Hemi-paretik Serebral Palsili Çocuklarda Sanal Gerçeklik Uygulamasının Kaba Motor Becerileri Üzerine Etkisi

Year 2018, Volume: 5 Issue: 3, 77 - 87, 25.02.2019

Orkun Tahir Aran , Sedef Şahin , Barkın Köse Meral Huri

https://doi.org/10.21020/husbfd.476635

Cited By: 2

Abstract

Amaç: Sanal gerçeklik (SG) uygulamasının hemiparetik serebral palsili (HSP) çocukların kaba motor beceri düzeyi üzerine etkisini incelemek amacıyla planlandı.

Gereç ve yöntem: Yaş ortalaması 10,4 ± 2,92 yıl olan HSP’li çocuk (12 erkek-8 kız)  çalışmaya dâhil edildi. Bilgisayar yazılımı için özel olarak programlanmış SG oyunları, haftada bir kez 30 dakika süreyle 8 hafta boyunca çocuklara uygulandı. Kaba motor beceri düzeyleri Bruininks - Oseretsky Motor Yeterlilik Testi Kısa Formu'nun (BOMYT-KF) 1-4 alt testleri ile müdahale öncesi, 4. ve 8. Haftalarda olmak üzere 3 kez tekrarlandı. Müdahalenin etkileri tekrarlanan ölçümler ANOVA yöntemi ile analiz edildi.

Bulgular: Çocukların 11'inin sağ ve 9’ununda sol HSP olduğu bulundu. Kaba motor beceri düzeyleri müdahale öncesi 7,60 ± 3,16, müdahalenin 4. Haftasında 10,75 ± 2,61, müdahale sonrası (8. haftada) 12,65 ± 2,47 olarak bulundu. BOMYT-KF’nun tüm alt testlerindeki artış, istatistiksel olarak anlamlı bulundu (p<0.05). 4. ve 8. Hafta ölçümleri arası ölçümlerde denge ve kuvvet alt bölümlerinde istatistiksel olarak anlamlı fark bulundu (p<0.05).

Sonuç: HSP’li çocuklarda en az dört haftalık SG müdahalesi ile tedavi programlarının geliştirilmesinin, koşma, denge, bilateral koordinasyon ve kuvvet gibi kaba motor beceri düzeylerini artırabilir. HSP çocuklara yapılan rehabilitasyon uygulamalarında SG uygulamalarının daha yaygın olarak kullanılması ile çocukların motor becerilerinde daha fazla kazanım sağlayacağını düşünmekteyiz.

Keywords

Serebral Palsi, İş Uğraşı Terapisi, Sanal Gerçeklik, Motor Beceri

Effects of Virtual Reality Interventions on Gross Motor Function in Hemi-paretic Cerebral Palsy

Abstract

Objectives: It was aimed to analyze effect of virtual reality (VR) games on gross
motor function of children with hemi-paretic Cerebral Palsy (HCP).

Material and Methods: 20 children with HCP with mean age 10,4 ± 2,92 (12
boys, 8 girls) years were included. Specially programmed virtual reality games
for PC SDK software were applied to the children twice a week for 30 minutes
for 8 weeks. Gross motor function was evaluated with 1-4 subtests of the
Bruininks - Oseretsky Motor Proficiency Test Short Form (BOMPT-SF).
Intervention effects were analyzed with Repeated Measures ANOVA.

Results: 11 of the
children were right whereas 9 were left HCP. BOMPT-SF scores were 7,60 ± 3,16
at pre-intervention, 10,75 ± 2,61 at 4th week, 12,65 ± 2,47 at 8th week.  Significant increases were found for all
subtests of BOMPT-SF(p<0.05). 
Significant statistical difference were found between strenght and
balance subtests (p<0.05).

Conclusion: The development of treatment programs with at least four weeks SG
intervention in children with HSP may increase the level of gross motor skills
like running, balance, bilateral coordination and strength. We think that the
more common use of SG applications in rehabilitation practices for HSP will
provide more gain in motor skills.

Keywords

Cerebral Palsy, Occupational Therapy, Virtual Reality, Motor Skill

References

• Anttila, H., Autti-Rämö, I., Suoranta, J., Mäkelä, M., ve Malmivaara, A. (2008). Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review. BMC pediatrics, 8(1), 14.
• Aran, O. T., Köse, B., Akel, B. S., ve Öksüz, Ç. (2014). Ataksili Bir Bireyde Sanal Gerçeklik Temelli Rehabilitasyon Uygulamasının Etkinliği-Olgu Raporu. Ergoterapi ve Rehabilitasyon Dergisi, 2(3), 159-164.
• Aran, O. T., Şahin, S., Torpil, B., Demirok, T., ve Kayıhan, H. l. (2017). Virtual Reality and Occupational Therapy Occupational Therapy-Occupation Focused Holistic Practice in Rehabilitation: InTech.
• Bailes, A. F., Gannotti, M., Bellows, D. M., Shusterman, M., Lyman, J., ve Horn, S. D. (2018). Caregiver knowledge and preferences for gross motor function information in cerebral palsy. Developmental Medicine & Child Neurology.
• Bryanton, C., Bosse, J., Brien, M., Mclean, J., McCormick, A., ve Sveistrup, H. (2006). Feasibility, motivation, and selective motor control: virtual reality compared to conventional home exercise in children with cerebral palsy. Cyberpsychology & behavior, 9(2), 123-128.
• Chang, Y.-J., Han, W.-Y., ve Tsai, Y.-C. (2013). A Kinect-based upper limb rehabilitation system to assist people with cerebral palsy. Research in developmental disabilities, 34(11), 3654-3659.
• Cho, C., Hwang, W., Hwang, S., ve Chung, Y. (2016). Treadmill training with virtual reality improves gait, balance, and muscle strength in children with cerebral palsy. The Tohoku journal of experimental medicine, 238(3), 213-218.
• Erdoğanoğlu, Y., ve Günel, Y. (2010). Serebral paralizili çocukların motor ve fonksiyonel seviyeleri ile sağlıkla ilgili yaĢam kaliteleri arasındaki iliĢkinin incelenmesi. Toplum Hekimliği Bülteni, 26(3), 13-18.
• Gagliardi, C., Turconi, A. C., Biffi, E., Maghini, C., Marelli, A., Cesareo, A., ve diğ. . (2018). Immersive virtual reality to improve walking abilities in cerebral palsy: a pilot study. Annals of biomedical engineering, 1-9.
• Galli, M., Cimolin, V., Rigoldi, C., Tenore, N., ve Albertini, G. (2010). Gait patterns in hemiplegic children with cerebral palsy: comparison of right and left hemiplegia. Research in developmental disabilities, 31(6), 1340-1345.
• Holden, S. H., ve Fletcher, P. D. (2005). The virtual value chain and e-government partnership: non-monetary agreements in the IRS e-file program. International Journal of Public Administration, 28(7-8), 643-664.
• Jelsma, J., Pronk, M., Ferguson, G., ve Jelsma-Smit, D. (2013). The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy. Developmental neurorehabilitation, 16(1), 27-37.
• Köse, B. (2018). Bruininks-Oseretsky Motor Yeterlik Testi 2 Kısa Formunun Türkçe Uyarlaması ve Özgül Öğrenme Güçlüğü Olan Çocuklarda Geçerlilik ve Güvenilirliği.
• Levac, D., McCormick, A., Levin, M. F., Brien, M., Mills, R., Miller, E., ve diğ. . (2018). Active video gaming for children with cerebral palsy: Does a clinic-based virtual reality component offer an additive benefit? A pilot study. Physical & occupational therapy in pediatrics, 38(1), 74-87.
• Loureiro, R., Amirabdollahian, F., Coote, S., Stokes, E., ve Harwin, W. (2001). Using haptics technology to deliver motivational therapies in stroke patients: Concepts and initial pilot studies. Paper presented at the Proceedings of EuroHaptics.
• Lucas, B. R., Latimer, J., Doney, R., Ferreira, M. L., Adams, R., Hawkes, G., ve diğ. . (2013). The Bruininks-Oseretsky test of motor proficiency-short form is reliable in children living in remote Australian aboriginal communities. BMC pediatrics, 13(1), 135.
• Mayston, M. (2002). 10 Physiotherapy Management In Cerebral Palsy: An Update On Treatment Approaches. Clinics in Developmental Medicine(161), 147-160.
• Mülazımoğlu Ballı, Ö. (2006). Bruininks-Oseretsky Motor Yeterlik Testinin Geçerlik, Güvenirlik Çalışması Ve Beş-Altı Yaş Grubu Çocuklara Uygulanan Cimnastik Eğitim Programının Motor Gelişime Etkisinin İncelenmesi. Yayımlanmamış doktora tezi. Ankara: Ankara Üniversitesi. Fen Bilimleri Enstitüsü.
• Oskoui, M., Coutinho, F., Dykeman, J., Jetté, N., ve Pringsheim, T. (2013). An update on the prevalence of cerebral palsy: a systematic review and meta‐analysis. Developmental Medicine & Child Neurology, 55(6), 509-519.
• Rand, D., Kizony, R., ve Weiss, P. T. L. (2008). The Sony PlayStation II EyeToy: low-cost virtual reality for use in rehabilitation. Journal of neurologic physical therapy, 32(4), 155-163.
• Rathinam, C., Mohan, V., Peirson, J., Skinner, J., Nethaji, K. S., ve Kuhn, I. (2018). Effectiveness of virtual reality in the treatment of hand function in children with cerebral palsy: A systematic review. Journal of Hand Therapy.
• Riener, R., ve Harders, M. (2012). Virtual reality for rehabilitation Virtual Reality in Medicine (pp. 161-180): Springer.
• Riva, G., Bolzoni, M., Carella, F., Galimberti, C., Griffin, M., Lewis, C., ve diğ. . (1997). Virtual reality environments for psycho-neuro-physiological assessment and rehabilitation. Studies in health technology and informatics, 39, 34-45.
• Rose, T., Nam, C. S., ve Chen, K. B. (2018). Immersion of virtual reality for rehabilitation-Review. Applied ergonomics, 69, 153-161.
• Serdaroǧlu, A., Cansu, A., Özkan, S., ve Tezcan, S. (2006). Prevalence of cerebral palsy in Turkish children between the ages of 2 and 16 years. Developmental medicine and child neurology, 48(6), 413-416.
• Sharan, D., Ajeesh, P., Rameshkumar, R., Mathankumar, M., Paulina, R. J., ve Manjula, M. (2012). Virtual reality based therapy for post operative rehabilitation of children with cerebral palsy. Work, 41(Supplement 1), 3612-3615.
• Steuer, J. (1992). Defining virtual reality: Dimensions determining telepresence. Journal of communication, 42(4), 73-93.
• Wright, F. V., Lam, C. Y., Mistry, B., ve Walker, J. (2018). Evaluation of the reliability of the Challenge when used to measure advanced motor skills of children with cerebral palsy. Physical & occupational therapy in pediatrics, 38(4), 382-394.
• Wuang, Y.-P., ve Su, C.-Y. (2009). Reliability and responsiveness of the Bruininks–Oseretsky Test of Motor Proficiency-in children with intellectual disability. Research in Developmental Disabilities, 30(5), 847-855.Zhang, Z. (2012). Microsoft kinect sensor and its effect. IEEE multimedia, 19(2), 4-10.