Editorial: Cerebral Palsy: New Developments

Effect of the Dynamic Orthotic Garment on Postural Control, and Endurance in Children with Spastic Diplegic Cerebral Palsy: A Randomized Controlled Trial

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.

Psychometric properties of the Obstacles and Curb tests and their discriminative ability across functional levels in ambulatory children with spastic cerebral palsy

The Obstacles and Curb tests are timed walking assessments that have emerged from the Spinal Cord Injury Functional Ambulation Profile and have been modified for children; however, their psychometric properties have not been adequately investigated. The aim of this research was to examine the psychometric properties of the Obstacles and Curb tests for children with cerebral palsy (CP). This cross-sectional study included 68 children aged 6-12 years; there were 34 children with CP and 34 age- and sex-matched typically developing children. Validity was examined by correlation with the 10-m Walk Test (10-MWT), Modified Time Up and Go test (mTUG), and Pediatric Balance Scale (PBS). Differences in the Obstacle and Curb test scores were calculated between children with CP and typically developing children and within different Gross Motor Function Classification System (GMFCS) levels. Children with CP completed the tests twice within a 30-min interval in the same session. The tests showed significant strong to very strong correlations with the 10-MWT, mTUG, and PBS. The within-session reliability was excellent, typically developing children were significantly faster than children with CP with high sensitivity and specificity, and the time differed significantly within the GMFCS level. Thus, the Obstacles and Curb tests can be considered valid, reliable, and sensitive walking tests for ambulatory children with CP.

The Experience of Dancing Among Individuals with Cerebral Palsy at an Inclusive Dance Group: A Qualitative Study

BACKGROUND

Art practices such as dance have the potential to support people with disabilities. It is possible that through dancing, bodies that may be regarded as "deficient" can be strengthened while enhancing their personal and cultural identities. It is also possible that inclusive group dance classes can enable the integration of people with disabilities in their social context. However, there is limited research on how these potential benefits are experienced by participants.

AIM

The purpose of this research is to describe the experience of people with cerebral palsy participating in regular dance classes.

METHODS

Semi-structured interviews were conducted with six participants with cerebral palsy who participated in an inclusive dance group that was informed by the creative approach of Laban. The interviews were transcribed, coded, and analyzed according to the thematic analysis of Braun and Clarke. The qualitative analysis software program ATLAS.TI version 8 was used for organizing and data analysis.

FINDINGS

The six interviews were analyzed and codified in four main categories: (1) the experience of cerebral palsy (the body does not help); (2) dance as a form of relationship with myself and the other; (3) the value of dancing and; (4) the dancer. These categories led to the creation of two subthemes: (a) the "unlocking" concerning the therapeutic effect of dance and (b) the "acquisition of a dancer's identity" by engaging with dance as an artform. An overall theme also emerged, "the passage from darkness to light."

CONCLUSIONS

Individuals with cerebral palsy, while taking the risk of being physically "exposed" in dance classes and dance group performances, managed to unlock their bodies, develop connections with others, acquire the identity of a dancer, and move from "darkness" to "light."