Spastik Serebral Palsili Çocuklarda Fonksiyonel Gövde Eğitiminin Üst Ve Alt Ekstremite Motor Fonksiyonları Üzerine Etkisinin Araştırılması

Abstract

The purpose of this study is to broadly investigate the effect of individually structured trunk training on trunk control, upper and lower limb motor function of children with spastic Cerebral Palsy (CP). 38 bilaterally effected children with spastic CP whom receive routine physiotherapy program twice a week recruited for this study. Stratified random sampling used according to the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels to set two statistically equal groups. Motor functions of trunk, upper and lower extremities, daily living skills, activity and participation levels assessed with Trunk Control Measurement Scale (TCMS), Gross Motor Function Measurement (GMFM), Quality of Upper Extremity Skills Test (QUEST), Pediatric Balance Scale (PBS),Timed Up and Go Test (TUG),Surface Electromyography (sEMG), Modified Tardieu Scale (MTS), Physicians Rating Scale (PRS), 1 Minute Walk Test (1 MWT), Gillette Functional Assessment Scale (Gillette FAS), Functional Independence Measure for Children (WeeFIM), Impact on Family Scale (IPFAM) and Child Health Questionnaire Parent Form 50 (CHQ-PF 50) at baseline for both groups. After randomization one group received individually structured functional trunk training which includes trunk targeted neurodevelopmental treatment approach, other group set as control group. Children assessed with same outcome measures after 8 week intervention. According to the our results; TCMS, GMFM, QUEST, sEMG (Erector Spina), PBS, TUG, 1 MWT, PRS (Knee), Gilette Skill Test and WeeFIM scores showed improvement in intervention group with respect to the control group (p<0.05). This results show selected and adapted trunk training could be use for improving trunk, upper and lower extremity motor functions and activity levels of children with bilateral spastic CP.