Obstetrik Brakiyal Pleksus Paralizisi Olan Çoçuklarda Ev Egzersiz Programına Uyum İle Fonksiyonel İyileşme Arasındaki İlişkinin Araştırılması

Abstract

Tarhan, E. An Investigation of the Relation Between Adherence to Home-Based Exercise Program and Motor Recovery in Children with Obstetric Brachial Plexus Paralysis. Hacettepe University Institute of Health Science. Thesis in Physical Therapy and Rehabilitation Programme, Ankara, 2018. The aim of this study were to find out the relationship between the adherence to home-based exercise program (HEP) and the motor recovery in children with Obstetric brachial plexus paralysis (OBPP), and to compare the functional results of the children whose the mothers were provided additional motivation with those whose mothers’ not. 33 patients with an age between 0-18 months suffered from OBBP with either type 2a or 2b in Narakas clinical classification were included to the study. The patients and their mothers were followed up with HEP for three times as the first examination, 6th week and after 12 weeks. For the evaluation of the motor function of the patients, Active Movement Scale (AMS), Gilbert Shoulder-Elbow Movement Assessment Scales and Raimondi Hand Function Assessment were used. In order to determine the adherence of mothers to HEP, exercise diary chart was used. The exercises were evaluated in two parts, the adherence to movement of repetition and time dependent exercise. The mothers were assessed with following tests, which are Nottingham Health Profile (NHP) for life quality; short form of International Physical Activity Questionnaire (IPAQ) for the level of physical activity; Intrinsic Motivation Inventory (IMI) for the level of motivation levels; State-Trait Anxiety Inventory (STAI) for the level of anxiety. The mothers were divided into two categories which were the ones additional motivation provided (n=16, study group) and not (n=17, control group). There was no relation between the percentage of the mothers’ adherence to HEPs and the motor function of the patients (p>0,05). It was deduced that the quality life, anxiety level and physical activity level of the mothers did not make any effect on adherence to HEP. The increase in the mothers’ motivation levels in IMI was positively correlated with the percentage of their adherence to HEP (p<0,05). The physical activity levels of the mothers were positively related with the motor function of the children. There was no difference between the groups in terms of the adherence to HEPs and the motor function of the children (p>0,05). However, a strong relation between the percentage of adherence to time-dependent exercise and AMS total scores (p<0,05). The treatment progress of Narakas 2 group children between the ages of 0-18 months was not related with their mother’s adherence to HEP. In the study, The mothers are more willing to adhere the sensory input and that improves the motor function of the children. However, it is important to use the more effective methods for improving the adherence to mothers to HEP. Increasing intrinsic motivation levels of mothers should be at the forefront among the methods.