scholarly journals Association between Gait Deviation Index and Physical Function in Children with Bilateral Spastic Cerebral Palsy: A Cross-Sectional Study

2019 ◽  
Vol 9 (1) ◽  
pp. 28 ◽  
Author(s):  
Tadashi Ito ◽  
Koji Noritake ◽  
Hiroshi Sugiura ◽  
Yasunari Kamiya ◽  
Hidehito Tomita ◽  
...  

This study examined the association between Gait Deviation Index (GDI) and the five-times-sit-to-stand test (FTSST) or gait speed results, which represent mobility and muscle strength of the lower extremities in ambulatory children with Gross Motor Function Classification System (GMFCS) level I and II spastic cerebral palsy. In this cross-sectional, observational study, three-dimensional gait analysis data were obtained during gait trials to evaluate the GDI in 35 children (age 5–16 years) with spastic palsy. Motor function was evaluated using FTSST and gait speed. Gross motor function was evaluated using GMFCS. Children with GMFCS level II spastic cerebral palsy demonstrated lower GDI (p < 0.001) and poorer FTSST (p = 0.031) than those with GMFCS level I spastic cerebral palsy. Correlation analysis showed that FTSST results were significantly correlated with GDI (r = −0.624; p < 0.001). Motor function may be important for the maintenance of gait quality in patients with GMFCS level I and II spastic cerebral palsy and should not be ignored. In conclusion, reduction in gait impairment may affect the values of FTSST and GDI in patients with spastic cerebral palsy who can ambulate without an assistive device.

2009 ◽  
Vol 89 (12) ◽  
pp. 1304-1314 ◽  
Author(s):  
Robert J. Palisano ◽  
Lin-Ju Kang ◽  
Lisa A. Chiarello ◽  
Margo Orlin ◽  
Donna Oeffinger ◽  
...  

Background Through social and community participation, children and youth with cerebral palsy (CP) form friendships, gain knowledge, learn skills, express creativity, and determine meaning and purpose in life. Objective The purposes of this study were: (1) to determine whether social and community participation of children and youth with CP differ based on age, sex, and gross motor function, and (2) to identify the types of activities in which social and community participation are highest. Design and Methods A prospective cross-sectional analytic design was used. The participants were a sample of convenience of 291 children (6–12 years of age) and 209 youth (13–21 years of age) with CP (55.4% males, 44.6% females) receiving services from 7 children's hospitals. Participants completed the Children's Assessment of Participation and Enjoyment (CAPE) by structured interview. Gross Motor Function Classification System (GMFCS) level was determined by the researchers. Results Youth did a higher percentage of activities with friends and others and outside the home than children. Children and youth in level I did a higher percentage of activities with friends and others compared with children and youth in levels II and III and in levels IV and V. Children and youth in level I and in levels IV and V did a higher percentage of activities outside the home than children and youth in levels II and III. Differences were not found between females and males. The percentage of activities done with friends and others and outside the home was highest for physical and skill-based activities. Limitations Findings cannot be attributed only to GMFCS level. Conclusions The ability to walk without restrictions is desirable for social and community participation. For children and youth with CP who have limitations in mobility, physical therapists have roles as consultants for accessibility, activity accommodations, and assistive technology and as advocates for inclusive environments.


2019 ◽  
Vol 50 (03) ◽  
pp. 170-177 ◽  
Author(s):  
Yeo Seung Mi ◽  
Lee Ji Young ◽  
Shin Hye Yeon ◽  
Seo Yun Sik ◽  
Kwon Jeong Yi

Objective This study was aimed to identify individual factors influencing the gross motor outcome of hippotherapy in children with cerebral palsy (CP). Methods One hundred and forty-six children with CP (mean age: 5.78 ± 1.72 years, male: 56.2%) presenting variable function (gross motor function classification system [GMFCS], levels I–IV) participated in this study. Participants received 30 minutes of hippotherapy twice a week for 8 weeks. Clinical information including GMFCS level, age, sex, CP distribution, CP type, gross motor function measure-88 (GMFM-88), GMFM-66, and pediatric balance scale (PBS) score were collected retrospectively. We regarded the children with GMFM-66 score increased by 2.0 points as good responders to hippotherapy. Further we analyzed factors affecting good responders. Results GMFCS level I and II compared with IV (odds ratio [OR] = 6.83) and III compared with IV (OR = 4.45) were significantly associated with a good response to hippotherapy. Higher baseline GMFM E (OR = 1.05) and lower baseline GMFM B (OR = 0.93) were also significantly associated with a good response to hippotherapy. Sex, age, CP type, and distribution were not factors influencing gross motor outcome of hippotherapy. Conclusions The children with CP, GMFCS level I–III, with relatively poor postural control in sitting might have a greater chance to improve their GMFM-66 scores through hippotherapy. This supports the hypothesis that hippotherapy is a context-focused therapy to improve postural control in sitting.


2000 ◽  
Vol 80 (10) ◽  
pp. 974-985 ◽  
Author(s):  
Robert J Palisano ◽  
Steven E Hanna ◽  
Peter L Rosenbaum ◽  
Dianne J Russell ◽  
Stephen D Walter ◽  
...  

Abstract Background and Purpose. Development of gross motor function in children with cerebral palsy (CP) has not been documented. The purposes of this study were to examine a model of gross motor function in children with CP and to apply the model to construct gross motor function curves for each of the 5 levels of the Gross Motor Function Classification System (GMFCS). Subjects. A stratified sample of 586 children with CP, 1 to 12 years of age, who reside in Ontario, Canada, and are known to rehabilitation centers participated. Methods. Subjects were classified using the GMFCS, and gross motor function was measured with the Gross Motor Function Measure (GMFM). Four models were examined to construct curves that described the nonlinear relationship between age and gross motor function. Results. The model in which both the limit parameter (maximum GMFM score) and the rate parameter (rate at which the maximum GMFM score is approached) vary for each GMFCS level explained 83% of the variation in GMFM scores. The predicted maximum GMFM scores differed among the 5 curves (level I=96.8, level II=89.3, level III=61.3, level IV=36.1, and level V=12.9). The rate at which children at level II approached their maximum GMFM score was slower than the rates for levels I and III. The correlation between GMFCS levels and GMFM scores was −.91. Logistic regression, used to estimate the probability that children with CP are able to achieve gross motor milestones based on their GMFM total scores, suggests that distinctions between GMFCS levels are clinically meaningful. Conclusion and Discussion. Classification of children with CP based on functional abilities and limitations is predictive of gross motor function, whereas age alone is a poor predictor. Evaluation of gross motor function of children with CP by comparison with children of the same age and GMFCS level has implications for decision making and interpretation of intervention outcomes.


2020 ◽  
Vol 2 (3) ◽  
pp. 1-7
Author(s):  
Alaa Noureldeen Kora ◽  
Faten Hassan Abdelaziem

Delayed development of the gross motor function abilities is the main manifestation of cerebral palsy (CP) in all children affected by it. Rebound therapy was introduced to help children with different disabilities such as CP. The aim of this case study was to assess the effect of the rebound therapy on the gross motor function abilities in a child with spastic CP. An eight year old girl with spastic CP of Level I on the gross motor function classification system (GMFSC) and graded 1 on the Modified Ashworth Scale (MAS) was selected to undergo the rebound therapy program using mini trampoline. Gross motor abilities were assessed pre- and post- rebound therapy program. The program was conducted for three successive months - three times / week for half an hour / session. The comparison of pre- and post- treatment results showed that rebound therapy improved the total gross motor function abilities by 3.8%, the sitting function by 5%, the kneeling and crawling functions by 3%, the standing function by 2.7% and the walking, running and jumping functions by 8% in a child with spastic CP. Rebound therapy was effective in improving gross motor function abilities in a child with spastic CP. However, further randomized control trials are recommended.


2020 ◽  
Vol 2 (3) ◽  
pp. 1-7
Author(s):  
Alaa Noureldeen Kora ◽  
Faten Hassan Abdelaziem

Delayed development of the gross motor function abilities is the main manifestation of cerebral palsy (CP) in all children affected by it. Rebound therapy was introduced to help children with different disabilities such as CP. The aim of this case study was to assess the effect of the rebound therapy on the gross motor function abilities in a child with spastic CP. An eight year old girl with spastic CP of Level I on the gross motor function classification system (GMFSC) and graded 1 on the Modified Ashworth Scale (MAS) was selected to undergo the rebound therapy program using mini trampoline. Gross motor abilities were assessed pre- and post- rebound therapy program. The program was conducted for three successive months - three times / week for half an hour / session. The comparison of pre- and post- treatment results showed that rebound therapy improved the total gross motor function abilities by 3.8%, the sitting function by 5%, the kneeling and crawling functions by 3%, the standing function by 2.7% and the walking, running and jumping functions by 8% in a child with spastic CP. Rebound therapy was effective in improving gross motor function abilities in a child with spastic CP. However, further randomized control trials are recommended.


Author(s):  
Wardah Rauf ◽  
Samia Sarmad ◽  
Iqra Khan ◽  
Muhammad Jawad ◽  
Admin

Abstract Objective: To evaluate the effect of positioning on gross motor function and spasticity in spastic quadriplegic cerebral palsy children with Gross Motor Function Classification System level IV and V. Methods: A quasi-experimental study was conducted at two Paediatric Physical Therapy Centres from November 2018 to July 2019. The study was comprised of seventy four children with quadriplegic cerebral palsy aged between 3 to 8 years. Data was obtained and gross motor functional abilities and spasticity were assessed by GMFM-88 and Modified Ashworth Scale respectively. Twenty four-hour positioning in specific seats, night positioning and standing frames for six months. The child was being positioned in 24 hours according to his challenges for the period of six months. Semi reclined positioning was performed to manage aspiration, oral leak and to develop retention. Prone positioning was done to develop righting reactions, functional sitting position was used in the treatment regime to attain better upright position and neutral pelvic standing using standing frames. SPSS 24 was used to analyse the data. Results: Paired t-test reported significant improvement in the test scores in lying position, rolling, sitting position, crawling, kneeling, standing, walking or running. n=59 subjects exhibited improvement in the spasticity before and after interventional procedures, while n=15 showed no improvement as the value of p<0.05. Conclusion: Twenty-Four-hour proper body positioning and postural techniques improved gross motor functioning in all of the five dimensions of functioning. The overall spasticity in quadriplegic cerebral palsy children was also reduced due to appropriate positioning techniques.  Continuous....


2021 ◽  
Vol 1 ◽  
pp. 430-438
Author(s):  
Khusnah Khauliya ◽  
A Abdurrachman

AbstractSpastic Cerebral Palsy is a type of Cerebral Palsy that experiences stiffness or tightness of the muscles. These muscles become stiff because messages to the muscles are conveyed incorrectly by the damaged part of the brain. The presence of spasticity will affect gross motor function disorders in children with cerebral palsy. One of the physiotherapy approaches to improve gross motor function is hippotherapy. This literature review study aims to describe gross motor function in Spastic Cerebral Palsy children after giving hippotherapy from several articles. The selection of articles in this study was a literature review analysis using the PICO method, five articles were obtained for review from several data bases such as PubMed (n=2) and Google Scholar (n=3). The measuring instrument uses GMFM (Gross Motor Function Measure) to measure gross motor function in Spastic Cerebral Palsy children. The results of the literature review analysis in these five articles indicate that hippotherapy can improve gross motor function in Spastic Cerebral Palsy children with an average value before the action of 63.65 and after the action of 66.68. From the results of the literature review of these five articles, it shows that hippotherapy is proven to improve gross motor function in Spastic Cerebral Palsy children before and after giving intervention with hippotherapy modality with an average difference of 3.03. Hippotherapy can be used as a reference material for interventions or research materials or physiotherapy research, especially in pediatric cases.Keywords: GMFM; spastic cerebral palsy; hippotherapy AbstrakCerebral Palsy Spastik merupakan salah satu jenis Cerebral Palsy yang mengalami kekakuan atau keketatan otot-otot. Otot ini menjadi kaku karena pesan pada otot disampaikan secara tidak benar oleh bagian otak yang rusak. Adanya spastisitas akan berpengaruh terhadap gangguan fungsi motorik kasar pada anak Cerebral Palsy. Salah satu pendekatan fisioterapi untuk meningkatkan fungsi motorik kasar adalah hippotherapy. Penelitian literature review ini bertujuan untuk mengetahui gambaran fungsi motorik kasar pada anak Cerebral Palsy Spastik setelah pemberian hippotherapy dari beberapa artikel. Pemilihan artikel pada penelitian ini yaitu analisis literature review dengan metode PICO, didapatkan lima artikel untuk direview dari beberapa data base sepertiPubMed (n=2) dan Google Scholar (n=3). Alat ukur menggunakan GMFM (Gross Motor Function Measure) untuk mengukur fungsi motorik kasar pada anak Cerebral Palsy Spastik. Hasil analisis literature review pada kelima artikel ini menunjukkan bahwa hippotherapy dapat meningkatkan fungsi motorik kasar pada anak Cerebral Palsy Spastik dengan nilai rata-rata sebelum tindakan 63,65 dan sesudah tindakan 66,68. Dari hasil literature review kelima artikel ini menunjukkan bahwa hippotherapy terbukti dapat meningkatkan fungsi motorik kasar pada anak Cerebral Palsy Spastik sebelum dan sesudah pemberian intervensi dengan modalitas hippotherapy dengan hasil selisih rata-rata sebesar 3,03. Hippotherapy dapat digunakan sebagai bahan acuan untuk intervensi maupun bahan riset atau penelitian fisioterapi khususnya pada kasus pediatric.Kata kunci : GMFM;cerebral palsy spastik;hippotherapy


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