Publication: Serebral palsili çocuklarda denge eğitimi
Abstract
SEREBRAL PALSİLİ ÇOCUKLARDA DENGE EĞİTİMİ ÖZET Serebral palsi, gelişimini sürdüren beyinde oluşan ilerleyici olmayan, kalıcı hareket ve postür bozukluğudur. Serebral palsideki önemli problemlerden biride denge kontrolünün azalmasıdır. Bu çalışmanın amacı serebral palsili çocuklar ile sağlıklı çocukları denge kontrolü açısından karşılaştırmak ve serebral palsili çocuklarda denge kontrolünün arttırılmasıdır. Çalışmaya 5-14 yaş arası 20 sağlıklı çocuk ve 20 serebral palsili çocuk dahil edildi. Çalışma grubu rehabilitasyon ve ev egzersiz grubu olarak ayrıldı. Bu gruplarda kendi arasında değerlendirildi. Rehabilitasyon grubu haftada 3 gün 8 hafta boyunca tedaviye alındı. Ev egzersiz grubuna ise egzersizler öğretildikten sonra ayda bir takip edildi. Çalışma ve kontrol grubundaki çocuklar tek ayak üzerinde denge testi, tek ayak üzerinde ve çift ayak üzerinde zıplama testi, Kaba Motor Fonksiyon Ölçümü (KMFÖ), Berg Denge Testi, Timed up&Go Testi ve bilgisayarlı denge testi ile değerlendirildi. Çalışma grubundaki rehabilitasyon ve ev egzersiz grubu hem tedavi öncesi hem tedavi sonrası aynı parametrelerle değerlendirildi. Gruplar yaş ve cinsiyet dağılımı açısından birbirine benzerdi. (p>0.05). 8 hafta sonunda serebral palsi grubunda tek ayak üzerinde denge, KMFÖ, Berg Denge Testi ve Timed up&Go testleri skorlarında başlangıca göre anlamlı farklılık bulundu. (p<0,05). Bilgisayarlı denge testi değerlerinde ise anlamlı bir düzelme gözlendi. (p<0.05). Tek ayak üzerinde zıplama ve çift ayak üzerinde zıplama testlerinde bir farklılık bulunamadı. (p>0.05). Rehabilitasyon ve ev egzersiz grubunda tek ayak üzerinde denge, KMFÖ, Berg Denge Testi ve Timed up&Go testleri skorlarında başlangıca göre anlamlı farklılık bulundu. (p<0.05). Tek ayak üzerinde zıplama ve çift ayak üzerinde zıplama testlerinde bir farklılık bulunamadı. (p>0.05). Bilgisayarlı denge testinde başlangıca göre rehabilitasyon grubunda sapma ve salınım genişliğinde anlamlı degişiklik saptandı (p<0.05), salınım uzunluğunda anlamlı düzelme saptanmadı. (p>0.05). Ev egzersiz grubunda bilgisayarlı denge testleri skorlarında başlangıç skorlarına göre anlamlı farlılık bulunmadı. (p>0.05) Sonuç olarak; denge eğitimi serebral palsili çocuklarda postür ve denge kontrolünü arttırmakta, stabilizasyonu sağlamaktadır. Serebral palsi’de denge eğitiminde uygulanan rehabilitasyon egzersiz programına göre daha etkilidir. ANAHTAR SÖZCÜKLER: Serebral palsi, denge, rehabilitasyon, postür. BALANCE TRAINING IN THE CHILDREN WITH CEREBRAL PALSY
Cerebral palsy, which is formed in developing brain, is a permanent movement and posture defeat. Balance control decreases with cerebral palsy and it is an important problem. The purposes of this study are to compare balance contol between children with cerebral palsy and healty children and increase balance control in children with cerebral palsy. Twenty healty children and twenty children with cerebral palsy aged 5 to 14 year were included in this study. The study group parted into rehabilitation and home exercise programme’s group. This groups were evaluated between themselves. The rehabilitation group was worked 3 times weekly for 8 weeks. Exercises were taught to home exercise programme’s group and then they were followed once a month. The rehabilitation group and the home exercise programme’s group were evaluated by single leg stance test, single leg and double leg jumping test, Gross Motor Function Measurement (GMFM), Berg Balance Test, Timed up&go test and computerized balance test. The rehabilitation group and the home exercise programme’s group were evaluated with same parameters before treatment and after treatment. Two groups were similar in terms of age and sex (p>0.05) at the end of 8 weeks,cerebral palsy group showed sifnificant improvement in single leg stance test, Gross Motor Function Measurement (GMFM), Berg Balance Test, Timed up&go test and computerized balance test (p<0.05). However, cerebral palsy group did not demonstrate any improvement in single leg and double leg jumping test (p>0.05). The rehabilitation and home exercise programme’s groups showed significant improvement in single leg stance test, Gross Motor Function Measurement (GMFM), Berg Balance Test, Timed up&go test (p<0.05). However, two groups did not demonstrate any improvement in single leg and double leg jumping test (p>0.05). The rehabilitation group showed significant improvement in deviation and sway width (p<0.05), didn’t showed improvement in sway length. The home exercise programme’s group didn’t showed improvement in computerized balance test (p>0.05). As a result; balance trainig increases posture and balance control, provides stabilization in the children with cerebral palsy. The rehabilitation programme is more effective than home exercise programme in children with cerebral palsy. KEY WORDS: Cerebral palsy, balance, rehabilitation, posture.
Cerebral palsy, which is formed in developing brain, is a permanent movement and posture defeat. Balance control decreases with cerebral palsy and it is an important problem. The purposes of this study are to compare balance contol between children with cerebral palsy and healty children and increase balance control in children with cerebral palsy. Twenty healty children and twenty children with cerebral palsy aged 5 to 14 year were included in this study. The study group parted into rehabilitation and home exercise programme’s group. This groups were evaluated between themselves. The rehabilitation group was worked 3 times weekly for 8 weeks. Exercises were taught to home exercise programme’s group and then they were followed once a month. The rehabilitation group and the home exercise programme’s group were evaluated by single leg stance test, single leg and double leg jumping test, Gross Motor Function Measurement (GMFM), Berg Balance Test, Timed up&go test and computerized balance test. The rehabilitation group and the home exercise programme’s group were evaluated with same parameters before treatment and after treatment. Two groups were similar in terms of age and sex (p>0.05) at the end of 8 weeks,cerebral palsy group showed sifnificant improvement in single leg stance test, Gross Motor Function Measurement (GMFM), Berg Balance Test, Timed up&go test and computerized balance test (p<0.05). However, cerebral palsy group did not demonstrate any improvement in single leg and double leg jumping test (p>0.05). The rehabilitation and home exercise programme’s groups showed significant improvement in single leg stance test, Gross Motor Function Measurement (GMFM), Berg Balance Test, Timed up&go test (p<0.05). However, two groups did not demonstrate any improvement in single leg and double leg jumping test (p>0.05). The rehabilitation group showed significant improvement in deviation and sway width (p<0.05), didn’t showed improvement in sway length. The home exercise programme’s group didn’t showed improvement in computerized balance test (p>0.05). As a result; balance trainig increases posture and balance control, provides stabilization in the children with cerebral palsy. The rehabilitation programme is more effective than home exercise programme in children with cerebral palsy. KEY WORDS: Cerebral palsy, balance, rehabilitation, posture.