Follow-Up and Community Care of the Child With a Chronic Disease

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DOI :10.26650/B/CH32.2024.010.037   IUP :10.26650/B/CH32.2024.010.037    Full Text (PDF)

Follow-up and Community Care of the Child with Cerebral Palsy

Fuat Bilgili, Mehmet Demirel

Cerebral palsy (CP) is a developmental movement and posture disorder caused by a nonprogressive lesion. In children, CP manifests variably. Gross motor function classification system is the most frequently used system in determining functional status. Health-related quality of life is measured based on physical functioning, psychological problems, social functioning, symptoms, and disability. CP is most often associated with orthopedic disorders due to spasticity and multiple comorbidities that negatively affect the quality of life. However, there remains no cure for CP, but a multidisciplinary treatment and follow-up can change the natural course of the disease and improve the participation and quality of life of children with CP. Mental disability, spasticity and dystonia, inability to walk, pain management, hip joint problems, spinal curvatures, speech and communication problems, bladder control problems, epilepsy, behavioral and visual disorders and blindness, hearing loss, sleep disorders, nutrition, swallowing, and gastrointestinal system disorders are common problems during treatment and follow-up. Meanwhile, orthopedic follow-up is aimed at avoiding the dislocation of the hip joint. Given the several complexities of CP, a multidisciplinary team is needed to make the necessary adjustments in the treatment plan based on the child’s individual needs. This chapter presents the orthopedic approach and fundamental principles in the treatment and follow-up of children with CP.


Keywords: Cerebral palsy, treatment and follow-up protocol, comorbidities, orthopedic disorders, multidisciplinary approach
DOI :10.26650/B/CH32.2024.010.037   IUP :10.26650/B/CH32.2024.010.037    Full Text (PDF)

Serebral Palsi̇ Sorunu Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Fuat Bilgili, Mehmet Demirel

Serebral palsi, ilerleyici olmayan bir lezyon sonucu ortaya çıkan gelişimsel bir hareket ve postür bozukluğudur. Serebral palsisi olan çocuklar karşımıza çok geniş yelpazede klinik bulgular ile gelebilmektedir. Kaba motor fonksiyon sınıflandırma sistemi fonksiyonel durumun belirlenmesinde en sık kullanılan sistemdir. Sağlıkla ilgili yaşam kalitesi ise fiziksel işlevsellik, psikolojik sorunlar, sosyal işlevsellik, semptomlar ve engellilik ölçümlerini içerir. Serebral palsi, çoğunlukla spastisite ve yaşam kalitesini olumsuz yönde etkileyen çoklu komorbiditeler oluşturan çeşitli ortopedik bozukluklarla ilişkilidir. Günümüzde serebral palsinin henüz şifa ile sonlanacak tedavisi yoktur, ancak multidisipliner tedavi ve izlem yaklaşımı hastalığın doğal seyrini değiştirebilir ve bu durumdaki çocukların hayata katılımlarını ve yaşam kalitesini iyileştirebilir. Serebral palsisi olan çocukların tedavi ve izlemleri esnasında sık karşılaşılan sorunlar; zihinsel yetersizlik, spastisite ve distoni, yürüyememe, ağrı yönetimi, kalça eklemi sorunları, omurga eğrilikleri, konuşma ve iletişim sorunları, mesane kontrol sorunları, epilepsi, davranış ve görme bozuklukları ve körlük, işitme kaybı, uyku bozuklukları, beslenme, yutma ve gastrointestinal sistem bozukluklarıdır. Ortopedik izlemlerdeki en önemli nokta kalça çıkığının önlenmesidir. Serebral palside eşlik eden birçok karmaşık bozukluk nedeniyle tedavi ve takip için multidisipliner bir ekibe ihtiyaç vardır. Tedavi planının çocuğun bireysel ihtiyaçlarına göre ayarlanmasında multidisipliner ekip önemlidir. Bu bölümde serebral palsisi olan çocukların tedavi ve izlem süreçlerinde ortopedik yaklaşım ve klinisyenlerin dikkat etmesi gereken esaslar üzerinde durulacaktır. 


Keywords: Serebral palsi, tedavi ve izlem, komorbiditeler, ortopedik bozukluklar, multidisipliner yaklaşım

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