SEREBRAL PALSİ’DE GÜNCEL FİZYOTERAPİ VE REHABİLİTASYON YAKLAŞIMLARI1

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

Gonca Arı Mintaze Kerem Günel

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

Keywords

Serebral palsi, Fizyoterapi, Rehabilitasyon, Nörogelişimsel Tedavi

Current Physiotherapy and Rehabilitation Approach on Cerebral Palsy

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

Keywords

Cerebral palsy, physiotherapy, rehabilitation, neurodevelopmental therapy

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