Türkiye’de Pediatrik Fizyoterapi ve Rehabilitasyon Alanında Fizyoterapistlerin Serebral Palsi Yönetiminin İncelenmesi

Abstract

Amaç: Türkiye’de Pediatrik Fizyoterapi ve Rehabilitasyon alanında çalışan fizyoterapistlerin serebral palsi (SP) yönetimi ile ilgili görüşlerini incelemekti. Gereç ve Yöntem: Çalışmaya yaş ortalaması 32.48+8.16 (22-57) yıl olan Türkiye’de pediatrik fizyoterapi ve rehabilitasyon alanında çalışan 172 fizyoterapist (%66 kadın) dahil edildi. Fizyoterapistlere Google form ile hazırlanan “SP yönetimi anketi” uygulandı. Eğitim düzeyleri ve çalıştıkları kuruma göre fizyoterapistlerin uyguladıkları değerlendirme ve müdahale yöntemleri ile çalışma şartlarına göre SP yönetimi deneyimleri Ki-kare testi ile karşılaştırıldı. Bulgular: SP’li çocuklarda değerlendirme kapsamında lisansüstü mezunu fizyoterapistler daha çok günlük yaşam aktiviteleri (p=0.006), sosyal katılım (p=0.028) düzeylerine odaklanırken lisans mezunu olanlar vücut yapı ve fonksiyonlarına odaklandı (p<0.035). Akademide ve özel kliniklerde çalışanlar günlük yaşam aktivitelerini diğer kurumlarda çalışanlara göre daha çok tercih etti (p=0.025). Müdahale yöntemleri kapsamında lisansüstü mezunlar yenilikçi teknolojileri (p<0.037) daha çok tercih ederken lisans mezunları kuvvetlendirme (p=0.009) ve germe eğitimlerini (p=0.012) tercih etti. Kamu/özel hastanelerde çalışanlar kuvvetlendirme (0.041) ve germe eğitimini (p=0.002), akademik çalışanlar teknolojik müdahaleleri (p<0.05), özel kliniklerde çalışanlar bantlama/osteopati/masaj gibi bölgesel uygulamaları diğer gruplara göre daha çok tercih etti (p<0.05). Çevresel koşullar düşünüldüğünde çocuğa özel hedefler seçme, çocuğu çok boyutlu değerlendirme, güncel bilgileri takip etme ve invaziv bir uygulama sonrası bireyselleştirilmiş program belirlemede zorluk kurumlara göre farklılık gösterdi (p>0.05). Sonuç: Türkiye'de pediatrik fizyoterapi ve rehabilitasyon alanında çalışan fizyoterapistler, eğitim düzeylerine ve kurumlarına göre farklı değerlendirme ve müdahale yöntemleri kullanmaktadır. Lisansüstü eğitim ve geniş zaman aralıklı bireysel çalışma ortamı (akademi ve özel kliniklerde) SP’li çocukları çok boyutlu değerlendirme ve kanıta dayalı fizyoterapi ve rehabilitasyon müdahalelerini uygulamayı kolaylaştırabilir.

Keywords

• çocuk
• serebral palsi
• fizyoterapist
• rehabilitasyon

Investigating of Cerebral Palsy Management of Physiotherapists in the Field of Pediatric Physiotherapy and Rehabilitation in Turkey

Abstract

Objectives: To investigate the opinions of physiotherapists about the management of cerebral palsy (CP) in the field of Pediatric Physiotherapy and Rehabilitation in Turkey. Materials and Methods:172 physiotherapists (66% female) with a mean age of 32.48+8.16 (22-57) years in the field of pediatric physiotherapy and rehabilitation in Turkey were included. “A survey on CP management” prepared with a Google Form was sent to physiotherapists. A Chi-square test was used to compare the evaluation and intervention methods used by physiotherapists according to their education levels and institutions as well as their CP management experiences according to their working conditions. Results: Physiotherapists with postgraduate degrees focused more on daily living activities (p=0.006) and social participation (p=0.028) when evaluating children with CP, whereas those with undergraduate degrees focused more on body structure and function (p<0.035). Academic and private clinic physiotherapists preferred daily living activities more than others (p=0.025). In intervention methods, postgraduate physiotherapists preferred innovative technologies (p<0.037), while undergraduate physiotherapists preferred strengthening (p=0.009) and stretching training (p=0.012). Those working in public/private hospitals preferred strengthening (0.041) and stretching training (p=0.002), academic ones preferred technological interventions (p<0.05), and private clinic physiotherapists preferred regional applications such as taping/osteopathy/massage more than others (p<0.05). The difficulties in choosing child-specific goals, multidimensional evaluation, following up-to-date information, and determining an individualized program after an invasive procedure varied according to the institutions (p<0.05). Conclusion: In Turkey, physiotherapists working in pediatric physiotherapy and rehabilitation use different evaluation and intervention methods depending on their education levels and institutions. The implementation of multidimensional assessment and evidence-based physiotherapy and rehabilitation interventions for children with CP can be facilitated by postgraduate education and an expanded working environment.

Keywords

• child
• cerebral palsy
• physical therapist
• rehabilitation

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