Publication: Brakiyal Pleksus zedelenmesi bulunan çocukların sağlam ekstremiteleri ile sağlıklı çocukların dominant ekstremitelerinin karşılaştırılması
Abstract
Çocukluk çağının önemli sorunlarından biri olan brakiyal pleksus zedelenmesi bireyin gelişimini etkileyen bir periferik sinir lezyonudur. Bugüne kadar birçok tedavi yöntemi geliştirilmiş, bu tedavi yöntemlerinin etkinliğini ve birbirine üstünlüğünü sorgulayan çalışmalar yapılmıştır. Çalışmamızda brakiyal pleksus zedelenmeli çocukların sağlam ekstremiteleri ile sağlıklı çocukların dominant ekstremitelerinin kıyaslanması amaçlanmıştır. Çalışmaya brakiyal pleksus zedelenmesi bulunan 53 çocuk ile yaş ve cinsiyet açısından eşleştirilmiş 51 sağlıklı çocuk dahil edildi. Grupların değerlendirilmesinde kaba motor değerlendirme için kutu-blok testi, ince motor değerlendirilmesi için dokuz delikli tahta testi, el ve parmak kavrama kuvvetleri için dinamometre kullanıldı. Hasta ve kontrol gruplar arasında kutu-blok testi ve dokuz delikli tahta testi sonuçları açısından istatistiksel olarak anlamlı fark bulundu fakat el ve parmak kavrama kuvvetleri açısından anlamlı bir fark saptanmadı. Katılımcıları yaş grubuna göre kategorize ettiğimizde 4-8 yaş grubundaki brakiyal pleksopatili çocukların ince el becerilerinde kendi yaşıtlarından geri oldukları fark edildi. Ancak ilerleyen yaşlarda (9-13 yaş) bu farkın ortadan kalktığı gözlendi. Sonuç olarak; doğumsal brakiyal pleksopati tanısı ile takip edilen çocukların 4-8 yaşlarında sağlam ekstremiteleri yaşıtlarından geri kalmaktadır. Okula başladıkları dönemde sağlam ekstremitelerini etkin kullanamayacakları göz önüne alınarak rehabilitasyon planı bu açıdan tekrar düzenlenmelidir. Obstetrik brakiyal pleksus felci, sağlam kol, ince-kaba motor, el-parmak kavrama.
Comparison of the unaffected extremities of children with obstetric brachial plexus injury with the dominant extremities of healthy children Obstetric brachial plexus injury, one of the major problem in the childhood, is a peripheric nerve lesion affecting child’s individual development. So far the lesion defined, many treatment modalities were developed and a number of studies comparing the effectiveness of these treatment methods were progressed. The aim of our study was to compare the unaffected extremities of children with obstetric brachial plexus injury with the dominant extremities of healty children. Fifty three children with obstetric brachial plexus injury were included into the study. Age and gender matched fifty one healty children were also defined as a control group. In order to evaluate each group, box and block test for gross motor evaluation, nine hole peg test for fine motor evaluation and dynamometer for grip strength hands and fingers were used. The results of box and block test and nine hole peg test showed that there was an statistically significant difference between patient and control groups. However, there was no statistically significant difference on hand and finger grip strength. As a result, when the participants were categorized according to age, in comparison with healthy cildren, participants in the age range of 4-8 years were not good at fine motor skills, but in the advanced age ( range of 9-13), the difference was disappeared. Therefore, when the children with obstetric brachial plexus palsy start the school, we must keep in mind that they are not able to use their unaffected arm as effective as their peers. Thus, their rehabilitation program must be reorganized in this respect. Key words: Obstetric brachial pleksus palsy, unaffected arm, fine-gross motor, hand- finger grip.
Comparison of the unaffected extremities of children with obstetric brachial plexus injury with the dominant extremities of healthy children Obstetric brachial plexus injury, one of the major problem in the childhood, is a peripheric nerve lesion affecting child’s individual development. So far the lesion defined, many treatment modalities were developed and a number of studies comparing the effectiveness of these treatment methods were progressed. The aim of our study was to compare the unaffected extremities of children with obstetric brachial plexus injury with the dominant extremities of healty children. Fifty three children with obstetric brachial plexus injury were included into the study. Age and gender matched fifty one healty children were also defined as a control group. In order to evaluate each group, box and block test for gross motor evaluation, nine hole peg test for fine motor evaluation and dynamometer for grip strength hands and fingers were used. The results of box and block test and nine hole peg test showed that there was an statistically significant difference between patient and control groups. However, there was no statistically significant difference on hand and finger grip strength. As a result, when the participants were categorized according to age, in comparison with healthy cildren, participants in the age range of 4-8 years were not good at fine motor skills, but in the advanced age ( range of 9-13), the difference was disappeared. Therefore, when the children with obstetric brachial plexus palsy start the school, we must keep in mind that they are not able to use their unaffected arm as effective as their peers. Thus, their rehabilitation program must be reorganized in this respect. Key words: Obstetric brachial pleksus palsy, unaffected arm, fine-gross motor, hand- finger grip.