Klinik Araştırma
BibTex RIS Kaynak Göster

THE EFFECTS OF SENSORY INTEGRATION THERAPY AND CONVENTIONAL THERAPY PROGRAMME ON SPASTICITY, BALANCE AND MOTOR FUNCTION IN SPASTIC DIPLEGIC CEREBRAL PALSY

Yıl 2025, Cilt: 6 Sayı: 1, 160 - 174, 28.02.2025
https://doi.org/10.70813/ssd.1584827

Öz

Purpose: This controlled intervention study was designed to investigate the effects of sensory integration therapy (SIT) added to a conventional therapy programme on levels of spasticity, balance, motor function and functional independence in children with spastic diplegic cerebral palsy (CP).
Method: Both groups received a 45-minute therapy programme 3 times a week for 8 weeks. Spasticity was assessed using the Modified Ashworth Scale (MAS), balance was assessed using the Pediatric Berg Balance Scale (PBBS), gross motor function was assessed using the Gross Motor Function Measure 88 (GMFM-88) and functional independence was assessed using the Functional Independence Measure For Children (WeeFIM).
Results: There was a significant change in hamstring MAS in the intervention group (p=0.008). When the groups were compared in terms of the difference in change scores for PBBS, a statistically significant difference was found in favour of the intervention group (p=0.001). When the groups were compared in terms of difference in change scores for WeeFIM, a statistically significant difference was found in favour of the intervention group (p=0.007).
Conclusion: SIT added to a conventional therapy programme was found to be more effective than a conventional therapy programme alone in relaxing hamstring muscles, improving balance and increasing functional independence in patients with CP.

Etik Beyan

There is no declaration of interest.

Destekleyen Kurum

There are no funding organisations supporting the study.

Teşekkür

The authors would like to thank the occupational therapists and physiotherapists for their support in developing the exercise programmes.

Kaynakça

  • Allen, S., & Casey, J. (2017). Developmental coordination disorders and sensory processing and integration: Incidence, associations and co-morbidities. British journal of occupational therapy, 80(9), 549-557.
  • An, S.-J. L. (2015). The effects of vestibular stimulation on a child with hypotonic cerebral palsy. Journal of physical therapy science, 27(4), 1279-1282.
  • Camarata, S., Miller, L. J., & Wallace, M. T. (2020). Evaluating sensory integration/sensory processing treatment: issues and analysis. Frontiers in integrative neuroscience, 14, 556660.
  • Critz, C., Blake, K., & Nogueira, E. (2015). Sensory processing challenges in children. The Journal for Nurse Practitioners, 11(7), 710-716.
  • Damiano, D. L., & Abel, M. F. (1996). Relation of gait analysis to gross motor function in cerebral palsy. Developmental Medicine & Child Neurology, 38(5), 389-396.
  • Franjoine, M. R., Darr, N., Young, B., McCoy, S. W., & LaForme Fiss, A. (2022). Examination of the effects of age, sex, and motor ability level on balance capabilities in children with cerebral palsy GMFCS levels I, II, III and typical development using the Pediatric Balance Scale. Developmental Neurorehabilitation, 25(2), 115-124.
  • Lee, B.-H. (2017). Relationship between gross motor function and the function, activity and participation components of the International Classification of Functioning in children with spastic cerebral palsy. Journal of physical therapy science, 29(10), 1732-1736.
  • Liao, H.-F., & Hwang, A.-W. (2003). Relations of balance function and gross motor ability for children with cerebral palsy. Perceptual and motor skills, 96(3_suppl), 1173-1184.
  • Mahaseth, P. K., & Choudhary, A. (2021). Sensory integration therapy verses conventional physical therapy among children with cerebral palsy on gross motor function–a comparative randomized controlled trial. Annals of the Romanian Society for Cell Biology, 17315-17334.
  • Mailleux, L., Franki, I., Emsell, L., Peedima, M.-L., Fehrenbach, A., Feys, H., & Ortibus, E. (2020). The relationship between neuroimaging and motor outcome in children with cerebral palsy: A systematic review—Part B diffusion imaging and tractography. Research in developmental disabilities, 97, 103569.
  • McIntyre, S., Goldsmith, S., Webb, A., Ehlinger, V., Hollung, S. J., McConnell, K., Arnaud, C., Smithers‐Sheedy, H., Oskoui, M., & Khandaker, G. (2022). Global prevalence of cerebral palsy: A systematic analysis. Developmental Medicine & Child Neurology, 64(12), 1494-1506.
  • Mittal, R., Dhiman, S., Ahmed, S., Sharma, R., Khan, M. H., Ajmera, P., Goyal, R. K., & Gulati, S. (2024). Impact of sensory-based therapy on problems with balance and posture in children with cerebral palsy: a systematic review and meta-analysis. Discover Public Health, 21(1), 1-13.
  • Padnani, R. G., & Arunachalam, D. (2019). Effectiveness of sensory integration therapy on gross motor function and MMAS in spastic diplegic cerebral palsy children. Int J Res Anal Rev, 6, 236-242.
  • Palisano, R. J., Hanna, S. E., Rosenbaum, P. L., Russell, D. J., Walter, S. D., Wood, E. P., Raina, P. S., & Galuppi, B. E. (2000). Validation of a model of gross motor function for children with cerebral palsy. Physical therapy, 80(10), 974-985.
  • Papadelis, C., Butler, E. E., Rubenstein, M., Sun, L., Zollei, L., Nimec, D., Snyder, B., & Grant, P. E. (2018). Reorganization of the somatosensory cortex in hemiplegic cerebral palsy associated with impaired sensory tracts. NeuroImage: Clinical, 17, 198-212.
  • Parashar, A., Pattnaik, M., & Mohanty, P. (2017). Effect of vestibular stimulation versus whole body vibration on standing balance in children with spastic diplegic cerebral palsy. J Nov Physiother, 7(348), 2.
  • Park, E.-Y., & Kim, W.-H. (2017). Effect of neurodevelopmental treatment-based physical therapy on the change of muscle strength, spasticity, and gross motor function in children with spastic cerebral palsy. Journal of physical therapy science, 29(6), 966-969.
  • Patel, B., Karthikbabu, S., & Syed, N. (2015). Feasibility of multisensory training and its effects on balance control in school going children with cerebral palsy. Indian Journal of Cerebral Palsy, 1(2).
  • Patel, D. R., Neelakantan, M., Pandher, K., & Merrick, J. (2020). Cerebral palsy in children: a clinical overview. Translational pediatrics, 9(Suppl 1), S125.
  • Paulson, A., & Vargus-Adams, J. (2017). Overview of four functional classification systems commonly used in cerebral palsy. Children, 4(4), 30.
  • Pavão, S. L., & Rocha, N. A. C. F. (2017). Sensory processing disorders in children with cerebral palsy. Infant Behavior and Development, 46, 1-6.
  • Pavão, S. L., Silva, F. P. d. S., Savelsbergh, G. J., & Rocha, N. A. C. F. (2015). Use of sensory information during postural control in children with cerebral palsy: systematic review. Journal of motor behavior, 47(4), 291-301.
  • Sadowska, M., Sarecka-Hujar, B., & Kopyta, I. (2020). Cerebral palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatric disease and treatment, 1505-1518.
  • Salavati, M., Rameckers, E., Waninge, A., Krijnen, W., Steenbergen, B., & Van der Schans, C. (2017). Gross motor function in children with spastic Cerebral Palsy and Cerebral Visual Impairment: A comparison between outcomes of the original and the Cerebral Visual Impairment adapted Gross Motor Function Measure-88 (GMFM-88-CVI). Research in developmental disabilities, 60, 269-276.
  • Schoen, S. A., Lane, S. J., Mailloux, Z., May‐Benson, T., Parham, L. D., Smith Roley, S., & Schaaf, R. C. (2019). A systematic review of ayres sensory integration intervention for children with autism. Autism Research, 12(1), 6-19.
  • Shamsoddini, A., & Hollisaz, M. (2009). Effect of sensory integration therapy on gross motor function in children with cerebral palsy.
  • Tramontano, M., Medici, A., Iosa, M., Chiariotti, A., Fusillo, G., Manzari, L., & Morelli, D. (2017). The effect of vestibular stimulation on motor functions of children with cerebral palsy. Motor control, 21(3), 299-311.
  • Tsao, H., Pannek, K., Boyd, R. N., & Rose, S. E. (2015). Changes in the integrity of thalamocortical connections are associated with sensorimotor deficits in children with congenital hemiplegia. Brain Structure and Function, 220, 307-318.
  • Vitrikas, K., Dalton, H., & Breish, D. (2020). Cerebral palsy: an overview. American family physician, 101(4), 213-220.
  • Vostrý, M., Lanková, B., Pešatová, I., Müllerová, L., & Vomáčková, H. (2022). Assessment of the Functional Level of Independence in Individuals with Mental Disabilities as Part of Special Education Diagnostics: Case Studies. International Journal of Environmental Research and Public Health, 19(23), 15474.
  • Yoo, M., Ahn, J. H., Rha, D.-w., & Park, E. S. (2022). Reliability of the modified Ashworth and modified tardieu scales with standardized movement speeds in children with spastic cerebral palsy. Children, 9(6), 827.

SPASTİK DİPLEJİK SEREBRAL PALSİDE DUYU BÜTÜNLEME TERAPİSİ VE GELENEKSEL FİZYOTERAPİ PROGRAMININ SPASTİTE, DENGE VE MOTOR FONKSİYONU ÜZERİNE ETKİLERİ

Yıl 2025, Cilt: 6 Sayı: 1, 160 - 174, 28.02.2025
https://doi.org/10.70813/ssd.1584827

Öz

Amaç: Bu kontrollü deneysel çalışma, spastik diplejik tip serebral palsili (SP) çocuklarda konvansiyonel tedavi programına eklenen duyu bütünleme tedavisinin (DBT); spastisite, denge ve motor fonksiyona etkisini araştırmak üzerine planlandı.
Yöntem: Her iki gruba da 8 hafta boyunca haftada 3 kez 45 dakikalık terapi programı uygulandı. Spastisite düzeyi Modifiye Ashworth Skalası (MAS) ile, denge düzeyi Pediatrik Berg Denge Ölçeği (PBDÖ) ile, motor fonksiyon düzeyi Kaba Motor Fonksiyon Ölçütü (KMFÖ-88) ile, fonksiyonel bağımsızlık düzeyi Pediatrik Fonksiyonel Bağımsızlık Ölçümü (PFBÖ) ile değerlendirildi.
Bulgular: Müdahale grubunun Hamstring MAS değerinde anlamlı bir değişiklik vardı (p=0,008). Gruplar PBDÖ'deki değişim farkı değerleri açısından karşılaştırıldığında, müdahale grubu lehine istatistiksel olarak anlamlı bir fark bulundu (p=0,001). Gruplar PFBÖ'deki değişim farkı değerleri açısından karşılaştırıldığında, müdahale grubu lehine istatistiksel olarak anlamlı bir fark bulundu (p=0,007).
Tartışma: Konvansiyonel terapi programına eklenen DBT, SP'li hastalarda hamstring kaslarının gevşetilmesi, dengenin iyileştirilmesi ve fonksiyonel bağımsızlığın artırılması açısından tek başına konvansiyonel terapi programından daha etkili olduğu görüldü.

Kaynakça

  • Allen, S., & Casey, J. (2017). Developmental coordination disorders and sensory processing and integration: Incidence, associations and co-morbidities. British journal of occupational therapy, 80(9), 549-557.
  • An, S.-J. L. (2015). The effects of vestibular stimulation on a child with hypotonic cerebral palsy. Journal of physical therapy science, 27(4), 1279-1282.
  • Camarata, S., Miller, L. J., & Wallace, M. T. (2020). Evaluating sensory integration/sensory processing treatment: issues and analysis. Frontiers in integrative neuroscience, 14, 556660.
  • Critz, C., Blake, K., & Nogueira, E. (2015). Sensory processing challenges in children. The Journal for Nurse Practitioners, 11(7), 710-716.
  • Damiano, D. L., & Abel, M. F. (1996). Relation of gait analysis to gross motor function in cerebral palsy. Developmental Medicine & Child Neurology, 38(5), 389-396.
  • Franjoine, M. R., Darr, N., Young, B., McCoy, S. W., & LaForme Fiss, A. (2022). Examination of the effects of age, sex, and motor ability level on balance capabilities in children with cerebral palsy GMFCS levels I, II, III and typical development using the Pediatric Balance Scale. Developmental Neurorehabilitation, 25(2), 115-124.
  • Lee, B.-H. (2017). Relationship between gross motor function and the function, activity and participation components of the International Classification of Functioning in children with spastic cerebral palsy. Journal of physical therapy science, 29(10), 1732-1736.
  • Liao, H.-F., & Hwang, A.-W. (2003). Relations of balance function and gross motor ability for children with cerebral palsy. Perceptual and motor skills, 96(3_suppl), 1173-1184.
  • Mahaseth, P. K., & Choudhary, A. (2021). Sensory integration therapy verses conventional physical therapy among children with cerebral palsy on gross motor function–a comparative randomized controlled trial. Annals of the Romanian Society for Cell Biology, 17315-17334.
  • Mailleux, L., Franki, I., Emsell, L., Peedima, M.-L., Fehrenbach, A., Feys, H., & Ortibus, E. (2020). The relationship between neuroimaging and motor outcome in children with cerebral palsy: A systematic review—Part B diffusion imaging and tractography. Research in developmental disabilities, 97, 103569.
  • McIntyre, S., Goldsmith, S., Webb, A., Ehlinger, V., Hollung, S. J., McConnell, K., Arnaud, C., Smithers‐Sheedy, H., Oskoui, M., & Khandaker, G. (2022). Global prevalence of cerebral palsy: A systematic analysis. Developmental Medicine & Child Neurology, 64(12), 1494-1506.
  • Mittal, R., Dhiman, S., Ahmed, S., Sharma, R., Khan, M. H., Ajmera, P., Goyal, R. K., & Gulati, S. (2024). Impact of sensory-based therapy on problems with balance and posture in children with cerebral palsy: a systematic review and meta-analysis. Discover Public Health, 21(1), 1-13.
  • Padnani, R. G., & Arunachalam, D. (2019). Effectiveness of sensory integration therapy on gross motor function and MMAS in spastic diplegic cerebral palsy children. Int J Res Anal Rev, 6, 236-242.
  • Palisano, R. J., Hanna, S. E., Rosenbaum, P. L., Russell, D. J., Walter, S. D., Wood, E. P., Raina, P. S., & Galuppi, B. E. (2000). Validation of a model of gross motor function for children with cerebral palsy. Physical therapy, 80(10), 974-985.
  • Papadelis, C., Butler, E. E., Rubenstein, M., Sun, L., Zollei, L., Nimec, D., Snyder, B., & Grant, P. E. (2018). Reorganization of the somatosensory cortex in hemiplegic cerebral palsy associated with impaired sensory tracts. NeuroImage: Clinical, 17, 198-212.
  • Parashar, A., Pattnaik, M., & Mohanty, P. (2017). Effect of vestibular stimulation versus whole body vibration on standing balance in children with spastic diplegic cerebral palsy. J Nov Physiother, 7(348), 2.
  • Park, E.-Y., & Kim, W.-H. (2017). Effect of neurodevelopmental treatment-based physical therapy on the change of muscle strength, spasticity, and gross motor function in children with spastic cerebral palsy. Journal of physical therapy science, 29(6), 966-969.
  • Patel, B., Karthikbabu, S., & Syed, N. (2015). Feasibility of multisensory training and its effects on balance control in school going children with cerebral palsy. Indian Journal of Cerebral Palsy, 1(2).
  • Patel, D. R., Neelakantan, M., Pandher, K., & Merrick, J. (2020). Cerebral palsy in children: a clinical overview. Translational pediatrics, 9(Suppl 1), S125.
  • Paulson, A., & Vargus-Adams, J. (2017). Overview of four functional classification systems commonly used in cerebral palsy. Children, 4(4), 30.
  • Pavão, S. L., & Rocha, N. A. C. F. (2017). Sensory processing disorders in children with cerebral palsy. Infant Behavior and Development, 46, 1-6.
  • Pavão, S. L., Silva, F. P. d. S., Savelsbergh, G. J., & Rocha, N. A. C. F. (2015). Use of sensory information during postural control in children with cerebral palsy: systematic review. Journal of motor behavior, 47(4), 291-301.
  • Sadowska, M., Sarecka-Hujar, B., & Kopyta, I. (2020). Cerebral palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatric disease and treatment, 1505-1518.
  • Salavati, M., Rameckers, E., Waninge, A., Krijnen, W., Steenbergen, B., & Van der Schans, C. (2017). Gross motor function in children with spastic Cerebral Palsy and Cerebral Visual Impairment: A comparison between outcomes of the original and the Cerebral Visual Impairment adapted Gross Motor Function Measure-88 (GMFM-88-CVI). Research in developmental disabilities, 60, 269-276.
  • Schoen, S. A., Lane, S. J., Mailloux, Z., May‐Benson, T., Parham, L. D., Smith Roley, S., & Schaaf, R. C. (2019). A systematic review of ayres sensory integration intervention for children with autism. Autism Research, 12(1), 6-19.
  • Shamsoddini, A., & Hollisaz, M. (2009). Effect of sensory integration therapy on gross motor function in children with cerebral palsy.
  • Tramontano, M., Medici, A., Iosa, M., Chiariotti, A., Fusillo, G., Manzari, L., & Morelli, D. (2017). The effect of vestibular stimulation on motor functions of children with cerebral palsy. Motor control, 21(3), 299-311.
  • Tsao, H., Pannek, K., Boyd, R. N., & Rose, S. E. (2015). Changes in the integrity of thalamocortical connections are associated with sensorimotor deficits in children with congenital hemiplegia. Brain Structure and Function, 220, 307-318.
  • Vitrikas, K., Dalton, H., & Breish, D. (2020). Cerebral palsy: an overview. American family physician, 101(4), 213-220.
  • Vostrý, M., Lanková, B., Pešatová, I., Müllerová, L., & Vomáčková, H. (2022). Assessment of the Functional Level of Independence in Individuals with Mental Disabilities as Part of Special Education Diagnostics: Case Studies. International Journal of Environmental Research and Public Health, 19(23), 15474.
  • Yoo, M., Ahn, J. H., Rha, D.-w., & Park, E. S. (2022). Reliability of the modified Ashworth and modified tardieu scales with standardized movement speeds in children with spastic cerebral palsy. Children, 9(6), 827.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Araştırma Makaleleri
Yazarlar

Atahan Turhan 0000-0001-9510-925X

Melek Yavuzer 0000-0002-2898-9389

Yayımlanma Tarihi 28 Şubat 2025
Gönderilme Tarihi 13 Kasım 2024
Kabul Tarihi 16 Aralık 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 6 Sayı: 1

Kaynak Göster

APA Turhan, A., & Yavuzer, M. (2025). THE EFFECTS OF SENSORY INTEGRATION THERAPY AND CONVENTIONAL THERAPY PROGRAMME ON SPASTICITY, BALANCE AND MOTOR FUNCTION IN SPASTIC DIPLEGIC CEREBRAL PALSY. Selçuk Sağlık Dergisi, 6(1), 160-174. https://doi.org/10.70813/ssd.1584827