Spina bifida'lı çocuklarda üst ekstremite ve gövde kas kuvvetinin solunum fonksiyonlarına etkisi

Abstract

Spina Bifida (SB) is a birth defect that causes protrusion of the meninges and nerves due to defect in the closure of the neural tube between 2-6. weeks of embryological period. In addition to musculoskeletal, nervous and genitourinary system problems, respiratory system problems also occur in SB. Mostly, respiratory problems are of secondary importance in the evaluation of SB because they are not seen as a primary problem. Therefore, there are few studies on the causes, evaluation and rehabilitation of respiratory system problems in SB. The aim of this study was to investigate the effect of muscle strength on pulmonary functions by evaluating the respiratory functions with the muscle strength of upper extremity and trunk in children with SB. In the scope of the research, 33 (15 female, 18 male) patients aged between 5 and 18 years were diagnosed with SB and 30 (15 female, 15 male) healthy subjects were studied. Only the patients with SB at the upper lumbar, lower lumbar and sacral level were included in the study, and the presence of thoracic effects was determined as an exclusion criterion. The demographic data and clinical information of the cases were recorded to the forms that prepared by the investigator. For the measurement of upper extremity and trunk muscle strength, manual muscle test was used. Pulmonary function test (PFTs) was performed to all cases and their chest excursion measurement were measured. The functional ability of patients with SB was estimated using the PEDI's Functional Skills sub-title. SPSS v.20 program was used for data analysis. When the groups were compared, both upper extremity and trunk muscle strength and PFTs results were significantly lower in the children with SB (p<0.05). In the statistical analysis between the groups, chest excursion measurement in axillary and epigastric levels was found to be significantly lower in patients with SB compared to the healthy ones (p<0.05). There was no significant difference in functional skills between female and male patients with SB (p>0.05). Values of self-care and mobility parameters of functional skills decreased as level of lesion ascends to upper segments of the spine (p<0.05). FVC and FEV1 values increased significantly as the ambulation level in patients with SB improved. In conclusion, our study showed that patients with SB at the upper lumbar, lower lumbar and sacral level had decreased upper extremity and trunk muscle strength and this weakness affected their pulmonary functions and functional skills in daily life.