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Rehabilitation Approaches in Cerebral Palsy: A comparative study
Rehabilltation Approaches in Cerebral Palsy: Acompatathrestudy
H &beer AghnukrttUUS
Hgayiruut Cerebral palsy (CP)is lifelong condition. It is charactensed by sensorimotor dysfunction; thus the other developmental a r e a s a r e negatively affected. Intervention is especially important from birth to three years, when developmentally delayed infants can improve much more rapidly. The major goal is to maximise fundional abilities and minimise handicap ping effects. For this reason developmental and h c tional approaches are used for CP. This study was conducted a t t h e Spastic Special Education and Rehabilitation Center in the Turkish Republic of North Cyprus in an early intervention programme. The goal of the study was to analyse t h e effects of individualised and group therapy approaches, with and without participation of families. The experimental group was composed of 20 children with an average age of 21.70 1.56 months, and the control group was composed of 20 children with a n average age of 24.70 i 1.73 months. The type and severity of disability were distributed evenly in both groups. The study integrated physical therapy including range of movement, stretching exercises, positioning, motor development, sensory and motor stimulation, functional fine movements and transfers with Peto play therapy (a technique adapted to Center programmes). Three basic factors of the programme were the active participation of the family, the group structure and the functional outcomes.
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Children in the experimental group were divided into
three subgroups; two with seven children and one with
six children. During designated periods the children’s group assignments were changed. The children participated with their mothers in 30-minute sessions conducted two day each week. During the programme year the session duration was increased to 1% or two hours.
The children in the control group received individualised physical therapy for K to 1 hour twice a week. The therapy was based on the Bobath concept and included ROM, RIP, facilitation of motor movements and balance reactions. The exercise programmes were individualised accorrlmg to the developmental level of each child. A floor mat, a roll and an exercise ball were used during the therapy. The home programme of each child was also individualised to include daily living activities. Adaptive and mobility equipment waa used both at home and a t the therapy Center. In both groups the children were observed, tested and assessed in upper extremity functions, gross motor activities and developmental areas. The developmental and functional assessment scales were used before and after the rehabilitation programmes. Upper extremities function and gross motor activities were assessed by the Center’s own scales. For the upper extremity function assessment the ’box and block’ test was also used. The Hawaii Early Learning Profile (HELP)checklist was used for assessment of the six developmental areas including cognitive, fine motor, gross motor, expressive language, social-emotional and self-help. T h e study showed t h e positive effects of both approaches in gross motor and developmental areas ( p < 0.05).In addition, Peto play therapy was found to be more effective in both motor ability, cognitive and socio-emotional development (p < 0.05). It can be concluded from the study that there is a positive development in cognitive and social and emotional areas with the participation of families within the group therapy of early intervention programmes.
H &beer AghnukrttUUS
Hgayiruut Cerebral palsy (CP)is lifelong condition. It is charactensed by sensorimotor dysfunction; thus the other developmental a r e a s a r e negatively affected. Intervention is especially important from birth to three years, when developmentally delayed infants can improve much more rapidly. The major goal is to maximise fundional abilities and minimise handicap ping effects. For this reason developmental and h c tional approaches are used for CP. This study was conducted a t t h e Spastic Special Education and Rehabilitation Center in the Turkish Republic of North Cyprus in an early intervention programme. The goal of the study was to analyse t h e effects of individualised and group therapy approaches, with and without participation of families. The experimental group was composed of 20 children with an average age of 21.70 1.56 months, and the control group was composed of 20 children with a n average age of 24.70 i 1.73 months. The type and severity of disability were distributed evenly in both groups. The study integrated physical therapy including range of movement, stretching exercises, positioning, motor development, sensory and motor stimulation, functional fine movements and transfers with Peto play therapy (a technique adapted to Center programmes). Three basic factors of the programme were the active participation of the family, the group structure and the functional outcomes.
*
Children in the experimental group were divided into
three subgroups; two with seven children and one with
six children. During designated periods the children’s group assignments were changed. The children participated with their mothers in 30-minute sessions conducted two day each week. During the programme year the session duration was increased to 1% or two hours.
The children in the control group received individualised physical therapy for K to 1 hour twice a week. The therapy was based on the Bobath concept and included ROM, RIP, facilitation of motor movements and balance reactions. The exercise programmes were individualised accorrlmg to the developmental level of each child. A floor mat, a roll and an exercise ball were used during the therapy. The home programme of each child was also individualised to include daily living activities. Adaptive and mobility equipment waa used both at home and a t the therapy Center. In both groups the children were observed, tested and assessed in upper extremity functions, gross motor activities and developmental areas. The developmental and functional assessment scales were used before and after the rehabilitation programmes. Upper extremities function and gross motor activities were assessed by the Center’s own scales. For the upper extremity function assessment the ’box and block’ test was also used. The Hawaii Early Learning Profile (HELP)checklist was used for assessment of the six developmental areas including cognitive, fine motor, gross motor, expressive language, social-emotional and self-help. T h e study showed t h e positive effects of both approaches in gross motor and developmental areas ( p < 0.05).In addition, Peto play therapy was found to be more effective in both motor ability, cognitive and socio-emotional development (p < 0.05). It can be concluded from the study that there is a positive development in cognitive and social and emotional areas with the participation of families within the group therapy of early intervention programmes.