SPASTİK DİPARETİK SEREBRAL PARALİZİLİ ÇOCUKLARDA OTURMA POSTÜRÜNÜN İNCELENMESİ

Öz

Çalışmanın amacı spastik diparetik serebral paralizi (SP)’ li çocuklarda oturma postürünü ve oturma postürüne etki eden faktörleri incelemektir. Çalışmada SP tanısı konmuş yaşları 2–10 yıl arasında değişen (ort: 5, 5 ± 3, 1 yıl) 50 spastik diparetik çocuk değerlendirildi. Oturma pozisyonu, Oturma Postürü Değerlendirme Skalası (OPDS) kullanılarak belirlendi. Alt ekstremitelerde kalça fleksörleri, adduktörleri, internal rotatörleri, hamistringler ve plantar fleksörlerin kas tonusu değerlendirmesi Modifiye Ashwort Skalası (MAS)’na göre yapıldı. Her iki alt ekstremite için toplam MAS skoru hesaplandı. Olguların motor fonksiyonu Kaba Motor Fonksiyon Sınıflaması- Gross Motor Functional Classification System (GMFCS)’ye göre yapıldı. OPDS ile oturma postürü değerlendirilen diparetik spastik SP’li olgularda, oturmada gövde ve ayak kontrolü motor fonksiyon seviyeleri ve alt ekstremitelerdeki spastisite şiddetinden etkilenirken (P<0. 01), buna karşın baş kontrolü üzerinde etkili olmadığı (P>0. 05) bulundu. Bu sonuç spastik diparatik çocuklarda OPDS’nin gövde ve ayak kontrolünü belirlemede etkin olabileceği ancak baş kontrolü için hassas olmadığını düşündürmüştür. Daha fazla sayıda spastik diparetik olgularda oturma değerlendirmesi için başka değerlendirme skalaları ile çalışmalara ihtiyaç vardır

Anahtar Kelimeler

• Serebral paralizi, Diparetik, Oturma postürü

POSTURAL CONTROL IN SITTING CHILDREN WITH SPASTIC DIPARETIC CEREBRAL PALSY

Öz

The aim of this study was to evaluate the sitting posture and to investigate the factors affecting sitting posture. 50 spastic diparetic children between ages of 2-10 years (5. 5±3. 1) who are diagnosed as cerebral palsy (CP) were included in the study. Sitting posture was assessed utilizing Sitting Posture Assessment Scale (SPAS). Hip flexor, adductor, internal rotator, hamstring and plantar flexor muscles tonus in lower extremity were evaluated according to Modified Ashworth Scale (MAS). A total MAS score was obtained for both lower extremities. Motor functions of the subjects were classified using Gross Motor Functional Classification System (GMFCS). Whilst the control of the feet and trunk in sitting was affected by the level of motor function and the severity of the spasticity (p<0. 05); it does not have an effect on head control (p>0. 05). This result indicates that in children with spastic diparetic. OPDS may be effective in determining the trunk and feet control however, it is not sensitive for head control. Further studies involving greater numbers of subjects are needed which use different scales evaluating sitting

Anahtar Kelimeler

• Cerebral palsy, Diparetic, Sitting posture, Rehabilitation

Kaynakça

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