Serebral Palsili Çocuklarda Farklı Oturma Pozisyonlarının Üst Ekstremite Motor Fonksiyonlarına Etkisinin Araştırılması

Abstract

This study was designed to investigate the effects of different sitting positions, unsupported and supported with adaptive seating device, on quality of upper limb motor functions on children with spastic cerebral palsy (CP) and for this aim, 41 children with spastic quadriplegic CP whom level III and IV according to GMFCS, age between 18 months and 5 years old included to this study. All examinations were performed within two groups as a Level III and IV. The demographic properties of participant children (gender, diagnosis, date and place of birth, body height, body weight, prenatal, natal and postnatal history, informations of the mother and father of child) was recorded and each child was evaluated with Modified Ashworth Scale (MAS), Gross Motor Function Measurement (GMFM), Gross Motor Function Classification System (GMFCS), Quality of Upper Extremity Skills Test (QUEST), Early Clinical Assessment of Balance (ECAB). The quality of upper limb functions of children were evaluated with Quality of Upper Extremity Skills Test in four different positions which are long and short sitting positions, with adaptive seating device and without support. According to the outcomes, children who were level III were been higher GMFM, ECAB, QUEST subdivisions and total scores than level IV in supported, unsupported short or long sitting position (p<0.05). According to the comparison in two different positions within both groups, QUEST total scores with adaptive supported short and long sitting were better than unsupported short and long sitting, supported or unsupported short sitting were better than unsupported short or long sitting positions (p<0.05). Short sitting position with adaptive seating device was identified the most supportive position about the quality of upper extremity skills ( p<0.05). In conclusion, it may emphesised that adaptive seating device tool should be used to support to increase their upper extremity function and the participation of children in daily life activities in controlled, symmetric and balanced different sitting position for level III and IV children with spastic quadriplegic CP.