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
Nilgün SEREMET KÜRKLÜa, Özgün KAYA KARAb, Merve Şeyda KARAÇİL ERMUMCUa,
Hülya KAMARLI ALTUNa, Emine ŞENa
aAkdeniz Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Antalya, Türkiye
bAkdeniz Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Antalya, Türkiye
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.
Anahtar Kelimeler: Çiğneme; disfaji; malnütrisyon; serebral palsi
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.
Keywords: Chewing; dysphagia; malnutrition; cerebral palsy
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