SEREBRAL PALSİ’Lİ ÇOCUKLARDA SU İÇİ EGZERSİZLER

Year 2019, Volume: 20 Issue: 4, 282 - 288, 21.10.2019

Sevda Adar Hasan Toktaş

https://doi.org/10.18229/kocatepetip.464804

Abstract

Çocuklarda ön planda motor bozukluklarla seyreden serebral palsi
(SP) tedavisinde amaç, fonksiyonelliği artırmak, yetenekleri geliştirmek ve
hareket, bilişsel gelişim, sosyal etkileşim ve bağımsızlık açısından sağlığı
sürdürmek olmalıdır. SP rehabilitasyonunda nörofizyolojik yaklaşımlar (bobath,
vojta, rood yöntemleri), konvansiyonel egzersizler, elektriksel stimulasyon,
zorunlu kullanım tedavisi, iş uğraşı terapisi, ortezleme ve yardımcı cihazlar
gibi çeşitli yöntemler kullanılmaktadır. Ek olarak hippoterapi, hidroterapi (su
içi egzersizler), oyun terapisi, akupunktur, masaj, suit terapi, kraniosakral
terapi ve feldenkrais gibi tedavi yöntemleri de uygulanabilir. Su içi yaklaşımlar SP’li
çocukların rehabilitasyonunda popüler tedavi yöntemlerinden biridir. Su içi aktivitelerin zindelik halini,
fonksiyonu ve katılımı etkileme potansiyeli olabilir. Çocuğun
aktif olduğu rehabilitasyon yaklaşımlarının nöroplastisiteyi indüklediği
düşünülmektedir ve bu yaklaşımlar su içi ortamda uygulanabilir. Su içi egzersizler
çocuklara fonksiyonel durumu, mobiliteyi ve kendine güveni artıran, yeni
hareket paternlerini öğrenmeyi sağlayan sayısız deneyim fırsatı sunar. Kaldırma
kuvveti, viskozite ve hidrostatik basınç suyun vücudu asiste eden ya da direnç
gösteren fiziksel özellikleridir. Karada uygulanan egzersiz yaklaşımları su içi
ortama uyarlanabileceği gibi su içi tedavilere özgü bazı yaklaşımlar da
(Halliwick Terapi, Watsu, Bad Ragaz Halka Metodu) mevcuttur. Sıklıkla yüzme
başta olmak üzere aerobik egzersizler uygulanır. Her çocuk kendine özgü su içi egzersiz programına
ihtiyaç duyar. Su içi egzersizler SP’li çocukların spastisiteleri, motor
fonksiyonları, aerobik kapasiteleri, yaşam kaliteleri ve sosyal ilişkileri
üzerine etkili olabilir.  Bu derlemenin
amacı SP’li çocuklarda su içi egzersiz uygulamalarına ve etkilerine literatüre
dayalı olarak genel bir bakış sağlamaktır. 

Keywords

serebral palsi, su içi egzersizler, hidroterapi

AQUATIC EXERCISES IN CHILDREN WITH CEREBRAL PALSY

Abstract

The aim of the treatment of cerebral palsy (CP) which is accompanied
with especially motor disorders is to increase functionality, improve
capabilities, and sustain health in terms of locomotion, cognitive development,
social interaction and independence. Various methods such as neurophysiological
approaches (bobath, vojta, rood methods), conventional exercises, electrical
stimulation, constrained induced movement therapy, occupational therapy,
bracing and assistive devices are used in SP rehabilitation. In addition, other
treatment methods such as hippotherapy, hydrotherapy (aquatic exercises), play therapy,
acupuncture, massage, suit therapy, craniosacral therapy and feldenkrais
methods can be applied.  Aquatic therapy
approaches are one of the popular therapy methods in the treatment of children
with CP. Aquatic activities may have the potential to affect fitness, function
and participation. It is thought that the rehabilitation approaches in which
the child is active, induce neuroplasticity and these approaches can be applied
in water. Aquatic exercises offer children numerous opportunities to improve
their functional status, mobility and self-confidence, and to learn new
movement patterns. Buoyancy, viscosity and hydrostatic pressure are the
physical qualities of water which assists or resists to the body. As like the
exercise approaches which applied on the land can be adapted to the water
environment, there are also some approaches specific to aquatic therapy (Halliwick
Therapy, Watsu, Bad Ragaz Ring Method). Aerobic exercises, mainly swimming, are
usually applied. Every child needs his/her own personel aquatic exercise program.
Aquatic exercises can be effective in spasticity, motor functions, aerobic
capacity, quality of life and social relations of children with CP. The aim of
this article is to provide a general view to aquatic exercise applications and
their effects in children with CP based on the literature.

Keywords

cerebral palsy, aquatic exercises, hydrotherapy

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