Serebral Palsili (Sp) Çocuklarda Çiğneme Performans Seviyesi ile Besin Tüketim Durumu ve Aile Etkilenimi İlişkisinin Belirlenmesi

Abstract

Özder, F. Determination of the Relationship between Chewing Performance Level, Dietary Intake and Family Impact in Children with Cerebral Palsy (CP), Hacettepe University Graduate School of Health Sciences, Neurology Physiotherapist Master's Thesis Master's Thesis, Ankara, 2022. The aim of this study is to determine the relationship between chewing performance level, dietary intake and family impact in children with Cerebral Palsy (CP). Forty children with CP with a mean age of 45.90±15.63 months were included in the study. Demographic information and anthropometric measurements of the children were recorded. Z-scores were calculated according to anthropometric measurements. The Karaduman Chewing Performance Scale (KCPS) and the Mastication Observation and Evaluation (T-MOE) instrument were used to evaluate chewing performance. One-day food consumption records were obtained from the families with a 24-hour diet recall method to determine the amount of energy and nutrients taken in daily diet. The foods consumed by the children were grouped as liquidised, minced&moist and solid foods. The Feeding/Swallowing Impact Survey (T-FS-IS) was used to determine the swallowing related family impact, and the State-Trait Anxiety Inventory (STAI) was used to evaluate the anxiety level. It was determined that there was a low negative correlation between the KCPS score and the daily protein intake of children included in the study (r=-0.32, p=0.04). A high, positive correlation was determined between the KCPS score and the ratios (%) of daily energy and carbohydrate intake from liquidised foods (r=0.72, p<0.001; r=0.73, p<0.001; respectively), and a moderate positive correlation between the ratios of protein, fat and fiber intake from liquidised foods (r=0.66, p<0.001; r=0.66, p<0.001; r=0.68, p<0.001; respectively). A high, negative correlation was found between the KCPS score and the energy, protein, fat, carbohydrate and fiber intake ratios from solid foods (r=-0.75, p<0.001; r=-0.74, p<0.001; r =-0.74, p<0.001; r=-0.74, p<0.001; r=-0.74, p<0.001; respectively). A low, negative correlation was found between T-MOE score of the children and T-FS-IS sub-parameters of daily activity, worry and feeding difficulty (r=-0.36, p=0.02; r=-0.37, p=0,01; r=-0.36, p=0.02; respectively), a moderate negative correlation between T-FS-IS total score (r=-0.40, p<0.01). As a result; it was determined that as the chewing performance decreased in children with CP, daily inkate ratios of energy and macronutrients from liquidised foods and family impact related to swallowing increased. Chewing disorders in children with CP should be evaluated in the early period with a physiotherapist and dietitians, including both the child and the parents, and should be followed up with a child and family-centered chewing education and nutrition program. Keywords: cerebral palsy; chewing; chewing disorder; nutrition