Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Serebral Palsili Çocukların Kaba Motor ve Fonksiyonel Seviyeleri ile Solunum Fonksiyonları Arasındaki İlişkinin İncelenmesi
Investigation of the Relationship Between Gross Motor and Functional Levels and Respiratory Functions in Children with Cerebral Palsy
Ayşegül DEMİR SARIİPEKa
aBandırma Onyedi Eylül Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu, Fizyoterapi Programı, Balıkesir, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2021;6(4):770-8
doi: 10.5336/healthsci.2020-79021
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, serebral palsili (SP) çocukların kaba motor seviyeleri ve fonksiyonel seviyeleri ile solunum fonksiyonları arasındaki ilişkinin incelenmesidir. Gereç ve Yöntemler: Çalışmaya İstanbul'da bulunan Yeşeren Düşler Özel Eğitim ve Rehabilitasyon Merkezi'ne devam eden 50 SP'li çocuk (26 erkek, 24 kız) ve bu çocukların 30 sağlıklı kardeşleri (16 kız, 14 erkek) dâhil edildi. Olgular Kaba Motor Fonksiyon Sınıflama Sistemine (KMFSS) ve SP tiplerine göre sınıflandırıldı. Fonksiyonel seviye Pediatrik Fonksiyonel Bağımsızlık Ölçeği (WeeFIM) ile değerlendirildi. Solunum fonksiyonları ölçümü için SpiroAnalyzer ST-75 spirometre kullanıldı. Değişkenler arasındaki ilişkinin incelenmesi için Pearson Korelasyon Analizi ve gruplar arasındaki farkın değerlendirilmesi için Independent Samples t-test kullanıldı. Bulgular: SP grubunda KMFSS ve WeeFIM ölçekleri arasında korelasyon bulundu (p≤0,01). İki grup arasında zirve ekspiratuar akımı (PEF) dışında tüm değişkenler açısından istatistiksel olarak anlamlı fark bulundu (p<0,05). KMFSS'ye göre seviye I-II ve III-V arasında olan SP'li çocukların zorlu vital kapasite (FVC), zorlu ekspiryumun 1. saniyesinde çıkarılan hava hacmi (FEV1), FEV1/FVC, PEF, zorlu vital kapasitenin %75'inin atıldığı noktadaki zorlu ekspiratuar akım hızı (MEF75) değerleri arasında istatistiksel olarak anlamlı fark bulundu (p<0,05). Sonuç: SP'li çocukların solunum değerlerinin, normal gelişim gösteren yaşıtlarından düşük ve fonksiyonellik ile ilişkili olduğu dolayısıyla SP'nin solunum fonksiyonlarını etkilediği sonucuna varıldı. SP'li çocuklara uygulanan rehabilitasyon programlarına, solunum rehabilitasyonun da dâhil edilmesi ile solunum fonksiyonlarının gelişimine yardımcı olunabilir.

Anahtar Kelimeler: Serebral palsi; kaba motor; fonksiyonel seviye; solunum fonksiyonları
ABSTRACT
 Objective: The aims of this study were to asses the impact of gross motor development level and functional level of children with Cerebral Palsy on respiratory functions. Material and Methods: 50 children with CP (26 males, 24 females) who treated at Yeşeren Düşler Special Education and Rehabilitation Center and 30 healthy siblings (16 females, 14 males) were included in this study. The cases were classified according to the Gross Motor Function Classification System (GMFCS) and CP types. The functional level was assessed with the Pediatric Functional Independence Measure (WeeFIM). SpiroAnalyzer ST-75 spirometer was used for respiratory functions measuring. Pearson Correlation Analysis was used to examine the relationship between variables and Independent Samples t-test was used to evaluate the difference between groups. Results: A correlation was found between KMFSS and WeeFIM scales of SP group. (p ≤0.01) A statistically significant difference was found between the two groups in terms of all variables except peak expiratory flow (PEF) (p<0.05) According to KMFSS, children with CP between levels I-II and III-V were compared and there were statistically significant difference was found between forced vital capacity (FVC), air volume ejected in the first second of forced expiration (FEV1), FEV1 / FVC, PEF, forced expiratory flow rate at the point where 75% of forced vital capacity is expelled (MEF75) values. (p<0.05) Conclusion: As a conclusion, respiratory values of children with CP were lower than their peers with normal development and correlated with functionality, so CP affected the respiratory functions. Incorporation of respiratory rehabilitation into rehabilitation programs for children with CP can help to improve pulmonary capacities.

Keywords: Cerebral palsy; gross motor; functional status; respiratory functions
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