The Effect Of Somatosensory Perception And Proprioception On Upper Extremity Functional Skills In Children With Hemiparetic And Diparetic Cerebral Palsy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 45
- 试验地点
- 1
- 主要终点
- Kinesthesia Test
研究概览
简要总结
Cerebral Palsy (CP) is a non-progressive neurodevelopmental disorder characterized by posture and movement disorders as a result of damage to the immature brain for any reason before, during or after birth.In addition to tone, postural and neuromuscular control in children with Cerebral Palsy; Problems are also observed in communication skills, perceptual and cognitive systems and sensory systems.
详细描述
In neurodevelopmental theory, sensory and motor systems mutually support the development of each other. In addition to the motor problems observed in SP; Sensory-motor impairment, which occurs with the effects of systems such as proprioception, tactile (touch), and vestibular (balance), emerges as the main problem. With the involvement of the central nervous system (CNS) in CP, the sensory systems are also affected along with the motor systems. The involvement of the sensory system is seen in 45% of these children and presents with a white matter lesion. One of the important factors affecting the activities of daily living (ADL) in children with Cerebral Palsy is the deficiencies in their functions as a result of the affected upper extremity. Deficiencies in sensory input can cause delays in learning new motor movements. This can result in disuse of the extremities and sensitivity. The somatosensory cortex, which is important for sensory integration; It is the area of the brain that is sensitive to tactile sensations from the body. It is known that the somatosensory system, which carries these tactile stimuli to the somatosensory cortex, is active from the early stage of life. Sensory and motor interactions experienced in the early stages of life are important for motor development even in the early stages. The improvement in measurable cortical responses of the tactile system; It starts from the 8th week of intrauterine and continues until the postpartum period. In the newborn period, the infant's responses to tactile and proprioceptive stimuli play an important role in the development of motor, cognitive, social and communication skills during infancy and early childhood. The aim of this study is to investigate the effects of somatosensory perception and proprioception on upper extremity functional skills in children with hemiparetic and diparetic CP.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 6 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Diagnosed with Hemiparetic and Diparetic CP with Gross Motor Function Classification System (GMFCS) Level ≤ 3
- •Children with ≤ 2 upper extremity muscles according to the Modified Ashworth Scale (MAS)
- •Children with Manual Skills Classification System (MACS) ≤ 3
- •Not being diagnosed with mental disability by the RAM (Guidance Research Center)
- •Children with CP aged 6-18 years
- •Not receiving surgery or Botox (Botulinum Toxin) treatment in the last 6 months
- •Children with CP with parental approval
排除标准
- •Joint contracture in the shoulder, elbow and hand-wrist
- •Having any hearing or vision problems
结局指标
主要结局
Kinesthesia Test
时间窗: first day of assessment
The difference in the distance between the point where the child ends the movement and the end point of the real line is measured on the evaluation paper with a ruler. The total value of the right and left obtained is recorded by subtracting from 50. The higher the difference, the better the kinesthesia. The test will be applied bilaterally.
somatosensory perception of upper extremity (touch stimulus localization test)
时间窗: first day of assesment
Touch stimulus localization test is one of the Ayres' Southern California Sensory Integration and Praxis Test (SIPT) somatosensory perception subtests. Before starting the test, the child is asked to close his eyes. The hand, wrist and forearm are touched once with a pencil in order, first in the pronation position and then in the supination position, and the child is asked to point to the touched area with his finger. The distance between the place touched by the pen and the place indicated by the child is measured with a ruler and recorded on the evaluation sheet in cm. The test is applied bilaterally. Evaluation; The farther the distance between the real touched place and the child touches, the worse tactile perception is interpreted, the closer the real touched place and the child's touched place, the better it is interpreted to show tactile perception.
somatosensory perception of upper extremity (finger recognition test)
时间窗: first day of assesment
Finger recognition test is one of the Ayres' Southern California Sensory Integration and Praxis Test (SIPT) somatosensory perception subtests. Before starting the test, the child is asked to close his eyes. He is asked to put his hands on the table and the child's eyes are closed and 16 different points (8 right hand-8 left hand) are touched with a pencil. They are asked to point to the touched points with their fingers or to express audibly. For each point touched, scoring is done as 1 for a correct answer and 0 for an incorrect answer. The test was performed bilaterally. The patient's total score is obtained by summing the scores for both hands. In this measurement method, which is evaluated out of 16; The closer the value to 16 indicates good tactile perception, while the farther away it is, the worse it indicates tactile perception.
upper extremity proprioseption test
时间窗: first day of assessment
Measurements will be done by a goniometer for bilateral upper extremity shoulder flexion-abduction, elbow flexion-extension, supination-pronation, hand-wrist flexion. The eyes will be closed or the head turned to the opposite direction of the evaluated area. The difference between the value for the full range and the value for the half range will be recorded on the test paper as angular. Higher angular difference indicates worse proprioception.
somatosensory perception of upper extremity (right-left discrimination test)
时间窗: first day of assesment
Right-left discrimination test is one of the Ayres' Southern California Sensory Integration and Praxis Test (SIPT) somatosensory perception subtests. The child is asked to repeat the same by giving 10 body imitation commands. With the paper with the test questions in the hands of the physiotherapist, the assessment of the child begins. The score for the test is 2 points if he answers correctly in the first three seconds, 1 point if he answers in ten seconds, and 0 points if he fails to answer. The total score is recorded by summing all the sub-scores of the child from the 10 questions in the test.
somatosensory perception of upper extremity (double-touch stimulus localization test)
时间窗: first day of assesment
Double-touch stimulus localization test is one of the Ayres' Southern California Sensory Integration and Praxis Test (SIPT) somatosensory perception subtests. Before starting the test, the child is asked to close his eyes. With 2 separate pens, you can simultaneously use two different points such as left hand-right cheek, right hand-left hand, left cheek-right cheek, left hand-left cheek, right hand-left cheek, right hand-right cheek while eyes are closed. tactile. The child is asked to say or show both points touched. If the child knows both points, 2 points, 1 point if he knows one, 0 points if he does not know, and a total score is obtained. In scoring, where the best value is measured out of 14, the lower this value is interpreted as the worse tactile perception, the closer it is to this value, the better tactile perception is interpreted.
The Jebsen Taylor Hand Function Test (JTHFT)
时间窗: first day of assesment
The Jebsen Taylor Hand Function Test (JTHFT) will be used to assess upper extremity functional skills. JTEFT, which is used in the 6-18 age range, consists of serial subtests representing hand function in daily life. The application of this test, which consists of 6 items, takes 15-45 minutes. A scaled board is used to provide a standard arrangement of objects in the test. The time when all activities are done is recorded with a stopwatch. Higher duration indicates worse hand function.
次要结局
- manuel ability classification system (MACS)(first day of assessment)
- demographic information(first day of assessment)
- Gross Motor Function Classification System(GMFCS)(first day of assessment)
研究者
Hatice Adiguzel
Assistant Proffessor
Kahramanmaras Sutcu Imam University