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Emara HA, Al-Johany AH, Khaled OA, Al-Shenqiti AM, Ali ARH, Aljohani MM, Sobh E. Effect of the Dynamic Orthotic Garment on Postural Control, and Endurance in Children with Spastic Diplegic Cerebral Palsy: A Randomized Controlled Trial. J Multidiscip Healthc 2024; 17:419-428. [PMID: 38314010 PMCID: PMC10838099 DOI: 10.2147/jmdh.s438474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/14/2023] [Indexed: 02/06/2024] Open
Abstract
Purpose To investigate the effect of dynamic orthotic garments (Thera togs) on foot pressure distribution, postural control, and endurance in children with spastic diplegic CP. Patients and Methods This is a single-blind randomized controlled clinical trial involving 34 (8-10 years) with spastic diplegic CP. The control group received conventional physical therapy (CPT), whereas the study group received CPT in addition to wearing TheraTogs. We recorded foot pressure distribution, trunk control measurement scale, trunk position sense, Pediatric Berg Balance Scale (PBS), and six-minute walking distance (6MWD). Results Both groups showed improvement. The study group had significant improvement in foot pressure distribution (p-value 0.003, 0.001, <0.001 for forefoot, midfoot, and rearfoot mean pressures respectively, and 0.005, <0.001, and 0.005 for forefoot, midfoot, and rearfoot peak pressures respectively), Pediatric balance scale, The trunk control measurement scale, and Trunk position sense (p-value < 0.001) and six-minute walking distance (p-value 0.029). Our data suggest that adding TheraTogs to conventional physiotherapy improves foot pressure, postural control, and endurance in children with spastic diplegic cerebral palsy. Conclusion Both TheraTogs and conventional physical therapy corrected foot pressure distribution, trunk control, improved balance, and increased 6MWD in children with spastic diplegic CP but the improvement was more significant in TheraTogs group. Clinical Trial Registration NCT05271149.
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Affiliation(s)
- Hatem A Emara
- Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia
- Department of Physical Therapy for Growth and Developmental Disorders in Children and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ahmed H Al-Johany
- Medical Rehabilitation Hospital, Ministry of Health, Medina, Saudi Arabia
| | - Osama A Khaled
- Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Abdullah M Al-Shenqiti
- Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia
| | - Abdul Rahman H Ali
- College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia
| | - Marwan M Aljohani
- Physical Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia
| | - Eman Sobh
- Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia
- Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
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Stergiou AN, Mattila-Rautiainen S, Varvarousis DN, Tzoufi M, Plyta P, Beris A, Ploumis A. The efficacy of Equine Assisted Therapy intervention in gross motor function, performance, and spasticity in children with Cerebral Palsy. Front Vet Sci 2023; 10:1203481. [PMID: 37649564 PMCID: PMC10464617 DOI: 10.3389/fvets.2023.1203481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/01/2023] [Indexed: 09/01/2023] Open
Abstract
Purpose To evaluate the efficacy of Equine Assisted Therapy in children with Cerebral Palsy, in terms of gross motor function, performance, and spasticity as well as whether this improvement can be maintained for 2 months after the end of the intervention. Methods Children with Cerebral Palsy participated in this prospective cohort study. The study lasted for 28 weeks, of which the equine assisted therapy lasted 12 weeks taking place once a week for 30 min. Repeated measures within the subject design were used for the evaluation of each child's physical performance and mental capacity consisting of six measurements: Gross Motor Function Measure-88 (GMFM-88), Gross Motor Performance Measure (GMPM), Gross Motor Function Classification System (GMFCS), Modified Ashworth Scale (MAS) and Wechsler Intelligence Scale for Children (WISC III). Results Statistically significant improvements were achieved for 31 children in Gross Motor Function Measure and all its subcategories (p < 0.005), also in total Gross Motor Performance Measure and all subcategories (p < 0.005). These Gross Motor Function Measure results remained consistent for 2 months after the last session of the intervention. Regarding spasticity, although an improving trend was seen, this was not found to be statistically significant. Conclusion and implications Equine Assisted Therapy improves motor ability (qualitatively and quantitatively) in children with Cerebral Palsy, with clinical significance in gross motor function.
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Affiliation(s)
- Alexandra N. Stergiou
- Division of Surgery, Department of Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece
- Ioannina Therapeutic Riding Center, Ioannina, Greece
| | | | | | - Meropi Tzoufi
- Division of Child’s Health, Department of Paediatrics, University of Ioannina Medical School, Ioannina, Greece
| | - Panagiota Plyta
- Division of Surgery, Department of Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece
- Ioannina Therapeutic Riding Center, Ioannina, Greece
| | - Alexandros Beris
- Division of Surgery, Department of Orthopaedics, University of Ioannina Medical School, Ioannina, Greece
| | - Avraam Ploumis
- Division of Surgery, Department of Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece
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Nawge S, Karthikbabu S. Does bimanual task training benefit manual ability and hand function of children with bilateral spastic cerebral palsy? J Pediatr Rehabil Med 2022; 16:49-57. [PMID: 36373302 DOI: 10.3233/prm-210109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Sixty percent of children with bilateral cerebral palsy have impaired hand function. The study's purpose was to examine the benefits of bimanual task practice on the manual ability and hand function of children with bilateral spastic cerebral palsy. METHODS In this pre-post study design, 18 children with bilateral spastic cerebral palsy with an average age of 11.5 (+/-1.9) years, Manual Ability Classification System levels I-III and Bimanual Fine Motor Function levels I-III participated in bimanual task practice of upper extremities. The task practice included clay activities, paper manipulation and activities of daily needs. The children underwent 45-minute training sessions 3 times a week over 6 weeks. The outcome measures were ABILHAND-Kids, Quality of Upper Extremity Skills Test and grip strength. RESULTS Post-training, a mean change of 6.44 logits in ABILHAND-Kids, 11 points on the Quality of Upper Extremity Skills Test, and 3.3 and 3.1 kilograms grip strength in the dominant and nondominant hands respectively were observed with a statistical significance (p < 0.05). CONCLUSION Bimanual task training might be beneficial in improving manual ability, hand function and grip strength in children with bilateral spastic cerebral palsy.
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Affiliation(s)
- Surabhi Nawge
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Hospital, Bangalore campus, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Suruliraj Karthikbabu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Hospital, Bangalore campus, Manipal Academy of Higher Education, Manipal, Karnataka, India.,KMCH College of Physiotherapy, Kovai Medical Center Research and Educational Trust, Coimbatore, The Tamil Nadu Dr M.G.R. Medical University, Chennai, India
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El Kafy EMA, El-Shamy SM. Efficacy of TheraTogs orthotic undergarment on modulation of spinal geometry in children with diplegic cerebral palsy. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2021. [DOI: 10.1186/s43161-021-00047-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The use of TheraTogs orthotic undergarments has been suggested to improve the ability to stabilize the posture, to correct or prevent deformities, to improve functionality, and to enable the user a more appropriate functional pattern. The aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on modulation of spinal geometry in children with diplegic cerebral palsy. Forty children with diplegic cerebral palsy, with ages ranging from 6 to 9 years, were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Spinal geometry was measured at baseline and after 3 months of intervention using the Formetric system.
Results
Children in both groups showed significant improvements in the spinal geometry (P < 0.05), with significantly greater improvements in the experimental group than the control group. The post-treatment mean values of lateral deviation (mm), pelvic tilt (mm), trunk imbalance (mm), and surface rotation (mm) were 5.45, 6.35, 8.8, and 3.65 and 8, 8.9, 11.2, and 5.9 for the experimental and control group, respectively.
Conclusions
TheraTogs orthotic undergarment may be a useful tool for improving spinal geometry in children with diplegic cerebral palsy.
Trial registration
This study was registered in the ClinicalTrial.gov PRS (NCT04271618).
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Sah AK, Balaji GK, Agrahara S. Effects of Task-oriented Activities Based on Neurodevelopmental Therapy Principles on Trunk Control, Balance, and Gross Motor Function in Children with Spastic Diplegic Cerebral Palsy: A Single-blinded Randomized Clinical Trial. J Pediatr Neurosci 2019; 14:120-126. [PMID: 31649770 PMCID: PMC6798271 DOI: 10.4103/jpn.jpn_35_19] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/19/2019] [Accepted: 06/03/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose: To examine the effects of task-oriented activities based on neurodevelopmental therapy (TOA-NDT) principles on trunk control, balance, and gross motor function in children with spastic diplegic cerebral palsy (SDCP). Materials and Methods: Forty-four children with SDCP, aged 7–15 years, were recruited to participate in the randomized clinical trial. After random allocation, twenty-two (n = 22) children with SDCP participated in TOA-NDT principles and twenty-two (n = 22) in conventional physiotherapy (CPT) program. Each group underwent the treatment for a duration of 60min per day, 6 days a week for 6 weeks. Gross motor function measure-88 (GMFM-88), postural assessment scale (PAS), pediatric balance scale (PBS), and trunk impairment scale (TIS) were the outcome measures used to document the pre- and post-intervention effect. Results: The mean difference of GMFM-88, PAS, PBS, and TIS was 8.53 (5.84–11.23), 0.90 (5.84–11.23), 4.86 (2.93–6.79), and 1.45 (0.30–2.60), respectively. TOA-NDT group showed improvement in all the outcomes. Conclusion: TOA-NDT principles are more beneficial in improving the trunk control, balance, and gross motor function parameters than CPT.
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Affiliation(s)
- Ajaya K Sah
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
| | | | - Sahana Agrahara
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
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Barela AMF, Gama GL, Russo-Junior DV, Celestino ML, Barela JA. Gait alterations during walking with partial body weight supported on a treadmill and over the ground. Sci Rep 2019; 9:8139. [PMID: 31148585 PMCID: PMC6544641 DOI: 10.1038/s41598-019-44652-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 05/21/2019] [Indexed: 11/29/2022] Open
Abstract
Understanding the changes induced by body weight support (BWS) systems when non-disabled adults walk can help develop appropriate rehabilitation protocols. The purpose of this study was to investigate spatial-temporal gait alterations during walking with BWS on a treadmill and over the ground. Fourteen non-disabled young adults (including seven women) walked over the ground and on a treadmill with 0%, 10%, and 20% of BWS at 80% of their self-selected comfortable walking speed (baseline). The stride length and speed, step length, and stance and double-limb support durations were calculated and compared among the different conditions. The non-disabled adults modulated their spatial-temporal gait parameters according to the surface and percentage of BWS. They walked with shorter and slower strides and shorter steps and spent more time in contact with the support surface as they walked on the treadmill than as they did over the ground. Walking on the treadmill promoted less variability and a higher rate of change than did walking over the ground. Both the surface and amount of BWS should be taken into consideration when using BWS systems for (re)learning and/or reestablishing gait.
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Affiliation(s)
- Ana Maria F Barela
- Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, Rua Galvão Bueno, 868, São Paulo, SP, Brazil.
| | - Gabriela L Gama
- Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, Rua Galvão Bueno, 868, São Paulo, SP, Brazil
| | - Douglas V Russo-Junior
- Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, Rua Galvão Bueno, 868, São Paulo, SP, Brazil
| | - Melissa L Celestino
- Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, Rua Galvão Bueno, 868, São Paulo, SP, Brazil
| | - José A Barela
- Department of Physical Education, Institute of Biosciences, São Paulo State University, Av. 24-A, 1515, Rio Claro, SP, Brazil
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