AN ICF CORE SET BASED INVESTIGATION OF THE EFFECTS OF GROSS MOTOR FUNCTIONS ON HEALTH IN CHILDREN WITH CEREBRAL PALSY

Abstract

Purpose: The Gross Motor Function Measure (GMFM) is commonly used to assess gross motor functions in children with cerebral palsy (CP). Our aim was to investigate the relationship between gross motor function and health status in children with CP based on clinical types and functional levels. Methods: This cross-sectional study included 75 children with CP (mean age ± SD 7.59 ±3.86 years). The 66-item Gross Motor Function Measure (GMFM-66) was used to measure the gross motor functions of children. The International Classification of Functioning, Disability and Health (ICF) CP Core Set was used to assess the general health status of children including body functions and structures, activity and participation, and environmental factors for obtaining a holistic framework. Results: Of the children, 61 (81.3%) were spastic and 14 (18.7%) were dyskinetic. Children were divided into 3 groups based on the Gross Motor Function Classification System (GMFCS) level as mild (levels 1-2, n=28), moderate (level 3, n=16), and severe (levels 4-5, n=31). The GMFM-66 had moderate to strong correlations with body functions and structures (r=-0.811, p<0.001) and activity and participation (r=-0.862, p<0.001) domains of the ICF in severely affected children with CP although it had no strong correlation in any of the ICF domains in mildly or moderately affected children. Conclusion: Although gross motor functions may reflect the health status holistically in severely affected children with CP, it seems not sufficient to reflect the health status in mildly or moderately affected children with CP.

Keywords

• Cerebral palsy
• Gross motor function
• Health status
• ICF

SEREBRAL PALSİLİ ÇOCUKLARDA KABA MOTOR FONKSİYONLARIN SAĞLIK ÜZERİNE ETKİLERİNİN ICF ÇEKİRDEK SETİ TEMEL ALINARAK ARAŞTIRILMASI

Öz

Amaç: Kaba Motor Fonksiyon Ölçümü (GMFM), serebral palsili (SP) çocuklarda kaba motor fonksiyonların değerlendirilmesinde yaygın olarak kullanılmaktadır. Amacımız SP'li çocuklarda klinik tipe ve fonksiyonel seviyelere göre kaba motor fonksiyon ile sağlık durumu arasındaki ilişkiyi araştırmaktı. Yöntem: Bu kesitsel çalışmaya SP'li 75 çocuk (ortalama±standart sapma yaş 7,59±3,86 yıl) dahil edildi. Çocukların kaba motor fonksiyonlarını ölçmek için 66 maddelik Kaba Motor Fonksiyon Ölçeği (GMFM-66) kullanıldı. Bütünsel bir çerçeve elde etmek amacıyla vücut yapı ve fonksiyonları, aktivite ve katılım düzeyi ve çevresel faktörler de dahil olmak üzere çocukların genel sağlık durumunu değerlendirmek için Uluslararası İşlevsellik, Engellilik ve Sağlık Sınıflandırması (ICF) SP Çekirdek Seti kullanıldı. Sonuçlar: Çocukların 61'i (%81,3) spastik, 14'ü (%18,7) diskinetikti. Çocuklar Kaba Motor Fonksiyon Sınıflandırması (GMFCS) düzeyine göre hafif (seviye 1-2, n=28), orta (seviye 3, n=16) ve şiddetli (seviye 4-5, n=31) olmak üzere 3 gruba ayrıldı.GMFM-66 ağır etkilenimli SP’li çocuklarda ICF’in vücut yapı ve fonksiyonları (r=-0,811, p<0,001) ve aktivite ve katılım seviyesi (r=-0,862, p<0,001) ile orta-güçlü ilişkiye sahipken, hafif veya orta şiddetli etkilenimi olan SP’li çocuklarda ICF’in hiçbir alanı ile güçlü ilişkisi bulunmadı. Tartışma: Kaba motor fonksiyonlar, ağır etkilenmiş SP'li çocuklarda sağlık durumunu bütünsel olarak yansıtabilse de, hafif veya orta derecede etkilenmiş SP'li çocuklarda sağlık durumunu yansıtmada yeterli görünmemektedir.

Anahtar Kelimeler

• Serebral palsi
• Kaba motor fonksiyonlar
• Sağlık durumu
• ICF

Kaynakça

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