Obstetrik Brakiyal Pleksus Paralizisi Olan Çocuklarda Kasların Viskoelastik Özellikleri ile Motor Fonksiyonları Arasındaki Ilişkinin Araştırılması

Abstract

The aim of this study was to investigate the relationship between motor function and viscoelastic properties of the upper extremity muscles and to compare the viscoelastic properties of the unaffected and affected extremity in children with obstetric brachial plexus palsy. 61 patients who were type 2a or type 2b in Narakas's Classification System and 1-36 month age range were assessed. The patients were grouped according to their clinical types and age groups: 1-5 months, 6-24 months, 25-36 months and 1-36 months.The study was designed as a case-control study. Active Movement Score (AMS) system and Gilbert's Elbow Movement Evaluation (GEME) system were used to evaluate the motor function of the patients. Shoulder flexion and abduction,flexion and extension movements for elbow and wrist were evaluated by using AMS, and elbow flexion, extensiton and extensiton deficits were evaluated by using GEME. Myoton-3 myotonometric measuring device was used to measure the viscoelastic properties of deltoid, biceps brachii, triceps brachii, and extensor carpi radialis longus - brevis muscles. Muscle tone, elasticity and stiffness of the muscles were bilaterally assessed. There was relationship between viscoelastic properties of the muscles and the motor functions of the muscles (p<0.05). The differences between viscoelastic properties in affected and unaffected arm were observed only for 1-5 months and 6-24 months (p<0.05). However, there was no difference between sides for 24-36 months and 1-36 months (p>0.05). As the viscoelastic properties differences between the affected and unaffected arm were observed in the first 24 months after birth and they tend to reduce through 36 months, it may be thought that the first 24 months of the treatment is important.