Serebral Palsili Çocuklarda Ortez Kullanımı ile İlgili Fonksiyonel Seviyenin İncelenmesi
Year 2021,
Volume: 4 Issue: 3, 201 - 211, 30.09.2021
Halis Doğan
Özlem Erodabaşı
Abstract
Amaç: Serebral palsili (SP) çocuklarda ortez kullanımı hakkında bilgi edinmek ve ortez kullanımının motor fonksiyon düzeyleriyle ilişkisini değerlendirmekti.
Gereç ve Yöntem: Çalışmaya 2-18 yaş arası 86 SP’li çocuk dahil edildi. Çocukların spastisiteleri Modifiye Asworth Skalası (MAS) ile fonksiyonel seviyeleri Kaba Motor Fonksiyon Sınıflama Sistemi (KMFSS) ile değerlendirildi. Sosyo-demografik özellikleri ve ortez kullanımı sorgulandı.
Bulgular: 86 katılımcının 51’i (%59,30) ortez kullanmaktaydı. Ortez kullanan 51 katılımcıdan 50’sinin alt ekstremite ortezleri (%98) kullandığı, bunların 30’unun (%58,80) ayak-ayakbilek ortezi (AFO) kullandıkları tespit edildi. 26 katılımcının (% 51) mobilizasyona katkı için ortez kullandığı tespit edildi. KMFSS düzeyleri ve bedensel engel düzeylerinin, ortez kullanımı ve ortezin fonksiyonelliğe katkısı üzerinde; spastisite düzeylerinin ortez kullanımı üzerinde; SP’nin tutulum şeklinin ortezin fonksiyonelliğe katkısı üzerindeki etkisi istatistiksel olarak anlamlı tespit edildi (p<0,05). MAS ve KMFSS düzeyleri arasında korelasyon tespit edildi (r=0,625, p<0,001).
Sonuç: Ortez kullanımının fonksiyonel seviye ile ilişkili olduğu ve düşük fonksiyonel seviyelerde ortezlerin koruma amaçlı kullanıldığı, daha iyi fonksiyonel seviyelerde ortezlerin mobilizasyon amaçlı kullanıldığı görüldü.
Supporting Institution
Çalışmayı destekleyen kurum yoktur.
Thanks
Katılımcı çocuklara ve ebeveynlerine, destek veren meslektaşlarımıza ve rehabilitasyon kurumlarına teşekkür ederiz.
References
- 1. Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy. Dev Med Child Neurol. 2006; 49:8–14.
- 2. Christensen D, Braun KVN, Doernberg NA, et al. Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning-autism and developmental disabilities monitoring network, USA, 2008. Dev Med Child Neurol 2014;56:59-65.
- 3. Oskoui M, Coutinho F, Dykeman J, Jetté N, Pringsheim T. An update on the prevalence of CP: a systematic review and meta-analysis. Dev Med Child Neurol 2013;55(6):509-519.
- 4. Krigger KW. CP: an overview. Am Fam Phys 2006;73(1):91-100.
- 5. Dormans J, Susman M, Çeviri: Yalçın S., Özaras N. Serebaral Palsi Tedavi ve Rehabilitasyon, Mas Matbaacılık, İstanbul. 2000.
- 6. Martin L, Baker R, Harvey A. A systematic review of common physiotherapy interventions in school-aged children with cerebral palsy. Phys Occup Ther Pediatr 2010;30(4):294-312.
- 7. Clutterbuck G, Auld M, Johnston L. Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy: a systematic review. Disabil Rehabil 2019;41(10):1131-1151.
- 8. Aydoğmuş İ, Bek N, Yakut Y. Spastik diparetik serebral palsili çocuklarda ayak tabanına uygulanan kamaların alt ekstremite eklem dizilimine etkisi. Fizyoterapi Rehabilitasyon,2011; 22(1):30-38.
- 9. McMahon M, Pruitt D, Vargus-Adams J. Cerebral Palsy. Ed. Alexander MA, Matthews DJ. İn. Pediatric Rehabilitation Principles and Practice. New York: Demos Medical Publishing. 2010; p: 166- 197.
- 10. Ofluoğlu D. Beyin felcinde ortez uygulamaları. Acta Orthop. Traumatol. Turc. 2009; 43(2):165-172.
- 11. Özgirgin N, ve Atasü S. Serebral felçli hastalarda alt ekstremite ortez uygulamaları Acta Orthop. Traumatol Turc.,1994; 28:123-126.
- 12. Hayek S, Hemo Y, Chamis S, et al. The effect of community-prescribed ankle–foot orthoses on gait parameters in children with spastic cerebral palsy. J. Child. Orthop. 2007; 1:325–332.
- 13. Bax M, Goldstein M, Rosenbaum P, Paneth N. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol 2005;47(8):571-6.
- 14. Rosenbaum P, Stewart D. The WHO international classification of functioning, disability and health: A model to guide clinical thinking, practice and research in the field of cerebral palsy. Seminars in Paediatr Neurol 2004;2(1):5-10.
- 15. Pakula AT, Braun KVN, Yeargin-Allsopp M. Cerebral palsy: classification and epidemiology. Phys Med Rehabil Clin N Am 2009;20(3):425-52.
- 16. Tatar Y. Serebral palside ortezler ve yardımcı cihazlar. Turkiye Klinikleri J PM&R-Special Topics 2009; 2(2):38-47.
- 17. Livanelioğlu A. Serebral paralizili çocuklarda inhibitör ortez uygulamasının plantar fleksör spastisitesi üzerine etkisi. Artroplasti Artroskopik Cerrahi Vol, 13, 2002; 2:85-89.
- 18. Rha DW, Kim DJ, Park ES. Effect of hinged ankle-foot orthoses on standing balance control in children with bilateral spastic cerebral palsy. Yonsei Med. J., 2010;51(5):746-752.
- 19. Naslund A, Sundelin G, Hirschfeld H. Reach performance and postural adjustments during standing in children with severe spastic diplegia using dynamic ankle-foot orthoses. J Rehabil Med. 2007;39:715-723.
- 20. Park ES, Park CI, Chang HJ, Choi JE, Lee DS. The effect of hinged ankle-foot orthoses on sit-to-stand transfer in children with spastic cerebral palsy. Arch. Phys. Med. Rehabil., 2004; 85.12: 2053-2057.
- 21. https://canchild.ca/system/tenon/assets/attachments/000/000/083/original/GMFCS-ER_Translation-Turksih.pdf
- 22. Palisano, RJ, Rosenbaum P, Bartlett, D, & Livingston, MH. Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine & Child Neurology, 2008;50(10), 744-750.
- 23. Charalambous, CP. Interrater reliability of a modified Ashworth scale of muscle spasticity. In Classic papers in orthopaedic. Springer, London, 2014; 415-417.
- 24. El Ö, Peker Ö, Bozan Ö, Berk H, Koşay C. Serebral palsi hastalarının genel özellikleri. DEÜ Tıp Fakültesi Dergisi, 2007;21(2):75-80.
- 25. Vurucu S, Sarı O, Gülgün M, Ünay B, Akın R, Özcan O. Serebral palsili hastalarımızın etiyolojik, klinik ve laboratuvar bulgularının değerlendirilmesi. TAF Prev. Med. Bull., 2008;7(6):477-484.
- 26. Ones K, Yilmaz E, Cetinkaya B, Caglar N. Assessment of the quality of life of mothers of children with cerebral palsy (primary caregivers). Neurorehabil Neural Repair 2005;19:232-7.
- 27. Sucuoğlu H. Serebral palsili hastaların demografik ve klinik özellikleri. İstanbul Med J 2018;19(3):219-24.
- 28. Morris C, Bowersc R, Rossc K, Stevensd P, Philli D. Orthotic management of cerebral palsy: Recommendations from a consensus conference. NeuroRehabilitation, 2011;28:37–46.
- 29. Russell DJ, Gorter JW. Assessing functional differences in gross motor skills in children with cerebral palsy who use an ambulatory aid or orthoses: can the GMFM-88 help? Developmental Medicine & Child. Neurology, 2005;47:462–467.
Evaluation of Orthosis Use in Relation the to the Functional Level of Children with Cerebral Palsy
Year 2021,
Volume: 4 Issue: 3, 201 - 211, 30.09.2021
Halis Doğan
Özlem Erodabaşı
Abstract
Aim: To learn about the use of orthoses in children with cerebral palsy (CP) and to evaluate the relationship between orthosis use and motor function levels.
Materials and Methods: 86 children with CP between the ages of 2-18 were included in the study. Spasticity of the children was evaluated with Modified Asworth Scale (MAS) and functional levels with the Gross Motor Function Classification System (GMFCS). Socio-demographic characteristics and use of orthoses were questioned.
Results: Fifty-one (59.30%) of 86 participants were using orthoses. It was determined that 50 of 51 participants using orthosis used lower extremity orthoses (98%), 30 of them (58.80%) were used foot-ankle orthosis (AFO). It was determined that 26 participants (51%) used orthoses to contribute to mobilization. GMFCS levels and physical disability levels on the use of orthosis and the contribution of orthosis to functionality; spasticity levels on the use of orthoses; The effect of the involvement type of CP on the contribution of the orthosis to functionality was found to be statistically significant (p <0.05). There was a positive correlation between MAS and KMFSS levels (r=0.625, p<0.001).
Conclusion: It was observed that the use of orthoses was related to the functional level, and orthoses at lower functional levels were used for protection, and better functional levels were used for mobilization.
References
- 1. Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy. Dev Med Child Neurol. 2006; 49:8–14.
- 2. Christensen D, Braun KVN, Doernberg NA, et al. Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning-autism and developmental disabilities monitoring network, USA, 2008. Dev Med Child Neurol 2014;56:59-65.
- 3. Oskoui M, Coutinho F, Dykeman J, Jetté N, Pringsheim T. An update on the prevalence of CP: a systematic review and meta-analysis. Dev Med Child Neurol 2013;55(6):509-519.
- 4. Krigger KW. CP: an overview. Am Fam Phys 2006;73(1):91-100.
- 5. Dormans J, Susman M, Çeviri: Yalçın S., Özaras N. Serebaral Palsi Tedavi ve Rehabilitasyon, Mas Matbaacılık, İstanbul. 2000.
- 6. Martin L, Baker R, Harvey A. A systematic review of common physiotherapy interventions in school-aged children with cerebral palsy. Phys Occup Ther Pediatr 2010;30(4):294-312.
- 7. Clutterbuck G, Auld M, Johnston L. Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy: a systematic review. Disabil Rehabil 2019;41(10):1131-1151.
- 8. Aydoğmuş İ, Bek N, Yakut Y. Spastik diparetik serebral palsili çocuklarda ayak tabanına uygulanan kamaların alt ekstremite eklem dizilimine etkisi. Fizyoterapi Rehabilitasyon,2011; 22(1):30-38.
- 9. McMahon M, Pruitt D, Vargus-Adams J. Cerebral Palsy. Ed. Alexander MA, Matthews DJ. İn. Pediatric Rehabilitation Principles and Practice. New York: Demos Medical Publishing. 2010; p: 166- 197.
- 10. Ofluoğlu D. Beyin felcinde ortez uygulamaları. Acta Orthop. Traumatol. Turc. 2009; 43(2):165-172.
- 11. Özgirgin N, ve Atasü S. Serebral felçli hastalarda alt ekstremite ortez uygulamaları Acta Orthop. Traumatol Turc.,1994; 28:123-126.
- 12. Hayek S, Hemo Y, Chamis S, et al. The effect of community-prescribed ankle–foot orthoses on gait parameters in children with spastic cerebral palsy. J. Child. Orthop. 2007; 1:325–332.
- 13. Bax M, Goldstein M, Rosenbaum P, Paneth N. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol 2005;47(8):571-6.
- 14. Rosenbaum P, Stewart D. The WHO international classification of functioning, disability and health: A model to guide clinical thinking, practice and research in the field of cerebral palsy. Seminars in Paediatr Neurol 2004;2(1):5-10.
- 15. Pakula AT, Braun KVN, Yeargin-Allsopp M. Cerebral palsy: classification and epidemiology. Phys Med Rehabil Clin N Am 2009;20(3):425-52.
- 16. Tatar Y. Serebral palside ortezler ve yardımcı cihazlar. Turkiye Klinikleri J PM&R-Special Topics 2009; 2(2):38-47.
- 17. Livanelioğlu A. Serebral paralizili çocuklarda inhibitör ortez uygulamasının plantar fleksör spastisitesi üzerine etkisi. Artroplasti Artroskopik Cerrahi Vol, 13, 2002; 2:85-89.
- 18. Rha DW, Kim DJ, Park ES. Effect of hinged ankle-foot orthoses on standing balance control in children with bilateral spastic cerebral palsy. Yonsei Med. J., 2010;51(5):746-752.
- 19. Naslund A, Sundelin G, Hirschfeld H. Reach performance and postural adjustments during standing in children with severe spastic diplegia using dynamic ankle-foot orthoses. J Rehabil Med. 2007;39:715-723.
- 20. Park ES, Park CI, Chang HJ, Choi JE, Lee DS. The effect of hinged ankle-foot orthoses on sit-to-stand transfer in children with spastic cerebral palsy. Arch. Phys. Med. Rehabil., 2004; 85.12: 2053-2057.
- 21. https://canchild.ca/system/tenon/assets/attachments/000/000/083/original/GMFCS-ER_Translation-Turksih.pdf
- 22. Palisano, RJ, Rosenbaum P, Bartlett, D, & Livingston, MH. Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine & Child Neurology, 2008;50(10), 744-750.
- 23. Charalambous, CP. Interrater reliability of a modified Ashworth scale of muscle spasticity. In Classic papers in orthopaedic. Springer, London, 2014; 415-417.
- 24. El Ö, Peker Ö, Bozan Ö, Berk H, Koşay C. Serebral palsi hastalarının genel özellikleri. DEÜ Tıp Fakültesi Dergisi, 2007;21(2):75-80.
- 25. Vurucu S, Sarı O, Gülgün M, Ünay B, Akın R, Özcan O. Serebral palsili hastalarımızın etiyolojik, klinik ve laboratuvar bulgularının değerlendirilmesi. TAF Prev. Med. Bull., 2008;7(6):477-484.
- 26. Ones K, Yilmaz E, Cetinkaya B, Caglar N. Assessment of the quality of life of mothers of children with cerebral palsy (primary caregivers). Neurorehabil Neural Repair 2005;19:232-7.
- 27. Sucuoğlu H. Serebral palsili hastaların demografik ve klinik özellikleri. İstanbul Med J 2018;19(3):219-24.
- 28. Morris C, Bowersc R, Rossc K, Stevensd P, Philli D. Orthotic management of cerebral palsy: Recommendations from a consensus conference. NeuroRehabilitation, 2011;28:37–46.
- 29. Russell DJ, Gorter JW. Assessing functional differences in gross motor skills in children with cerebral palsy who use an ambulatory aid or orthoses: can the GMFM-88 help? Developmental Medicine & Child. Neurology, 2005;47:462–467.