Publication: Oral motor problemi olan serebral palsili çocuklarda gövde stabilizasyon egzersizlerinin iletişim ve yaşam kalitesine etkisinin değerlendirilmesi
Abstract
Amaç: Oral motor problemi olan serebral palsili (SP) çocuklarda boyun ve gövde stabilizasyon egzersizlerinin iletişim ve yaşam kalitesine etkinliğini araştırmaktır.Gereç ve Yöntem: Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS) I-V, İletişim Fonksiyon Sınıflandırma Sistemi (İFSS) I-V ve Viking Konuşma Ölçeği (VKÖ) II-IV olan 40 SP'li çocuk randomize olarak Çalışma Grubu (ÇG) ve Kontrol Grubuna (KG) ayrıldı. Her iki gruba nörogelişimsel tedavi (NGT) yaklaşımları ve oral motor terapi uygulandı. ÇG ayrıca boyun-gövde stabilizasyon eğitimi aldı. Tedaviler haftada 2 gün, 6 hafta devam etti. Olgular tedavi öncesi ve sonrası KMFSS, İFSS, Katz, Ailenin yaşam kalitesi (Short Form 36[SF-36]), Çocuğun yaşam kalitesi (ÇİYKÖ), iletişim durumu Visuel Analog Skala (VAS) ile tedavi öncesi ve 6. haftada yapıldı.Bulgular: Tedavi sonrası her iki grupta da %70 oranında malnütrisyon saptandı. VAS ve Okul Fonksiyonlarında Sorunlar ve ÇİYKÖ Toplam Puanı sonuçlarında her iki tedavi grubunda anlamlı düzelme saptandı (p<0,05). Tedavi sonrası ÇG’da SF-36 Fiziksel fonksiyon alt parametresinde grup içi değişimde düzelme saptandı (p<0,05). SF-36 sonuçlarının Türk toplunumu Norm değerlerine göre daha düşük bulundu. ÇG’da ÇİYKÖ ile SF-36 Sosyal Sağlık ve Genel Sağlık Algısı alt parametreleri arasında ilişki saptandı.Sonuçlar: Tüm KMFSS seviyelerindeki SP’li çocuklar malnütrisyon açısından takip edilmelidir. NGT yaklaşımlarına yoğun baş-boyun ve gövde stabilizasyon egzersizleri, aile ve ÇİYKO puanlarının artışı ve iletişim becerilerinin artması göz önüne alındığında standart rehabilitasyon uygulamalarında eklenmelidir.
Objective: To investigate the effectiveness of neck and trunk stabilization exercises on communication and quality of life in children with cerebral palsy (CP) with oral motor problems.Materials and Methods: 40 children with CP who had Gross Motor Function Classification System (GMFCS) I-V, Communication Function Classification System (CFCS) I-V and Viking Speech Scale (VSS) II-IV were randomly divided into Study Group (SG) and Control Group (CG). Neurodevelopmental treatment approaches (NDT) and oral motor therapy were applied to both groups. SG also received neck-trunk stabilization training. Treatment was continued 2 days/ week for 6 weeks. Cases were performed before and after treatment with GMFCS, CFCS, Katz, QOL of family (Short Form 36 [SF-36]), Quality of life of child PedsQL, communication status with Visual Analogue Scale (VAS) before and at 6th week.Results: After treatment, 70% malnutrition was detected in both groups. There was significant improvement in VAS and School Function Problems and PedsQL Total Score in both treatment groups (p<0.05). There was significant improvement in Physical function SF-36 sub-parameter within SG after treatment (p<0.05). SF-36 results were lower than Turkish norms. There was a relationship between PedsQL and SF-36 Social Health and General Health Perception sub-parameters.Conclusions: Children with CP at all GMFCS levels should be monitored for malnutrition. NDT approaches should be included in standard rehabilitation practices considering intensive head-neck and trunk stabilization exercises, increasing family and PedsQL scores and increasing communication skills.
Objective: To investigate the effectiveness of neck and trunk stabilization exercises on communication and quality of life in children with cerebral palsy (CP) with oral motor problems.Materials and Methods: 40 children with CP who had Gross Motor Function Classification System (GMFCS) I-V, Communication Function Classification System (CFCS) I-V and Viking Speech Scale (VSS) II-IV were randomly divided into Study Group (SG) and Control Group (CG). Neurodevelopmental treatment approaches (NDT) and oral motor therapy were applied to both groups. SG also received neck-trunk stabilization training. Treatment was continued 2 days/ week for 6 weeks. Cases were performed before and after treatment with GMFCS, CFCS, Katz, QOL of family (Short Form 36 [SF-36]), Quality of life of child PedsQL, communication status with Visual Analogue Scale (VAS) before and at 6th week.Results: After treatment, 70% malnutrition was detected in both groups. There was significant improvement in VAS and School Function Problems and PedsQL Total Score in both treatment groups (p<0.05). There was significant improvement in Physical function SF-36 sub-parameter within SG after treatment (p<0.05). SF-36 results were lower than Turkish norms. There was a relationship between PedsQL and SF-36 Social Health and General Health Perception sub-parameters.Conclusions: Children with CP at all GMFCS levels should be monitored for malnutrition. NDT approaches should be included in standard rehabilitation practices considering intensive head-neck and trunk stabilization exercises, increasing family and PedsQL scores and increasing communication skills.