Serebral Palside Üst Ekstremite Rehabilitasyonunda Kullanılan Fizyoterapi Yöntemleri
Özet
Serebral Palsi (SP), erken çocukluk döneminde görülen fiziksel dizabilite nedenlerinin başında yer alır. SP’de üst ekstremitede hem motor hem de duyusal açıdan çeşitli klinik bulgular gözlenmektedir. Bu etkilenimler arasında kas güçsüzlüğü, pasif eklem hareket açıklığında azalma, taktil bozukluklar, propriosepsiyon defisitleri, ayna hareketlerinin görülmesi, bimanuel koordinasyon bozukluğu, spastisite, bozulmuş selektif motor kontrol, azalmış unimanuel kapasite ve düşük bimanuel performans yer almaktadır. SP’de üst ekstremite rehabilitasyonu, günlük yaşam aktivitelerine katılımı, fonksiyonel bağımsızlığı ve yaşam kalitesini artırmayı amaçlamaktadır. Bu amaçlar doğrultusunda nörogelişimsel tedavi, kısıtlayıcı-zorunlu hareket tedavisi ile bimanuel yoğunlaştırılmış üst ekstremite eğitimini içeren yoğun terapiler, ayna terapisi, hareket gözlem tedavisi ile motor imgelemeyi içeren kognitif yaklaşımlar, robotik rehabilitasyon ile sanal gerçekliği içeren teknoloji tabanlı yaklaşımlar ve kinezyolojik bantlama ile splintlemeyi içeren destekleyici yaklaşımlar kullanılmaktadır. SP’de üst ekstremite rehabilitasyonu, bu yaklaşımlardan yalnızca birine bağlı kalmak yerine bireysel ihtiyaçlara göre farklı yaklaşımların entegrasyonunu gerektirmektedir. Rehabilitasyonun başarısı ise bireyselleştirilmiş, kanıta dayalı ve interdisipliner bir yaklaşımla mümkündür.
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