Sensory and Motor Proficiency For Children With Spina Bifida
Condition: Spina Bifida; Sensory Disorder; Motor Disorders; Upper Extremity Dysfunction
MeSH terms: Spinal Dysraphism; Sensation Disorders; Motor Disorders
Study type: Observational

Summary: 
      Spina bifida is one of the neural tube defects that cause neuromuscular dysfunction. Spina
      bifida is a disease accompanied by motor paralysis, musculoskeletal problems, Arnold-Chiari
      malformation, osteoporosis, hydrocephalus, upper limb coordination disorder. The affected
      upper extremity functionality and hand skills are very important for independence in daily
      living activities.

      There are some studies in the literature showing that upper extremity motor function is
      affected in patients with spina bifida. However, no study was found in which the upper
      extremity was investigated in terms of sensory and motor proficiency.The social and
      professional aspects of the upper extremity are of great importance.Therefore, our study aims
      to investigate the effects of upper extremity sensory and motor proficiency in patients with
      spina bifida
    

Detailed description: 
      This study aims to examine the relationship between hand skills and upper extremity
      functional level patients with spina bifida. Fifteen patients with spina bifida and 20
      healthy subjects as a control group aged 8-12 years living in Denizli province were included
      in the study. The participants were informed about the research and read the voluntary
      consent form, and written consent was obtained from their families since the participants
      were children.

      Children with literate, well cooperated, aged 8-12 years, and attending any primary school
      were included in the study. Children who had a second illness and could not be contacted were
      not included in the study. Non-dominant and dominant extremities of all cases were evaluated
      by the tests. It was recorded socio-demographic data were questioned. Sensory evaluation
      forms for upper extremities, Bruininks-Oseretsky motor proficiency, and ability tests were
      administered by a physiotherapist.

      All sensory evaluations; In a quiet, bright, warm room with only the physiotherapist and the
      subject, the evaluation was made while the subject was sitting in a chair with back support.

        -  Stereognosis: For the evaluation of stereognosis, the subject was asked to recognize the
           materials placed in his hand by using a pen, paper, clip, cotton, and coin while his
           visual field was closed. Both dominant and nondominant extremities were evaluated.

        -  Graphesthesia: When the visual field is closed, square, triangle, circle, and cross
           signs drawn on the palms of the subjects were asked to know these shapes.

        -  Finger identification: The patient's fingers were numbered and the patient was asked to
           know which finger was touched by touching his finger while his visual field was closed,
           verbally or by showing.

        -  Kinesthetic sense of hands: A total of 9 evaluations were made, the first of which was a
           trial, while the patient's visual field was closed. The evaluation was made for both
           dominant and nondominant extremities. The evaluation was made with both eyes open and
           closed.8 Evaluation under the title of visual and kinesthetic kinesthesia was scored
           between 0-3.

        -  The motor proficiency and ability level of the cases were evaluated with the
           Bruininks-Oseretsky Test, which is used to evaluate the motor abilities of children aged
           4.5-14.5 years in pediatric rehabilitation. The test consists of a total of 46 tests, 8
           of which are subtests. Subtests to be applied to the patients in the study: Drawing
           lines through the path and folding paper tests were performed for the fine motor
           precision test.

      Copying a square and copying star tests were applied for fine motor integration.

      Transferring coins has been applied for manual dexterity. The case took the coin with the
      dominant hand and puts it in the box with the non-dominant hand. The number of coins left in
      the well in 15 seconds is calculated. The case was given 2 attempts.For upper extremity
      coordination, the tests of dropping and catching the ball with both hands and dribbling the
      ball with alternating hands were applied. For the test of dropping and catching the ball with
      both hands, the subject was given a tennis ball and asked to catch the ball by throwing it on
      the ground with both hands. A trial was allowed before starting the test.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Fifteen patients with spina bifida and 20 healthy subjects as a control group aged 8-12
        years living in Denizli province were included in the study.
      
Keywords: spina bifida; upper extremity function; sense; motor function