Spastik serebral palsili çocuklarda spastisiteyi değerlendiren iki farklı klinik ölçeğin kaba motor fonksiyonu ile ilişkisi

Abstract

Amaç: Bu çalışma spastik serebral palsili (SP) çocuklarda spastisiteyi değerlendirmek için kullanılan iki farklı klinik yöntemin birbirleri ve kaba motor fonksiyon ile ilişkilerini belirlemek amacıyla yapıldı. Kaba motor fonksiyon üzerinde hangi kasların etkili olduğu araştırıldı.

Yöntem: Çalışmada, 37 spastik SP’li çocuğun dirsek fleksör, el bileği fleksör, kalça addüktör, hamstring, gasroknemius ve soleus kasları spastisitenin şiddeti açısından Modifiye Ashworth Skalası (MAS) ve Modifiye Tardieu Skalası (MTS) ile değerlendirildi. Çocukların kaba motor fonksiyon seviyeleri Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS) ile belirlendi.

Bulgular: MAS ve MTS arasındaki ilişki analiz edildiğinde en çok uyum dirsek fleksörleri, el bileği fleksörleri, kalça addüktörleri ve hamstring kasları için bulundu (p<0,05). MAS ve MTS’nin KMFSS ile olan ilişkisine bakıldığında ise iki testte de hamstring kasları ile KMFSS seviyesi arasında anlamlı ilişki bulundu (p<0,05).

Sonuç: Bu çalışmanın sonuçlarına göre MAS ve MTS’nin genel olarak birbirleriyle uyumlu olduğu fakat bu uyumun değerlendirilen kaslara göre değişiklik gösterebileceği, hamstring kaslarının spastisitesinin ve statik kontraktürlerinin kaba motor fonksiyonu etkilediği görüldü.

Keywords

• Hasta sonuç değerlendirmesi,Serebral palsi,Kas spastisitesi,Motor beceriler

Relation of two different clinical scales evaluating spasticity with gross motor function in children with spastic cerebral palsy

Abstract

Purpose: The aim of this study was to analyze relation within two different clinical methods which assess spasticity, gross motor function in children with cerebral palsy (CP). It was investigated which muscles have more effects on gross motor function.

Methods: Elbow flexor muscles, wrist flexor muscles, hip adductors, hamstrings, gastrocnemius and soleus muscles of 37 children with spastic CP were evaluated using the Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) in terms of the severity of spasticity. Gross motor function levels of children were determined by the Gross Motor Function Classification System.

Results: For MAS and MTS, most related values were for the elbow flexors, wrist flexors, hip adductors and hamstrings (p<0.05). The relationship between GMFCS level and MAS and MTS scores were significant correlated between for the hamstring muscles and GMFCS (p<0.05).

Conclusion: According to results of this study, it was observed that MAS and MTS were in general compatible with each other, but the spasticity of the hamstring muscles and static contractures affect gross motor function, which may vary according to the evaluated muscles. 

Keywords

• Patient outcome assessment,Cerebral palsy,Muscle spasticity,Motor skills.

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