Diplejik Serebral Palsili Çocuklarda Telerehabilitasyon İle Uygulanan İnce Motor Beceri Eğitiminin Yazı Yazma ve El Becerilerine Etkisi

Abstract

ABSTRACT Akpınar, E., Effect of Fine Motor Skills Training Through Telerehabilitation on Handwriting and Manual Skills in Children with Diplegic Cerebral Palsy, Hacettepe University, Graduate School of Health Sciences Occupational Therapy Program, Master’s Thesis, Ankara, 2023. Difficulty in manipulating objects is one of the significant determinants of limitations in daily life activities and participation in children with cerebral palsy. The aim of the study was to examine the effects of tele-rehabilitation-based fine motor skill training on handwriting, occupational performance, fine motor skills, and hand skills in children with diplegic cerebral palsy. Forty children diagnosed with diplegic cerebral palsy, aged between 7 and 12, were included in the study. The children were randomly assigned to an intervention group (n=20) and a control group (n=20). Both groups were provided with an occupational therapy home program targeting the intervention goals. In addition to the home program, the intervention group received tele-rehabilitation- based fine motor skill training for 45 minutes per day, three days a week, for a total of eight weeks. In the evaluation, first, demographic information about the child was obtained from the parent, and the Children’s Hand‐Skills Ability Questionnairewas filled out with the parent. In the second stage, the Canadian Occupational Performance Measure, Assessment of Children’s Hand Skills, Minnesota Handwriting Test, Shriners Hospital Upper Extremity Evaluation, and Bruininks- Oseretsky Motor Proficiency Test 2-Short Form evaluations were applied through a video call with the child. Evaluations were repeated for both groups at the end of the eighth week. As a result of the study, compared to the initial evaluations, performance scores in COPM, Minnesota Handwriting Test measurement and range scores, Assessment of Children’s Hand Skills score, Shriners Hospital Upper Extremity Evaluation Spontaneous Functional Analysis and Dynamic Positional Analysis scores, and Bruininks-Oseretsky Motor Proficiency Test 2-Short Form "Making dots in circles with preferred hand" scores were significantly improved in the intervention group(p<0.05). In conclusion, tele-rehabilitation-based fine motor skill training in children with diplegic cerebral palsy is an effective method for improving fine motor skills, occupational performance, hand skills, and particularly handwriting performance. It is important for therapists to integrate tele-rehabilitation as an alternative therapy and patient follow-up method for fine motor skill training, especially for children with cerebral palsy who have limited access to therapists, particularly in rural areas.