Serebral Palsili Çocuklarda Gövde Kontrolünün El Fonksiyonu, Günlük Yaşam Aktiviteleri ve Yaşam Kalitesi Üzerindeki Rolü

Öz

Amaç: Bu çalışma, hemiparetik ve diparetik Serebral Palsi (SP)’li çocuklarda gövde kontrolünün el fonksiyonu, günlük yaşam aktiviteleri ve yaşam kalitesi üzerindeki etkisini değerlendirmeyi amaçlamaktadır. Yöntem: Kaba Motor Sınıflandırma Sistemi seviye I–III olarak sınıflandırılan, ambulatuar 46 SP’li çocuk çalışmaya dahil edildi. Çocuklar, medyan Gövde Kontrol Ölçüm Skalası (GKÖS) skoru (42,50) temel alınarak yüksek (Grup 1, n = 23) ve düşük (Grup 2, n = 23) gövde kontrolüne sahip olarak iki gruba ayrıldı. El fonksiyonu 9-Delikli Peg Testi (9-DPT) ile, günlük yaşam aktiviteleri Pediatrik Fonksiyonel Bağımsızlık Ölçeği (PFBÖ) ile ve yaşam kalitesi Çocuklar İçin Yaşam Kalitesi Ölçeği (ÇiYKÖ) ile değerlendirildi. Sonuçlar: Daha yüksek gövde kontrolüne sahip çocuklar, daha düşük gövde kontrolüne sahip olanlara kıyasla dominant el 9-DPT performansında (p=0,005) ve PFBÖ skorlarında (p=0,001) anlamlı derecede daha iyi sonuçlar göstermiştir. Tüm GKÖS parametreleri ile PFBÖ arasında orta-düşük düzeyde pozitif korelasyonlar bulunmuştur (r=0,455–0,568, p<0,01). Dominant el 9-DPT performansı ile GKÖS parametreleri arasında ise orta-düşük düzeyde negatif korelasyonlar saptanmıştır (r=–0,422–0,601, p<0,01). ÇiYKÖ parametreleri veya non-dominant el 9-DPT performansı ile anlamlı bir ilişki bulunmamıştır (p>0,05). Tartışma: Bozulmuş gövde kontrolü, dominant el fonksiyonu ve günlük yaşam aktiviteleri ile ilişkili bulunmuş, ancak non-dominant el fonksiyonu veya yaşam kalitesi ile ilişkili bulunmamıştır. El fonksiyonu ve günlük yaşam aktiviteleri ile olan ilişkisi göz önünde bulundurulduğunda, gövde kontrolü değerlendirme sürecine dahil edilmelidir.

Anahtar Kelimeler

• Günlük yaşam aktiviteleri
• Serebral palsi
• El fonksiyonu
• Yaşam kalitesi
• Gövde kontrolü

The Role of Trunk Control on Hand Function, Activities of Daily Living, and Quality of Life in Children with Cerebral Palsy

Öz

Purpose: This study aims to evaluate the impact of trunk control on hand function, daily living activities, and quality of life in children with hemiparetic and diparetic Cerebral Palsy (CP). Methods: We included 46 ambulatory children with CP classified at Gross Motor Function Classification System levels I-III. Children were divided into two groups based on the median Trunk Control Measurement Scale (TCMS) score (42.50): those with higher trunk control (Group 1, n = 23) and those with lower trunk control (Group 2, n = 23). We evaluated their hand function using 9-Hole Peg Test (9-HPT), activities of daily living (ADLs) using Functional Independence Measure for Children (WeeFIM), and quality of life using Pediatric Quality of Life Inventory (PedsQL). Results: Children with higher trunk control demonstrated significantly better 9-HPT dominant hand function (p=0.005) and higher scores in WeeFIM (p=0.001) compared to those with lower trunk control. Moderate to low positive correlations were found between all TCMS parameters and WeeFIM (r=0.455 to 0.568, p<0.01), while 9-HPT dominant hand function showed moderate to low negative correlations with TCMS parameters (r=–0.422 to –0.601, p<0.01). No significant associations were observed with PedsQL parameters or 9-HPT non-dominant hand function (p>0.05). Conclusion: Impaired trunk control was associated with dominant hand function and ADLs, but not with non-dominant hand function or quality of life. Considering its relationship with hand function and ADLs, trunk control should be incorporated into the assessment process.

Anahtar Kelimeler

• Activities of daily living
• Cerebral palsy
• Hand function
• Quality of life
• Trunk control

Kaynakça

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