AN INVESTIGATION OF RELATIONSHIP BETWEEN TRUNK AND LOWER EXTREMITY MUSCLE STRENGTH AND FUNCTIONAL ACTIVITY IN CHILDREN WITH SPASTIC CEREBRAL PALSY

Abstract

Purpose: Muscle weakness is an motor important impairment among children with cerebral palsy (CP). This study investigated the correlation between trunk and lower extremity isometric muscle strength and functional activity in children with ambulatory spastic CP. Methods: Fifty-four ambulatory children with spastic CP, aged 7-18 years (age=12.53±3.27 years) were included in this study. Hand dynamometer was used to determine trunk flexor and extansor and lower extremity muscles (hip flexos, extansor, abductor, and adductor, knee flexor and extansor, ankle dorsiflexor and plantar flexor muscles) isometric muscle strength. Gross motor function measured using Gross Motor Function Measure (GMFM) dimensions D and E, and Gross Motor Function Classification System (GMFCS) was used to classified gross motor function level. timed up and go test (TUG) and sit to stand test (SST) were used for the evaluation of functional activity. Results: The GMFM D and E scores were significantly related to hip flexor, extansor, abductor and adductor, knee extansor and flexor, ankle dorsiflexor, and plantar flexor muscle strength (p<0.05). The TUG test was significantly associated with hip extansor and abductor, knee extansor and ankle plantar flexor muscle strength (p<0.05). The SST was significantly correlated with hip extansor and abductor, knee extansor and ankle plantar flexor muscle strength (p<0.05). Conclusion: This study showed that there is a relationship between muscle strength of the trunk and lower extremity muscle strength in children with CP and functional activity at different levels, severity, and direction. Muscle strength might play critical role in functional activities in children with CP.

Keywords

• Cerebral Palsy
• Child
• Dynamometer
• Strengh

SEREBRAL PALSİLİ ÇOCUKLARDA GÖVDE VE ALT EKSTREMİTE KAS KUVVETİ İLE FONKSİYONEL AKTİVİTE ARASINDAKİ İLİŞKİNİN İNCELENMESİ

Öz

Amaç: Serebral palsili (SP) olgularda kas zayıflığı önemli motor problemler arasında yer almaktadır. Bu çalışmanın amacı, ambule spastik tip SP’li olgularda gövde ve alt ekstremite kaslarının izometrik kuvveti ile fonksiyonel aktivite arasındaki ilişkiyi incelemekti. Yöntem: Çalışmaya yaşları 7-18 yıl arasında değişen ve yaş ortalamaları 12,53±3,27 yıl olan 54 spastik tip SP’li olgu dâhil edildi. Olguların gövde fleksor ve ekstansor kasları ve alt ekstremite kaslarının (kalça fleksor, ekstansor, abduktor ve adduktor, diz fleksor ve ekstansor, ayak bileği dorsifleksor ve plantar fleksor) izometrik kuvvet değerlendirmeleri el dinamometresi ile yapıldı. Olguların kaba motor fonksiyonları Kaba Motor Fonksiyon Ölçütü (KMFÖ)’nün D ve E bölümleri ile değerlendirildi ve Kaba Motor Fonksiyon Sınıflama Sistemi (KMFSS) ile seviyeleri belirlendi. Fonksiyonel aktivitenin değerlendirilebilmesi için süreli kalk yürü testi (TUG) ve otur kalk testi (OKT) kullanıldı. Sonuçlar: KMFÖ D ve E puanları ile kalça fleksor, ekstansor, abduktor ve adduktor, diz ekstansor ve fleksor, ayak bileği dorsifleksor ve plantar fleksor kas kuvveti arasında anlamlı ilişki olduğu gözlemlendi (p<0,05). TUG testi ile kalça ekstansor ve abduktor, diz ekstansor ve ayak bileği plantar fleksor kas kuvveti arasında anlamlı ilişki olduğu belirlendi (p<0,05). OKT ile kalça fleksor, ekstansor, abduktor adduktor, diz ekstansor ve fleksor, dorsifleksor ve plantar fleksor kasları arasında anlamlı ilişki olduğu gözlemlendi (p<0,05). Tartışma: Bu çalışma, SP’li çocuklarda gövde ve alt ekstremite kas kuvveti ile fonksiyonel aktivite arasında farklı seviyelerde, değişik şiddette ve yönde ilişki olduğunu göstermektedir. SP’li çocuklarda kas kuvveti fonksiyonel aktivite için kritik rol oynamaktadır.

Anahtar Kelimeler

• Çocuk
• Dinamometre
• Kas Kuvveti
• Serebral Palsi

Kaynakça

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