Down Sendromlu çocuklarda nörogelişimsel tedavi yaklaşımının (Bobath Tedavisinin) denge ve mobilite üzerine etkisi
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2019
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Down Sendromu 21. kromozoma fazladan bir kromozom eklenmesinden kaynaklanan, bireylerin motor ve mental gelişimlerini etkileyen kromozomal bir bozukluktur. Down Sendromlu çocuklarda en çok görülen sağlık sorunları eklemlerde hipermobilite, bağ dokuda gevşeklik, hafif-orta derece obezite ve hipotonidir. Bu sağlık sorunları denge ve mobilitenin bozulmasına sebep olmaktadır. Çalışmamızda Down Sendromlu çocuklara uygulanan Nörogelişimsel Tedavi Yaklaşımının denge ve mobilite üzerine etkilerinin incelenmesi amaçlandı. Çalışmamıza 3-6 yaş aralığında 11 kız, 9 erkek çocuk olmak üzere toplam 20 Down Sendromlu çocuk katıldı. Çocuklara 8 hafta boyunca, haftada 2 seans olmak üzere Nörogelişimsel Tedavi uygulandı. Down Sendromlu çocukların tedavi öncesi ve sonrası değerlendirmelerinde; kaba motor fonksiyon seviyesi için Kaba Motor Fonksiyon Sınıflama Sistemi, denge için Pediatrik Denge Ölçeği, yürüme süresi için Modifiye Kalk ve Yürü Testi, yürüme mesafesi için Bir Dakika Yürüme Testi, fonksiyonel bağımsızlık seviyesi için Pediatrik Fonksiyonel Bağımsızlık Ölçeği kullanıldı. Tüm analizlerde istatistiksel anlamlılık düzeyi p<0,05 olarak kabul edildi. Down Sendromlu çocukların kaba motor fonksiyon seviyesinde tedavi sonrasında istatistiksel olarak anlamlı bir azalma bulundu (p<0,05). Denge yeteneklerinde tedavi sonrasında istatistiksel olarak anlamlı bir artış bulundu (p<0,05). Yürüme süresinde tedavi sonrasında istatistiksel olarak anlamlı bir azalma bulundu (p<0,05). Yürüme mesafesinde tedavi sonrasında istatistiksel olarak anlamlı bir artma bulundu (p<0,05). Fonksiyonel bağımsızlık seviyesinde tedavi sonrasında istatistiksel olarak anlamlı bir artış bulundu (p<0,05). Sonuç olarak Down Sendromlu çocuklara uygulanan Nörogelişimsel Tedavi yaklaşımının denge ve mobilitenin geliştirilmesinde etkili olduğu sonucuna ulaşıldı. Nörogelişimsel Tedavi, Down Sendromlu çocukların denge ve mobilitesinin geliştirilmesi için fizyoterapistler tarafından kullanılabilecek uygun bir yaklaşımdır.
Down Syndrome is a chromosomal disorder that affects the motor and mental development of individuals resulting from the addition of an extra chromosome to the 21st chromosome. The most common health problems in Down Syndrome children are hypermobility in joints, laxity of connective tissue, mild to moderate obesity and hypotonia. These health problems lead to deterioration of balance and mobility. The aim of this study was to investigate the effects of Neurodevelopmental Treatment Approaches on balance and mobility in children with Down Syndrome. A total of 20 Down Syndrome children (11 girls, 9 boys) aged 3-6 years participated in the study. Children underwent Neurodevelopmental Treatment for 8 weeks, 2 sessions per week. Pre-treatment and post-treatment assessments of children with Down Syndrome; Gross Motor Function Classification System was used for gross motor function level, Pediatric Balance Scale for balance, The Modified Timed Up and Go Test for walking time, One Minute Walk Test for walking distance, Pediatric Functional Independence Scale for functional independence level were used. Statistical significance was accepted as p <0.05 in all analyzes. There was a statistically significant decrease in gross motor function level of children with Down Syndrome after treatment (p<0.05). There was a statistically significant increase in balance abilities after treatment (p<0.05). There was a statistically significant decrease in walking time after treatment (p<0.05). There was a statistically significant increase in walking distance after treatment (p <0.05). There was a statistically significant increase in functional independence after treatment (p <0.05). In conclusion, the Neurodevelopmental Treatment approach applied to Down Syndrome children has a positive effect on the development of balance and mobility. Neurodevelopmental Treatment is an appropriate approach that can be used by physiotherapists to improve the balance and mobility of Down Syndrome children.
Down Syndrome is a chromosomal disorder that affects the motor and mental development of individuals resulting from the addition of an extra chromosome to the 21st chromosome. The most common health problems in Down Syndrome children are hypermobility in joints, laxity of connective tissue, mild to moderate obesity and hypotonia. These health problems lead to deterioration of balance and mobility. The aim of this study was to investigate the effects of Neurodevelopmental Treatment Approaches on balance and mobility in children with Down Syndrome. A total of 20 Down Syndrome children (11 girls, 9 boys) aged 3-6 years participated in the study. Children underwent Neurodevelopmental Treatment for 8 weeks, 2 sessions per week. Pre-treatment and post-treatment assessments of children with Down Syndrome; Gross Motor Function Classification System was used for gross motor function level, Pediatric Balance Scale for balance, The Modified Timed Up and Go Test for walking time, One Minute Walk Test for walking distance, Pediatric Functional Independence Scale for functional independence level were used. Statistical significance was accepted as p <0.05 in all analyzes. There was a statistically significant decrease in gross motor function level of children with Down Syndrome after treatment (p<0.05). There was a statistically significant increase in balance abilities after treatment (p<0.05). There was a statistically significant decrease in walking time after treatment (p<0.05). There was a statistically significant increase in walking distance after treatment (p <0.05). There was a statistically significant increase in functional independence after treatment (p <0.05). In conclusion, the Neurodevelopmental Treatment approach applied to Down Syndrome children has a positive effect on the development of balance and mobility. Neurodevelopmental Treatment is an appropriate approach that can be used by physiotherapists to improve the balance and mobility of Down Syndrome children.
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Fizyoterapi ve Rehabilitasyon, Denge, Down sendromu, Physiotherapy and Rehabilitation, Hareketlilik, Equilibrium, Down syndrome, Nörogelişimsel bozukluklar, Mobility, Postural denge, Neurodevelopmental disorders, Postural balance, Tedavi, Treatment
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