Abstract
Purpose
The aim of this study is to investigate the effects of kinesio taping (KT) and neuromuscular electrical stimulation (NMES) implementation in addition to neurodevelopmental treatment (NDT) on the activities of daily living and the quality of life in children with cerebral palsy (CP).
Methods
Forty five children between the ages 5 and 12 years and diagnosed with CP were included in the study. According to the gross motor function classification system (GMFCS), the children were on the level 3,4 and/or 5. Children were separated into 3 groups. NGT was applied in the first group, NGT and NMES were applied on the second group and NGT, NMES and KT were applied on the third group respectively for 6 weeks. Assessments were done before and after the treatment. Sitting section of the gross motor function measure (GMFM) was used to assess the sitting posture of the children. Modified functional reach test was used to evaluate the functional reach ability of children with CP. WeeFIM was used to evaluate the activity of daily living. Cerebral Palsy Quality of Life (CPQOL) was used to assess life qualities of children.
Results
Significant difference was observed in the sitting section of GMFM in all the groups; however, change in the third group was gerater than the other groups (p<0.05). Significant difference (p<0.05) was observed only in the third group in the self-care, communication and social cognition section of the WeeFIM whereas, significant difference (p<0.05) was observed in the second and the third group according to the total score of the WeeFIM. Significant difference was observed in all groups in CPQOL quality of life questionnaire but, the change in the third group was gerater than the other groups.
Discussion
Implementation of NMES and KT in addition to NGT improves the sitting performances, independence in the activities of daily living and the quality of life in children with cerebral palsy.
Öz
Amaç
Bu çalışmanın amacı Serebral Palsili (SP) bireylerde nörogelişimsel tedavi programına (NGT) ek olarak uygulanan kinezyoteyp (KT) ve nöromüsküler elektrik stimülasyonu (NMES) uygulamalarının günlük yaşam aktiviteleri ve yaşam kaliteleri üzerine etkilerini araştırmaktır.
Yöntemler
Çalışmaya yaşları 5-12 arasında değişen, SP tanısı almış, kaba motor fonksiyon sınıflama sistemi (KMFSS)’ne göre 3-4-5 seyiyesinde toplam 45 çocuk dahil edildi. Çocuklar 3 gruba ayrıldı; 1. gruba NGT uygulandı, 2. gruba NGT ve NMES uygulaması yapıldı, 3. gruba ise NGT’ye ek olarak NMES ve KT birlikte uygulandı. Tedaviler 6 hafta boyunca devam etti. Değerlendirmeler tedavi öncesi ve tedavi sonrasında yapıldı. Oturma dengelerini değerlendirmek için kaba motor fonksiyon ölçümünün (KMFÖ) oturma bölümü, fonksiyonel uzanma becerilerini değerlendirmek amacıyla modifiye fonksiyonel uzanma testi, günlük yaşam becerilerini değerlendirmek için WeeFIM ve yaşam kalitelerini değerlendirmek için de Serebral Palsi’de Yaşam Kalitesi anketi (CPQOL) kullanıldı.
Sonuçlar
İstatistiksel analize göre KMFÖ oturma bölümünde 3 grupta da anlamlı fark görüldü ama 3. gruptaki değişim diğer gruplardan daha fazlaydı (p<0.05). WeeFIM’in kendine bakım, iletişim ve sosyal iletişim bölümünde sadece 3. grupta anlamlı fark görülürken (p<0.05), WeeFIM total skorunda 2. ve 3. gruplarda anlamlı artış görüldü (p<0.05). CPQOL yaşam kalitesi anketinde de genel olarak tüm gruplarda anlamlı fark gözlenirken 3. gruptaki artışın daha fazla olduğu gözlendi.
Tartışma
SP’li çocuklarda NGT’ye ek olarak paravertebral kaslara uygulanan NMES ve KT uygulamaları oturma performanslarını artırmakta günlük yaşam aktivitelerindeki bağımsızlıklarını ve yaşam kalitelerini olumlu yönde etkilemektedir.
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Kaynaklar
Swaiman KF, Wu YW. Cerebral palsy. In: Swaiman KF, Ashwal S, Ferriero DM, editors. Principles and Practice of Pediatric Neurology. Philadelphia, PA: Elsevier, 2006; p. 491-504.
Matthews DJ, Wilson P. Cerebral Palsy. In: Molnar GE, Alexander MA, editors. Pediatric Rehabilitation. Philadelphia: Hanley and Belfus Inc, 1999; p. 193-219.
Richards CL, Malouin F. Cerebral palsy: definition, assessment and rehabilitation. Handb Clin Neurol. 2013;111:183-95.
Dursun N. Serebral Palsi. In: Oğuz H, Dursun E, Dursun, editors. Tıbbi Rehabilitasyon. İstanbul: Nobel Tıp Kitapevleri, 2004; p. 957-74.
Günel MK. Rehabilitation of children with cerebral palsy from a physiotherapist's perspective. Acta Orthop Traumatol Turc. 2009; 43(2):173-180.
Rosenbaum P, Paneth N, Leviton A., Goldstein M. and Bax MA. The definition and classification of cerebral palsy. Dev Med Child Neurol Suppl; 2007;109:8-14.
Nelson B. Cerebral Palsy. In: Swaiman KF editor. Pediatric Neurology, St.Louis,Baltimore,Toronto, 1989; p. 363-372.
Livanelioğlu A, Günel MK. Serebral Palside Fizyoterapi 1. Baskı. Ankara: Yeni Özbek Matbaası. 2009.
Footer CD. The effects of therapeutic taping on gross motor function in children with cerebral palsy. Pediatr Phys Ther. 2006;18(4):245-52.
Capozzo A. Analysis of the linear displacement of the head and trunk during walking at different speeds. J Biomech. 1981;14(6):411-25.
Moe-Nilssen R, Helbostad JL. Interstride trunk acceleration variability but not step width variability can differentiate between fit and frail older adults. Gait Posture. 2005;21(2):164-70.
Prosser LA, Lee SCK, Barbe MF, VanSant AF. & Lauer RT. Trunk and hip muscle activity in early walkers with and without cerebral palsy: A frequency analysis. J Electromyogr Kinesiol. 2010; 20(5):851-859.
Verheyden G, Mertin J, Preger R, Kiekens C, Weerdt WD. The Trunk Impairment Scale: A new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18(3):326-34.
Bertenthal B, von Hofsten C. Eye, head and trunk control: The foundation for manual development. Neurosci Biobeh Rev. 1998;22(4):515-20.
Saavedra S, Joshi A, Wollacott MH, Van Donkleaar P. Eye-hand coordination in children with cerebral palsy. Exp Brain Res. 2009;192(2):155-65.
Saavedra S, Woollacott MH, Van Donkleaar P. Head stability during quite sitting in children with cerebral palsy: Effect of vision and trunk support. Exp Brain Res. 2010;201(1):13-23.
Verheyden G, Nieuwboer A, Wit L De, Feys H, Schuback B, Baert I et al. Trunk Performance after stroke: An eye catching predictor of functional outcome. J Neurol Neurosurg Psychiatry. 2007;78(7):694-8.
Raine S. Defining the Bobath concept-using the Delphi technique. Phys Res Int. 2006; 11(1):4-13.
Raine S. The Bobath Concept: Devolepments and Current Theoretical Underpinning. In Raine S (editor). Bobath Concept: Theory and Clinical Practice In Neurological Rehabilitation. Singapore: Wiley-Blackwell, 2009; p. 1-22.
Velickovic TD, Perat MV. Basic Principles of the neurodevelopmental treatment. Medicana. 2005;42(41):112-20.
Bobath K, Bobath B. The neuro-developmental treatment. In: Scrutton D, editor. Management of the Motor Disorders of Children with Cerebral Palsy. Oxford: Blackwell Scientific Publications Ltd, 1984; p6-18.
Karabay İ, Dogan A, Arslan MD, Dost G, Ozgirgin N. Effects of functional electrical stimulation on trunk control in children with diplegic cerebral palsy. Disabil Rehabil. 2012; 34(11): 965-70.
Park ES, Park CI, Lee HJ, Cho YS. The effect of electrical stimulation on the trunk control in young children with spastic diplegic cerebral palsy. J Korean Med Sci. 2001;16(3):347-50.
Şimşek TT, Türkücüoğlu B, Çokal N, Üstünbaş G, Şimşek İE. The effects of Kinesio taping on sitting posture, functional independence and gross motor function in children with cerebral palsy. Disabil Rehabil. 2011;33(21-22):2058-63.
Palisano R, Rosenbaum P, Walter S, Russell D, Wood E. and Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39(4):214-23.
Wood E, Rosenbaum P. The Gross Motor Function Classification System for Cerebral Palsy: a study of reliability and stability over time. Dev Med Child Neurol. 2000;42(5):292-96.
Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45(6):192-7.
Balaban Ö, Nacır B, Erdem HR, Karagöz A. Denge Fonksiyonunun Değerlendirilmesi. J Phys Med Rehabil Sci. 2009;12(3):133-9.
Erkin G, Aybay C. Pediatrik rehabilitasyonda kullanılan fonksiyonel değerlendirme metodları, Türk Fiz Tıp Rehab Derg. 2001;47(3):16-20. “Article in Turkish”
Cerebral Palsy Quality of Life [homepage on the Internet]. Melbourne: 2009-2015[2001 Sep 3; 2015 Feb 26]. Available from : http://www.cpqol.org.au/index.html.
Kase K, Martin P, Yasukawa A. Kinesiotaping in Pediatrics: Fundamentals and Whole Body Taping. 2nd ed. USA, LLC. 2006.
Dewar R, Love S, Johnston ML. Exercise interventions improve postural control in children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2014; 57(6):504-20.
Simon A, Pinho AS, Santos AS, Pagnussat AS. Facilitation handlings induce increase in electromyographic activity of muscles involved in head control of Cerebral Palsy children. Res Dev Disabil. 2014;35(10:)2547-57.
Knox V, Ewans AL. Evaluation of thefunctional effects of acourse of Bobaththerapy in childrenwith cerebral palsy: apreliminary study. Dev Med Child Neurol. 2002;44(7):447-60.
Liu WY, Zaino CA, Westcott SL. Anticipatory postural adjustments in children with cerebral palsy and children with typical development. Pediatr Phys Ther. 2007;19(3):188-95.
Uniform Data System for Medical Rehabilitation. Guide for the Uniform Data Set for Medical Rehabilitation for Children (Wee- FIM), version 4.0. [homepage on the Internet]. Buffalo, NY: State University of New York at Buffalo, 1993 [cited 2014 Sept 28]. Available from: http://cirrie.buffalo.edu/encyclopedia/en/pdf/functional_assessment.pdf.
Kara OK, Uysal SA, Turker D, Karayazgan S, Gunel MK., Baltaci G. The effects of Kinesio Taping on body functions and activity in unilateral spastic cerebral palsy: a single-blind randomized controlled trial. Dev Med Child Neurol. 2014;57(1):81-8
Waters E, Davis E, Mackinnon A, Boyd R, Graham HK. Kai Lo. S. et al. Psychometric properties of the quality of life questionnaire for children with CP. Dev Med Child Neurol. 2007;49(1):49-55.
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İletişim (Correspondence):
İletişim Bilgileri:
Kamile uzun akkaya
Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi Emek Mah. 16/8 Emek/Ankara
Tel: 05364491979
e-mail: kuzun87@hotmail.com
1 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi
2 Gazi Üniversitesi, Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü
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Uzun Akkaya, K., Elbasan, B. The effects of different physiotherapy interventions on the activities of daily living and the quality of life in children with cerebral palsy. Turk J Physiother Rehabil 26, 21 (2015). https://doi.org/10.7603/s40680-015-0021-5
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DOI: https://doi.org/10.7603/s40680-015-0021-5