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ORIJINAL ARAŞTIRMA

Serebral Palsili Çocuklarda Oral Motor Fonksiyonlar ile Malnütrisyon Arasındaki İlişkinin Değerlendirilmesi
Evaluation of the Relationship Between Oral Motor Functions and Malnutrition in Children with Cerebral Palsy
Received Date : 19 May 2022
Accepted Date : 03 Aug 2022
Available Online : 12 Aug 2022
Doi: 10.31609/jpmrs.2022-91405 - Makale Dili: TR
J PMR Sci. 2022;25(3):362-8
ÖZET
Amaç: Serebral palsili (SP) çocuklarda beslenme problemleri ve malnütrisyon sıklıkla karşılaşılan sorunlardan biridir. Bu çalışma, SP tanısı almış çocuklarda sık görülen oromotor disfonksiyonlar ile malnütrisyon durumları arasındaki ilişkinin belirlenmesi amacıyla yürütülmüştür. Gereç ve Yöntemler: Araştırmaya 3-18 yaş arasındaki 55 SP tanısı almış çocuk dâhil edildi. SP’li çocukların kaba motor fonksiyon seviyeleri, kaba motor fonksiyon sınıflandırma sistemi (KMFSS) ile sınıflandırıldı. Çocukların yaşa ve cinsiyete özgü yaşa göre boy [height for age (HFA)], yaşa göre beden kütle indeksi [body mass index for age (BFA)] ve yaşa göre vücut ağırlığı [weight for age (WFA)] z skorları hesaplandı. Çocukların oral motor becerilerinin değerlendirilmesinde Karaduman Çiğneme Performans Skalası (KÇPS), Yeme ve İçme Becerileri Sınıflama Sistemi, Dil İtme Refleksi Skalası ve Pediatrik Yeme Değerlendirme Aracı-10 [Pediatric Eating Assessment Tool- 10 (PEDI-EAT-10)] kullanıldı. Bulgular: Çocukların yaş ortalaması 8,4±3,85 yıl olup, KMFSS’ye göre çocukların %32,7’si Seviye 5’te yer almaktaydı. Çocuklarda HFA, BFA ve WFA z skoruna göre malnütrisyon görülme oranlarının sırasıyla %36,4, %27,3 ve %21,8 olduğu belirlendi. KÇPS’ye göre Seviye 1 olan çocukların çoğunluğunda HFA, BFA ve WFA z skoruna göre malnütrisyon bulunmaz iken (sırasıyla %85,7, %82,1 ve %89,5) KÇPS Seviye 5 olan çocuklarda malnütrisyon oranların daha yüksek olduğu saptandı (p<0,05). PEDI-EAT-10 puanlarının HFA, BFA ve WFA z skoruna göre malnütrisyon olan çocuklarda anlamlı düzeyde daha yüksek olduğu tespit edildi (p<0,05). Sonuç: SP’li çocuklarda çiğneme ve yutma bozuklukları sıklıkla karşılaşılan problemler arasındadır. Oral motor becerilerdeki azalma SP’li çocuklarda görülen malnütrisyon oranları ile ilişkilidir.
ABSTRACT
Objective: Feeding problems and malnutrition are frequently seen in children with cerebral palsy (CP). This study aimed to determine the relationship between oromotor dysfunctions and malnutrition, which are common in children with CP. Material and Methods: This study was conducted with 55 children aged between 3-18 years diagnosed with CP. Gross motor function levels of children with CP were classified by gross motor function classification system (GMFCS). Z‐scores for weight for age (WFA), height for age (HFA) and body mass index for age (BFA) were calculated. Oral motor skills of the children were evaluated by the Karaduman Chewing Performance Scale (KCPS), Eating and Drinking Skills Classification System, Tongue Thrust Rating Scale and Pediatric Eating Assessment Tool-10 (PEDI-EAT-10). Results: The mean age of the children was 8.4±3.85 years, and 32.7% of the them were at Level 5 according to GMFCS. According to the children’s z scores of HFA, BFA and WFA, the prevalence of malnutrition in children was found as 36.4%, 27.3% and 21.8%, respectively. While the majority of children with KCPS Level 1 did not have malnutrition according to z scores of HFA, BFA and WFA (85.7%, 82.1% and 89.5%, respectively), it was found that the percentage of malnutrition was higher in children with KCPS Level 5 (p<0.05). PEDI-EAT-10 scores were found to be significantly higher in children with malnutrition according to z scores of HFA, BFA and WFA (p<0.05). Conclusion: Chewing and swallowing disorders are frequently seen in children with CP. Decreased oral motor skills are associated with malnutrition rates in children with CP.
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