Title Usporedba učinkovitosti terapije bobath i konvencionalne medicinske gimnastike u djece s motoričkim deficitom Title (english) Comparison of the effectiveness of BOBATH therapy and conventional medical gymnastics in children with motor impairment Author Zrinka Djukić Koroljević Mentor Valentina Matijević (mentor)Mentor Iris Zavoreo (komentor)Committee member Tatjana Trošt Bobić (predsjednik povjerenstva)Committee member Lana Ružić (član povjerenstva)Committee member Maša Malenica (član povjerenstva)Committee member Lidija Petrinović (član povjerenstva)Granter University of Zagreb Defense date and country 2023-05-11, Croatia Scientific / art field, SOCIAL SCIENCES Universal decimal classificationUDC ) 796/799 - Sport Abstract CILJ: Cilj ovog istraživanja je, usporedbom učinkovitosti Bobath koncepta i konvencionalne medicinske gimnastike kao dva najčešće korištena habilitacijska koncepta, dokazati da ne postoji razlika učinkovitosti ispitivanih habilitacijskih programa, odnosno da će pravovremena i pravilna primjena starijeg i jeftinijeg programa konvencionalne medicinske gimnastike u jednakoj mjeri dovesti do redukcije neuromotoričkih odstupanja kao novija i skuplja Bobath habilitacijska metoda. Time bi se identificirala optimalna metoda liječenja, što bi dovelo do konsenzusa struke. METODE: Istraživanjem je obuhvaćeno 100 djece starosti do 3 mjeseca s dijagnozom blagog neuromotoričkog odstupanja potvrđenog od strane dječjeg fizijatra temeljem kliničkog pregleda, testa Münchenske funkcionalne razvojne dijagnostike za 1. godinu života te Ages and Stages upitnika. Istraživanje se provodilo na Klinici za reumatologiju, fizikalnu medicinu i rehabilitaciju KBC Sestre milosrdnice u trajanju od 6 mjeseci. Ispitanici su randomizirani u dvije skupine metodom računalnog slučajnog odabira. Jedna je skupina habilitirana po Bobath metodi od strane licenciranog Bobath terapeuta frekvencijom od 1 sata tjedno ambulantno te svakodnevno od strane roditelja/ skrbnika tijekom 2 sata dnevno podijeljeno u nekoliko serija ovisno o dnevnim aktivnostima i potrebama djeteta. Druga je skupina istom frekvencijom habilitirana od strane fizioterapeuta i domicilno od strane roditelja/skrbnika metodom konvencionalne medicinske gimnastike. Dojenčad je po dječjem fizijatru klinički pregledana nakon 3 i 6 mjeseci provođenja terapije, kada je ponovljena i procjena navedenim testovima. Pri završnoj procjeni sakupljeni su Dnevnici rada i Upitnici. Rezultati su analizirani od strane nezavisnog statističara. REZULTATI: Rezultati statističke obrade prikupljenih podataka potvrdili su hipotezu i ciljeve istraživanja. Promatrani parametri bili su fina i gruba motorika, vještina rješavanja problema i komunikacije te psiho-socijalni status dojenčeta. Usporedbom dvaju habilitacijskih metoda nije nađeno statistički značajne razlike učinkovitosti po pitanju redukcije odstupanja nakon 3 mjeseca provođenja terapije. Također, obje su metode dovele do normalizacije promatranih parametara nakon 6 mjeseci provođenja habilitacije. ZAKLJUČAK: Ovim istraživanjem dokazana je jednaka učinkovitost dviju ispitivanih habilitacijskih programa u liječenju blagog neuromotiričkog odstupanja dojenčadi nakon 6 mjeseci provođenja terapije. Ukazana je potreba za što ranijim postavljanjem dijagnoze i početkom stimulacije kroz preporučen proces habilitacije, s ciljem minimaliziranja neuromotoričkog odstupanja u fazi najveće plastičnosti mozga. Jednako tako, istraživanjem je dokazana jednaka učinkovitost jeftinijeg i starijeg koncepta konvencionalne medicinske gimnastike i novijeg i skupljeg Bobath koncepta habilitacije, čime je postavljen temelj konsenzusa struke prilikom odabira optimalne metode liječenja dojenčadi s blagim neuromotoričkim odstupanjem.
Abstract (english) AIM: The main objective of this research was, by comparing the effectiveness of the Bobath concept and conventional medical gymnastics, as the two most commonly used habilitation concepts, to prove that there is no difference in the effectiveness of habilitation programs. Timely and correct execution of the older and cheaper program of conventional medical gymnastics will equally lead to reduction of neuromotor disorder as a newer and more expensive Bobath habilitation method. This would identify the optimal method of treatment, which would lead to professional consensus of physiatrists. METHODS: The study included 100 children up to 3 months of age with diagnosed mild neuromotor disorder confirmed by a pediatric physiatrist based on a clinical examination, the Münich Functional Developmental Diagnostic Test for the 1st year of life, and the Ages and Stages questionnaire. The research was conducted at the Clinic for Rheumatology, Physical Medicine and Rehabilitation of the Sisters of Charity Hospital Zagreb for 6 months. The respondents were randomized into two groups using the computer random selection method. One group was habilitated according to the Bobath method by a licensed Bobath therapist with a frequency of 1 hour per week on an outpatient basis and daily by parents/guardians for 2 hours per day divided into several series depending on the daily activities and needs of the child. The second group was habilitated with the same frequency by a physiotherapist and at home by parents/guardians using the method of conventional medical gymnastics. The infants were clinically examined by a pediatric physiatrist after 3 and 6 months of therapy, when the assessment with the mentioned tests was repeated. During the final assessment, work diaries and questionnaires were collected. The results were analyzed by an independent statistician. RESULTS: The results of statistical analysis of collected data confirmed the hypothesis and objectives of the research. The observed parameters were fine and gross motor skills, problem-solving and communication skills, and the infant's psycho-social status. By comparing the two habilitation methods, no statistically significant differences in effectiveness were found in the reduction of deviations after 3 months of therapy. Also, both methods led to the normalization of the observed parameters after 6 months of habilitation. CONCLUSION: This research proved the equal effectiveness of two tested habilitation programs in mild neuromotor disorder treatment in infants after 6 months of therapy. The need for the earliest possible diagnosis and the beginning of stimulation through the recommended habilitation process was indicated, with the aim of minimizing neuromotor disorder during the phase of brain's greatest plasticity. Also, this research proved the equal effectiveness of the cheaper and older concept of conventional medical gymnastics and the newer and more expensive Bobath concept of habilitation, which laid the foundation for professional consensus when choosing the optimal treatment method for infants with mild neuromotor disorder.
Keywords
neuromotoričko odstupanje
habilitacija
Bobath terapija
medicinska gimnastika
Keywords (english)
neuromotor disorder
habilitation
Bobath therapy
medical gymnastics
Language croatian URN:NBN urn:nbn:hr:117:862504 Promotion 2023 Study programme Title: postgraduate doctoral study of kinesiology Type of resource Text Extent 145 str. File origin Born digital Access conditions Open access Terms of use Created on 2023-05-26 06:38:43
