Veština korišćenja invalidskih kolica kod osoba sa cerebralnom paralizom
Abstract
Uvod: Cerebralna paraliza je termin koji podrazumeva grupu neprogresivnih, ali često promenljivih simptoma motoričkog oštećenja, kretanja i posture. Pomenuta motorička oštećenja zahtevaju upotrebu različite asistivne tehnologije, a najčešća je upotreba invalidskih kolica. Svaki korisnik kolica je jedinstven i nema „standardnih“ kolica za određeni oblik onesposobljenosti.
Cilj: Cilj ovog istraživanja je da se utvrdi stepen samostalnosti osoba sa cerebralnom paralizom pri upravljanju invalidskim kolicima u zavisnosti od težine oboljenja, anatomskog i funkcionalnog stanja, kao i utvrditi u kojoj meri se korisnici invalidskih kolica suočavaju sa arhitektonskim barijerama i koliko ih uspešno prevazilaze.
Materijal i metode: Studija je obuhvatila 40 ispitanika sa dijagnozom cerebralne paralize koji koriste manuelna invalidska kolica. Kao merni instrumenti korišćeni su sledeći upitnici: Standardizovani upitnik za procenu sposobnosti savladavanja arhitektonskih barijera u zatvorenom prostoru - Power Mobility Indoor Driving Assessment (PIDA score), Upitnik za procenu samostalnosti pri upravljanju manuelnim invalidskim kolicima - Wheelchair Skills Test (WST) Version 4. 2 i Nestandardizovani upitnik za procenu stanja i potreba korisnika u invalidskim kolicima, koji je dizajniran za potrebe ovog istraživanja. Statistkička obrada podataka izvršena je pomoću metode deskriptivne statistike.
Rezultati: Analiziranjem rezultata iz korišćenih testova dobijeno je da 65% ispitanika spada u kategoriju kompletne zavisnosti prilikom prevazilaženja arhitektonskih barijera u zatvorenom prostoru, da je 62,5% ispitanika potpuno nesamostalno pri upravljanju invalidskim kolicima, da je najviše potrebna pomoć pri kretanju i obavljanju aktivnosti samozbrinjavanja, a da najveći procenat ispitanika, pored invalidskih kolica, ne koristi drugu asistivnu tehnologiju.
Zaključak: Dobijeni rezultati potvrđuju da je stepen samostalnosti osoba sa cerebralnom paralizom koje koriste invalidska kolica nizak i da je pomoć pri savladavanju arhitektonskih barijera potrebna kod preko 50% ispitanika. Takođe, uočeno je da su upitnici koji su primenjivani u svrhu ovog istraživanja pokazali značajnu primenu u idetifikaciji kako samih arhitektonskih barijera, tako i nivoa potrebne pomoći u savladavanju istih.
Ključne reči: cerebralna paraliza, invalidska kolica, samostalnost, barijere, sposobnosti.
References
Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, Dan B, Jacobsson B. A report: the definition and classification of cerebral palsy. Developmental Medicine and Child Neurology 2007; 49: 8–14.
Gajdobranski Đ. (2009). Ortopedsko lečenje deformiteta lokomotornog aparata kod dece obolele od cerebralne paralize. Novi Sad: Medicinski fakultet.
Radojčić B. (1985). Bolesti nervnog sistema. Zagreb: Medicinska knjiga Beograd.
Panet N, Kiely J. (1984). The frequency of cerebral palsy: A review of population studies in indrustrialised nation since 1950. In Stanley F., Alberman E. Clinic and Developmental Medicine, No. 87, pp 46-56.
Capute AJ, Shapiro BK, Palmer FB.Spectrum of developmental disabilities: Continuum of motor disfunction. Orthopedic Clinic of North America 1981; 12(1): 3-22.
Rapaić D, Nedović G. (2011). Cerebralna paraliza praksičke i kognitivne funkcije. Beograd: Fakultet za specijalnu edukaciju i rehabilitaciju Beograd.
Gillam R, Thomas M, Martin F (2011). Communication Sciences and Disorders: From Science to Clinical Practice. Canada: Jones & Bartlett Learning.
Dimitrijević L. Primena ortoza u tretmanu cerebralne paralize. Novi Sad: 2009. Medicinski fakultet.
World Healthn Organization. (2001). Internacional classification of functioning, disability, and health (ICF). Geneva: Author.
Tefft D, Guerette P, Furumasu J. Cognitive predictors of young children's readiness for powered mobility. Developmental Medicine and Child Neurology 1999; 41(10): 665–670.
Fernandes T. Independent mobility for children with disabilities. International Journal of Therapy and Rehabilitation 2006; 13(7): 329–333.
Palisano RJ, Tieman BL, Walter SD, Bartlett DJ, Rosenbaum PL, Russell D, Hanna SE. Effect of environmental setting on mobility methods of children with cerebral palsy. Developmental Medicine and Child Neurology 2003; 45(2): 113–120.
Salminen AL, Brandt A, Samuelsson K, Toytari O, Malmivaara A. Mobility devices to promote activity and participation: a systematic review. Journal of Rehabilitation Medicine 2009; 41(9):697–706.
Kovač, I. Invalidska kolica: pomagalo za kretanje kod neuroloških bolesnika. Dialog 2007; 7: 2-7.
Lazor M, Isakov M, Ivković N. (2012). Asistivna tehnologija u školi. Novi Sad: Škola za osnovno i srednje obrazovanje “Milan Petrović” sa domom učenika.
Rodby-Bousquet E, Hägglund G. Use of manual and powered wheelchair in children with cerebral palsy: a cross-sectional study. BMC Pediatrics 2010; 10: 59.
Jutai J, Bayley M, Teasell R, Hartley M. (2003). Psychosocial impact of assistive technology devices in stroke. In G. C. et al (Ed.), Assistive technology - Shaping the future. Washington, DC: IOS Press.
Brandt A, Iwarsson S, Stahle A. Older people's use of powered wheelchairs for activity and participation. Journal of Rehabilitation Medicine 2004; 36(2): 70-77.
Brechtelsbauer DA, Louie A. Wheelchair use among long-term care residents. Annals of Long-Term Care 1999; 7(6): 213-220.
Verschuren O, Zwinkels M, Ketelaar M. Reproducibility and validity of the 10-meter shuttle ride test in wheelchairusing children and adolescents with cerebral palsy. Phyical Therapy 2013; 93: 967–974.
MacPhee AH, Kirby RL, Coolen AL, Smith C, MacLeod DA, Dupuis DJ. Wheelchair Skills Training Program: a randomized clinical trial of wheelchair users undergoing initial rehabilitation. Arch Phys Med Rehabil 2004: 85: 41-50.
Dawson D, Chan R, Kaiserman E. Development of the power-mobility indoor driving assessment for residents of long-term care facilities: A preliminary report.
Dawson D, Kaiserman-Goldenstein E, Chan R, Gleason J. (2006). Power mobility indoor driving assessment manual (PIDA), Retrieved May 12, 2015, from http://fhs.mcmaster.ca/powermobility/pida.htm
Kirby L, Smith C, Parker K, MacLeod DA, McAllister M, Rushton PW, Routhier F. (2013). Wheelchair skills test (WST) version 4.2 manual. Retrieved April 3, 2013. from: https://wheelchairskillsprogram.ca/eng/testers.php
Routhier FO, Voncent C, Desrosiers J, Nadeau S. Mobility of wheelchair users: a proposed performance assessment framework. Disability and Rehabilitation 2003; 25(1): 19-34.
Mortenson WB, Miller WC, Steele B, Crawford EM, Desharnais G. Perceptions of power mobility use and safety within residential facilities. Canadian Journal of Occupational Therapy 2005; 72(3): 142–152.
Kilkens O, Post M, Dallmeijer AJ, Floris WA, Asbeck MD, Lucas HV. Relationship between manual wheelchair skill performance and participation of persons with spinal cord injuries 1 year after discharge from inpatient rehabilitation. Journal of Rehabilitation Research & Development 2005; 42(3): 65–74.
Hall K, Partnoy J, Tenenbaum S, Dawson DR. Power mobility driving training for seniors: A pilot study. Assistive Technology 2005; 17(1): 47-56.
Hoenig H, Landerman L, Shipp K, George L. Activity restriction among wheelchair users. Journal of the American Geriatrics Society 2003; 51: 1244–1251.
Sawatzky B, Rushton PW, Denison I, McDonald R. Wheelchair skills training programme for children: A pilot study. Australian Occupational Therapy Journal 2012; 59: 2–9.
Raina P, O'Donnell M, Schwellnus H, Rosenbaum P, King G, Brehaut J. Caregiving process and caregiver burden: Conceptual models to guide research and practice. BMC Pediatrics 2004; 4: 1-13.
Porter D. Patterns of postural deformity in non-ambulant people with cerebral palsy: what is the relationship between the direction scoliosis, direction of pelvic obliquity, direction of windswept hip deformity and side of hip dislocation. Clinical Rehabilitation 2007; 21: 1087-1096.
Andre E, Grimbyoe G. Dependence and perceived diculty in activities of daily living in adults with cerebral palsy and spina bifida. Disability and rehabilitation 2000; 22(7): 299-307.