Hemiparetik ve diparetik serebral palsili çocuklarda somatosensoriyel algı ve propriyosepsiyonun üst ekstremite fonksiyonel becerilerine etkisi

Yıl 2024, , 285 - 296, 23.09.2024

Büşra Doğan , Hatice Adıgüzel , Arzu Demirgüç

https://doi.org/10.21673/anadoluklin.1395613

Öz

Amaç: Bu çalışmanın amacı hemiparetik ve diparetik Serebral Palsi (SP)’li çocuklarda somatoduyusal algı ve propriosepsiyonun üst ekstremite fonksiyonel becerilerine etkilerini belirlemektir.

Yöntemler: Çalışmaya yaş ortalamaları 10,71± 4,09 olan, Kaba Motor Fonksiyon Sınıflama Sistemi (GMFCS) 1-2 ve 3 ile El Beceri Sınıflama Sistemi (MACS) 1-2-3 düzeyindeki 15 hemiparetik SP’li çocuk, 15 diparetik SP’li çocuk ve 15 sağlıklı çocuk (24 erkek/21 kız) dahil edildi. Somatoduyusal algı Ayres Güney Kaliforniya Duyu Bütünleme ve Praxis Testi (SIPT)’nin alt parametreleri olan kinestezi, dokunma uyarısının lokalizasyonu, çift dokunma uyarısı lokalizasyonu, parmak tanıma ve sağ-sol ayırımı testleriyle değerlendirildi. Propriosepsiyon değerlendirmesi için omuz, dirsek, el-el bileğine gonyometrik ölçümü yapıldı. Üst ekstremite fonksiyonel becelerileri Jebsen Taylor El Fonksiyon Testi (JTEFT) değerlendirildi.

Bulgular: SP’li çocuklar ile kontrol grubu arasında somatoduyusal algı ile propriosepsiyonun farklı olduğu ve bu parametrelerin de el becerileriyle anlamlı olarak ilişkili olduğu bulundu (p<0.05). Kontrol grubunun somatoduyusal algı ve propriosepsiyonlarının SP’li gruplara göre anlamlı düzeyde daha iyi olduğu bulundu (p<0.05). SP’li çocukların somatoduyusal algı, propriosepsiyon ve JTEFT testlerinde; hemiparetik grubun diparetik gruba göre anlamlı düzeyde daha iyi olduğu bulundu (p<0.05).

Sonuç: SP’li çocukların sağlıklı yaşıtlarına göre üst ekstremitelerinde daha düşük somatosensoriyel algı düzeylerine sahip olduğu ve üst ekstremitelerinde propriyoseptif kayıpların olduğu belirlendi. Sağlıklı akranlarına göre somatosensoriyel algı ve propriyosepsiyon testlerinde diparetik çocukların hemiparetiklerden daha düşük skorlarının olduğu gösterildi. SP’li çocukların sağlıklı akranlarına göre daha düşük el becerilerine sahip oldukları, hemiparetik çocukların ise diparetik gruba göre daha iyi düzeyde olduğu belirlendi.

Anahtar Kelimeler

Algı, üst ekstremite, propriyosepsiyon, serebral palsi

The effect of somatosensory perception and proprioception on upper extremity functional skills in children with hemiparetic and diparetic cerebral palsy

Öz

Aim: The aim of the current research is to determine the impacts of somatosensory perception and proprioception on upper extremity functional skills in children with hemiparetic and diparetic cerebral palsy (CP).

Methods: Children with hemiparetic (n=15) and diparetic (n=15) CP at Gross Motor Function Classification System (GMFCS) I-III and Manual Ability Classification System (MACS) I-III levels and healthy children (n=15) with a mean age of 10.71± 4.09 were enrolled in the research. Somatosensory perception was evaluated with the Ayres’ Southern California Sensory Integration and Praxis Test (SIPT) sub-parameters, kinesthesia (KIN), touch stimulus localization (TSL), double-touch stimulus localization (DTL), finger recognition (FR), and right-left discrimination (RLD) tests. Proprioception measurements were performed with a goniometer on the shoulder, elbow, and hand-wrist. Upper extremity functional skills were evaluated by the Jebsen-Taylor Hand Function Test (JTHFT).

Results: Somatosensory perception and proprioception of the control group were determined to be significantly better than those of both groups with CP (p<0.05). The somatosensory perception, proprioception, and JTHFT test results of children with CP were significantly better in the hemiparetics in comparison with the diparetics (p<0.05).

Conclusion: The study showed that children with CP had lower somatosensory perception levels in their upper extremities and had proprioceptive losses in their upper extremities in comparison with their healthy peers. It was shown that diparetic children had lower scores than hemiparetic children in somatosensory perception and proprioception tests compared to their healthy peers.
It was determined that children with CP had lower hand skills compared to their healthy peers and hemiparetic children were better than diparetic group in hand skills. It was revealed that children with CP had lower manual dexterity than their healthy peers, and hemiparetic children had better skills than the diparetic group.

Anahtar Kelimeler

Cerebral palsy, hand, perception, proprioception

Etik Beyan

Approval for the research was received from the XXXXX Clinical Research Ethics Committee on 07.07.2020 with the decision numbered 2020/09-11, and the study was performed in accordance with the Declaration of Helsinki.

Destekleyen Kurum

None.

Teşekkür

We express our gratitude to the children and their families participating in this study.

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