Klinik Araştırma
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The Relationship Between Functional Level, Trunk Control, and Respiratory Functions in Children with Cerebral Palsy

Yıl 2023, Cilt: 4 Sayı: 3, 178 - 187, 22.12.2023

Didem Gündüz Gamze Aydın

https://doi.org/10.58770/joinihp.1379541

Öz

Cerebral palsy (CP) is a developmental disorder characterized by a group of movement and posture problems that occur as a result of a lesion in the immature brain and affect the development of the brain. Our study aimed to examine and compare the functional level, trunk control, and respiratory functions in children with cerebral palsy (CP). There were a total of 61 children with CP, 51% female, and 49% male, with a mean age of 11.21±3.02 years. Demographic and disease-related information were evaluated with ‘sociodemographic data form,’ functional levels with the ‘Gross Motor Function Classification System, trunk control with the ‘Trunk Control Measurement Scale’ (TCMS), and respiratory functions with ‘the respiratory function test’ using a spirometer. The functional levels of children with CP, 54% were Level 1, 26% were Level 2 and 20% were Level 3. In intergroup analysis, the mean trunk control of the children with Level 1 and 2 were statistically significantly higher than the children in Level 3 (p<0.05). Despite this, the children's FVC, FEV1, PEF, FEF25, FEF75, FEF25-75, and FEV1/FVC parameters did not show significant statistical differences at functional levels (p>0.05). There was a positive low-level statistically significant correlation between the mean FEV1 value and the scores of TCMS (r=0.01, p<0.05). On the other hand, no statistically significant correlation was found between trunk control and other respiratory function parameters (p>0.05). In children with CP, while trunk control increased as the functional level rose, there was no change in their respiratory functions.

Anahtar Kelimeler

Cerebral palsy respiratory function test trunk control

Etik Beyan

Ethical approval for this study was obtained from Social and Non-Interventional Health Sciences Research Ethics Committee of Istanbul Okan University (IRB study protocol: 29.12.2021-147).

Destekleyen Kurum

None

Teşekkür

None

Kaynakça

  • [1] J. Sheu, D. Cohen, T. Sousa, K. L. D. Pham, “Cerebral Palsy: Current Concepts and Practices in Musculoskeletal Care,” Pediatrics in review, vol. 43, no. 10, pp. 572–581, 2022. https://doi.org/10.1542/pir.2022-005657
  • [2] M. Stoknes, G. L. Andersen, A. I. Elkamil, L. M. Irgens, J. Skranes, K. Å. Salvesen, T. Vik, “The effects of multiple pre- and perinatal risk factors on the occurrence of cerebral palsy. A Norwegian register based study,” European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society, vol. 16, no. 1, pp. 56–63, 2012. https://doi.org/10.1016/j.ejpn.2011.10.004
  • [3] M. Oskoui, F. Coutinho, J. Dykeman, N. Jetté, T. Pringsheim, “An update on the prevalence of cerebral palsy: a systematic review and meta-analysis,” Developmental medicine and child neurology, vol. 55, no. 6, pp. 509–519, 2013. https://doi.org/10.1111/dmcn.12080
  • [4] Y. E. Choi, H. R. Jung, J. H. Kim, “Comparison of Trunk Control on Gross Motor Function and Topography in Children with Spastic Cerebral Palsy,” Journal of the Korean Society Physical Medicine, vol. 4, no, 4, pp. 45-53, 2019.
  • [5] Y. H. Kwon, H. Y. Lee, “Differences of respiratory function according to level of the gross motor function classification system in children with cerebral palsy,” Journal of physical therapy science, vol. 26, no. 3, pp. 389–391, 2014. https://doi.org/10.1589/jpts.26.389
  • [6] R. Sæther, J. L. Helbostad, L. Adde, S. Braendvik, S. Lydersen, T. Vik, “The relationship between trunk control in sitting and during gait in children and adolescents with cerebral palsy,” Developmental medicine and child neurology, vol. 57,no. 4, pp. 344–350, 2015. https://doi.org/10.1111/dmcn.12628
  • [7] J. Rose, D. R. Wolff, V. K. Jones, D. A. Bloch, J. W. Oehlert, J. G. Gamble, “Postural balance in children with cerebral palsy,” Developmental medicine and child neurology, vol. 44, no. 1, pp. 58–63, 2002. https://doi.org/10.1017/s0012162201001669
  • [8] Y. H. Kwon, H. Y. Lee, “Differences of the Truncal Expansion and Respiratory Function between Children with Spastic Diplegic and Hemiplegic Cerebral Palsy,” Journal of physical therapy science, vol. 25, no. 12, pp. 1633–1635. 2013. https://doi.org/10.1589/jpts.25.1633
  • [9] Y. H. Kwon, H. Y. Lee, “Differences of respiratory function in children with spastic diplegic and hemiplegic cerebral palsy, compared with normally developed children,” Journal of pediatric rehabilitation medicine, vol. 6, no. 2, pp. 113–117, 2013. https://doi.org/10.3233/PRM-130246
  • [10] Y. H. Kwon, H. Y. Lee, “Differences in respiratory pressure and pulmonary function among children with spastic diplegic and hemiplegic cerebral palsy in comparison with normal controls,” Journal of physical therapy science, vol. 27, no. 2, pp. 401–403, 2015. https://doi.org/10.1589/jpts.27.401
  • [11] O. Verschuren, T. Takken, “Aerobic capacity in children and adolescents with cerebral palsy,” Research in developmental disabilities, vol. 31, no. 6, 1352–1357 2010. https://doi.org/10.1016/j.ridd.2010.07.005
  • [12] R. Muammer, Z. S. Baktır, K. Muammer, “Comparison of respiratory parameters of physically disabled and healthy children,” Bezmialem Science. Vol. 3, pp. 8-11, 2015.
  • [13] J. C. van der Heide, C. Begeer, J. M. Fock, B. Otten, E. Stremmelaar, L. A. van Eykern, M. Hadders-Algra, “Postural control during reaching in preterm children with cerebral palsy,” Developmental medicine and child neurology, vol. 46, no. 4, pp. 253–266, 2004. https://doi.org/10.1017/s0012162204000416
  • [14] L. Heyrman, G. Molenaers, K. Desloovere, G. Verheyden, J. De Cat, E. Monbaliu, H. Feys, ”A clinical tool to measure trunk control in children with cerebral palsy: the Trunk Control Measurement Scale,” Research in developmental disabilities, vol. 32, no. 6, pp. 2624–2635, 2011. https://doi.org/10.1016/j.ridd.2011.06.012
  • [15] M. R. Miller, J. Hankinson, V. Brusasco, F. Burgos, R. Casaburi, A. Coates, R. Crapo, P. Enright, C. P. van der Grinten, P. Gustafsson, R. Jensen, D. C. Johnson, N. MacIntyre, R. McKay, D. Navajas, O. F. Pedersen, R. Pellegrino, G. Viegi, J. Wanger, “ATS/ERS Task Force. Standardisation of spirometry,” The European respiratory journal, vol. 26, no. 2, pp. 319–338, 2005. https://doi.org/10.1183/09031936.05.00034805
  • [16] N. L. Young, A. M. McCormick, T. Gilbert, A. Ayling-Campos, T. Burke, D. Fehlings, J. Wedge, “Reasons for hospital admissions among youth and young adults with cerebral palsy,” Archives of physical medicine and rehabilitation, vol. 92, no. 1, pp. 46–50, 2011. https://doi.org/10.1016/j.apmr.2010.10.002
  • [17] L. Heyrman, K. Desloovere, G. Molenaers, G. Verheyden, K. Klingels, E. Monbaliu, H. Feys, “Clinical characteristics of impaired trunk control in children with spastic cerebral palsy,” Research in developmental disabilities, vol. 34, no. 1, pp. 327–334, 2013. https://doi.org/10.1016/j.ridd.2012.08.015
  • [18] S. Jung, S. Song, D. Lee, K. Lee, G. Lee, “Effects of Kinect Video Game Training on Lower Extremity Motor Function, Balance, and Gait in Adolescents with Spastic Diplegia Cerebral Palsy: A Pilot Randomized Controlled Trial,” Developmental neurorehabilitation, vol. 24, no. 3, pp. 159–165, 2021. https://doi.org/10.1080/17518423.2020.1819458
  • [19] M. Domagalska-Szopa, A. Szopa, “Postural pattern recognition in children with unilateral cerebral palsy,” Therapeutics and clinical risk management, vol. 10, pp. 113–120, 2014. https://doi.org/10.2147/TCRM.S58186
  • [20] S. W. Saunders, D. Rath, P. W. Hodges, “Postural and respiratory activation of the trunk muscles changes with mode and speed of locomotion,” Gait & posture, vol. 20, no. 3, pp. 280–290, 2004. https://doi.org/10.1016/j.gaitpost.2003.10.003

Serebral Palsili Çocuklarda Fonksiyonel Seviye, Gövde Kontrolü ve Solunum Fonksiyonları Arasındaki İlişki

Yıl 2023, Cilt: 4 Sayı: 3, 178 - 187, 22.12.2023

Didem Gündüz Gamze Aydın

https://doi.org/10.58770/joinihp.1379541

Öz

Serebral Palsi (SP), immatür beyinde bir lezyon sonucu ortaya çıkan ve beynin gelişimini etkileyen, bir grup hareket ve postür problemleri ile karakterize gelişimsel bir bozukluktur. Çalışmamızın amacı, SP’li çocuklarda, fonksiyonel seviye, gövde kontrolü ve solunum fonksiyonlarının incelenmesi ve karşılaştırılmasıydı. Çalışmamıza, ortalama yaşları 11,21±3,02 yıl olan, %.51’i kız, %.49’u erkek, toplam 61 SP’li çocuk dahil edildi. Katılımcıların demografik ve hastalıkla ilgili bilgileri ‘sosyodemografik veri formu’ ile; fonksiyonel seviyeleri, “Kaba Motor Fonksiyon Sınıflandırma Sistemi” (KMFSS) ile; gövde kontrolü, “Gövde Kontrol Ölçüm Skalası” (GKÖS) ile; solunum fonksiyonları spirometre kullanılarak yapılan ‘solunum fonksiyon testi’ ile değerlendirildi. SP’li çocukların, %54’ü, Seviye 1; %26’sı, Seviye 2; %20’si, Seviye 3 içinde yer almaktaydı. Gruplar arası değerlendirmelerde, Seviye 1 ve 2’de yer alan çocukların gövde kontrolü, Seviye 3’te yer alan çocuklardan daha iyi düzeydeydi (p<0,05). Bununla birlikte, çocukların fonksiyonel seviyesine göre FVC, FEV1, PEF, FEF25, FEF75, FEF25-75, ve FEV1/FVC parametreleri istatistiksel olarak anlamlı farklılık göstermedi (p>0,05). Gövde kontrolü ile birinci saniyede çıkarılan ekspirasyon hacmi (FEV1) arasında pozitif yönlü düşük düzey istatistiksel olarak anlamlı ilişki saptandı (r=0,01, p=0,05). Öte yandan, gövde kontrolü ile diğer solunum fonksiyonları parametreleri arasında istatistiksel olarak anlamlı düzeyde ilişki yoktu (p>0,05). SP’li çocuklarda, fonksiyonel seviye arttıkça gövde kontrolü artarken solunum fonksiyonlarında değişiklik görülmedi.

Anahtar Kelimeler

Gövde kontrolü serebral palsi solunum fonksiyon testi

Kaynakça

  • [1] J. Sheu, D. Cohen, T. Sousa, K. L. D. Pham, “Cerebral Palsy: Current Concepts and Practices in Musculoskeletal Care,” Pediatrics in review, vol. 43, no. 10, pp. 572–581, 2022. https://doi.org/10.1542/pir.2022-005657
  • [2] M. Stoknes, G. L. Andersen, A. I. Elkamil, L. M. Irgens, J. Skranes, K. Å. Salvesen, T. Vik, “The effects of multiple pre- and perinatal risk factors on the occurrence of cerebral palsy. A Norwegian register based study,” European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society, vol. 16, no. 1, pp. 56–63, 2012. https://doi.org/10.1016/j.ejpn.2011.10.004
  • [3] M. Oskoui, F. Coutinho, J. Dykeman, N. Jetté, T. Pringsheim, “An update on the prevalence of cerebral palsy: a systematic review and meta-analysis,” Developmental medicine and child neurology, vol. 55, no. 6, pp. 509–519, 2013. https://doi.org/10.1111/dmcn.12080
  • [4] Y. E. Choi, H. R. Jung, J. H. Kim, “Comparison of Trunk Control on Gross Motor Function and Topography in Children with Spastic Cerebral Palsy,” Journal of the Korean Society Physical Medicine, vol. 4, no, 4, pp. 45-53, 2019.
  • [5] Y. H. Kwon, H. Y. Lee, “Differences of respiratory function according to level of the gross motor function classification system in children with cerebral palsy,” Journal of physical therapy science, vol. 26, no. 3, pp. 389–391, 2014. https://doi.org/10.1589/jpts.26.389
  • [6] R. Sæther, J. L. Helbostad, L. Adde, S. Braendvik, S. Lydersen, T. Vik, “The relationship between trunk control in sitting and during gait in children and adolescents with cerebral palsy,” Developmental medicine and child neurology, vol. 57,no. 4, pp. 344–350, 2015. https://doi.org/10.1111/dmcn.12628
  • [7] J. Rose, D. R. Wolff, V. K. Jones, D. A. Bloch, J. W. Oehlert, J. G. Gamble, “Postural balance in children with cerebral palsy,” Developmental medicine and child neurology, vol. 44, no. 1, pp. 58–63, 2002. https://doi.org/10.1017/s0012162201001669
  • [8] Y. H. Kwon, H. Y. Lee, “Differences of the Truncal Expansion and Respiratory Function between Children with Spastic Diplegic and Hemiplegic Cerebral Palsy,” Journal of physical therapy science, vol. 25, no. 12, pp. 1633–1635. 2013. https://doi.org/10.1589/jpts.25.1633
  • [9] Y. H. Kwon, H. Y. Lee, “Differences of respiratory function in children with spastic diplegic and hemiplegic cerebral palsy, compared with normally developed children,” Journal of pediatric rehabilitation medicine, vol. 6, no. 2, pp. 113–117, 2013. https://doi.org/10.3233/PRM-130246
  • [10] Y. H. Kwon, H. Y. Lee, “Differences in respiratory pressure and pulmonary function among children with spastic diplegic and hemiplegic cerebral palsy in comparison with normal controls,” Journal of physical therapy science, vol. 27, no. 2, pp. 401–403, 2015. https://doi.org/10.1589/jpts.27.401
  • [11] O. Verschuren, T. Takken, “Aerobic capacity in children and adolescents with cerebral palsy,” Research in developmental disabilities, vol. 31, no. 6, 1352–1357 2010. https://doi.org/10.1016/j.ridd.2010.07.005
  • [12] R. Muammer, Z. S. Baktır, K. Muammer, “Comparison of respiratory parameters of physically disabled and healthy children,” Bezmialem Science. Vol. 3, pp. 8-11, 2015.
  • [13] J. C. van der Heide, C. Begeer, J. M. Fock, B. Otten, E. Stremmelaar, L. A. van Eykern, M. Hadders-Algra, “Postural control during reaching in preterm children with cerebral palsy,” Developmental medicine and child neurology, vol. 46, no. 4, pp. 253–266, 2004. https://doi.org/10.1017/s0012162204000416
  • [14] L. Heyrman, G. Molenaers, K. Desloovere, G. Verheyden, J. De Cat, E. Monbaliu, H. Feys, ”A clinical tool to measure trunk control in children with cerebral palsy: the Trunk Control Measurement Scale,” Research in developmental disabilities, vol. 32, no. 6, pp. 2624–2635, 2011. https://doi.org/10.1016/j.ridd.2011.06.012
  • [15] M. R. Miller, J. Hankinson, V. Brusasco, F. Burgos, R. Casaburi, A. Coates, R. Crapo, P. Enright, C. P. van der Grinten, P. Gustafsson, R. Jensen, D. C. Johnson, N. MacIntyre, R. McKay, D. Navajas, O. F. Pedersen, R. Pellegrino, G. Viegi, J. Wanger, “ATS/ERS Task Force. Standardisation of spirometry,” The European respiratory journal, vol. 26, no. 2, pp. 319–338, 2005. https://doi.org/10.1183/09031936.05.00034805
  • [16] N. L. Young, A. M. McCormick, T. Gilbert, A. Ayling-Campos, T. Burke, D. Fehlings, J. Wedge, “Reasons for hospital admissions among youth and young adults with cerebral palsy,” Archives of physical medicine and rehabilitation, vol. 92, no. 1, pp. 46–50, 2011. https://doi.org/10.1016/j.apmr.2010.10.002
  • [17] L. Heyrman, K. Desloovere, G. Molenaers, G. Verheyden, K. Klingels, E. Monbaliu, H. Feys, “Clinical characteristics of impaired trunk control in children with spastic cerebral palsy,” Research in developmental disabilities, vol. 34, no. 1, pp. 327–334, 2013. https://doi.org/10.1016/j.ridd.2012.08.015
  • [18] S. Jung, S. Song, D. Lee, K. Lee, G. Lee, “Effects of Kinect Video Game Training on Lower Extremity Motor Function, Balance, and Gait in Adolescents with Spastic Diplegia Cerebral Palsy: A Pilot Randomized Controlled Trial,” Developmental neurorehabilitation, vol. 24, no. 3, pp. 159–165, 2021. https://doi.org/10.1080/17518423.2020.1819458
  • [19] M. Domagalska-Szopa, A. Szopa, “Postural pattern recognition in children with unilateral cerebral palsy,” Therapeutics and clinical risk management, vol. 10, pp. 113–120, 2014. https://doi.org/10.2147/TCRM.S58186
  • [20] S. W. Saunders, D. Rath, P. W. Hodges, “Postural and respiratory activation of the trunk muscles changes with mode and speed of locomotion,” Gait & posture, vol. 20, no. 3, pp. 280–290, 2004. https://doi.org/10.1016/j.gaitpost.2003.10.003
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Rehabilitasyon
Bölüm Araştırma Makaleleri
Yazarlar

Didem Gündüz 0000-0001-9063-483X

Gamze Aydın 0000-0002-4952-2825

Erken Görünüm Tarihi 22 Aralık 2023
Yayımlanma Tarihi 22 Aralık 2023
Gönderilme Tarihi 21 Ekim 2023
Kabul Tarihi 14 Aralık 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 4 Sayı: 3

Kaynak Göster

IEEE D. Gündüz ve G. Aydın, “The Relationship Between Functional Level, Trunk Control, and Respiratory Functions in Children with Cerebral Palsy”, Journal of Innovative Healthcare Practices, c. 4, sy. 3, ss. 178–187, 2023, doi: 10.58770/joinihp.1379541.
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