Publication: Spina bifidalı çocuklarda lezyon seviyesine göre oturma becerisi ve üst ekstremite fonksiyonlarının incelenmesi
Abstract
Amaç: Bu çalışmada spina bifidalı (SB) çocuklarda lezyon seviyesine göre ambulasyon becerileri, oturma dengesi ve üst ekstremite fonksiyonları değerlendirildi.Hastalar ve yöntemler: Çalışmaya 90 SB hastası (44 erkek, 46 kız; ort. yaş 7 yıl; dağılım 4-12 yıl) ve yaş ve cinsiyet açısından eşleştirilmiş 42 sağlıklı çocuk (20 erkek, 22 kız; ort. yaş 7.5 yıl; dağılım 4-12 yıl) dahil edildi. Hastaların ambulasyon becerileri ve el fonksiyon düzeyleri incelendi. Üst ekstremite değerlendirmeleri kutu blok testi (KBT), dokuz delik tahta testi (DDTT) ve dinamometre ile yapıldı.Bulgular: Spina bifida hastalarının DDTT, KBT performansları, sağlıklı kontrollere kıyasla, daha kötü ve el kavrama güçleri daha zayıftı. Şant varlığı, üst ekstremite fonksiyonlarını olumsuz etkileyen önemli bir faktör olarak tespit edildi; ancak şantı olmayan SB'li hastaların testlerdeki performansı da, sağlıklı kontrollere kıyasla, daha kötüydü. Lezyon seviyesi yükseldikçe, ambulasyonun kötüleştiği ve oturma becerisinin olumsuz etkilendiği gözlendi. Ambulasyon becerisi ile oturma süresi de ilişki bulundu.Sonuç: Spina bifidalı hastaların ambulasyon sorunlarının yanı sıra oturma becerileri ve üst ekstremite fonksiyonlarında da sorun vardır. Değerlendirme sırasında, özellikle şantı olan SB'li hastalarda bu noktalar gözden kaçırılmamalı ve üst ekstremite ve gövde dengesine yönelik çalışmalar da programda yer almalıdır
Objectives: This study aims to evaluate the ambulation skills, sitting balance, and upper extremity functions according to the lesion level in children with spina bifida (SB).Patients and methods: A total of 90 SB patients (44 boys, 46 girls; mean age 7 years; range 4 to 12 years) and 42 age- and sex-matched healthy children (20 boys, 22 girls; mean age 7.5 years; range 4 to 12 years) were included in the study. The ambulation skills and upper extremity functions of the patients were analyzed. The upper extremity functions were assessed using the box and blocks test (BBT), nine-hole peg test (NHPT), and dynamometer.Results: Spina bifida patients had worse performance on the NHPT, BBT and their handgrip hold was weaker, compared to healthy controls. The presence of shunt was found to be an important factor which deteriorated the upper extremity functions; however, SB patients without a shunt also had worse upper extremity function test performance, compared to healthy controls. As the lesion level increased, ambulation worsened and the sitting ability was adversely affected. The ambulation skill and sitting duration were also found to be correlated to each other.Conclusion: Patients with SB have troubles with sitting abilities and upper extremity functions besides the ambulation problems. During the evaluation of SB patients with a shunt, particularly, these considerations should be kept in mind and the workouts for upper extremity functions and trunk balance should take part in the rehabilitation program
Objectives: This study aims to evaluate the ambulation skills, sitting balance, and upper extremity functions according to the lesion level in children with spina bifida (SB).Patients and methods: A total of 90 SB patients (44 boys, 46 girls; mean age 7 years; range 4 to 12 years) and 42 age- and sex-matched healthy children (20 boys, 22 girls; mean age 7.5 years; range 4 to 12 years) were included in the study. The ambulation skills and upper extremity functions of the patients were analyzed. The upper extremity functions were assessed using the box and blocks test (BBT), nine-hole peg test (NHPT), and dynamometer.Results: Spina bifida patients had worse performance on the NHPT, BBT and their handgrip hold was weaker, compared to healthy controls. The presence of shunt was found to be an important factor which deteriorated the upper extremity functions; however, SB patients without a shunt also had worse upper extremity function test performance, compared to healthy controls. As the lesion level increased, ambulation worsened and the sitting ability was adversely affected. The ambulation skill and sitting duration were also found to be correlated to each other.Conclusion: Patients with SB have troubles with sitting abilities and upper extremity functions besides the ambulation problems. During the evaluation of SB patients with a shunt, particularly, these considerations should be kept in mind and the workouts for upper extremity functions and trunk balance should take part in the rehabilitation program