Effect of position on gross motor function and spasticity in spastic cerebral palsy children

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....

2019 ◽  
Vol 8 (1) ◽  
pp. 13-18
Author(s):  
Zeenat Fatima ◽  
Yarmiyah Rashaquat

OBJECTIVES To determine the effects of hydrotherapy therapy on spastic cerebral palsy children using Modified ashworths scale and Gross motor functional classification scale after 32 weeks of training protocol. STUDY DESIGN Quasi experimental study STUDY SETTING Liaquat National Hospital PARTICIPANTS Spastic (diplegic, hemiplegic and quadriplegic) cerebral palsy children INTERVENTIONS 58 Spastic Cerebral Palsywere assessed on the basis of modified Ashworth scale and gross motor function measure for spasticity and change in gross motor function respectively. Assessment was done, before and at the end of 10th week. Each therapy session was of 40-45 minutes thrice a week in a pool with the temperature maintained at 32°C-34°C and at the end cool down activities were performed. RESULTS Results indicated marked improvement in Muscle tone and Gross Motor Functioning of the enrolled children with p=0.001. CONCLUSIONS It was concluded that pool therapy is effective in reducing spasticity and improving gross motor functions among CP.


2021 ◽  
pp. 1-6
Author(s):  
Åsa Andersson ◽  
Petra Lundström ◽  
Katarina Lauruschkus ◽  
Åsa B. Tornberg

Purpose: To investigate the acute exercise effects of dynamic standing exercise on blood glucose and blood lactate among children and adolescents with cerebral palsy who are nonambulant. Methods: Twenty-four participants with cerebral palsy who are nonambulant performed 30 minutes of dynamic standing exercise using a motorized device enabling assisted passive movements in an upright weight-bearing position. Capillary blood samples were taken from the fingertip for measurement of blood glucose and blood lactate at rest and at the end of exercise. Results: At rest, the participants had hyperlactatemia that was unaffected after exercise, presented as median and interquartile range at rest 1.8 (1.3:2.7) mmol/L, and after exercise 2.0 (1.1:2.5) mmol/L. Children and adolescents with Gross Motor Function Classification System, level V, had higher lactate levels at rest (2.5 [1.8:2.9] vs 1.4 [1.0:2.0]; P = .030) and after exercise (2.3 [2.0:2.6] vs 1.2 [0.9:2.2]; P = .032) compared with children and adolescents with Gross Motor Function Classification System, level IV, respectively. A statistically significant larger decrease in blood lactate levels after exercise was observed in children and adolescents with higher resting blood lactate levels (ρ = .56; P = .004). There were no statistically significant changes in blood glucose. Conclusions: Forty percentage of the participants had mild hyperlactatemia at rest and participants with the highest blood lactate levels at rest had the greatest decrease in blood lactate levels after one bout of exercise. Children and adolescents who were classified with the highest level of the Gross Motor Function Classification Scale had higher blood lactate levels. More studies are needed on how to prevent chronically high resting levels of lactate with exercise in children with cerebral palsy who are nonambulant.


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


2018 ◽  
Vol 52 (5) ◽  
pp. 581-586
Author(s):  
Indre Bakaniene ◽  
Gintare Urbonaviciene ◽  
Kristina Janaviciute ◽  
Audrone Prasauskiene

2017 ◽  
Vol 7 (1) ◽  
pp. 78-82
Author(s):  
G. Paszko-Patej ◽  
W. Kułak ◽  
B. Okurowska-Zawada ◽  
D. Sienkiewicz ◽  
J. Wojtkowski ◽  
...  

neuroinflammation and apoptosis in brains affected by cerebral palsy could be therapeutic targets. Granulocyte colony-stimulating factor (G-CSF) exerts anti-inflammatory and antiapoptosis effects and stimulates the proliferation of neural stem and progenitor cells in the brain. Purpose: To assess the efficacy and safety of G-CSF treatment in children and adolescents with CP. Materials and methods: Six patients with spastic tetraplegia CP aged 3-15 years were enrolled in this study. Five patients had GMFCS (Gross Motor Function Classification System) level at V, three children had epilepsy, and three had severe mental retardation. We used the gross motor function measure-66 (GMFM-66) to assess motor function.GCSF (5μg/kg/body/day) was administered subcutaneously for five consecutive days during the four months. The parents also evaluated the physical and mental development of their children. Results: We observed improvement in motor function in patients with CP on the GMFM-66 scale. Parents reported improvement in behavior, speech development, and a decrease in spasticity in children with CP. G-CSF therapy was well-tolerated. No side effects were observed during the study. Conclusions: Our preliminary report suggests that G-CSF treatment improves motor and mental function in patients with CP. Further studies are needed to confirm these observations


2020 ◽  
Vol 11 (4) ◽  
pp. 5158-5163
Author(s):  
Sathish G ◽  
Swarnakumari P ◽  
Mridhula K Abraham

To find out functional strength training exercise on improving gross motor function among the children with spastic hemiplegic cerebral palsy children. Single group pre-experimental research design. The most common cause of movement disability in infancy is cerebral palsy. Cerebral palsy patients have impairments such as spasticity, low muscle strength and selective motor control in their body function. Such deficiencies may limit activity performance and participation in everyday life. Improving and optimising activities and involvement are crucial treatment objectives. Functional strength workouts are vital to overcoming obstacles to improving the functionality of children with neurological issues. 92 subjects of spastic hemiplegic cerebral palsied aged 4-8, male and female with spastic hemiplegic cerebral palsy were selected under purposive sampling technique and received functional strength training exercise for a period of ten weeks. To assess the gross motor function (functional independence) pre and post the exercise program, Gross motor functional measure was used. Results: The pre and post measurements shows significant changes in the gross motor function among children with spastic hemiplegic cerebral palsy. The results of the post-test mean values show improvement in gross motor functions after functional strength training program (p<0.05). The functional strength training program proves that increased gross motor function and thereby improvement in functional abilities among children with spastic hemiplegic cerebral palsy after ten weeks of intervention.


2021 ◽  
Vol 42 (4) ◽  
pp. 60-74
Author(s):  
Hye-Yoon Lee ◽  
Young-Ju Yun ◽  
Yong-Beom Shin ◽  
Soo-Yeon Kim ◽  
Jun-hee Han ◽  
...  

Objectives: This study aimed to analyse: 1) the clinical effectiveness and safety of traditional Korean Medicine (TKM) and frequency of TKM therapies used and their relationship with conventional treatments.Methods: This prospective observational study enrolled children with cerebral palsy (CP) aged 6-78 months (n=126). The children who used herbal medication for >30 days or acupuncture treatment >12 sessions within 6 months were defined as the integrated rehabilitation (IR) group; the remaining participants were included in the conventional rehabilitation (CR) group.Results: Changes in the Gross Motor Function Measure-66 (GMFM-66) were greater in the IR group (6.4±6.1) than in the CR group (4.6±5.8). The reduction in the number of other health problems was greater in the IR group than in the CR group. The GMFM-66 improvement was greatest in gross motor function classification system level 1. There was no between-group difference in the frequency of rehabilitation therapy (10.9±6.6 and 12.0±9.9 in the IR and CR groups, respectively).Conclusion: TKM may offer additional benefits in terms of the GMFM-66 score and other health problems. However, there is a need for further randomized controlled trials involving a restricted CP type and a controlled treatment type and intensity to confirm these findings.


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