Access of Children with Cerebral Palsy to Rehabilitation and Special Education Services During the COVID-19 Pandemic

Year 2023, Volume: 76 Issue: 4, 310 - 315, 05.04.2024

Sevgi Esra Ozdemir Tekes , Yuzlem Gyuner Sidzhimli Mehmet Tekeş , Birkan Sonel , Şehim Kutlay

Abstract

Objectives: Prohibitions and precautions implemented due to the coronavirus disease-2019 (COVID-19) pandemic have disrupted children with cerebral palsy (CP) from accessing special education, rehabilitation and medical care. This study aimed to determine the changes and problems of children with CP regarding health and special education due to the COVID-19 pandemic.

Materials and Methods: Hundred children were included with CP who were followed up with a diagnosis of CP in the Ankara University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Pediatric Rehabilitation Unit. Hundred patients aged 0-18 years, who accepted to participate, were included between January 1, 2021 and January 31, 2022. Afterwards, questions were asked to the parents within the scope of the questionnaire consisting of 25 open- and close-ended questions.

Results: Hundred children with CP [47 female, 53 male; mean age 7.4 (2-16 years)] were included. It was determined that 19% of children had COVID-19 infection and only 2 children had impaired functional status. It was determined that 38% of children could not continue special education, but 81% could go to regular outpatient clinic control. It was observed that 31 (31%) children needed botulinum toxin injection and only 17 children were injected. It was noted that 92% of the participants had internet access at home, but only 2 (2%) had knowledge about telemedicine or telerehabilitation. In this process, it was seen that 44% of the participants continued their home exercises every day and 30% of them performed more than 3 days a week.

Conclusion: It was determined that, pediatric patients with CP who needed special education and rehabilitation were affected due to the COVID-19 pandemic. Difficulty in accessing interventional procedures such as botulinum toxin injection, special education services and the use of telerehabilitation were identified as the most affected areas. This pandemic has taught us that we should include alternative approaches such as telemedicine and telerehabilitation in the rehabilitation program to minimize these effects.

Key Words: Cerebral Palsy, COVID-19, Rehabilitation, Telerehabilitation, Telemedicine

Keywords

Cerebral Palsy , COVID-19 , Rehabilitation , Telerehabilitation , Telemedicine

Ethical Statement

Ethics Committee Approval: The research was carried out with the decision of Ankara University Faculty of Medicine, Human Research Ethics Committee numbered İ2-128-21, and dated 19.02.2021. Informed Consent: The patients who accepted to participate were informed about the study and invited after routine outpatient control examinations. Peer-review: Externally peer-reviewed

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COVID-19 Pandemi Sürecinde Serebral Palsili Çocukların Rehabilitasyon ve Tedavi Hizmetlerine Ulaşımlarının Değerlendirilmesi

Abstract

Amaç: Koronavirüs hastalığı-2019 (COVID-19) pandemisi nedeniyle uygulanan önlemler serebral palsili (SP) çocukların özel eğitim, rehabilitasyon ve tıbbi tedavilere erişimlerinde kesintilere neden olmuştur. Bu çalışmada, COVID-19 pandemisi nedeniyle SP’li çocukların ve ailelerinin, sağlık ve eğitim ile ilgili yaşadıkları değişimleri ve sorunları belirlemek amaçlanmıştır.

Gereç ve Yöntem: Ankara Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı Pediyatrik Rehabilitasyon Ünitesi’nde SP tanısı ile izlenen 100 SP’li çocuk dahil edilmiştir. Açık ve kapalı 25 sorudan oluşan anket formu ile 1 Ocak 2021-31 Ocak 2022 arasında değerlendirme yapılmıştır.

Bulgular: Çocukların 47’si kız, 53’ü erkek olup ortalama yaş 7,4’tür (2-16 yaş). SP tiplerine göre dağılımları ise; %30’u hemiplejik, %49’u diplejik ve %21’i tüm vücut tutulumlu şeklindeydi. SP’li çocukların %19’unun COVID-19 enfeksiyonu geçirdiği ve sadece 2 tanesinin fonksiyonel durumunda bozulma olduğu görüldü. SP’li çocukların %38’i pandemi sürecinde özel eğitime devam edememiştir, buna karşılık %81’inin düzenli fiziksel tıp ve rehabilitasyon polikliniği kontrolüne gidebildiği saptanmıştır. Otuz bir hastanın pandemi sürecinde botulinum toksin enjeksiyonu ihtiyacınınolduğu ve yalnızca 17 hastaya botulinum toksin enjeksiyonu yapıldığı görülmüştür. Katılımcıların %92’si evinde internet erişimi olduğunu, ancak katılımcılardan sadece 2 tanesinin (%2) teletıp veya telerehabilitasyon konusunda bilgi sahibi olduğu dikkat çekmiştir. Bu süreçte %68 hastanın evde egzersizlerinin yaptırıldığı ve bu hastaların %44’ünün her gün, %30’unun ise haftada 3 günden fazla ev egzersizlerine devamlılık sağladığı görülmüştür.

Sonuç: COVID-19 pandemisi nedeniyle tüm hasta grupları gibi özel eğitim ve rehabilitasyon ihtiyacı duyan SP’li çocuk yaş grubu hastaların da etkilendiği saptanmıştır. En sık etkilenen alanlar olarak; özel eğitim hizmetleri, botulinum toksin enjeksiyonu gibi girişimsel işlemlere ulaşımda güçlük ve telerehabilitasyon uygulamalarının yaygın olarak kullanılmadığı saptanmıştır. Günümüzde teknolojideki gelişimler, birçok medikal alanda kullanılmaktadır, bu pandemi nedeniyle görüyoruz ki teknolojideki bu gelişimleri teletıp ve telerehabilitasyon alanlarına uyarlayarak rehabilitasyon programlarına daha sık dahil etmeliyiz.

Anahtar Kelimeler: Serebral Palsi, COVID-19, Rehabilitasyon, Telerehabilitasyon, Teletıp

Keywords

Serebral Palsi , COVID-19 , Rehabilitasyon , Telerehabilitasyon , Teletıp

Ethical Statement

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