ICF‐CY‐Based Physiotherapy Management in Children with Cerebral Palsy

The immature brain damage causes cerebral palsy (CP) in children, and these children have many disorders of movement and posture development, often accompanied by disturbances of sensation, perception, cognition, communication, and behavior and by epilepsy and secondary musculoskeletal problems. According to the children and youth version of the WHO\u27s classification as International Classification of Functioning, Disability and Health—child and youth (ICF‐CY), function can be classified, measured, and influenced in several dimensions. In the treatment of CP, various approaches used are based on different theories of motor learning. Commonly used approaches in the treatment of children with CP are as follows: (1) neurodevelopmental therapy, (2) goal‐directed therapy, (3) constraint‐induced movement therapy, (4) bimanual intensive manual therapy, (5) treadmill training, (6) muscle strength training, (7) virtual reality, (8) aquatherapy, (9) hippotherapy, (10) family education and home‐based treatment

Serebral Palsili Çocuklarda Çevresel Faktörler ile Aktivite ve Katılım Arasındaki İlişkinin İncelenmesi

Cankaya O. Investigating the Relationship Between Environmental Factors and Activity and Participation in Children with Cerebral Palsy, Hacettepe University, Graduate School of Health Sciences, Physical Therapy and Rehabilitation Program, PhD Thesis, Ankara, 2019. The aim of this study was to investigate the relationship between environmental factors and activity and participation in children with cerebral palsy (CP). In the scope of the study, firstly Turkish validity and reliability of European Child Environment Questionnaire (ECEQ) was investigated to evaluate environmental factors. For validity and reliability of the ECEQ questionnaire, ECEQ and Pediatric Evaluation of Disability Inventory (PEDI) were completed by 306 families of children with CP aged between 2 and 18 years. Test-retest evaluation was completed with 65 parents. Secondly 106 children with CP aged between 5 and 13 years and their parents were selected from the same sample to determine the relationship between environmental factors and activity and participation. Functional status was determined by gross motor function level (Gross Motor Function Classification System-Expanded&Revised-GMFCS-ER), fine motor function level (Manual Ability Classification System-MACS), communication function level (Communication Function Classification System-CFCS) and eating drinking function level (Eating Drinking Ability Classification System-EDACS). Activity (Gross Motor Function Measurement-GMFM-88), participation (Life Habits Questionnaire-LIFE-H), familial impact (Impact on Family Scale-IPFAM), personal factors (demographic information) and environmental factors (ECEQ) were evaluated. As a result; Turkish ECEQ questionnaire was valid (RMSEA 0.90; ICC >0.70). The most important factor affecting activity and participation of children with CP was determined as functional status. Personal factors including gestational weight and gestational age, comorbid problems like epilepsy, bladder-bowel, speech and swallowing problems, familial impact and environmental factors were associated with activity and participation limitations (RMSEA 0,90; ICC >0,70) bulundu. SP’li çocukların aktivite ve katılımını etkileyen en önemli faktör fonksiyonel durum olarak belirlendi. Gestasyonel ağırlık ve gestasyonel yaş gibi kişisel faktörlerin, epilepsi, mesane-bağırsak, konuşma ve yutma problemi gibi eşlik eden problemlerin, ailesel etkilenimin ve çevresel faktörlerin aktivite ve katılım kısıtlılığı ile ilişkili olduğu bulundu (RMSEA<0,080; p<0,05). Bu sonuçlar doğrultusunda SP’li çocuklarda aktivite ve katılımı etkileyebilen kişisel faktörler, ailesel faktörler ve çevresel faktörlerin ayrıntılı değerlendirilmesinin, klinik uygulamalarda aktivite ve katılımı artırmaya yönelik rehabilitasyon programının yapılandırılmasında önemli olduğunu söyleyebiliriz