OBSTETRİK BRAKİYAL PLEKSUS PALSİLİ ÇOCUKLARIN AKTİVİTE PERFORMANSININ GELİŞTİRİLMESİNE YÖNELİK MÜDAHALE

Öz

Amaç: Obstetrik brakiyal pleksus paralizisi (OBPP) doğum sırasında meydana gelen, ameliyat edilse bile çocukların aktivite ve katılım sorunlarının görüldüğü bir sendromdur. Bu çalışmanın amacı OBPP olan çocukların aktivite performanslarını (AP) arttırmak için yapılan müdahalenin etkilerini araştırmaktı. Yöntemler: Bu çalışmaya OBPP tanısı olan, 4-7 yaşları arasında 29 çocuk katıldı. Müdahale grubu altı kız ve 12 erkekten, kontrol grubu ise sekiz kız, üç erkekten oluştu. Çocuklarının AP sorunları Kanada Aktivite Performans Ölçeği (COPM) ile belirlendi. Çocukların fonksiyonel kapasiteleri ise, Pediatrik Özürlülük Değerlendirme Envanteri (PEDI) ile değerlendirildi. Müdahale grubundaki çocuklar, kendileri, ailelerinin belirttiği istek ve beklentileri ile terapistin değerlendirmesine yönelik hazırlanan AP içeren programa üç ay boyunca haftada üç gün, günde 40 dakika katıldı. Sonuçlar: Müdahale grubunda, kendine bakım, mobilite, sosyal fonksiyon ve toplam PEDI puanları ile COPM performans ve memnuniyet puanları anlamlı olarak arttı (p<0.05). Kontrol grubunda PEDI mobilite, sosyal fonksiyon ve toplam puanları anlamlı olarak düzeldi (p<0.05). PEDI kendine bakım (p=0,020) ve toplam (p=0,009) puanları açısından iki grup arasında anlamlı fark vardı. Kontrol grubunda COPM performans ve memnuniyet puanları açısından anlamlı farklılık saptanmadı (p>0.05). Tartışma: Bu çalışma, OBPP'li çocuklarda AP müdahalesi ile ilgili ilk çalışmadır. Bu çalışma, OBPP'li çocuklarda AP artırılmasına yönelik müdahaleyi ve bu müdahalede COPM kullanılarak değerlendirmeyi önermektedir.

Anahtar Kelimeler

• Günlük Yaşam Aktiviteleri
• Brakial Pleksus Nöropatileri
• Aktivite Performansı

AN INTERVENTION TO ENHANCE OCCUPATIONAL PERFORMANCE OF CHILDREN WITH OBSTETRICAL BRACHIAL PLEXUS PALSY

Abstract

Purpose: Children with obstetric brachial plexus palsy (OBPP) have problems with activity and participation, even if they are operated. The study aimed to investigate the intervention's effects to increase the occupational performance (OP) of children with OBPP. Methods: Twenty-nine children with OBPP, aged 4-7 years, participated in this study. The intervention group consisted of six girls and 12 boys, and a control group was composed of eight girls and three boys. The Canadian Occupational Performance Measure (COPM) determined children's OP. The Pediatric Evaluation of Disability Inventory (PEDI) was used to evaluate functional capability. All subjects continued their traditional physiotherapy program of 45 minutes every two days. The intervention group participated in an intervention program, consisting of the children and their families' needs, expectations, and therapists' assessment, about OP 40 minutes per day three days per week for three months. Results: The PEDI self-care, mobility, social function, and total scores and COPM-performance and COPM-satisfaction scores significantly increased in the intervention group (p<0.05). PEDI mobility, social function, and total scores significantly improved in the control group (p<0.05, Table 1). There was a significant difference in PEDI self-care (p=0.020) and total scores (p=0.009) between the two groups. There was no significant difference in COPM-performance and COPM-satisfaction scores in the control group (p>0.05). Conclusions: The present study is the first study on OP intervention in children with OBPP. The present study suggests intervening to enhance OP and via assessing using COPM in the children with OBPP.

Keywords

• Activities of Daily Living
• Brachial Plexus Neuropathies
• Occupational Performance

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