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COMPARISON OF FUNCTIONAL WALKING, BALANCE, AND FUNCTIONAL INDEPENDENCE IN CHILDREN WITH DIPLEGIC AND HEMIPLEGIC CEREBRAL PALSY

Yıl 2024, Cilt: 5 Sayı: 3, 314 - 325, 20.12.2024
https://doi.org/10.70813/ssd.1407579

Öz

Purpose: Cerebral palsy results in brain damage to specific regions responsible for regulating muscle tone, gross and fine motor skills, balance control, and posture. This condition directly impacts patients' ability to walk, maintain balance, and perform everyday tasks effectively. The objective of this study was to assess and compare the functional walking ability, balance, and functional independence of children with hemiplegic and diplegic cerebral palsy.
Methods: A study employing a quasi-experimental design was done in three hospitals in Wasit province, Iraq, with a sample of 60 children diagnosed with cerebral palsy. The demographic information of 30 patients diagnosed with diplegia and 30 patients diagnosed with hemiplegia, aged between 0 and 18 years, and classed as GMFCS level I-III, was documented. The patients underwent assessment using the Gillette Functional Gait Assessment Questionnaire (FAQ), the Pediatric Balance Scale (PBS), and the Independence Measure for Children (WeeFIM).
Results: The statistical analysis revealed a significant difference between the groups in FAQ and PBS (p<0.05), however, no significant difference was observed in WeeFIM (p>0.05). In this study, there was a significant difference (p < 0.05) observed in the self-care and social cognition subgroups of WeeFIM between the groups. However, no statistically significant difference (p > 0.05) was found in the other subgroups.
Conclusion: Children with hemiplegia exhibit significantly better walking, balance, and lower extremity function compared to children with diplegia. However, they have worse upper extremity performance.

Kaynakça

  • Bambang Trisnowiyanto, B. T., & Isna Andriani, I. A. (2020). Cerebral Palsy Types Based on Kind of Disability Correlated with The Functional Independence. JKb Jurnal Kebidanan, 10(1), 74-79.‏
  • Bülbül İ. Effects of robotic rehabilitation application on functional walking, balance and functional independence in children with spastic TYPE cerebral palsy [Master thesis]]. İstanbul: İstanbul Medipol Üniversitesi; 2021.
  • Chounti A, Hägglund G, Wagner P, Westbom L. Sex differences in cerebral palsy incidence and functional ability: a total population study. Acta Paediatr. 2013 Jul;102(7):712–7.
  • Damiano D, Abel M, Romness M, Oeffinger D, Tylkowski C, Gorton G, et al. Comparing functional profiles of children with hemiplegic and diplegic cerebral palsy in GMFCS Levels I and II: are separate classifications needed? Dev Med Child Neurol. 2006 Oct;48(10):797–803.
  • Drougia A, Giapros V, Krallis N, Theocharis P, Nikaki A, Tzoufi M, et al. Incidence and risk factors for cerebral palsy in infants with perinatal problems: a 15-year review. Early Hum Dev. 2007 Aug;83(8):541–7.
  • Gage J. The treatment of gait problems in cerebral palsy. London: Mac Keith Press; 2004.
  • Gibson BE, Teachman G, Wright V, Fehlings D, Young NL, McKeever P. Children's and parent's beliefs regarding the value of walking: rehabilitation implications for children with cerebral palsy. Child Care Health Dev. 2012 Jan;38(1):61–9.
  • Girolami GL, Shiratori T, Aruin AS. Anticipatory postural adjustments in children with hemiplegia and diplegia. J Electromyogr Kinesiol. 2011 Dec;21(6):988–97.
  • Gooden-Ledbetter MJ, Cole MT, Maher JK, Condeluci A. Self-efficacy and interdependence as predictors of life satisfaction for people with disabilities: implications for independent living programs. J Vocat Rehabil. 2007;27(3):153–61.
  • Gorton GE 3rd, Stout JL, Bagley AM, Bevans K, Novacheck TF, Tucker CA. Gillette Functional Assessment Questionnaire 22-item skill set: factor and Rasch analyzes. Dev Med Child Neurol. 2011 Mar;53(3):250–5.
  • Gunel MK, Mutlu A, Tarsuslu T, Livanelioglu A. Relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy. Eur J Pediatr. 2009 Apr;168(4):477–85.
  • Johnston MV, Hagberg H. Sex and the pathogenesis of cerebral palsy. Dev Med Child Neurol. 2007 Jan;49(1):74–8.
  • Kim CJ, Son SM. Comparison of spatiotemporal gait parameters between children with normal development and children with diplegic cerebral palsy. J Phys Ther Sci. 2014 Sep;26(9):1317–9.
  • Mutlu A, Bugusan S, Kara O. Impairments, activity limitations, and participation restrictions of the international classification of functioning, disability, and health model in children with ambulatory cerebral palsy. Saudi Medical Journal. 2017;38(2):176-185.
  • Novak I, Hines M, Goldsmith S, Barclay R. Clinical prognostic messages from a systematic review on cerebral palsy. Pediatrics. 2012 Nov;130(5):e1285–312.
  • Opheim A, Jahnsen R, Olsson E, Stanghelle JK. Balance in relation to walking deterioration in adults with spastic bilateral cerebral palsy. Phys Ther. 2012 Feb;92(2):279–88.
  • Ostensjø S, Carlberg EB, Vøllestad NK. Everyday functioning in young children with cerebral palsy: functional skills, caregiver assistance, and modifications of the environment. Dev Med Child Neurol. 2003 Sep;45(9):603–12.
  • Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol. 2008 Oct;50(10):744–50.
  • Panibatla S, Kumar V, Narayan A. Relationship between trunk control and balance in children with spastic cerebral palsy: a cross-sectional study. J Clin Diagn Res. 2017 Sep;11(9): YC05–08.
  • Posłuszny A, Myśliwiec A, Saulicz E, Doroniewicz I, Linek P, Wolny T. Current understanding of the factors influencing the functional independence of people with cerebral palsy: a review of the literature. Int J Dev Disabil. 2017;63(2):77–90.
  • Rojas VG, Rebolledo GM, Muñoz EG, Cortés NI, Gaete CB, Delgado CM. Differences in standing balance between patients with diplegic and hemiplegic cerebral palsy. Neural Regen Res. 2013 Sep;8(26):2478–83.
  • Rosenbaum P. Cerebral palsy: what parents and doctors want to know. BMJ. 2003;326(7396):970-974.
  • Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatr Dis Treat. 2020 Jun;16:1505–18.
  • Wong V, Wong S, Chan K, Wong W. Functional independence measure (WeeFIM) for Chinese children: hong Kong cohort. Pediatrics. 2002 Feb;109(2):E36.

DİPLEJİK VE HEMİPLEGİK SEREBRAL PALSİ OLAN ÇOCUKLARDA FONKSİYONEL YÜRÜME, DENGE VE FONKSİYONEL BAĞIMSIZLIĞIN KARŞILAŞTIRILMASI

Yıl 2024, Cilt: 5 Sayı: 3, 314 - 325, 20.12.2024
https://doi.org/10.70813/ssd.1407579

Öz

Amaç: Serebral palsi, beynin kas tonusunu, kaba ve ince motor yeteneklerini, denge kontrolünü ve duruşunu kontrol eden bölümlerinde beyin hasarına neden olarak hastaların yürüme yeteneklerini, dengesini ve fonksiyonel aktivitelerdeki başarısını etkiler. Bu çalışma hemiplejili ve diplejili serebral palsili çocuklarda fonksiyonel yürüme, denge ve fonksiyonel bağımsızlığı karşılaştırmayı amaçladı.
Yöntem: Irak'ın Wasit eyaletindeki üç hastanede serebral palsili 60 çocuğu içeren yarı deneysel bir tasarım çalışması yapıldı. GMFCS düzey I-III olarak sınıflandırılan, 0-18 yaş arası 30 diplejili ve 30 hemiplejili hastanın demografik bilgileri kaydedildi. Hastalar Gillette Fonksiyonel Yürüyüş Değerlendirme Anketi (FYDA), Pediatrik Denge Ölçeği (PDÖ) ve Çocuklar için Bağımsızlık Ölçütü (WeeFIM) ile değerlendirildi.
Sonuçlar: İstatistiksel analiz, WeeFIM'de anlamlı bir fark olmamasına rağmen (p>0.05), FYDA ve PDÖ'de gruplar arasında anlamlı bir fark gösterdi (p<0.05). WeeFIM'in öz bakım ve sosyal biliş alt grupları, sonuçlarımızda gruplar arasında anlamlı farklılık gösterirken (p<0.05), diğer alt gruplar istatistiksel olarak farklı değildi (p > 0.05).
Tartışma: Hemipleji çocuklar, dipleji çocuklara göre yürüme, denge ve alt ekstremite fonksiyonlarında önemli ölçüde daha iyi ancak üst ekstremite fonksiyonlarında daha kötüdür.

Kaynakça

  • Bambang Trisnowiyanto, B. T., & Isna Andriani, I. A. (2020). Cerebral Palsy Types Based on Kind of Disability Correlated with The Functional Independence. JKb Jurnal Kebidanan, 10(1), 74-79.‏
  • Bülbül İ. Effects of robotic rehabilitation application on functional walking, balance and functional independence in children with spastic TYPE cerebral palsy [Master thesis]]. İstanbul: İstanbul Medipol Üniversitesi; 2021.
  • Chounti A, Hägglund G, Wagner P, Westbom L. Sex differences in cerebral palsy incidence and functional ability: a total population study. Acta Paediatr. 2013 Jul;102(7):712–7.
  • Damiano D, Abel M, Romness M, Oeffinger D, Tylkowski C, Gorton G, et al. Comparing functional profiles of children with hemiplegic and diplegic cerebral palsy in GMFCS Levels I and II: are separate classifications needed? Dev Med Child Neurol. 2006 Oct;48(10):797–803.
  • Drougia A, Giapros V, Krallis N, Theocharis P, Nikaki A, Tzoufi M, et al. Incidence and risk factors for cerebral palsy in infants with perinatal problems: a 15-year review. Early Hum Dev. 2007 Aug;83(8):541–7.
  • Gage J. The treatment of gait problems in cerebral palsy. London: Mac Keith Press; 2004.
  • Gibson BE, Teachman G, Wright V, Fehlings D, Young NL, McKeever P. Children's and parent's beliefs regarding the value of walking: rehabilitation implications for children with cerebral palsy. Child Care Health Dev. 2012 Jan;38(1):61–9.
  • Girolami GL, Shiratori T, Aruin AS. Anticipatory postural adjustments in children with hemiplegia and diplegia. J Electromyogr Kinesiol. 2011 Dec;21(6):988–97.
  • Gooden-Ledbetter MJ, Cole MT, Maher JK, Condeluci A. Self-efficacy and interdependence as predictors of life satisfaction for people with disabilities: implications for independent living programs. J Vocat Rehabil. 2007;27(3):153–61.
  • Gorton GE 3rd, Stout JL, Bagley AM, Bevans K, Novacheck TF, Tucker CA. Gillette Functional Assessment Questionnaire 22-item skill set: factor and Rasch analyzes. Dev Med Child Neurol. 2011 Mar;53(3):250–5.
  • Gunel MK, Mutlu A, Tarsuslu T, Livanelioglu A. Relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy. Eur J Pediatr. 2009 Apr;168(4):477–85.
  • Johnston MV, Hagberg H. Sex and the pathogenesis of cerebral palsy. Dev Med Child Neurol. 2007 Jan;49(1):74–8.
  • Kim CJ, Son SM. Comparison of spatiotemporal gait parameters between children with normal development and children with diplegic cerebral palsy. J Phys Ther Sci. 2014 Sep;26(9):1317–9.
  • Mutlu A, Bugusan S, Kara O. Impairments, activity limitations, and participation restrictions of the international classification of functioning, disability, and health model in children with ambulatory cerebral palsy. Saudi Medical Journal. 2017;38(2):176-185.
  • Novak I, Hines M, Goldsmith S, Barclay R. Clinical prognostic messages from a systematic review on cerebral palsy. Pediatrics. 2012 Nov;130(5):e1285–312.
  • Opheim A, Jahnsen R, Olsson E, Stanghelle JK. Balance in relation to walking deterioration in adults with spastic bilateral cerebral palsy. Phys Ther. 2012 Feb;92(2):279–88.
  • Ostensjø S, Carlberg EB, Vøllestad NK. Everyday functioning in young children with cerebral palsy: functional skills, caregiver assistance, and modifications of the environment. Dev Med Child Neurol. 2003 Sep;45(9):603–12.
  • Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol. 2008 Oct;50(10):744–50.
  • Panibatla S, Kumar V, Narayan A. Relationship between trunk control and balance in children with spastic cerebral palsy: a cross-sectional study. J Clin Diagn Res. 2017 Sep;11(9): YC05–08.
  • Posłuszny A, Myśliwiec A, Saulicz E, Doroniewicz I, Linek P, Wolny T. Current understanding of the factors influencing the functional independence of people with cerebral palsy: a review of the literature. Int J Dev Disabil. 2017;63(2):77–90.
  • Rojas VG, Rebolledo GM, Muñoz EG, Cortés NI, Gaete CB, Delgado CM. Differences in standing balance between patients with diplegic and hemiplegic cerebral palsy. Neural Regen Res. 2013 Sep;8(26):2478–83.
  • Rosenbaum P. Cerebral palsy: what parents and doctors want to know. BMJ. 2003;326(7396):970-974.
  • Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatr Dis Treat. 2020 Jun;16:1505–18.
  • Wong V, Wong S, Chan K, Wong W. Functional independence measure (WeeFIM) for Chinese children: hong Kong cohort. Pediatrics. 2002 Feb;109(2):E36.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Araştırma Makaleleri
Yazarlar

Kamal Alaayedi 0000-0002-6603-1382

Anıl Özdoğru 0000-0002-7507-9863

Yayımlanma Tarihi 20 Aralık 2024
Gönderilme Tarihi 20 Aralık 2023
Kabul Tarihi 4 Haziran 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 5 Sayı: 3

Kaynak Göster

APA Alaayedi, K., & Özdoğru, A. (2024). DİPLEJİK VE HEMİPLEGİK SEREBRAL PALSİ OLAN ÇOCUKLARDA FONKSİYONEL YÜRÜME, DENGE VE FONKSİYONEL BAĞIMSIZLIĞIN KARŞILAŞTIRILMASI. Selçuk Sağlık Dergisi, 5(3), 314-325. https://doi.org/10.70813/ssd.1407579