Duchenne Musküler Distrofi’li Çocuklarda Telerehabilitasyon Tabanlı Motor İmgeleme Eğitiminin Motor İmgeleme Becerisi, Motor Fonksiyon ve Fiziksel Performans Üzerine Etkilerinin İncelenmesi

Abstract

The objective of this study was to compare the motor imagery (MI) ability of children with Duchenne muscular dystrophy (DMD) with those of healthy children and to examine the effect of telerehabilitation-based motor imagery (Tele-MI) training on MI ability, motor function, physical performance, and psychosocial factors in children with DMD. The study included 23 children with DMD at level 1 or 2 (early stage) according to the Brooke Lower Extremity Functional Classification and 12 healthy children. The DMD cohort was randomized by age and functional status into two groups, Group 1 [Tele-MI training and telerehabilitation-based routine physiotherapy program (Tele-PTP), n=12] and Group 2 (Tele-PTP only, n=11). No training was implemented for healthy children. Before and 8 weeks after training, MI ability was assessed by Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10), Motor Imagery Questionnaire for Children (MIQ-C) and mental chronometry tests, motor function by Motor Function Measure (MFM), North Star Ambulation Assessment (NSAA) and Four Square Step Test (FSST), physical performance by timed performance tests, psychosocial factors and quality of life by PedsQL-3.0 Neuromuscular Module, and fatigue status was assessed with the PedsQL Multidimensional Fatigue Scale. In healthy children, only MI ability was assessed with the KVIQ-10, MIQ-C and mental chronometry. The DMD cohort and healthy children were found to be similar in terms of age and body mass index (p > 0.05). The MI ability of the DMD cohort was found to be lower than that of the healthy children (p < 0.05). A difference was observed in the improvement of the KVIQ-10, MIQ-C (kinesthetic), 10-meter walk mental chronometry, MFM D1 (standing and transfers), MFM total, NSAA, and FSST scores in Group 1 after training (p < 0.05). A comparison of the post-training changes between the groups revealed a diffrerence in favor of Group 1 for MI ability, quality of life, and fatigue assessments, and the effect size of the Tele-MI training was found to be large (p < 0.05, d>0.80). This study showed that 8 weeks of Tele-MI training improved MI ability, increased quality of life and reduced fatigue in the DMD cohort. The functional improvements observed after Tele-MI training suggested that this training may be a promising tool that can be used in the rehabilitation of children with DMD.