Investigation of the Relationship of Hand-Wrist Sensation with Functional Independence and Participation in Individuals with Meningomyelocele

Öz

Purpose: The aim of this study was to investigate the relationship of hand-wrist sensation with independence and participation in children with meningomyelocele. Material and Methods: 23 normally developing children and 23 children with MMC between the ages of 6-12 were included in the study. Light touch sense “Semmes-Weinstein monofilament test”, two-point discrimination sense “Discriminator”, proprioception “Goniometer”, kinesthesia “Ability to copy different hand positions”, independence “Barthel Index” and participation “Child and adolescent participation questionnaire (CASP)” was evaluated. Results: Participation and functional independence were statistically lower in children with MMC than in normally developing individuals. There was no statistically significant correlation between light touch sense, two-point discrimination sense, proprioception and kinesthesia sense and Barthel index (p> 0.05). There was a statistically significant negative correlation between dominant and non-dominant side light touch sense and two-point discrimination sense and CASP sub-parameter home community participation and school participation (p<0.05). In addition, there was a positive, statistically significant relationship between hand kinesthesia and CASP subparameters, neighborhood community participation and home community participation (p<0.05). Conclusion: Hand-wrist sensation is associated with participation in children with meningomyelocele. Hand-wrist sensation should be included in the assessment, physiotherapy and rehabilitation program in children with meningomyelocele. Improving hand-wrist sensation in children with meningomyelocele may contribute to increased participation.

Anahtar Kelimeler

• Meningomyelocele
• participation
• functional independence
• hand-wrist sensation

Meningomyeloselli Çocuklarda El-El Bileği Duyusunun Fonksiyonel Bağımsızlık ve Katılım ile İlişkisinin Araştırılması

Öz

Amaç: Meningomyeloselli (MMC) çocuklarda el-el bileği duyusunun günlük yaşam aktivitelerindeki fonksiyonel bağımsızlık ve katılım ile ilişkisinin araştırılmasıdır. Gereç ve Yöntem: Çalışmaya 6-12 yaş aralığında 23 normal gelişim gösteren ve 23 MMC’li çocuk dahil edildi. Hafif dokunma duyusu “Semmes-Weinstein Monofilament Testi”, iki nokta ayırımı duyusu “Diskriminatör”, propriyosepsiyon “Gonyometre”, kinestezi “Farklı el pozisyonlarını kopya edebilme yeteneği”, fonksiyonel bağımsızlık “Barthel Indeks” ve katılım “Çocuk ve Adölesan Katılım Anketi (CASP)” ile değerlendirildi. Sonuçlar: MMC’li çocuklarda normal gelişim gösteren çocuklara göre katılım ve fonksiyonel bağımsızlık anket skorları düşüktü. MMC’li çocuklarda dominant ve dominant olmayan taraf hafif dokunma duyusu, iki nokta ayırımı duyusu, propriyosepsiyon ve kinestezi duyusu ile Barthel indeksi arasında istatistiksel olarak anlamlı bir ilişki yoktu (p> 0.05). Dominant ve dominant olmayan taraf hafif dokunma duyusu ve iki nokta ayırımı duyusu ile katılım ve alt parametresi ev toplum katılımı ve okul katılımı arasında negatif yönlü istatistiksel olarak anlamlı orta düzeyde ilişki vardı (p< 0.05). El kinestezi duyusu ile CASP alt parametreleri mahalle toplum katılımı ve ev toplum katılımı arasında pozitif yönlü istatistiksel olarak anlamlı orta düzeyde ilişki vardı. Tartışma: Meningomyeloselli çocuklarda el-el bileği duyusu katılım ile ilişkilidir. Meningomyeloselli çocuklarda el- el bileği duyusu değerlendirme, fizyoterapi ve rehabilitasyon programına dahil edilmelidir. Meningomyeloselli çocuklarda el-el bileği duyusunun geliştirilmesi katılımın artmasına katkı sağlayabilir.

Anahtar Kelimeler

• Meningomyelosel
• katılım
• fonksiyonel bağımsızlık
• El-El Bileği Duyusu

Kaynakça

1. Anderson, E. M. (1976). Impairment of a motor (manual) skill in children with spina bifida myelomeningocele and hydrocephalus. British Journal of Occupational Therapy, 39, 91-92. https://doi.org/10.1177/030802267603900403
2. Atasavun Uysal, S., Dülger, E., Bilgin, S., Elbasan, B., Çetin, H., Türkmen, C., Karabulut, E., Habibzadeh, A., Yakut, Y., Düger, T. (2018). Çocuk ve Adölesan Katılım Anketi’ nin (CASP) Türkçe geçerlik ve güvenirlik çalışması: XVII. Fizyoterapi ve Rehabilitasyonda Gelişmeler Kongresi, Turkey, 87.
3. Bakaniene, I. & Prasauskiene, A. (2020). Patterns and predictors of participation in children and adolescents with spina bifida. Disability and Rehabilitation, 42(26), 3771-3779. https://doi.org/10.1080/09638288.2019.1610510
4. Bakaniene, I., Žiukiene, L., Vasiliauskiene, V., Prasauskiene, A. (2018). Participation of children with spina bifida: A scoping review using the ınternational classification of functioning, disability and health for children and youth (ICF-CY) as a reference framework. Medicina, 54(3), 40. https://doi.org/10.3390/medicina54030040
5. Bedell, G. M. (2004). Developing a follow-up survey focused on participation of children and youth with acquired brain injuries after discharge from inpatient rehabilitation. NeuroRehabilitation, 19(3), 191-205. https://doi.org/10.3233/NRE-2004-19303
6. Bedell, G. (2008). The child and adolescent scale of participation (CASP): Further psychometric testing. The Journal of Head Trauma Rehabilitation, 23(5), 341. https://doi.org/10.1097/01.HTR.0000336850.29574.7a
7. Bloemen, M. A., Verschuren O., Mechelen, C. V., Borst H. E., De Leeuw, A. J., Hoef, M., Groot, J.F. (2015). Personal and environmental factors to consider when aiming to improve participation in physical activity in children with spina bifida: A qualitative study. BMC Neurology, 15, 11. https://doi.org/10.1186/s12883-015-0265-9
8. Buran, C. F., Sawin, K.J., Brei, T. J., Fastenau, P. S. (2004). Adolescents with myelomeningocele: activities, beliefs, expectations, and perceptions. Developmental Medicine & Child Neurology, 46, 244–252. https://doi.org/10.1111/j.14698749.2004.tb00479.x

9. Colver, A. (2006). Study protocol: SPARCLE--a multi-centre European study of the relationship of environment to participation and quality of life in children with cerebral palsy. BMC Public Health, 6, 105. https://doi.org/10.1186/1471-2458-6-105
10. Dellon, A. L. (1978). The moving two-point discrimination test: Clinical evaluation of the quickly adapting fiber/receptor system. The Journal of Hand Surgery, 3(5), 474-481. https://doi.org/10.1016/S0363-5023(78)80143-9
11. Di Marino, E., Tremblay, S., Khetani, M., Anaby, D. (2018). The effect of child, family and environmental factors on the participation of young children with disabilities. Disability and Health Journal, 11(1), 36-42 https://doi.org/10.1016/j.dhjo.2017.05.005
12. Donnan, J., Walsh, S., Sikora, L., Morrissey, A., Collins, K., MacDonald, D. (2017). A systematic review of the risks factors associated with the onset and natural progression of spina bifida. Neurotoxicology, 61, 20-31. https://doi.org/10.1016/j.neuro.2016.03.008
13. Dua, K., Lancaster, T. P., Abzug, J. M. (2019). Age-dependent reliability of Semmes-Weinstein and 2-point discrimination tests in children. Journal of Pediatric Orthopaedics, 39(2), 98-103. https://doi.org/10.1097/BPO.0000000000000892
14. Günel, M. K., Mutlu, A., Tarsuslu, T., Livanelioglu, 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. Europan Journal of Pediatrics, 168(4), 477-485. https://doi.org/10.1007/s00431-008-0775-1
15. Günel M. K. (2022). Çocuklarda tipik motor ve fonksiyonel gelişim. Hipokrat Yayıncılık. Ankara.
16. Hamilton, A. M. (1991). Sensory hand function of the child with spina bifida myelomeningocele. British Journal of Occupational Therapy, 54(9), 346-349. https://doi.org/10.1177/030802269105400907
17. Hayran, M., Hayran, M. (2020). Sağlık Araştırmaları İçin Temel İstatistik. Pelikan Yayınevi, Ankara.
18. Hwang, R., Kentish, M., Burns, Y. (2002). Hand positioning sense in children with spina bifida myelomeningocele. Australian Journal of Physiotherapy, 48(1), 17-22. https://doi.org/10.1016/S0004-9514(14)60278-6
19. Jerosch-Herold, C. (2005). Assessment of sensibility after nerve injury and repair: A systematic review of evidence for validity, reliability and responsiveness of tests. Journal of Hand Surgery, 30(3), 252-264. https://doi.org/10.1016/J.JHSB.2004.12.006
20. Law, M., Anaby, D., Teplicky, R., Khetani, M. A., Coster, W., Bedell, G. (2013). Participation in the home environment among children and youth with and without disabilities. British Journal of Occupational Therapy, 76(2), 58-66. https://doi.org/10.4276/030802213X13603244419112
21. Liptak, G. S., Kennedy, J. A., Dosa, N. P. (2010). Youth with spina bifida and transitions: Health and social participation in a nationally represented sample. The Journal of Pediatrics, 157(4), 584-588. https://doi.org/10.1016/j.jpeds.2010.04.004
22. Lynch, M. R., Raymer, M. E., Elvery, J. H., Walsh, A. L., & Burns, Y. R. (1992). The development of hand position sense. New Zealand Journal of Physiotherapy, 20(0001), 00015-00020.
23. Mahoney, F. I., Barthel, D. W. (1965). Functional evaluation: The Barthel Index: A simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Maryland State Medical Journal, 14, 61–65.
24. McKernan, G., Izzo, S., Crytzer, T. M., Houtrow, A. J., Dicianno, B. E. (2020). Relationship between motor level and wheelchair transfer ability in spina bifida: A study from the national spina bifida patient registry. Archives of Physical Medicine and Rehabilitation, 101(11), 1953-1960. https://doi.org/10.1016/j.apmr.2020.06.016
25. Muen, W. J., Bannister, C. M. (1997). Hand function in subjects with spina bifida. European journal of pediatric surgery: Official journal of Austrian Association of Pediatric Surgery (Zeitschrift fur Kinderchirurgie), 7(1), 18-22. https://doi.org/10.1055/s-2008-1071203
26. Norrlin, S., Strinnholm, M., Carlsson, M., Dahl, M. (2003). Factors of significance for mobility in children with myelomeningocele. Acta Paediatrica, 92(2), 204-210.https://doi.org/10.1111/j.16512227.2003.tb00527.x
27. Phillips, L. A., Burton, J. M., Evans, S. H. (2017). Spina bifida management. Current Problems in Pediatric and Adolescent Health Care, 47(7), 173-177. https://doi.org/10.1016/j.cppeds.2017.06.007
28. Rendeli, C., Ausili, E., Tabacco, F., Caliandro, P., Aprile, I., Tonali, P., Salvaggio, E., Padua, L. (2005). Assessment of health status in children with spina bifida. Spinal cord, 43(4), 230–235. https://doi.org/10.1038/sj.sc.3101707
29. Schoenmakers, M. A., Uiterwaal, C. S., Gulmans, V. A., Gooskens, R. H., Helders, P. J. (2005). Determinants of functional independence and quality of life in children with spina bifida. Clinical Rehabilitation, 19(6), 677-685. https://doi.org/10.1191/0269215505cr865oa
30. Steinhart, S., Kornitzer, E., Baron, A. B., Wever, C., Shoshan, L., Katz-Leurer, M. (2018). Independence in self-care activities in children with myelomeningocele: Exploring factors based on the international classification of function model. Disability Rehabilitation, 40(1), 62-68. https://doi.org/10.1080/09638288.2016.1243158
31. Tekin, F., Can-Akman, T., Kitiş, A. (2022). Evaluation of the validity and reliability of the KFORCE Sens® electrogoniometer in evaluation of wrist proprioception. Hand Surgery & Rehabilitation, 41(2), 183-188. https://doi.org/10.1016/j.hansur.2021.12.006
32. Verhoef, M., Barf, H.A., Post, M.W., Van Asbeck, F.W., Gooskens, R.H., Prevo, A.J. (2006). Functional independ- ence among young adults with spina bifida in relation to hydrocephalus and level of lesion. Developmental medicine & child neurology, 48(2),114-119. https://doi.org/10.1017/S0012162206000259
33. World Health Organization. (2007). International Classification of Functioning, Disability, and Health: Children & Youth Version (ICF-CY). World Health Organization. https://iris.who.int