Faktor risiko yang memengaruhi keterlambatan perkembangan motorik kasar pasien sindrom down = Risk factors influences gross motoric development in children with down syndromes

Wulan Tristiyanti, author

Abstrak

ABSTRAK
Latar belakang : Sindrom Down merupakan penyakit genetik yang dapat

menyebabkan keterlambatan perkembangan motorik, bahasa, kognitif, dan

psikososial. Periode perkembangan anak dalam tiga tahun pertama kehidupan

sangat penting, karena merupakan dasar untuk hasil perkembangan selanjutnya.

Sampai saat ini belum dilakukan penelitian yang menghubungkan kemampuan

motorik pasien sindrom Down dengan faktor-faktor yang memengaruhinya.

Mengingat prevalensi anak sindrom Down yang cukup banyak di Indonesia, dan

belum didapatkan data tersebut maka penelitian dilakukan pada anaksindrom Down

sehingga anaksindrom Down mendapatkan hasil optimal dari program intervensi

yang dijalankan

Tujuan : Mengetahui karakteristik pertumbuhan dan perkembangan motorik anak

sindrom Down serta faktor yang memengaruhi tingkat perkembangan motorik kasar

untuk menentukan kemampuan anak, kebutuhan terapi dan meningkatkan kualitas

pelayanan.

Metode: Studi potong lintang deskriptif dan analitik selama Agustus sampai

September 2015 pada 103 anak sindrom Down usia 6 bulan - 3 tahun di Poli Anak

dan Poli Rehabilitasi medic Rumah Sakit Cipto Mangunkusumo (RSCM). Data

orang tua didapat dari autoanamnesis dan pencarian rekam medis, data

antropometrik berupa beratbadan, tinggi badan dan lingkar kepala diplot pada kurva

pertumbuhan khusus anak sindromDown, perkembangan motorik kasar dinilai

berdasarkan milestone khusus anak sindrom Down.

Hasil penelitian : Sejumlah 103 subjek (56 laki-laki, 47 perempuan) memenuhi

kriteria inklusi. Median subjek adalah 12 bulan. Jumlah subjek yang mengalami

gizi baik dan gizi kurang hampir sama. Mikrosefali dialami oleh sebagian kecil

subjek 10 (9,6%). Anak sindrom Down dengan tipe klasik ditemukan pada sebagian

besar pasien sebanyak 99 (96%) dan tipe translokasi sebanyak 4 (3,9%).

Keterlambatan motorik ringan dialami oleh 69,2% subjek, keterlambatan motorik

sedang 16,3%, dan keterlambatan motorik ringan 13,5%. Hasil analisis multivariate

memperlihatkan faktor risiko yang berhubungan dengan keterlambatan motorik

adalah lingkar kepala (p=0,011; OR 6,852; IK95% 1,565-30,038), riwayat asfiksia

(p=0,009; OR 4,033; IK95% 1,427-11,4), dan frekuensi program stimulasi

(p=0,006; OR 3,845; IK95% 1,460-10,125).

Kesimpulan : Lingkar kepala, riwayat asfiksia, dan frekuensi program stimulasi

merupakan faktor risiko keterlambatan perkembangan motorik anak sindromDown.ABSTRACT
Background : Down Syndrome is one of genetics disease that could cause delayed

motoric, language, cognitive, and psycho-social development. Development of the

first three years of life is crucial, because it is a basic for further development. Until

recently, there are not study which conducted to correlates motoric capabilities

Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of

child with Down Syndromes is quite high, there are no data depicted that

correlation;hence, this study was conducted in child with Down Syndromes so that

they obtained optimal outcome from intervention program conducted.

Aim: To know characteristics of motoric growth and development in children with

Down Syndromes and factors interfere degree of gross motoric development which

to determine children?s capability, needs therapy, and improves quality of service.

Methods : A descriptive cross-sectional study was conducted to 103 children with

Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and

Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo

(RSCM) during August to September 2015. Data were obtained by their parents

(auto-anamnesis) and medical records, anthropometric data comprised body

weight, body height, and head circumference which were plotted to special growth

curve of children with Down Syndromes, gross motoric developments were

assessed by special milestone of children with Down Syndromes.

Results : One hundred and three subjects were fulfilled as inclusion criterions.

Median subject was twelve months. Amount of subjects with good nutrition and

malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with

classical type of Down Syndromes were 99(96%) and translocation type were

4(3.9%). Children with mild motoric development were 69.2%, intermediate

motoric development were 16.3%, and severe motoric development were 13.5%.

Multivariate analysis showed risk factors correlates to motoric development were

head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of

asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation

programs (p=0,006; OR 3,845; CI95% 1,460-10,125).

Conclusion : Head circumference, history of asphyxia, and frequency of

stimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed