Publication: Hemiplejik serebral palsili çocuklarda dinamik yürüme indeksi’nin geçerlilik ve güvenilirliğinin araştırılması
Abstract
Amaç: Yetişkinler için hassas ve etkin bir denge değerlendirme aracı olan Dinamik Yürüme İndeksi’nin; kısa sürede uygulanabilir olması, basitliği ve idare kolaylığı gibi özellikleri açısından Hemiplejik Serebral Palsili çocuklardaki geçerliliği ve güvenilirliğini araştırmaktır.Gereç ve Yöntem: Çalışmaya 6-14 yaş arası, Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS) seviyesi I ve II olan 16 Hemiplejik Serebral Palsi (SP) tanılı çocuk ve yaşları eşleştirilmiş 16 sağlıklı çocuk dahil edildi. Yürüme ve denge; Dinamik Yürüme İndeksi (DYİ), Dört Adım Kare Testi (DAKT), Zamanlı Kalk ve Yürü Testi (ZKYT) ve Pediatrik Berg Denge Ölçeği (PBDÖ) ile değerlendirildi.Bulgular: Yapılan değerlendirmelerde DYİ ve diğer denge yöntemlerinin sonuçlarının karşılaştırılmasında hasta ve kontrol grup arasında kontrol grubu lehine ve KMFSS seviye I ve II arasında seviye I olan çocukların lehine anlamlı farklılık saptandı (p<0,05). Testin test-tekrar test (ICC=0,970 GA(0,915- 0,990)) ve değerlendiriciler arası (ICC=0,983 GA(0,882- 0,998)) güvenilirliği mükemmel olarak bulundu. DYİ’nin diğer denge yöntemleriyle olan ilişkisi incelendiğinde; DAKT ile negatif yönde orta derecede (r=-0,673, p=0,004) ilişki, ZKYT ile negatif yönde yüksek derecede (r=-0,828, p<0,001) ilişki ve PBDÖ ile pozitif yönde yüksek derecede (r=0,724, p=0,002) ilişki saptandı.Sonuçlar: Hemiplejik SP’li çocuklar sağlıklı yaşıtlarına kıyasla belirgin yürüme ve denge problemleri yaşamaktadırlar. Bu çocuklar için uygun tedavi yöntemlerini belirlemek ve bu yöntemlerin etkinliğini değerlendirmek için DYİ kolay uygulanabilir, geçerli ve güvenilir bir ölçüm yöntemidir.
Purpose: The aim of this study is to investigate the validity and reliability of Dynamic Gait Index -which is a sensitive and effective dynamic balance assessment tool for adults- with Hemiplegic Cerebral Palsy due to reasons such as being applicable in a short time, simplicity and ease of administration.Materials and Methods: 16 children aged 6-14 years with Hemiplegic Cerebral Palsy (CP) whose Gross Motor Function Classification System (GMFCS) levels were I and II and sixteen age-matched healthy children were included in this study. Gait and balance were evaluated with Dynamic Gait Index (DGI), Four Step Square Test (FSST), Timed Up and Go Test (TUG) and Pediatric Berg Balance Scale (PBS).Results: There was a significant difference between the patient and the control group in favor of the control group also between the children with GMFCS level I and II in favor of level I in the comparison of results of the DGI and other balance tests. The test-retest (ICC=0.970 CI(0.915- 0.990)) and inter-rater (ICC=0.983 CI(0.882- 0.998)) reliability was found to be excellent. When the relationship of DGI with other balance tests is examined, a moderate relationship in negative direction with FSST (r=0,673, p=0,004); a high relationship in positive direction with PBS (r=0,724, p=0,002) and a high relationship in negative direction with TUG (r=-0,828, p<0,001) were found.Conclusions: Children with Hemiplegic CP experience significant walking and balance problems compared to their healthy peers. To determine the appropriate treatment methods in these children and to evaluate the efficiency of these methods, the DGI test is an easily applicable, valid and reliable measurement tool.
Purpose: The aim of this study is to investigate the validity and reliability of Dynamic Gait Index -which is a sensitive and effective dynamic balance assessment tool for adults- with Hemiplegic Cerebral Palsy due to reasons such as being applicable in a short time, simplicity and ease of administration.Materials and Methods: 16 children aged 6-14 years with Hemiplegic Cerebral Palsy (CP) whose Gross Motor Function Classification System (GMFCS) levels were I and II and sixteen age-matched healthy children were included in this study. Gait and balance were evaluated with Dynamic Gait Index (DGI), Four Step Square Test (FSST), Timed Up and Go Test (TUG) and Pediatric Berg Balance Scale (PBS).Results: There was a significant difference between the patient and the control group in favor of the control group also between the children with GMFCS level I and II in favor of level I in the comparison of results of the DGI and other balance tests. The test-retest (ICC=0.970 CI(0.915- 0.990)) and inter-rater (ICC=0.983 CI(0.882- 0.998)) reliability was found to be excellent. When the relationship of DGI with other balance tests is examined, a moderate relationship in negative direction with FSST (r=0,673, p=0,004); a high relationship in positive direction with PBS (r=0,724, p=0,002) and a high relationship in negative direction with TUG (r=-0,828, p<0,001) were found.Conclusions: Children with Hemiplegic CP experience significant walking and balance problems compared to their healthy peers. To determine the appropriate treatment methods in these children and to evaluate the efficiency of these methods, the DGI test is an easily applicable, valid and reliable measurement tool.