22 KB358 KB21 KB200820252013Groleger, KatjaOsrečki, KsenijaVrečar, Irenaletnik:12številka:3str. 54-58ISSN:1580-9315COBISSID:1843817URN:URN:NBN:SI:doc-LDFDGD8VslUniverzitetni rehabilitacijski inštitut Slovenije - SočaRehabilitacija (Ljubljana)Cerebral Palsycerebralna paralizaChildkolčni sklepOrthotic Devicesortotski pripomočkiortozeotrociSWASH orthosisAnaliza predpisovanja in uporabe ortoze za kolk z medenično košaro pri otrocih s cerebralno paralizo od leta 2007 do 2012| Sitting, walking and standing hip orthosis for children with cerebral palsy - an analysis of prescriptions in the 2007-2012 period|Introduction: Displacement or dislocation of the hip is a common complication in children with cerebral palsy, particularly in children who are classified as level IV or V of the Gross Motor Function Classification System (GMFCS). We found little evidence of the potential effectiveness of Sitting, Walking and Standing Hip (SWASH) orthosis in the literature. We therefore wanted to check how many children were prescribed with a SWASH orthosis in the period from 2007 to 2012 at our Institute, what their GMFCS level was and whether they had hips position evaluated by X-ray. We also wanted to check whether any of the children had to be operated because of hip dislocation after being fitted with a SWASH orthosis. Methods: A retrospective analysis of patient records was performed for all children with prescribed SWASH orthosis in the period from 2007 to 2012, including data on their GMFCS level, results of hip X-ray and data on surgeries required because of hip dislocation. Results: SWASH orthosis was prescribed to 30 children, 26 with cerebral palsy. Of these, 19 children were classified as GMFCS level V and 10 children as level IV. Only 10 children had been examined by X-ray. Of these, one half had a good position of the hips or partial dislocation whereas the other half had already been operated because o fhip dislocation. In only one of the children surgery was required subsequently. After fitting the SWASH orthosis, physiotherapists reported a better sitting position in 11children; other four children had more appropriate alignment of lower extremities when sittingIzhodišča: Delni ali popolni izpah kolka je pogost zaplet pri otrocih s cerebralno paralizo. Predvsem je pogost pri tistih otrocih, ki spadajo v četrto in peto stopnjo lestvice za razvrščanje glede na grobe gibalne sposobnosti (GMFCS). V literaturi smo našli le malo podatkov o morebitni učinkovitosti ortoze za kolk z medenično košaro (SWASH), zato smo želeli preveriti, koliko otrokom smo od leta 2007 do 2012 sploh predpisali ortozo, kakšne so bile njihove sposobnosti gibanja in ali so imeli opravljeno rentgensko slikanje kolkov. Želeli smo tudi preveriti, ali se je pri katerem izmed otrok, ki smo mu predpisali ortozo, zgodilo, da je bila potrebna operativna korekcija zaradi zelo slabega položaja glave stegnenice v kolku ali pa celo izpaha kolka. Metode: Retrospektivno smo iz dokumentacije zbrali podatke o vseh predpisanih ortozah za kolk z medenično košaro od leta 2007 do 2012, o sposobnostih gibanja in rezultatih rentgenskega slikanja medenice s kolki ter podatke o morebitnih operativnih posegih zaradi izpaha kolka. Rezultati: Od leta 2007 do 2012 je ortozo dobilo 30 otrok, od tega 26 s cerebralno paralizo. Od teh jih je 19 spadalo v V. stopnjo GMFCS, 10 otrok pa v IV. stopnjo. Le 10 otrok je po podatkih iz dokumentacije opravilo rentgensko slikanje medenice s kolki. Izmed teh jih je polovica imela dober položaj kolkov ali pa delni izpah, druga polovica pa je bila zaradi izpaha kolka že pred opremo z ortozo operirana. Le pri enem izmed otrok je bil zaradi slabega položaja glave stegnenice v kolčnem sklepu pozneje potreben operativni poseg. Po namestitvi ortoze SWASH je bilo v dokumentaciji pri 11 otrocih zapisano, da so zmogli bolje sedeti, pri štirih je bilo zapisano, da so imeli spodnje ude pri sedenju primerneje poravnane.Zaključek: Vloga ortoze SWASH pri zadrževanju slabšanja položaja kolkov ali pa celo izboljšanja položaja ostaja nejasnaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverzitetni rehabilitacijski inštitut RS – Soča