| Abstract | Definicija cerebralne paralize tijekom povijest se često razmatrala, razvijala i mijenjala, a danas je najraširenija ona teza prema kojoj cerebralna paraliza (CP) označuje skupinu promjenjivih, neprogresivnih, ali trajnih poremećaja pokreta i / ili posture i motoričkih funkcija uzrokovanih oštećenjem nezrelog mozga i / ili mozga u razvoju. Prema podatcima, u razvijenom svijetu od cerebralne paralize boluje 2-2,5 od 1000 djece, a najčešće je zastupljen spastični oblik (75%). Obzirom na navedeno, CP se definira kao najčešći uzrok težih neuromotoričkih odstupanja kod djece. U literaturi pažnja se pridaje i pridruženim teškoćama kao što su: epilepsija, oštećenje senzorike vida i sluha, usporen neuromotorički razvoj, nespretnost fine i grube motorike, smetnje ponašanja, razvoja govora, kognitivnog razvoja i specifične smetnje učenja.
Posturalna kontrola definirana je kao posturalna stabilnost, odnosno sposobnost održavanja željene statičke i dinamičke posturalne orijentacije čime se omogućava izvršavanje mnogobrojnih radnji u različitim položajima tijela s obzirom na utjecaj sile gravitacije. Posturalni razvoj djece s CP zaostaje u odnosu na posturalni razvoj djece urednog razvoja, što je vidljivo već u ranom razvojnom razdoblju djeteta i ometa njihovo djelovanje u svakodnevnim aktivnostima. Najveća poteškoća posturalne kontrole djece s CP uključuje smanjen opseg i varijabilnost kretanja, lošu kontrolu brzine kretanja i perceptivne nedostatke u kretanju te im je smanjena mogućnost modulacije stupnja posturalne kontrakcije mišića u različitim situacijama.
Cilj ovog rada je predstaviti dosadašnje spoznaje o CP i razvoju posturalne kontrole kod djece s CP pregledom postojećih istraživanja o navedenoj problematici. U radu će se definirati tri teorije o razvoju posturalne kontrole : Neuralna maturacijska teorija (NMT) , Teorija dinamičkih sustava (DST) i Teorija odabira neuronskih grupa (NGST) kao i instrumenti procjene posturalne kontrole. |
| Abstract (english) | The definition of cerebral palsy throughout history has often been considered, developed and changed, and today the most widespread is the thesis according to which cerebral palsy (CP) refers to a group of variable, non-progressive, but permanent disorders of movement and/or posture and motor functions caused by damage to the immature brain and/or the developing brain. According to data, in the developed world every 2-2.5 out of 1000 children suffer from cerebral palsy, and the spastic form is the most common (75%). Considering the above, CP is defined as the most common cause of severe neuromotoric deviations in children. Throughout the literature, attention is also paid to associated difficulties such as: epilepsy, visual and hearing sensory impairment, delayed neuromotoric development, clumsiness of fine and gross motor skills, behavioral disorders, speech development, cognitive development and specific learning disabilities.
Postural control is defined as postural stability, that is, the ability to maintain the desired static and dynamic postural orientation, which enables the execution of numerous actions in different positions of the body with regard to the influence of the force of gravity. The postural development of children with CP lags behind the postural development of children with normal development, which is already visible in the early development period of the child and hinders their performance in everyday activities. The biggest difficulty in postural control of children with CP includes reduced range and variability of movement, poor control of movement speed and perceptual deficits in movement, and their ability to modulate the degree of postural muscle contraction in different situations is reduced.
The aim of this paper is to present the current findings and knowledge about cerebral palsy and the development of postural control in children with cerebral palsy by reviewing the literature, that is, existing research on the aforementioned issue. The paper will define three theories on the development of postural control: The Neural-Maturationist Theories (NMT), Dynamic Systems Theory (DST) and Neuronal Group Selection Theory (NGST) as well as assessment instruments for postural control. |
