Spastik Tip Serebral Palside Kaba Motor Fonksiyon Düzeyinin Belirleyicileri: Retrospektif Bir Çalışma

Öz

Amaç: Bu çalışma, iki yıl boyunca spastik tip Serebral Palsi'de (SP) kaba motor fonksiyonun belirleyicilerini belirlemeyi amaçladı. Yöntem: Spastik tip SP'li 108 çocuk (ortalama yaş: 6,43±4,83 yıl) iki yıl boyunca iki kez değerlendirildi. Sonuç ölçütleri; Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS), El Becerisi Sınıflandırma Sistemi (EBSS), İletişim Fonksiyon Sınıflandırma Sistemi (İFSS) ve Yeme ve İçme Becerisi Sınıflandırma Sistemi (YİBSS) idi. Yaş, cinsiyet, topografik dağılım ve KMFSS, EBSS, İFSS ve YİBSS düzeyleri gibi faktörlerin iki yıllık fizyoterapiden sonra KMFSS düzeyindeki iyileşmeyi tahmin edip edemeyeceğini belirlemek için ikili lojistik regresyon analizi kullanıldı. Sonuçlar: İFSS Seviye I olan çocuklarla karşılaştırıldığında, İFSS Seviye II, Seviye III ve Seviye IV olan çocukların KMFSS seviyesinde iyileşme olasılığı sırasıyla 0,001, 0,005 ve 0,006 kat daha azdı. Benzer şekilde, YİBSS Seviye III ve Seviye IV olan çocukların KMFSS seviyesinde iyileşme olasılığı Seviye I olanlara göre sırasıyla 1.605 ve 1.548 kat daha azdı. YİBSS Düzey IV ve V olanlar tüm yaş gruplarında iki yıl boyunca stabil kaldı. Tartışma: İFSS ve YİBSS, spastik tip SP'de kaba motor fonksiyon seviyesinin anlamlı belirleyicileriydi. Sağlık uzmanları, kaba motor fonksiyon seviyelerinin ilerleyişini tahmin etmek için İFSS ve YİBSS’yi kullanabilir, böylece daha uygun müdahaleler ve daha gerçekçi tahminler sağlayabilir.

Anahtar Kelimeler

• Serebral Palsi
• Sınıflandırma Sistemleri
• Kaba Motor Fonksiyon
• Öngörü
• Prognoz

Predictors of Gross Motor Function Level in Spastic Type Cerebral Palsy: A Retrospective Study

Abstract

Purpose: This study aimed to identify the predictors of gross motor function in spastic-type Cerebral Palsy (CP) over two years. Methods: 108 children with spastic-type CP (mean age: 6.43±4.83 years) underwent two assessments over two years. The outcomes were the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS). Binary logistic regression analysis was used to determine whether factors such as age, sex, topographical distribution, and levels of GMFCS, MACS, CFCS, and EDACS could predict the improvement in GMFCS level after two years of physiotherapy. Results: Compared to the children with CFCS Level I, children with CFCS Level II, Level III, and Level IV were 0.001, 0.005, and 0.006 times less likely to improve in GMFCS level, respectively. Similarly, children with EDACS Level III and Level IV were respectively 1.605 and 1.548 times less likely to improve in GMFCS level compared to those with Level I. Those with EDACS levels IV and V remained stable for two years in all age groups. Conclusion: CFCS and EDACS were significant predictors of gross motor function level in spastic-type CP. Healthcare professionals can use CFCS and EDACS to predict the progression of gross motor function levels, thereby providing more appropriate interventions and more realistic predictions.

Keywords

• Cerebral Palsy
• Classification Systems
• Gross Motor Function
• Prediction
• Prognosis

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