Hemiparetik Serebral Palsili Çocuklarda Trapeziometakarpal Eklem Pozisyonunun Stereognozi Duyusu Üzerine Etkisinin İncelenmesi

Yıl 2022, Cilt: 11 Sayı: 2, 317 - 323, 14.07.2022

Yıldız Erdoğanoğlu , Demet Sarıyıldız

https://doi.org/10.53424/balikesirsbd.1003632

Öz

Amaç: Bu çalışmanın amacı, hemiparetik Serebral Palsili çocuklarda Trapeziometakarpal (TMK) eklem pozisyonunun stereognozi duyusu üzerine etkisini incelemektir.
Gereç ve Yöntem: Çalışmaya, yaş ortalaması 9.67±3.21 yıl olan 4-16 yaş arasında 24 hemiparetik Serebral Palsili çocuk dahil edildi.
Çocukların başparmak spastisitesi Modifiye Ashworth Skalası ile, el becerileri Manuel Ability Classification ile, elin fonksiyonelliği House Hand Functional Classification System ile, stereognozi duyuları, gözleri kapalı iken Manual Form Perception ile değerlendirildi. Değerlendirme sonrası, McKie Thumb Splint ile TMK eklemi pozisyonlanarak stereognozi duyusu tekrar değerlendirildi.
Bulgular: TMK eklemi splintsiz ve splint ile pozisyonlanma sonrasında stereognozi duyusu, toplam puanları arasında anlamlı bir fark bulunmadı (p >0.05). Ancak TMK eklemi splintsiz ve splint ile pozisyonlanması sonrasında stereognozi test objelerinden diş fırçası ve tarak tanımada anlamlı fark olduğu görüldü (p <0.05).
Sonuç: Hemiparetik Serebral Palsili çocuklarda Trapeziometakarpal (TMK) eklem pozisyonlamasının stegronozi duyusu üzerinde olumlu etkisi olabileceği düşünüldü.

Anahtar Kelimeler

Hemipleji, Serebral Palsi, Stereognozi, Başparmak.

Destekleyen Kurum

-

Proje Numarası

-

Teşekkür

-

Investigation of the Effect of Trapeziometacarpal Joint Position on Stereognosis in Children with Hemiparetic Cerebral Palsy

Öz

Objective: This study is aimed to examine the effect of Trapeziometacarpal (TMC) joint position on stereognosis sense in children with hemiparetic cerebral palsy.
Material and Method: Twenty-four children with hemiparetic cerebral palsy between the ages of 4-16 with a mean age of 9.67 ± 3.21 years were included in the study. Thumb spasticity of the children was evaluated with the Modified Ashworth Scale, dexterity was evaluated with the Manual Ability Classification, the functionality of the hand was evaluated with the House Hand Functional Classification System, and the senses of stereognosia were evaluated with the Manual Form Perception with the eyes closed. After the evaluation, the TMC joint was positioned with McKie Thumb Splint, and stereognosis was re-evaluated.
Results: There was no significant difference between the sense of stereognosis and total scores after positioning with and without TMC joint splint (p> 0.05). However, after the TMC joint was positioned with and without splint, it was observed that there was a significant difference in recognition of toothbrush and comb, among the stereognosia test objects (p <0.05).
Conclusion: It was thought that trapeziometacarpal (TMC) joint positioning may have a positive effect on the sense of stegronosia in children with hemiparetic Cerebral Palsy.

Anahtar Kelimeler

Hemiplegia, Cerebral Palsy, Stereognosis, Thumb.

Proje Numarası

-

Kaynakça

• 1. Aisen, ML., Kerkovich, D., Direk, J., Mulroy, S., Wren, TA., Kay, RM., et al. (2011). Cerebral palsy: clinical care and neurologicalrehabilitation. Lancet Neurology. 10(9), 844-852.
• 2. Auld, ML., Boyd, RN., Moseley, GL., Ware, RS., Johnston, LM. (2012). Impact of tactile dysfunction on upper-limb motor performance in children with unilateral cerebral palsy. Archives of Physical Medicine and Rehabilitation. 93(4), 696–702.
• 3. Berge, SR. Ten, Boonstra, AM., Dijkstra, PU., Hadders-Algra, M., Haga, N., Maathuis, CGB. (2012). A systematic evaluation of the effect of thumb opponens splints on hand function in children with unilateral spastic cerebral palsy. Clinical Rehabilitation. 26(4),362–371.
• 4. Botte, MJ., Keenan, MA., Gellman, H., Garland, DE., Waters, RL. (1989). Surgical management of spastic thumb-in-palm deformity in adults with brain injury. Journal of Hand Surgery. 14(2pt1), 174-182.
• 5. Chen, YP., Kang, LJ., Chuang, TY., Doong, JL., Lee, SJ., Tsai, MW., et al. (2007). Use of virtual reality to improve upper-extremity control in children with cerebral palsy: A single-subject design. Physical Therapy. 87(11), 1441-1457.
• 6. Coll, GS, Garcia-Elias, M., Bergada, AL., Lopez, ML., Perez, ML., Baeza, AR. (2013) Carpal dynamic stability mechanisms. Experimental study. Revista Espanola de Cirugia Ortopedica y Traumatologia (English Edition). 57(2), 129-134.
• 7. Cooper, J., Majnemer, A., Rosenblatt, B., Birnbaum, R. (1995). The determination of sensory deficits in children with hemiplegic cerebral palsy. Journal of Child Neurology. 10(4), 300-309.
• 8. Dahlın, LB., Komoto-Tufvesson, Y., Salgeback, S. (1998). Surgery Of The Spastıc Hand In Cerebral Palsy Improvement in Stereognosis and Hand Function After Surgery. Journal of Hand Surgery. 23(3), 334-339.
• 9. Eliasson, A., Krumlinde-Sundholm, L., Rösblad, B., Beckung, E., Arner, M., Ohrvall, A., et al. (2006). The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Developmental Medicine & Child Neurology. 48(7), 549-554.
• 10. Goldner, LJ., Ferlic, DC. (1966). Sensory status of the hand as related to reconstructive surgery of the upper extremity in cerebral palsy. Clinical Orthopaedics. 46, 87-92.
• 11. Gordon, AM., Hung, YC., Brandao, M., Ferre, CL., Kuo, HC., Friel, K., et al. (2011). Bimanual training and constraint-induced movement therapy in children with hemiplegic cerebral palsy: A randomized trial. Neurorehabilitation and Neural Repair. 25(8), 692-702.
• 12. Gordon, AM., Schneider, JA., Chinnan, A., Charles, JR. (2007). Efficacy of a hand–arm bimanual intensive therapy (HABIT) in children with hemiplegic cerebral palsy: A randomized control trial. Developmental Medicine & Child Neurology. 249(11), 830–838.
• 13. Goodman, G., Bazyk, S. (1991). The effects of a short thumb opponens splint on hand function in cerebral palsy: A single-subject study. American Journal of Occupational Therapy. 45(pp), 726-731.
• 14. Kaya Kara, O., Atasavun Uysal, S., Turker, D., Karayazgan, S., Kerem Gunel, M., Baltaci, G. (2015). The effects of Kinesio Taping on body functions and activity in unilateral spastic cerebral palsy: a single-blind randomized controlled trial. Developmental Medicine & Child Neurology. 57(1), 81-88.
• 15. Keklicek H, Uygur F, Yakut Y. Effects of taping the hand in children with cerebral palsy. Journal of Hand Therapy. 2015;28(1):27-32.
• 16. Koman, LA., Smith, BP., Shilt, JS. (2004). Cerebral palsy. Lancet. 363(9421), 1619-31.
• 17. Koman, LA., Williams, RMM., Evans, PJ., Richardson, R., Naughton, MJ., Passmore, L., et al. (2008) Quantification of upper extremity function and range of motion in children with cerebral palsy. Developmental Medicine Child Neurology. 50(12), 910-917.
• 18. Mewasingh, LD., Sekhara, T., Pelc, K., Missa, A., Cheron, G, Dan B. (2004). Motor strategies in standing up in children with hemiplegia. Pediatric Neurology. 30(4), 257-61.
• 19. Naghdi, S., Ansari, NN., Azarnia, S., Kazemnejad, A. (2008). Interrater reliability of the Modified Modified Ashworth Scale (MMAS) for patients with wrist flexor muscle spasticity. Physiotherapy Theory and Practice. 24(5), 372-379.
• 20. Ohno, K., Saito, Y., Togawa, M., Shinohara, Y., Ito, T., Sugano, H., et al. (2015). Evolution of a symptomatic diffuse developmental venous anomaly with progressive cerebral atrophy in an atypical case of Sturge-Weber syndrome. Brain and Development. 37(8), 817-21.
• 21. Petersen, E., Tomhave, W., Agel, J., Bagley, A., James, M., Heest, AV. (2016). The effect of treatment on stereognosis in children with hemiplegic cerebral palsy. The Journal of Hand Surgery- Elsevier. 41(1), 91-96.
• 22. Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, D, et al. (2007). A report: the definition and classification of cerebral palsy April 2006. Developmental Medicine & Child Neurology. 49(6), 8-14.
• 23. Russo, RN., Atkins, R., Haan, E., Crotty, M. (2009). Upper limb orthoses and assistive technology utilization in children with hemiplegic cerebral palsy recruited from a population register. Developmental Neurorehabilitation. 12(2), 92-99.
• 24. Sakellarides, HT., Mital, MA., Matza, RA, (1995). Dimakopoulos P. Classification and surgical treatment of the thumb-in-palm deformity in cerebral palsy and spastic paralysis. The Journal of Hand Surgery. 20(3), 428-431.
• 25. Sakzewski, L., Ziviani, J., Abbott, D., Macdonell, RAL., Jackson, G., Boyd, R. (2011). Randomized trial of constraint-induced movement therapy and bimanual training on activity outcomes for children with congenital hemiplegia. Developmental Medicine & Child Neurology. 53(4), 313–332.
• 26. Sakzewski, L., Ziviani, J., Boyd, RN. (2014). Efficacy of upper limb therapies for unilateral cerebral palsy: a meta-analysis. Pediatrics. 133(1), 175-204.
• 27. Schermann, T., Tadi, P. (2020). Stereognosis. StatPearls [Internet].
• 28. Schoen, SA., Miller, LJ., Mulligan, S. (2017). Categorizing Sensory Processing and Integration Challenges: The First Step in Evidence-Based Practice. American Journal of Occupational Therapy. 71(4_Supplement_1):7111500005p1-p1.
• 29. Stevens, P. (2015). Are we giving kids a hand? Wrist and hand splints in the management of cerebral palsy. Med, CPO, Faaop opedge.com
• 30. Yasukawa, A., Patel, P., Sisung, C. (2006). Pilot study: investigatingthe effects of Kinesio Taping in an acute pediatric reha-bilitation setting.. American Journal of Occupational Therapy. 60, 104–110