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SEREBRAL PALSİ’DE GÜNCEL FİZYOTERAPİ VE REHABİLİTASYON YAKLAŞIMLARI1

Year 2010, Issue: 1, 5 - 22, 01.05.2010

Abstract

Serebral Palsi (SP), gelişimsel bir bozukluk olup; doğum öncesi, doğum sırası ya da doğum sonrasında immatür beyindeki lezyon nedeniyle oluşan hareket, denge ve postüral bozuklukları tanımlayan, çocukluk çağında yaygın olarak görülen ve bozukluk yaratan bir tablodur. Motor gelişim bozukluğunun yanı sıra; kognitif, görsel, işitsel ve davranışsal problemler de görülebilir. SP’ li çocuklarda, fonksiyonel bozukluklar ile birlikte gelişen fiziksel, kognitif, duyusal, emosyonel ve sosyal bozukluklarda çocukların hareket performanslarını olumsuz etkiler. Tıbbi tedavi, cerrahi uygulamalar ve rehabilitasyon modaliteleri çoklu ve multidisipliner konsepte uygun ele alınmalıdır. Fizyoterapi ve rehabilitasyon uygulamalarında, nörogelişimsel tedavi modalitesi ilkeleriyle edinilen fonksiyonel hareketler, hedefe yönelik olup, günlük yaşam aktivitelerine hareketlerine odaklanılarak yapılan zorunlu pasif hareketler, çocuğun aktif katılımını engeller ve istemsiz hareketler yaratabilir. Bu kapsamda, aile eğitimi, çocuğun ev ve okuldaki ihtiyaçları ve uygun ortez ile adaptif cihazlarının değerlendirilmesi büyük önem taşır. Fizyoterapi uygulamalarında; motivasyon, çeşitlilik ve tekrara odaklanılmalı ve çocuğun kişiliğine uygun seçilen fonksiyonel aktivitelerden hoşlanması için fırsat yaratılmalıdır. Erken fizyoterapi mevcut becerilerin geliştirilmesi ve ikincil komplikasyonların en aza edilmesine olanak sağlarken, çocuk ve ailesinin duruma erken adapte olmasını sağlar

References

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  • Anttila, H., Autti-Rämö, I., Suoranta, J., Mäkelä, M., Malmivaara, A. (2008) . Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review. BMC Pediatr. 24(8): 1471-2431. doi:10.1186/1471-2431- 8-14
  • Bar-Haim, S., Harries, N., Belokopytov, M., Frank, A., Copeliovitch, L., Kaplanski, J., Lahat,E. (2006) . Comparsion of efficacy of Adeli suit and neurodevelopmental treatmants in children with cerebral palsy. Dev Med Child Neurol. 48: 325-3309. doi: 10.1017/S0012162206000727
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  • Booth, C. M., Cortina-Borja, M. J., Theologis. T. N. (2001) . Collagen accumulation in muscles of children with cerebral palsy and correlation with severity of spasticity. 8749.2001.tb00211.x Med Child Neuro. 43:314-20.
  • Bower, E., McLellan, D. L. (1992) . Effect of increased exposure to physiotherapy on skill acquisition of children with cerebral palsy. Dev Med Child Neurol. 34(1):25–39. doi:10.1111/j.1469-8749.1992.tb08560.x
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  • Carlsson, M., Hagberg, G., Olsson, I. (2003) . Clinical and aetiological aspects of epilepsy in children with cerebral palsy. Dev Med Child Neurol. 45(6): 371-376. Doi: 10.1111/j.1469-8749.2003.tb00415.x
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  • Dan, B., Bouillot, E., Bengoetxea, A., Noël, P., Kahn, A., Cheron, G. (2000) . Head stability during whole body movements in spastic diplegia. Brain Dev. 22(2): 99-101. doi: S0387-7604(99)00123-0
  • Dodd, K. J., Taylor, N. F., Damiano, D. L. (2002) . A systematic review of the effectiveness of strength-training programs for people with cerebral palsy. Arch Phys Med Rehabil. 83(8):1157
  • Dong, V. A., Tung, I. H., Siu, H. W., Fong, K. N. (2012) . Studies comparing the efficacy of constraint-induced movement therapy and bimanual training in children with unilateral cerebral palsy: A systematic review. Developmental Neurorehabilitation. (doi:10.3109/17518423.2012.702136) 2013, Vol. 16, No:2, Pages 133-143
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  • Eliasson, A. C., Krumlinde-Sundholm, L., Rösblad, B., Beckung, E. ( 2007) . Using the MACS to facilitate communication about manual abilities of children with cerebral palsy. Dev Med Child Neurol. 49 (2): 156-157.
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  • Gracies, J. M. (2005) . Pathophysiology of spastic paresis. II: Emergence of muscle over activity. Muscle Nerve. 31(5): 552–571. doi: 10.1002/mus.20285
  • Günel, M. K, Mutlu, A., Tarsuslu, T., Livanelioğlu, A. (2009) . 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.168: 477-85. Doi: 10.1007/s00431- 008-0775-1
  • Harris, S. R., Roxborough, L. (2005) . Efficacy and effectiveness of physical therapy in enhancing postüral control in children with cerebral palsy. Neural Plast.12: 2090-5904. doi:10.1155/NP.2005.229
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  • Jacobson, L. K., Dutton, G. N. (2000) . Periventricular leukomalacia: an important cause of visual and ocular motility dysfunction in children. Surv Ophthalmol. 45(1): 1-13. doi:10.1016/S0039-6257(00)00134-X
  • Kerem Günel M. (2011) . Physiotherapy for Children with Cerebral Palsy Epilepsy in Children - Clinical and Social Aspects, ISBN: 978-953-307-681-2.
  • Kerem Günel, M. (2005) . Prematüre bebekte erken fizyoterapi. Katkı Pediatri Dergisi. 485-491.
  • Kerem Günel, M. (2009) . The view on pediatric rehabilitation with the title of cerebral palsy from the perspective of a physiotherapist. Acta Ortopaedica Et Traumatologia Turcica .43(2): 173-181. doi:10.3944/AOTT.2009.173
  • Kerem Günel, M. (2010) . Neurodevelopmental therapy approach on pediatric physiotherapy and rehabilitation appliying, Turkiye klinikleri J PM&R-special topics. 3(3): 1-8.
  • Kerem, M., Akı, E., Livanelioğlu, A., Aysun, S. (2001) . Normal zamanında doğan ve premature serebral paralizili çocuklarda ev egzersizi programının motor gelişim üzerine etkileri: Retrospektif bir çalışma. Fizyoterapi Rehabilitasyon; 12(3): 94- 98.
  • Kra¨geloh-Mann, I. (2004) . Imaging of early brain injury and cortical plasticity. Exp Neurol. 190:84–90. doi:10.1016/j.expneurol.2004.05.037
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Current Physiotherapy and Rehabilitation Approach on Cerebral Palsy

Year 2010, Issue: 1, 5 - 22, 01.05.2010

Abstract

It is a table that can cause defect, and that is seen commonly in childhood period. CP, which is a developmental disorder, is described as a neuromotor disorder in which movement, balance and postural disorders that occur as a result of a lesion in the immature brain before the birth, during the birth or after the birth. Besides the motor development disability, mental, visual, hearing, speaking and behavioural problems can be also seen. In children with CP, functional disorders that develop in parallel with physical, cognitive, sensory, emotional and social disorders, affect the movement performance of these children negatively and make difficult to fulfil their duties. Medical treatment, surgical applications and rehabilitation modalities should be handled with a multiple and multidisciplinary conception. Functional movements, which are gained by neurodevelopmental treatment modality principles in physiotherapy applications, should be goal-directed and adaptive to daily life activities. Focusing on the extremity movements with conservative exercise concept and the application of obligatory passive exercises prevent the active participation of the child and can increase the involuntary movements. Again, within this scope, it is important to determine family education, the needs of the child in environments like home and school, appropriate orthosis, adaptive equipments. During the physiotherapy applications it should be focused on motivation, variety and repetition; it should be created opportunities for the child to learn and to like the activities in functionality which are selected according to the child’s personal characteristics. Starting physiotherapy early enables for improving the existing skills and for minimizing the secondary complications, and also provides the early adaptation of the family and child to the illness

References

  • Acavedo, S. J. (1999) . Physical Therapy for the Child with Cerebral Palsy. In: Tecklin, J. S. (Ed) . Pediatric Physical Therapy. 3. ed. Philadelphia: Saunders WB: 107- 162.
  • Amblard, B., Assaiante, C., Fabre, J. C., Martin, N. Massion, J., Mouchnino, L., Vernazza, S. (1995) . Voluntary head stabilization in space during trunk movements in weightlessness. Acta Astronaut. 36(8-12): 415-22.
  • Anttila, H., Autti-Rämö, I., Suoranta, J., Mäkelä, M., Malmivaara, A. (2008) . Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review. BMC Pediatr. 24(8): 1471-2431. doi:10.1186/1471-2431- 8-14
  • Bar-Haim, S., Harries, N., Belokopytov, M., Frank, A., Copeliovitch, L., Kaplanski, J., Lahat,E. (2006) . Comparsion of efficacy of Adeli suit and neurodevelopmental treatmants in children with cerebral palsy. Dev Med Child Neurol. 48: 325-3309. doi: 10.1017/S0012162206000727
  • Bobath, K., Bobath, B. (1984) . The neuro-developmental treatment. In: Scrutton D, editor. Management of the motor disorders of children with cerebral palsy. Philadelphia: J. B. Lippincott: p. 6-18.
  • Booth, C. M., Cortina-Borja, M. J., Theologis. T. N. (2001) . Collagen accumulation in muscles of children with cerebral palsy and correlation with severity of spasticity. 8749.2001.tb00211.x Med Child Neuro. 43:314-20.
  • Bower, E., McLellan, D. L. (1992) . Effect of increased exposure to physiotherapy on skill acquisition of children with cerebral palsy. Dev Med Child Neurol. 34(1):25–39. doi:10.1111/j.1469-8749.1992.tb08560.x
  • Butler, C., Darrah, J. (2001) . AACPDM Evidence report: Effects of neurodevelopmental treatment (NDT) for cerebral palsy. Dev Med Child Neurol. 43(11): 778–790. doi: 10.1111/j.1469-8749.2001.tb00160.x
  • Carlberg, E., Löwing, K. (2010) . Goal directed training in children with cerebral palsy. Turkiye klinikleri J PM&R-special topics. 3(3):53-57.
  • Carlsson, M., Hagberg, G., Olsson, I. (2003) . Clinical and aetiological aspects of epilepsy in children with cerebral palsy. Dev Med Child Neurol. 45(6): 371-376. Doi: 10.1111/j.1469-8749.2003.tb00415.x
  • Collet, J. P., Vanasse, M., Marois, P. (2001) . Hyperbaric oxygen for children with cerebral palsy: a randomised multicentre trial. HBO-CP Research Group. Lancet 2001; 357: 582–6.
  • Cowan, F., Rutherford, M., Groenendaal, F., Eken, P., Mercuri, E., Bydder, G. M., Meiners, L. C., Dubowitz, L. M. S., Vries, L. S. (2003) . Origin and timing of brain lesions interm infants with neonatal encephalopathy. Lancet. 361: 736– 42. doi:10.1016/S0140-6736(03)12658-X
  • Damiano, D, L., Vaughan, C. L., Abel, M. F. (1995) . Muscle response to heavy resistance exercise in children with spastic cerebral palsy. Dev Med Child Neurol. 37:731-9. doi:10.1111/j.1469-8749.1995.tb15019.x
  • Dan, B., Bouillot, E., Bengoetxea, A., Noël, P., Kahn, A., Cheron, G. (2000) . Head stability during whole body movements in spastic diplegia. Brain Dev. 22(2): 99-101. doi: S0387-7604(99)00123-0
  • Dodd, K. J., Taylor, N. F., Damiano, D. L. (2002) . A systematic review of the effectiveness of strength-training programs for people with cerebral palsy. Arch Phys Med Rehabil. 83(8):1157
  • Dong, V. A., Tung, I. H., Siu, H. W., Fong, K. N. (2012) . Studies comparing the efficacy of constraint-induced movement therapy and bimanual training in children with unilateral cerebral palsy: A systematic review. Developmental Neurorehabilitation. (doi:10.3109/17518423.2012.702136) 2013, Vol. 16, No:2, Pages 133-143
  • Echols, K., DeLuca, S. C., Ramey, S. L. (2002) . Constraint-induced movement therapy versus traditional therapy services for young children with CP. Dev Med Child Neurol. 91:44.
  • Eliasson, A. C., Krumlinde-Sundholm, L., Rösblad, B., Beckung, E. ( 2007) . Using the MACS to facilitate communication about manual abilities of children with cerebral palsy. Dev Med Child Neurol. 49 (2): 156-157.
  • Gaebler-Spira, D., Revivo, G. (2003) . The use of botulinum toxin in pediatric disorders. Phys Med Rehabil Clin N Am. 14 (4): 703-725.doi:10.1016/S1047- 9651(03)00043-3
  • Gracies, J. M. (2005) . Pathophysiology of spastic paresis. II: Emergence of muscle over activity. Muscle Nerve. 31(5): 552–571. doi: 10.1002/mus.20285
  • Günel, M. K, Mutlu, A., Tarsuslu, T., Livanelioğlu, A. (2009) . 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.168: 477-85. Doi: 10.1007/s00431- 008-0775-1
  • Harris, S. R., Roxborough, L. (2005) . Efficacy and effectiveness of physical therapy in enhancing postüral control in children with cerebral palsy. Neural Plast.12: 2090-5904. doi:10.1155/NP.2005.229
  • Helders, P. J. M., Raoul, H., Engelbert, H., Custers, J. W. H., Gorter. J. W., Takken, T., Van Der Net, J. (2003) . Creating and being created: the changing panorama of pediatric rehabilitation. Pediatr Rehabil. 6(1): 5-12. doi: 10.1080/1363849031000095260
  • Hof, A.L. (2001) . Changes in muscles and tendons due to neural motor disorders: implications for therapeutic intervention. Neural Plast. 8(1-2): 71-81. doi:10.1155/NP.2001.71
  • Jacobson, L. K., Dutton, G. N. (2000) . Periventricular leukomalacia: an important cause of visual and ocular motility dysfunction in children. Surv Ophthalmol. 45(1): 1-13. doi:10.1016/S0039-6257(00)00134-X
  • Kerem Günel M. (2011) . Physiotherapy for Children with Cerebral Palsy Epilepsy in Children - Clinical and Social Aspects, ISBN: 978-953-307-681-2.
  • Kerem Günel, M. (2005) . Prematüre bebekte erken fizyoterapi. Katkı Pediatri Dergisi. 485-491.
  • Kerem Günel, M. (2009) . The view on pediatric rehabilitation with the title of cerebral palsy from the perspective of a physiotherapist. Acta Ortopaedica Et Traumatologia Turcica .43(2): 173-181. doi:10.3944/AOTT.2009.173
  • Kerem Günel, M. (2010) . Neurodevelopmental therapy approach on pediatric physiotherapy and rehabilitation appliying, Turkiye klinikleri J PM&R-special topics. 3(3): 1-8.
  • Kerem, M., Akı, E., Livanelioğlu, A., Aysun, S. (2001) . Normal zamanında doğan ve premature serebral paralizili çocuklarda ev egzersizi programının motor gelişim üzerine etkileri: Retrospektif bir çalışma. Fizyoterapi Rehabilitasyon; 12(3): 94- 98.
  • Kra¨geloh-Mann, I. (2004) . Imaging of early brain injury and cortical plasticity. Exp Neurol. 190:84–90. doi:10.1016/j.expneurol.2004.05.037
  • Kra¨geloh-Mann, I., Helber, A., Mader, I., Staudt, M., Wolff, M., Groenendaal. F., DeVries, L. (2002) . Bilateral lesions of thalamus and basal ganglia: origin and outcome. Dev Med Child Neurol. 44:477–84. doi:10.1111/j.1469- 8749.2002.tb00309.x
  • Krägeloh-Mann, I. Cans, C. (2009) . Cerebral palsy update. Brain Dev. 31 (7): 537- 544. doi:10.1016/j.braindev.2009.03.009
  • Kunz, R., Autti-Rämö, I., Anttila, H., Malmivaara, A., Mäkelä M, A. (2006) . Systematic review finds that methodological quality is better than its reputation but can be improved in physiotherapy trials in childhood cerebral palsy. J Clin Epidemiol. 59(12): 1239-1248. doi:10.1016/j.jclinepi.2006.03.009
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There are 62 citations in total.

Details

Primary Language Turkish
Journal Section Collection
Authors

Gonca Arı This is me

Mintaze Kerem Günel This is me

Publication Date May 1, 2010
Published in Issue Year 2010 Issue: 1

Cite

APA Arı, G., & Günel, M. K. (2010). SEREBRAL PALSİ’DE GÜNCEL FİZYOTERAPİ VE REHABİLİTASYON YAKLAŞIMLARI1. Ufkun Ötesi Bilim Dergisi(1), 5-22.