Nörolojik Riskli Bebeklerde Fizyoterapist ve Aile Temelli Hedefe Yönelik Nöromotor Tedavi Yaklaşımlarının Etkinliğinin Değerlendirilmesi

Abstract

This study is planned to investigate the effectiveness of goal directed neuromotor treatment approach in 20 at-risk infants between the ages of 0-15 months (corrected age for the pretem infants), on motor development and postural control applied by the physiotherapist and to compare with the home program including goal directed neuromotor treatment approach arranged by the physiotherapist and applied by the family. The infants were assigned to the groups by stratified sampling according to their ages, level of risk and maternal education. The goals are defined specific for each of the babies. Physiotherapy and rehabilitation group received therapy for 45 min, 3 days in a week for 12 weeks. In the home program group, after learning the exercises, parents were wanted to apply the exercises for 45 min, at least 3 days in a week. The family was guided for arrangement of exercise programme by home visits of the physiotherapist. The effectivenes of the therapy continued for 12 weeks was measured with Alberta Infant Motor Scale (AIMS), Nörosensory Motor Assessment (NSMDA), Hammersmith Infant Neurological Examination (HINE) and Goal Attainment Scale (GAS) instruments. The groups got better in postural control and neuromotor aspects after treatment compared to pretreatment (p<0.05). While a differance was found in HINE test results as positive in physiotherapy and rehabilitation group (p<0.05), no difference was found in AIMS, NSMDA and GAS results (p>0.05) between the groups. However, in all test results the effect size of physiotherapy and rehabilitation group was more than home program group and after treatment scores of physiotherapy and rehabilitation group in AIMS, HINE, GAS and NSMDA were more closer to the normal scores. According to this study goal directed neuromotor treatment approach is an applicable approach in neurologic at-risk infants. This approach can be apllied by both physiotherapists and families controlled by the physiotherapists.