脑瘫儿童的功能独立性水平对睡眠和便秘的影响。
The effect of functional independence levels on sleep and constipation in children with cerebral palsy.
机构信息
Hasan Kalyoncu University, Institute of Graduate Education, Division of Physiotherapy and Rehabilitation - Gaziantep, Turkey.
Halic University, Vocational School, Division of Physiotherapy - İstanbul, Turkey.
出版信息
Rev Assoc Med Bras (1992). 2023 Nov 13;69(12):e20230765. doi: 10.1590/1806-9282.20230765. eCollection 2023.
OBJECTIVE
The study aimed to examine the effect of functional independence levels on sleep behavior and constipation in children with cerebral palsy.
METHODS
This cross-sectional observational single-center study was carried out in a special rehabilitation center in Istanbul. Inclusion criteria were those aged between 4 and 18 years with Gross Motor Function Classification System III-IV-V functional independence levels. Those who had surgery concerning intestinal health, had a chronic infectious bowel disease, had congenital intestinal anomalies, had received botox treatment in the last 6 months, had uncontrolled epileptic seizures, had complained of constipation in the last 6 months, and had cardiopulmonary disease were excluded from the study. The sociodemographic characteristics of the participants and the Gross Motor Function Classification System were recorded. Pediatric Functional Independence Scale (Functional Independence Measure for Children) was used to measure the functional independence level, Pediatric Sleep Questionnaire was used to measure the level of sleep problems, and Constipation Severity Scale was used to measure constipation severity.
RESULTS
A total of 60 children who were diagnosed with cerebral palsy were included. According to Gross Motor Function Classification System, 46.7% of the cases were Level III, 35% were Level IV, and 18.3% were Level V. There was a negative moderate significant correlation between Functional Independence Measure for Children and Pediatric Sleep Questionnaire (r=-0.303; p=0.019) and between Functional Independence Measure for Children and Constipation Severity Scale (r=-0.342; p=0.007).
CONCLUSION
We described that lower functional independence levels were related to worse sleep and constipation symptoms. The results suggest that effective strategies for developing functional independence levels may be beneficial for both sleep and constipation symptoms in the concept of cerebral palsy management.
目的
本研究旨在探讨功能性独立水平对脑瘫儿童睡眠行为和便秘的影响。
方法
这是一项在伊斯坦布尔一家特殊康复中心进行的横断面观察性单中心研究。纳入标准为年龄在 4 至 18 岁之间、粗大运动功能分级系统（Gross Motor Function Classification System，GMFCS）III-IV-V 级别的儿童。排除标准为接受过与肠道健康相关的手术、患有慢性感染性肠道疾病、存在先天性肠道异常、在过去 6 个月内接受过肉毒杆菌治疗、癫痫发作无法控制、在过去 6 个月内有便秘主诉、患有心肺疾病的儿童。记录参与者的社会人口统计学特征和 GMFCS 分级。采用儿童功能性独立性量表（Pediatric Functional Independence Scale，WeeFIM）评估功能性独立水平，采用儿科睡眠问卷（Pediatric Sleep Questionnaire，PSQ）评估睡眠问题水平，采用便秘严重程度量表（Constipation Severity Scale，CSS）评估便秘严重程度。
结果
共纳入 60 例脑瘫患儿。根据 GMFCS 分级，35%为 III 级，35%为 IV 级，18.3%为 V 级。WeeFIM 与 PSQ 之间呈负中度显著相关（r=-0.303，p=0.019），WeeFIM 与 CSS 之间也呈负中度显著相关（r=-0.342，p=0.007）。
结论
本研究描述了较低的功能性独立水平与更差的睡眠和便秘症状相关。这些结果提示，在脑瘫管理概念中，制定提高功能性独立水平的有效策略可能对改善睡眠和便秘症状均有益。
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