Spastik hemiplejik serebral palside ayna terapisi uygulamasının beyin reorganizasyonu, fonksiyonel motor beceriler ve yaşam kalitesi üzerindeki etkisi

Abstract

Amaç: Spastik hemiplejik serebral palsi, duyusal-motor sorunlar, fonksiyonel hareket ve postür bozuklukları ile karakterize, günlük yaşam aktivitelerini olumsuz etkileyen kompleks bir nöro-gelişimsel bozukluktur. Bu çalışmanın amacı, üst ekstremite ve el fonksiyonlarına yönelik ayna terapisinin beyin yeniden örgütlenmesi, fonksiyonel motor gelişim, günlük yaşam aktiviteleri ve yaşam kalitesi üzerindeki etkilerini incelemekti. Yöntem: Bu özdenetimli çalışma, yaşları 4 ile 18 arasında değişen dokuz çocuktan oluştu. Çocuklar, sekiz haftalık rutin fizyoterapi öncesi ve sonrası değerlendirildi, ardından aynı fizyoterapist tarafından haftada üç gün, 30’ar dakikalık ayna terapisi seanslarını içeren bir müdahale programına alındı. Değerlendirmelerde aktivasyon şiddeti, üst ekstremite aktivasyon yoğunluğu, üst ekstremite beceri düzeyleri, hedef gerçekleştirme durumu, fonksiyonel bağımsızlık düzeyi, beyin yeniden örgütlenme durumu ve yaşam kalitesi ölçüldü. Bulgular: İlk sekiz haftalık takip döneminde, değerlendirme parametreleri açısından istatistiksel olarak anlamlı bir değişiklik saptanmadı (p>0,05). Ancak, ayna terapisinin fizyoterapi programına eklendiği ikinci sekiz haftalık dönemde üst ekstremite becerilerinde, fonksiyonel bağımsızlık düzeylerinde, beyin yeniden örgütlenme bulgularında ve yaşam kalitesinde istatistiksel olarak anlamlı iyileşme görüldü (p<0,05). Sonuç: Bu çalışma, spastik hemiplejik serebral palsili çocuklarda ayna terapisinin etkinliğinin belirlenmesinde fonksiyonel manyetik rezonans görüntüleme (fMRI) kullanımına ilişkin sınırlı literatüre katkı sağlamaktadır.

Keywords

• Serebral palsi
• Motor beceriler
• Fonksiyonel durum
• Yaşam kalitesi

Effect of mirror therapy on brain re-organization, functional motor skills and quality of life in spastic hemiplegic cerebral palsy

Abstract

Purpose: Spastic hemiplegic cerebral palsy is a complex disability with sensory-motor problems characterized by functional movement and posture disorders and negatively effects daily living activities. The aim of this study was to investigate the effects of mirror therapy for upper extremity and hand functions on brain re-organization, functional motor development, daily living activity level, and quality of life in children with spastic hemiplegic cerebral palsy. Methods: This self-control study employed a sample of nine children aged from 4 to 18. The children were evaluated before and after eight weeks of routine physiotherapy and were included in mirror therapy sessions of 30 minutes each for three days a week by the same physiotherapist. The evaluation measured activation intensity, upper extremity activation intensity, upper extremity skill levels, goal achievement states, functional independent states, brain re-organization states, and quality of life levels. Results: No statistically significant difference was detected regarding the evaluation parameters before and after the first eightweek follow-up period (p>0.05). However, a statistically significant improvement was found in upper extremity skill states, functional independence levels, brain re-organization states, and quality of life levels in the second 8-week study period in which mirror therapy was added to physiotherapy (p<0.05). Conclusion: This study contributes to the limited literature on the determination of treatment effectiveness by employing functional magnetic resonance imaging (fMRI) in the mirror therapy on children with spastic hemiplegic cerebral palsy.

Keywords

• Cerebral palsy
• Motor skills
• Functional status
• Quality of life.

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