HEMİPARETİK SEREBRAL PALSİLİ ÇOCUKLARDA EYLEM GÖZLEM TERAPİSİNİN DENGE VE ALT EKSTREMİTE FONKSİYONU ÜZERİNE ETKİSİ

Öz

Amaç: Eylem Gözlem Terapisi (AOT), ayna nöron sistemini kullanarak motor öğrenmeyi destekler ve serebral palsili çocuklarda üst ekstremite fonksiyonlarını geliştirmede umut verici sonuçlar göstermiştir. Ancak, hemiparetik serebral palsili çocuklarda denge ve alt ekstremite fonksiyonları üzerindeki etkileri yeterince araştırılmamıştır. Hemiparetik serebral palsili çocuklarda AOT’nin, konvansiyonel fizyoterapiye ek olarak uygulandığında dengeyi, alt ekstremite fonksiyonlarını ve yürüme performansını geliştirmedeki etkinliğini değerlendirmek. Yöntem: Hemiparetik serebral palsili (GMFCS seviye I–II) yirmi çocuk (ortalama yaş: 9,60 ± 2,19 yıl) rastgele olarak deney grubuna (konvansiyonel fizyoterapi + AOT) veya kontrol grubuna (yalnızca konvansiyonel fizyoterapi) ayrıldı. Müdahale 6 hafta sürdü; her iki grup da 12 fizyoterapi seansına katılırken, deney grubu ayrıca haftada iki kez 30 dakikalık AOT seansları aldı. Sonuç ölçütleri arasında Timed Up and Go (TUG) testi, Pediatrik Denge Ölçeği, Beş Basamak Merdiven Çıkma/İnme Testi ve 6 Dakika Yürüme Testi (6DYT) yer aldı. Bulgular: Müdahale sonrası deney grubu, TUG performansında, dinamik dengede (özellikle 360° dönüş ve öne uzanma görevlerinde) ve merdiven çıkma becerisinde kontrol grubuna kıyasla anlamlı derecede daha fazla iyileşme gösterdi. Her iki grup 6DYT’de anlamlı gelişim gösterse de bu ölçütte gruplar arasında anlamlı bir fark bulunmadı. Ayrıca, fiziksel büyüme parametreleri ile motor performans sonuçları arasında orta ila güçlü düzeyde korelasyonlar görüldü. Sonuç: Konvansiyonel fizyoterapi ile birlikte uygulanan AOT, hemiparetik serebral palsili çocuklarda dengeyi ve alt ekstremite fonksiyonlarını anlamlı şekilde artırmaktadır. Bu sonuçlar, dinamik denge ve fonksiyonel hareketliliği geliştirmek için AOT’nin rehabilitasyon programlarına entegre edilmesini desteklemektedir. Bulguların doğrulanması ve AOT’nin uzun dönem etkilerinin incelenmesi için daha geniş örneklemli ve uzun takip süreli çalışmalar önerilmektedir.

Anahtar Kelimeler

• Eylem Gözlem Terapisi
• Hemiparetik Serebral Palsi
• Denge
• Alt Ekstremite Fonksiyonu
• Rehabilitasyon

THE EFFECT OF ACTION OBSERVATION THERAPY ON BALANCE AND LOWER EXTREMITY FUNCTION IN CHILDREN WITH HEMIPARETIC CEREBRAL PALSY

Öz

Objective: Action Observation Therapy (AOT) leverages the mirror neuron system to enhance motor learning and has shown promise in improving upper extremity function in children with cerebral palsy. However, its effects on balance and lower extremity function in children with hemiparetic cerebral palsy remain underexplored. To evaluate the efficacy of AOT as an adjunct to conventional physiotherapy in improving balance, lower extremity function, and gait performance in children with hemiparetic cerebral palsy. Methods: Twenty children (mean age: 9.60 ± 2.19 years) with hemiparetic cerebral palsy (GMFCS levels I and II) were randomly assigned to either an experimental group (conventional physiotherapy plus AOT) or a control group (conventional physiotherapy only). The intervention lasted 6 weeks, with both groups attending 12 physiotherapy sessions, while the experimental group received additional AOT sessions twice weekly (30 minutes each). Outcome measures included the Timed Up and Go (TUG) test, Pediatric Balance Scale, Five-Step Stair Climbing and Descending Test, and the 6-Minute Walk Test (6MWT). Results: Post-intervention, the experimental group demonstrated significantly greater improvements in TUG performance, dynamic balance (notably 360° turning and forward reaching on the PBS), and stair climbing ability compared to the control group. Although both groups improved significantly in the 6MWT, no significant between-group differences were observed for this measure. Additionally, moderate to strong correlations were found between physical growth parameters and motor performance outcomes. Conclusion: AOT, when combined with conventional physiotherapy, significantly enhances balance and lower extremity function in children with hemiparetic cerebral palsy. These results support the integration of AOT into rehabilitation programs to improve dynamic balance and functional mobility in this population. Further studies with larger samples and longer follow-up periods are recommended to confirm these findings and explore the long-term benefits of AOT.

Anahtar Kelimeler

• Action Observation Therapy
• Hemiparetic Cerebral Palsy
• Balance
• Lower Extremity Function
• Rehabilitation

Kaynakça

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