The effects of upper extremity robotic rehabilitation on upper extremity skills and functional independence level in patients with hemiparetic cerebral palsy

THE EFFECTS OF UPPER EXTREMITY ROBOTIC REHABILITATION ON UPPER EXTREMITY SKILLS AND FUNCTIONAL INDEPENDENCE LEVEL IN PATIENTS WITH HEMIPARETIC CEREBRAL PASLY Nuriye Büyüktaş, Dokuz Eylül University Institute of Health Science, Physical Therapy and Rehabilitation, nuriyeozhan@hotmail.com ABSTRACT Objective: The aim of this study was to investigate the effects of upper extremity robotic rehabilitation on upper extremity skills and functional independence level in patients with hemiparetic cerebrel palsy (CP). Method: The subjects were 34 hemiparetic CP patients that among 4 to 18 years old and study was performed at Dr. Ayten Bozkaya Spastic Child Hospital and Rehabilitation Center. Children were diveded into two groups. 17 children in training group recived classical physiotherapy and rehabilitation and adittionally robotic rehabilitation. 17 children in the control group recived only classical physiotherpy and rehabilitation. Classical phyisiotherapy and rehabilitation program lasted 45 minutes, whereas robotic rehabilitation program lasted 30 minutes. All participants completed 15 session therapy. Measurements of body function and activity were made before and after the therapy. Muscle tone was measured with Modified Ashworth Scale, to evaluate hand function Abilhand-Kids test was used, The Quality of Upper Extremity Skills Test (QUEST) was utilized as a measure of upper extremity motor function and functional independence was examined with the Functional Independence Measurement for childeren (WeeFIM) test. Results: At the end of the study, upper extremity general muscle tone at the elbow and hand region was reduced more significantly in the trainig group (p<0,05). On the one hand there was a significant improvement at the measurement of hand skills, upper extremity motor function and functional independence level in both groups before and after therapy (p<0.05), on the other hand this significant difference was more obvious in the group that taken robotic rehabilitation additionally to classical physiotherapy (p<0,05). Conclusion: Robotic rehabilitation program adittionally to classical phyisiotherapy was enhanced upper extremity skills and functional independence level more than classical phyisiotherapy alone at the hemiparetic CP rehabilitation. In disorders, that require long term treatment approach, like CP, to increase motivation and effect of treatment, activities that applied with high technology robotic devices can be added to rehabilitation program for achiving more success. Key Words: Cerebral Palsy, Robotic Rehabilitation, Upper Extremity Skills, Functional Independence, QUEST, Spasticity