Publication: Serebral palsili olgularda görsel geri bildirimli eğitimin üst ekstremite fonksiyonlarına etkinliğinin araştırılması
Abstract
Amaç: Serebral Palsi tanılı çocuklarda Nörogelişimsel Tedavi (NGT) temelli üst ekstremite rehabilitasyonu programına eklenen görsel geri bildirimli eğitim cihazı olan “Cogniboard® Light Trainer” ın üst ekstremite eklem hareket açıklığı (EHA), kas tonusu, kavrama kuvveti, çimdikleyici kavrama kuvveti ve fonksiyonel yetenekler üzerine etkilerini karşılaştırmaktır.Gereç ve Yöntem: Araştırmaya Özel Yıldız Çocuk Dilbade Özel Eğitim ve Rehabilitasyon Merkezi’ne Serebral Palsi tanısıyla başvuran, 4 – 18 yaş aralığındaki bireyler dahil edilmiştir. Olgular randomize olarak iki gruba ayrılarak; haftada 2 gün, 8 hafta süresince toplam 16 seans rehabilitasyon uygulanmıştır. Uygulanan tedavi Grup: NGT temelli üst ekstremite rehabilitasyonu, II. Grup: NGT temelli üst ekstremite rehabilitasyonu + Cogniboard® Light Trainer eğitimi şeklindedir. Olguların tedavi öncesi ve sonrasında spastisitesi ‘Modifiye Ashworh Skalası’, üst ekstremite eklem hareket açıklıkları ‘gonyometre’, kaba kavrama ve çimdikleyici kavraması ‘dinamometre’, el becerileri ‘Minnesota El Beceri Testi’ ve fonksiyonel yetenekleri ‘Çocukluk Çağı Sağlık Değerlendirme Anketi (CHAQ)’, Kaba Motor Sınıflandırma Sistemi (KMFSS) ile değerlendirilmiştir. Bulgular: Tedavi sonrası elde edilen değişmeler incelendiğinde omuz fleksiyonu ve abdüksiyonu, süpinasyon ve el bileği fleksiyon ve ekstansiyonu EHA değerlerinde; bilateral Minnesota el beceri testi skorlarında II. grupta, I. gruba göre istatistiksel olarak daha üstün sonuçlar elde edildi. Her iki grup arasında KMFSS, kavrama kuvvetlerinin değişimi ve CHAQ skorlarının değişimi açısından anlamlı bir fark bulunamadı. Sonuçlar: Görsel geri bildirimli eğitim cihazının klasik rehabilitasyon programına eklendiği tedavi yönteminin SP’li olgularda klasik NGT temelli programa göre bazı sonuç ölçümleri üzerinde daha etkili olduğu görüldü. Uzun süren rehabilitasyon sürecinde bu yeni yöntemin çocuk, aile ve fizyoterapiste alternatif bir tedavi seçeneği olabileceği düşünülmekt
Investigation of the Visual Feedback Training Effectiveness on Upper Extremity Functions in Cerebral PalsyObjective: To investigate the effectiveness of Cogniboard® Light Trainer, a visual feedback device that is added to the Neurodevelopmental Therapy Method (NDT) based upper extremity rehabilitation in children with cerebral palsy, on upper extremity functions such as joint range of motion (ROM), muscle tone, grip strength, pinch strenght and functional abilities.Materials and Methods: Children aged between 4 and 18 years were included in the study, who were referred to the Special Yildiz Cocuk Dilbade Special Education and Rehabilitation Center with diagnosis of Cerebral Palsy. The individuals were randomly divided into two groups; A total of 16 sessions of rehabilitation program were applied for 2 days a week for 8 weeks. The treatment programs applied are; Group I: NDT based upper extremity rehabilitation, Group II: NDT based upper extremity rehabilitation + Cogniboard® Light Trainer training. In the cases, pre- and posttreatment spasticity was defined with 'Modified Ashworh Scale'; upper extremity joint range of motion with ‘goniometer'; grip and pinch strenght with ‘dynamometer'; hand skills with 'Minnesota Hand Skill Test'; functional abilities with 'Childhood Health Assessment Questionnaire (CHAQ) and functional level with ‘Gross Motor Function Classification System (GMFCS)’Results: When the changes obtained after treatment were examined, shoulder flexion and abduction, supination and wrist flexion and extension ROM values; bilateral Minnesota hand skill test scores results in Group II was statistically above compared to the Group I. There was no significant difference between the two groups in terms of changes in GMFCS, change of grip and pinch strength and CHAQ scores.Conclusions: The treatment method with visual feedback training device added to the classical rehabilitation program was found to be more effective on some outcome measures than the classical NDT based program in CP cases. In the long-term rehabilitation process, this new method is thought to be an alternative treatment option for children, families and physiotherapists.
Investigation of the Visual Feedback Training Effectiveness on Upper Extremity Functions in Cerebral PalsyObjective: To investigate the effectiveness of Cogniboard® Light Trainer, a visual feedback device that is added to the Neurodevelopmental Therapy Method (NDT) based upper extremity rehabilitation in children with cerebral palsy, on upper extremity functions such as joint range of motion (ROM), muscle tone, grip strength, pinch strenght and functional abilities.Materials and Methods: Children aged between 4 and 18 years were included in the study, who were referred to the Special Yildiz Cocuk Dilbade Special Education and Rehabilitation Center with diagnosis of Cerebral Palsy. The individuals were randomly divided into two groups; A total of 16 sessions of rehabilitation program were applied for 2 days a week for 8 weeks. The treatment programs applied are; Group I: NDT based upper extremity rehabilitation, Group II: NDT based upper extremity rehabilitation + Cogniboard® Light Trainer training. In the cases, pre- and posttreatment spasticity was defined with 'Modified Ashworh Scale'; upper extremity joint range of motion with ‘goniometer'; grip and pinch strenght with ‘dynamometer'; hand skills with 'Minnesota Hand Skill Test'; functional abilities with 'Childhood Health Assessment Questionnaire (CHAQ) and functional level with ‘Gross Motor Function Classification System (GMFCS)’Results: When the changes obtained after treatment were examined, shoulder flexion and abduction, supination and wrist flexion and extension ROM values; bilateral Minnesota hand skill test scores results in Group II was statistically above compared to the Group I. There was no significant difference between the two groups in terms of changes in GMFCS, change of grip and pinch strength and CHAQ scores.Conclusions: The treatment method with visual feedback training device added to the classical rehabilitation program was found to be more effective on some outcome measures than the classical NDT based program in CP cases. In the long-term rehabilitation process, this new method is thought to be an alternative treatment option for children, families and physiotherapists.