months with obstetrical brachial plexus palsy were included in the study. Patients were divided into two matched groups. Ten patients were in the treatment group. A rehabilitation program with Vojta method was carried out with this group in the pediatric rehabilitation unit. There were 9 patients in the control group. A home exercise program was given to the family. Baseline, third and sixth month arm circumference and length measurements, muscle testing, goniometric measurements were recorded, functional improvement and lagerreactions were evaluated. Groups were compared according to baseline, third month, sixth month values, no statistically significant difference was detected. Improvement was seen with treatment in both groups. At the end of treatment we observed statistically significant improvement in shoulder flexion, abduction, elbow flexion, forearm supination and wrist extension in all patients. At the end of the study superiority of Vojta method in the treatment of obstetrical brachial plexus palsy was not proven. Early and regular treatment is important in the treatment of obstetrical brachial plexus palsy. We think that a combination of Vojta method and conventional exercise program is applicable and beneficial in the rehabilitation of children with obstetrical brachial plexus palsy.