Pallister-killian sendromlu bir hastada bobath terapisi ve portage erken çocukluk dönemi eğitim programının etkisi: Olgu sunumu

Amaç: Pallister-Killian sendromu (PKS) mental retardasyon, nöbet, hipotoni, hiper- hipopigmentasyon ile karekterize bir genetik bozukluktur. Pallister – killian benzeri yapısal anomalisi ile tedaviye aldığımız olgunun bir yıllık fizyoterapi ve özel eğitim sonuçlarını incelemektir. Gereç ve yöntem: Bobath terapisi ve Portage Erken Çocukluk Dönemi Eğitim Programına alınan, 5 yaş 6’tı aylık olgunun bir yıl arayla Gross Motor Function Measure (GMFM), Gross Motor Functiom Classification System (GMFCS), Functional Independence Measure for Children (Wee- FIM) ve Denver Developmental Screening Test II (DDST II) değerlendirme yöntemleri kullanılarak değerlendirilmiştir. Olgu haftada 1gün fizyoterapi ve 2 gün özel eğitim almıştır. Hasta fizyoterapist, çocuk gelişim uzmanı ve özel eğitimciler tarafından ekip halinde takip edilmiştir. Sonuç: Olgunun ilk değerlendirmesinde GMFM total skoru % 64, GMFCS’i 2, Wee-FIM toplam skoru 33 olarak bulunmuştur. DDST II’ye göre ince ve kaba motor gelişim yaşı 20 ay olarak tespit edilmiştir. Bir yıl sonraki değerlendirmede ise GMFM total skoru % 77, GMFCS’i 2 ve Wee-FIM toplam skoru 45 olarak bulunmuştur. Ayrıca DDST II’ye göre ince ve kaba motor gelişim yaşı 24 aydır. Tartışma: Bu çocuklarda fizyoterapi ve özel eğitim uygulamaları mental ve motor gelişimi desteklemektedir. Bu hastaların yaşam kalitelerini arttırmak ve tedavilerini gerçekleştirmek için erken dönemde fizyoterapi ve özel eğitime başlanması önemlidir

Tuberosklerozlu bir hastada bobath terapisi ve portage erken çocukluk dönemi eğitim programının etkisi: Olgu sunumu

Amaç: Tuberoskleroz kompleksi santral sinir sistemini, deriyi ve iç organları tutan, otozomal dominant geçiş gösteren nörokütanöz bir hastalıktır. Ayrıca bu hastalarda epilepsi, mental ve motor retardasyon da görülmektedir. Tuberoskleroz ve epilepsi tanısı ile takip edilen olgunun bir yıllık fizyoterapi ve özel eğitim sonuçlarını incelemektir Gereç ve yöntem: Bobath terapisi ve Portage Erken Çocukluk Dönemi Eğitim Programına alınan, 4 yaşındaki erkek olgunun bir yıl arayla Gross Motor Function Measure (GMFM), Gross Motor Functiom Classification System (GMFCS), Functional Independence Measure for Children (Wee- FIM) ve Denver Developmental Screening Test II (DDST II) değerlendirme yöntemleri kullanılarak değerlendirilmiştir. Olgu haftada 1gün fizyoterapi ve 2 gün özel eğitim almıştır. Sonuç: Olgunun ilk değerlendirmesinde GMFM total skoru % 80, GMFCS’i 2, Wee- FIM toplam skoru 35 olarak bulunmuştur. DDST II’ye göre ince motor gelişim yaşı 14 ay ve kaba motor gelişim yaşı 15 ay olarak tespit edilmiştir. Bir yıl sonraki değerlendirmede ise GMFM total skoru % 94, GMFCS’i 1, Wee- FIM toplam skoru 44 olarak bulunmuştur. Ayrıca DDST II’ye göre ince ve kaba motor gelişim yaşı 22 aydır. Tartışma: Değerlendirme sonuçlarından da anlaşılacağı gibi tubreosklerozlu hastalar fizyoterapi ve özel eğitimden yarar görmektedirler. Bu hastaların yaşam kalitelerini arttırmak ve tedavilerini gerçekleştirmek için erken dönemde fizyoterapi ve özel eğitime başlanması önemlidir

Serebral palsili çocukların klinik özellikleri i̇le i̇letişim yetenekleri arasındaki i̇lişki

Amaç: Serebral Palsi (SP)’li çocuklar motor problemlerin yanında özürlülüğe neden olabilen pek çok bozukluklara sahiptirler ve iletişim bozukluğu da bunlardan birisidir. Bu çalışmanın amacı SP’li çocukların klinik özellikleri ile iletişim yetenekleri arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Denizli il merkezinde faaliyet gösteren Yağmur Çocukları Özel Eğitim Merkezi’nde tedavileri devam eden 2-18 yaş arası n=188 (K:84, E:104) SP’li çocuk çalışmaya dâhil edildi. Tüm katılımcılara demografik veri formu dolduruldu. Çocukların iletişim fonksiyonları İletişim Fonksiyon Sınıflandırma Sistemi (IFSS) ile değerlendirildi. Sonuçlar: SP’li çocukların yaş ortalaması 97,48±57,93 ay idi. SP’nin klinik tipleri içinde IFSS’ye göre; Seviye 1’de spastiklerin %43,7’si, diskinetiklerin %20’si, ataksiklerin %0’ı, hipotoniklerin ise %5,3’ü bulunuyordu. Seviye 5’te ise spastiklerin %24,1’i, diskinetiklerin %60’ı, ataksiklerin %25’i, hipotoniklerin ise %26,3’ü bulunuyordu. Bu dağılım istatistiksel olarak da anlamlıydı (p < 0,01). IFSS’ye göre SP’nin ekstremite dağılımı içinde Seviye 1’de hemiparetiklerin %54,5’i, diparetiklerin %52,3’ü, quadriparetiklerin %14,9’u, paraparetiklerin ise %60’ı bulunuyordu. Seviye 5’te ise hemiparetiklerin %7,3’ü, diparetiklerin %11,4’ü, quadriparetiklerin %44,6’sı ve paraparetiklerin %20’si bulunuyordu. Bu dağılım istatistiksel olarak da anlamlıydı (p < 0,01). Tartışma: SP’li çocuklarda klinik tip, ekstremite dağılımı ve SP nedenlerinin iletişim fonksiyonları üzerinde anlamlı etkileri olduğu görülmüştür

Correlation between hand function and activities of daily living in children with cerebral palsy

Introduction: Aim of this study was investigating the correlation between hand function and activities of daily living in children with cerebral palsy. Patient and method:15 children with bilateral or unilateral cerebral palsy in GMFCS level I, II or III were included the study. The subjects were being treated according to the Bobath concept. We used Manual Ability Classification Sys-tem (MACS) for assessing hand functions and Functional Independence Measure for Children (WeeFIM) for assessing independence in daily living activities. Results: Subjects mean age was 120.4 (SD 31.69) months. According to MACS, 7 subjects were both in Level I and II, and 1 subject was in Level III. According to GMFCS, 3 sub-jects were in level I, 8 subjects were in level II, and 4 subjects were in level III. Mean WeeFIM total point was 112.06 (SD13.34). Results of correlation analysis showed that there was a statistically significant negative strong correlation between GMFCS and WeeFIM scores, and negative weak correlation(r=-0.286) between MACS and WeeFIM. Conclusions: There was a strong correlation between gross motor function skills and activities of daily living in children with cerebral palsy. There was a moderate correlation between hand functions and gross motor function skills, and a weak correlation between hand functions and independence in activities of daily living

Relationship between hand functions and balance in cerebral palsied children

INTRODUCTION: This study was planned to examine the relationship between hand function and balance in Cerebral Palsied Children (CPC). MATERIALS AND METHODS: 15 diparetic or hemiparetic CPC, ages between 5‐15, were included in the study. They were at Level I, II or III according to Gross Motor Function Classification System (GMFCS), and we applied Neurodevelopmental Therapy(NDT) them. Intensive NDT program were applied 8 weeks. Evaluations were repeated before and after treatment. RESULTS: There were improvements in hand functions and balance skills. After treatment both MACS and balance tests’ scores changed in percentages. Thus hand functions and balance skills were correlated. But these correlations were not statistically significant. DISCUSSION: Hand functions have a relationship with balance. Better hand functions make the CPC set balance better by providing a good upper extremity functions. Good upper extremity functions provide better balance reactions. CPC could be able to set his/her balance by moving upper extremities

Impact of physiotherapy and diet program on obesity in children with intellectual disabilities

Introduction:Childhood obesity is an important health problemin children with intellectual disability as well as in healthychildren. The aim of this study was to investigate the long-term effect of physiotherapy and diet programs on obesity inchildren with intellectual disability during school and puberty.Patients and method:A total of 133 children with intellectualdisability (39 females, 94 males; mean age 15.23 3.25y) wereincluded in the study at Denizli Cßamlık Special Education andVocational Training Center School as primary and secondaryschool students. Waist-hip circumferences and height-weightwere measured, body mass indexes (BMIs) were defined. Eachchild was given a diet program by a specialist dietitian and aphysiotherapy program consisting of aerobic exercises andstrengthening exercises was given by physiotherapists 3 days aweek, for 20 minutes a day. After 1 year, cases were reevalu-ated.Results:Mean BMIs of cases were 22.79 6.64 kg/cm2at firstevaluation and 22.67 6.75 kg/cm2at second evaluation. Thischange was not significant (p>0.05). Waist circumference aver-aged 79.08 17.06cm at first evaluation and 79.20 17.66cm atsecond evaluation and this change was not significant (p>0.05);average hip circumference was 91.36 15.51cm at first evalua-tion and 88.08 15.62cm at second evaluation and this changewas significant (p<0.05).Conclusion:One-year diet and physiotherapy program did notcreate any change in waist circumference and BMI, whilethere were significant changes in hip circumference of thesechildren. It is thought that the reason for inability to achievedesired results is due to difficulty of implementing diet andphysiotherapy programs at home, underlying cognitive prob-lems, protectionism of families on nutrition, and occasionalimmobilization of children due to cognitive problems

Değişik özür seviyesine sahip serebral palsili çoçuk annelerinin bel- boyun problemleri ve yaşam kalitesi

Amaç :Çalışmanın amacı değişik özür seviyesine sahip serebral palsili çocuk annelerinin bel- boyun problemleri ve yaşam kalitesini incelemektir. Gereç ve Yöntem: Çalışmaya Türkiye'deki farklı illerdeki özel eğitim ve rehabilitasyon merkezlerinde tedaviye devam eden değişik özür seviyesine sahip 100 serebral palsili (SP) çocuk ve anneleri dahil edilmiştir. SP'li çocuklar, Kaba Motor Fonksiyon Sınıflama Sistemi (GMFCS), El Becerileri Sınıflama Sistemi (MACS), Fonksiyonel Mobilite Skalası (FMS) ve Pediatrik Fonksiyonel Bağımsızlık Ölçütü (Wee-FIM) kullanılarak değerlendirilmiştir. SP'li çocuk annelerinin sağlıkla ilgili yaşam kalitesini değerlendirmek için Nottingham Sağlık Profili (NHP) ve emosyonel durumlarını değerlendirmek için Beck Anksiyete Envanteri (BAE) kullanılmıştır. Annelerin boyun ve bel problemleri için Neck Disability Index (NDI) ve Roland- Morris Disability Questionnaire (RMDQ) kullanılmıştır. Bulgular SP'li çocukların yaş ortalaması 105.07±53.36 (min: 13- max 216)ay. Annelerin yaş ortalaması 35.66 ± 7.39 (min: 19- max: 56) yıl idi. SP'li çocukların GMFCS, FMS, MACS, Wee- FIM skorları arasında istatistiksel olarak ilişki bulunmuştur (p0.05). Çıkarımlar SP'li çocuk annelerinin bel ve boyun problemlerinin olmaması anksiyete düzeylerini azaltmakta ve sağlıkla ilgili yaşam kalitelerini arttırmaktadır. Çalışmaya dahil edilen SP'li çocukların, motor fonksiyonları ile fonksiyonel mobilite ve bağımsızlık düzeylerinin iyi olması annelerin boyun ve bel problemlerinin azalmasına ve sağlıkla ilgili yaşam kalitelerinin artmasına neden olmaktadır

Expectations from Rehabilitation of Children with Cerebral Palsy: The Agreement between the Physiotherapists and Mothers

Abstract. [Purpose] The aim of this study was to examine the agreement between physiotherapists (PTs) and mothers (Ms) about the treatment of children with cerebral palsy (CP) who received treatment in special education and rehabilitation centers. [Subjects] Ms of 130 children with CP (75 boys, 55 girls) and 130 PTs who applied reha-bilitation programs were interviewed. [Methods] Clinical types and gross motor function levels of the children were recorded. A questionnaire consisting of 6 open-ended questions was used to describe the expectations and views of the PTs and Ms about the physiotherapy and rehabilitation programs for the children. [Results] The mean age of the children was 89.80±52.05 months. The mean treatment period for the children was 73.62±42.11 months. The mean age of the mothers was 35.47±5.79 years, and the mean age of the PTs was 28.07±7.28 years. We found a statistically moderate level of agreement between the PTs and Ms regarding the appropriateness of the treatment provided to the children. There was statistically insignificant agreement regarding the applied treatment methods and the ap-propriateness of the applied rehabilitation programs. [Conclusion] We believe that the views and expectations of the Ms should be taken into account by the PTs when preparing a treatment program for children with CP

Relationship between hand functions and balance in children with cerebral palsy

Introduction: This study was planned to examine the relationship between hand function and balance in children with Cerebral Palsy(CP). Methods: 15 diparetic or hemiparetic CP children, between the ages of 5-15, was included in the study. They were at Level I, II or III according to Gross Motor Function Classification System (GMFCS), applied Neurodevelopmental Therapy(NDT). Intensive NDT were applied to increase the functional and motor skills for 8 weeks. Evaluations were repeated before and after treatment. MACS for functional hand using skills, 10 meter-walk test, 1 minute-walking test and Pediatric Balance Scale for balance capabilities of children with CP were used. Results: Mean ages of the patients were 120.40±31.69 months and 7(46.7%) were female, and 8(53.3%) were male. 8(53.3%) patients were diparetic, 2(13.3%) were right hemiparetic and 5(33.3%) were left hemiparetic. According to the distribution of the pre-treatment MACS, 7 patients for level I, 7 patients for level II and 1 patient for level III were in the study, and after treatment all patients were in Level I. Although improvements were detected in hand function and balance scores after treatment, hand using skills and balance scores were not correlated. Conclusion: It is known dexterity and balance in children with CP could be improved with proper treatment and clinical recommendations, and good functional hand using is effective on development of balance, positively. It is important to evaluate children and disability and interventions improving the functionality is required, while rehabilitation programs are planned

Effects of early physiotherapy on family needs and mother’s quality of life in i̇nfants with downsyndrome

Introduction: Down syndrome is the most common autosomaldisorder resulting from a genetic discrepancy. Mothers facesome problems and stress during the early stages of Downsyndrome. The aim of this study was to examine effects ofearly physiotherapy applied on infants with Down syndromeat an early stage on family needs and life quality of mothers. Patients And Method: Twenty-three cases (10 females, 13 males)with a diagnosis of Down syndrome between 0 and 2 years ofage were included in study. Demographic data such as mater-nal age, education level, occupational status, income level, andsocial security were saved. Children’s motor skills were evalu-ated by Alberta Infant Motor Profile. Physiotherapy programswere applied for 2 weeks, 1 hour sessions per day, for 6 weeks.The Family Needs Assessment Tool was used to define familyneeds, the Beck Depression Inventory was used to assessmothers’ depression levels, and the Nottingham Health Pro-file was used to evaluate mothers’ quality of life. All assess-ments were made before and after treatment program. Results: Pretreatment and posttreatment scores of assessmentswere compared with Wilcoxon Signed Ranks Test (t-test).Motor skills of children showed a statistically significantimprovement compared to pretreatment (p<0.05). Require-ments of parents decreased with all subfactors in comparisonto pretreatment (p<0.05). Similarly, depressive levels of moth-ers were statistically significantly decreased (p<0.05). Therewas a significant increase in quality of life of mothers com-pared to pretreatment (p<0.05). Conclusion: Six-week early physiotherapy program improvedmotor skills of 0 to 2-year-old children with Down syndrome,increasing quality of life of these children’s mothers whiledecreasing their depression levels and family needs