Spastik Diplejik Serebral Parsili Çocuklarda Gövde Kontrolünün Motor Fonksiyon Üzerine Etkisinin Araştırılması

Abstract

The aim of this study was to investigate the effects of trunk control on motor function, which plays an important role in the daily activities of children with Cerebral Palsy (CP) and often observed as a deficiency in children with CP. Fourty children with spastic diplegic cerebral palcy, ages between 3 to 10 years and with Gross Motor Function Classification System (GMFCS) level I, II, and III were included in this study. All children participated in physiotherapy for two days in a week and the routine physiotherapy practices are performed by a physiotherapist. Children were divided into two groups using randomisation and in training group, Bobath Therapy for trunk control in addition to classical physiotherapy programs was performed for 45 minutes, for two days a week, for 6 weeks. In control group, existing physiotherapy program, 45 minutes for two days a week, continued. Any addition was not made into the existing program of the control group. The Gross Motor Function Measure (GMFM), Modified Ashworth Scale (MAS), Pediatric Berg Balance Scale (PBBS), Trunk Control Measurement Scale (TCMS), Gillette Functional Assessment Questionnaire (GFAQ), 1 Minute Walk Test, Timed Up and Go Test (TUG) were applied to both groups before and after 6 weeks. Step lengths and cadences were measured based on their gait parameters. Moreover, trunk muscle strength of children was evaluated. After therapy, differences were found in results of MAS and PBBS, and trunk extensor strength between the training group and the control group in favor of the training group (p<0.05) while there was no difference in GMFM results and cadence in gait (p>0.05). However, after treatment, it was determined that training group's averages of TCMS, Gillette Functional Assessment Questionnaire,1 Minute Walk Test, Timed Up and Go Test, moreover, step length and all trunk muscle strength were higher compared to the control group. This study shows that adding exercises which aim trunk to conventional physiotherapy and exercise programs of children with CP, affects motor function positively.