HEMİPARETİK SEREBRAL PALSİLİ ÇOCUKLARDA EV EGZERSİZİ OLARAK UYGULANAN AYNA TEDAVİSİNİN EL BECERİLERİ ÜZERİNE ETKİSİ

Öz

Amaç: Hemiparetik serebral palsili çocuklarda ev egzersizi olarak uygulanan ayna tedavisinin el becerileri üzerine etkisini incelemek amacıyla planlanmıştır. Yöntem: Çalışmaya toplamda 4- 18 yaş arası 23 Hemiparetik SP (Serebral Palsi)’li çocuk dahil edildi. Çalışma gruplarındaki çocuklar randomizasyon yöntemi ile belirlendi. Tüm katılımcılar Özel Denizli Yağmur Çocukları Özel Eğitim ve Rehabilitasyon Merkezi ve Özel Esenyurt Özel Eğitim ve Rehabilitasyon Merkezi’nden belirlendi. Bu kapsamda Hemiparetik SP’li çocuklar Kaba Motor Fonksiyon Ölçütü (KMFÖ), Kaba Motor Fonksiyon Sınıflandırma Sistemi (KMFSS), El Becerileri Sınıflandırma Sistemi (EBSS), Dokuz Delikli Peg Testi, ölçekleri kullanılarak değerlendirildi. Toplamda her iki grup çocuklar 8 hafta boyunca Bobath Terapisi alırken çalışma grubundaki çocuklara ek ev egzersizi olarak ayna egzersizleri yaptırıldı, telekonferans ve video kayıt yöntemiyle izlendi. Sonuçlar: Çalışmada sekiz hafta boyunca çalışma grubundaki çocuklara fizyoterapist ve aile gözetiminde Ev Egzersizi Olarak Uygulanan Ayna Tedavisinin el becerileri üzerine anlamlı bir etkisi olduğu bulundu (p<0,05). Kontrol grubundaki bazı çocuklarda minimal düzeyde ilerleme olduğu görüldü (p<0,05). Hemiparetik SP’li çocuklarda ev egzersizi olarak uygulanan Ayna Tedavisinin el becerilerinin artırılmasında daha etkili olduğu belirlendi (p<0,05). Tartışma: Çalışmada ev egzersizi olarak yapılan ayna tedavisi sonucunda çocuklarda üst ekstremite fonksiyonel kapasitesinin anlamlı olarak arttığı görülmüştür. Bu gelişme sonucunda ayna egzersiz programında kullanılan egzersizlerin üst ektremite kas kuvvetini artırmasında etkili olduğunu düşünmekteyiz. Bununla beraber ayna tedavisinin Hemiparetik SP’li çocukların üst ekstremite kas kuvveti üzerine etkisini net olarak belirleyebilmek için ileri çalışmalar yapılmasına ihtiyaç olduğu kanısındayız.

Anahtar Kelimeler

• Ayna terapisi
• Serebral Palsi
• Bobath tedavisi
• El fonksiyonu

THE EFFECT OF MIRROR THERAPY APPLIED AS HOME EXERCISE ON HAND SKILLS IN CHILDREN WITH HEMIPARETIC CEREBRAL PALSY

Öz

Purpose: The aim of this study was to investigate the effect of mirror therapy applied as a home exercise on manual dexterity in children with hemiparetic cerebral palsy. Methods: A total of 23 children with hemiparetic CP (Cerebral Palsy) aged 4-18 years were included in the study. Children in the study groups were determined by randomization method. All participants were recruited from Denizli Yağmur Çocukları Private Education and Rehabilitation Center and Esenyurt Private Education and Rehabilitation Center. In this context, children with hemiparetic CP were evaluated using the Gross Motor Function Measure (GMFM), Gross Motor Function Classification System (GMFCS), Manual Skills Classification System (MDSS), Nine Hole Peg Test, scales. In total, both groups of children received Bobath Therapy for 8 weeks, while the children in the study group were given mirror exercises as an additional home exercise and monitored by teleconference and video recording. Results: In the study, it was found that Mirror Therapy Applied as Home Exercise to the children in the study group under the supervision of a physiotherapist and family for eight weeks had a significant effect on manual dexterity (p<0.05). Some children in the control group showed minimal improvement (p<0.05). Mirror therapy applied as a home exercise was found to be more effective in increasing manual dexterity in children with hemiparetic CP (p<0.05). Conclusion: In the study, it was observed that the functional capacity of the upper extremity increased significantly in children as a result of mirror therapy as home exercise. As a result of this development, we think that the exercises used in the mirror exercise program are effective in increasing upper extremity muscle strength. However, we believe that further studies are needed to determine the effect of mirror therapy on upper extremity muscle strength of children with hemiparetic CP.

Anahtar Kelimeler

• Mirror therapy
• Cerebral Palsy
• Bobath therapy
• Hand function.

Kaynakça

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