Unilateral Serebral Palsili Çocuklarda Eylem Gözlem Terapisi ve Ayna Terapisinin Üst Ekstremite Fonksiyonları Üzerine Etkileri: 1 Ay Takipli Randomize Kontrollü Çalışma

Abstract

This study aimed to investigate the effects of Action Observation Therapy (AOT) and Mirror Therapy (MT) interventions on upper extremity functions in children with unilateral cerebral palsy (CP). The study included 24 children with unilateral CP aged between 6 and 12 years. The children were randomly divided into two groups, with 12 participants in the AOT group and 12 in the MT group. The Canadian Occupational Performance Measure (COPM) was used to identify the children’s activity preferences for upper extremity skills, while the Goal Attainment Scale (GAS) was employed to establish activity goals. Upper extremity functions were evaluated using the Shriners Hospital Upper Extremity Evaluation, the Melbourne Assessment of Unilateral Upper Extremity Function, and the ABILHAND-Kids Questionnaire. Following the initial assessments, both groups underwent 18 intervention sessions over 6 weeks, with sessions lasting 1 hour per day, 3 days per week. The AOT group participated in 30 minutes of Bilateral Activity Training (BAT) and 30 minutes of AOT, while the MT group engaged in 30 minutes of AOT and 30 minutes of MT. After completing the 6-week intervention period and a subsequent 1-month follow-up, the same standardized assessments were re-administered to both groups. Statistically significant improvements were observed in both groups in terms of occupational performance and satisfaction, achievement of activity goals, and upper extremity functional skills (p<0.05). The AOT group demonstrated a greater effect size in occupational satisfaction and bilateral hand-use skills, while the MT group exhibited a greater effect size in occupational performance, achievement of activity goals, and upper extremity functional skills. This study highlights the effectiveness of AOT and MT interventions, when combined with BAT, in improving the upper extremity functions of children with unilateral CP. In this context, therapists' implementation of interventions such as AOT and MT as supportive intervention methods in clinics in addition to routine intervention programs will better support the achievement of treatment goals. Key words: Unilateral cerebral palsy, action observation therapy, mirror therapy, upper extremity functions.