Publication: Hemiparetik Serebral Palsili çocuklarda iki farklı telerehabilitasyon tekniği kullanılarak uygulanan hareket gözlem tedavisinin etkinliğinin değerlendirilmesi
Abstract
Amaç: Çalışmada, hemiparetik Serebral Palsi’li (SP) çocuklarda, ev ortamında ebeveyn gözetimi altında (EG) ve video konferans yoluyla fizyoterapistin gözetimi altında (FG) uygulanan hareket gözlem tedavisinin (HGT) etkinliğini değerlendirmek amaçlanmıştır. Gereç ve Yöntem: 6-12 yaş aralığındaki 36 hemiparetik SP’li çocuk FG, EG ve kontrol grubu (KG) olmak üzere üç gruba randomize edilmiştir. 3 hafta boyunca FG ile EG grupları rutin konvansiyonel fizyoterapi programına ek olarak HGT ve KG grubu yalnızca rutin konvansiyonel fizyoterapi almıştır. 2 aylık takip süresince üç grup da yalnızca konvansiyonel fizyoterapi almaya devam etmiştir. Değerlendirmeler, başlangıçta (T0), 4. haftada (T4) ve 12. haftada (T12) olmak üzere üç kez yapılmıştır. Primer sonuç ölçütü gözlemlenen bimanuel performans olup, değerlendiricisi çalışma gruplarına kördü. Sekonder sonuç ölçütleri ise algılanan bimanuel performans, kontralateral ve etkilenen ellerin unimanuel kapasitesi ile kavrama kuvveti, bimanuel kapasite, kas tonusu, gövde kontrolü, katılım ve rehabilitasyon memnuniyeti idi. Bulgular: FG ve EG gruplarında, gözlemlenen bimanuel performans, algılanan bimanuel performansa dair bazı parametreler, kontralateral ve etkilenen ellerin unimanuel kapasitesi ve bimanuel kapasitede iyileşme gözlemlenmiştir (p<0,05). Ayrıca, FG grubunda kontralateral elin kavrama kuvveti, dinamik oturma dengesi ve gövde kontrolünde gelişme; EG grubunda ise toplumsal katılım sıklığında artış belirlenmiştir (p<0,05). Her iki elin kullanıldığı aktivite yüzdesi (T4-T0 ve T12-T0) ve dinamik oturma dengesindeki değişim (T12-T0) FG grubunda KG grubundan, toplumsal katılım sıklığındaki değişim (T12-T0) ise EG grubunda FG grubundan daha fazla bulunmuştur (p<0,017). Sonuç: HGT, konvansiyonel fizyoterapiye ek olarak, ev ortamında hem fizyoterapist hem ebeveyn gözetiminde uygulandığında etkili ve yararlı bulunmuştur.
Objective: The aim of this study was to assess the effectiveness of action observation treatment (AOT) in children with hemiparetic cerebral palsy (CP), administered at home under parental supervision (EG) and under the supervision of a physiotherapist via videoconferencing (FG). Materials and Methods: Thirty-six hemiparetic children with CP, aged 6-12 years, were randomized into three groups: FG, EG, and a control group (CG). For 3 weeks, the FG and EG groups received AOT in addition to the routine conventional physiotherapy program, while the CG group received only the routine conventional physiotherapy program. During the 2-month follow-up, all three groups continued to receive only conventional physiotherapy. Assessments were conducted three times: at baseline (T0), at week 4 (T4), and at week 12 (T12). The primary outcome measure was observed bimanual performance, with the assessor blinded to the study groups. Secondary outcome measures included perceived bimanual performance, unimanual capacity and grip strength of the contralateral and affected hands, bimanual capacity, muscle tone, trunk control, participation, and satisfaction with the rehabilitation program. Results: In the FG and EG groups, observed bimanual performance, certain parameters related to perceived bimanual performance, unimanual capacity of the contralateral and affected hands, and bimanual capacity all showed improvement (p<0.05). Additionally, contralateral hand grip strength, dynamic sitting balance, and trunk control improved in the FG group, while community participation frequency increased in the EG group (p<0.05). The changes in the percentage of activities involving both hands (T4-T0 and T12-T0) and in dynamic sitting balance (T12-T0) were greater in the FG group than the CG group, while the change in community participation frequency (T12-T0) was greater in the EG group than the FG group (p<0.017). Conclusion: AOT has been found to be effective and beneficial when applied at home under the supervision of both a physiotherapist and a parent, alongside conventional physiotherapy.
Objective: The aim of this study was to assess the effectiveness of action observation treatment (AOT) in children with hemiparetic cerebral palsy (CP), administered at home under parental supervision (EG) and under the supervision of a physiotherapist via videoconferencing (FG). Materials and Methods: Thirty-six hemiparetic children with CP, aged 6-12 years, were randomized into three groups: FG, EG, and a control group (CG). For 3 weeks, the FG and EG groups received AOT in addition to the routine conventional physiotherapy program, while the CG group received only the routine conventional physiotherapy program. During the 2-month follow-up, all three groups continued to receive only conventional physiotherapy. Assessments were conducted three times: at baseline (T0), at week 4 (T4), and at week 12 (T12). The primary outcome measure was observed bimanual performance, with the assessor blinded to the study groups. Secondary outcome measures included perceived bimanual performance, unimanual capacity and grip strength of the contralateral and affected hands, bimanual capacity, muscle tone, trunk control, participation, and satisfaction with the rehabilitation program. Results: In the FG and EG groups, observed bimanual performance, certain parameters related to perceived bimanual performance, unimanual capacity of the contralateral and affected hands, and bimanual capacity all showed improvement (p<0.05). Additionally, contralateral hand grip strength, dynamic sitting balance, and trunk control improved in the FG group, while community participation frequency increased in the EG group (p<0.05). The changes in the percentage of activities involving both hands (T4-T0 and T12-T0) and in dynamic sitting balance (T12-T0) were greater in the FG group than the CG group, while the change in community participation frequency (T12-T0) was greater in the EG group than the FG group (p<0.017). Conclusion: AOT has been found to be effective and beneficial when applied at home under the supervision of both a physiotherapist and a parent, alongside conventional physiotherapy.
Description
Keywords
Cerebral palsied children, conventional physiotherapy, Hareket gözlem tedavisi, hemiparetic cerebral palsy, hemiparetik serebral palsi, konvansiyonel fizyoterapi, Rehabilitasyon, Rehabilitation, Serebral palsili çocuklar, telerehabilitasyon, telerehabilitation, upper extremity, üst ekstremite Action observation treatment