[ effects of static cock up c-bar splint on strength, spasticity, ROM, and dominant hand function in spastic diplegic children]

Cerebral Palsy [CP] children are the most clients referred to occupational therapy settings. Hand function is important in Activities of Daily living. There is a hand dysfunction in most cerebral palsy children. Orthosis and splints are commonly used to improve the position, range of motion, quality of movement and function of a personrm or hand. The aim of this study was to investigate the effects of static cock up c-bar splint on strength, spasticity, range of motion, and dominant hand function in spastic diplegic children with 8 to 12 years old. This interventional study is in a before-after design. Thirteen spastic diplegic cerebral palsy children with 8 to 12 years old were selected through students who studied in physical disabled schools in Tehran city and had the inclusion criteria. Patients used a static cock up c-bar splint [wrist in 10 degrees of extension and thumb in palmar abduction and opposition] for two months, 2 hours daily and 4-6 hours at night. In this study the Jebsen Taylor test was used to evaluate hand function, the Modified Ashworth Scale was used to assess spasticity of thumb, wrist and elbow, ROM of thumb, wrist and elbow were tested with goniometer and power grip was evaluated with dynamometer. Results showed a significant improvement in hand function [p<0.001], in wrist's spasticity [p<0.001], elbow's spasticity [p<0.008], palmar abduction of thumb spasticity [p<0.002], wrist's ROM [p<0.001], Palmar abduction of thumb ROM [p<0.001] and power grip [p<0.001]. The data did not show significant improvement on elbow's joint ROM. Information from present research shows that using static cock up c-bar splint for 2 months, 2 hours a day and 4 to 6 hours nightly, can be an effective method to improve power grip, hand function, thumb, wrist and elbow spasticity and range of motion of thumb and wrist of spastic diplegic CP children

[ effect of C-bar Splint on hand function in 8-12 years old spastic diplegic children]

Cerebral palsy [CP] is a neurodevelopmental disorder caused by nonprogressive lesions. This disorder produces motor impairment deficits in early infancy. Hand function is essential in performing activities of daily living for everyone, including individuals with cerebral palsy. Adequate first web space is essential for web space expansion, thumb abduction, and a wide range of thumb mobility and hand function. The purpose of this study was to determine the effects of C-bar splint on hand function and strength and also wrist and thumb range of motion [ROM] of dominant hand of 8-12 years old children with spastic diplegic cerebral palsy. The design of this study was before- after and quasi-experimental. According with inclusion criteria, 8 to 12 years old children with spastic diplegia from physical - motor special school at Tehran [8 boys and 5 girls], were studied. They used a C-bar splint [40 degree of palmer abduction of thumb] for 8 weeks [6-8 hours during day and 4-6 hours at night]. In this study, hand function was evaluated by Jebsen Taylor Hand Function Test, hand strength by MIE dynamometer and thumb and wrist ROM by Goniometer. During intervention, they received routine occupational therapy program. The results of this study showed significant improvement in hand function [P=0.001], and thumb range of motion [P=0.02]. The data did not show any significant improvement in wrist ROM and hand strength. According to the result of this study, it seems that using C-bar splint can be an effective method in improvement of hand function and thumb ROM in 8-12 years old children with spastic diplegia

[ study of the effect of progressive resistance training on functional balance of 8-12 years old children with Down syndrome]

Rehabilitation interventions have significant role in reducing the disabilities of Down syndrome. Due to great role of balance in the function of individuals particularly in Activity of Daily Living and the effect of strength on balance, the aim of this study was to investigate the effects of Progressive Resistive Exercise on functional balance in children with Down syndrome. Fifteen girls children aged between 8 and 12 years, with Down syndrome participated in this study by available sampling method. The subjects participated three times per week in a six-week progressive strengthening program. During intervention, 3 of them excluded. Balance were measured by Berg Balance Scale and right/left hip abductor and flexor, knee extensor and flexor muscles isometric strengths were measured by Nickolas hand-held dynamometer. Paired-sampled T-Test was used for data analysis. The results of this study showed that the mean of functional balance and muscles isometric strengths were significantly increased after intervention [P<0.001]. It seems that the results of this study confirm the effect of progressive resistance training on progressing functional balance, and 8-12 years old children with Down syndrome can benefit from these exercises

[ effect of constraint -induced movement therapy [CIMT] on quality of life, function and range of motion of upper extremity of patients with stroke]

Constraint-induce movement therapy is one of the treatment methods to treat those who have stroke disorders. The aim of this study was to determine the effect of constraint-induced movement therapy [CIMT] on quality of life, function and range of motion of upper extremity of patients with stroke. This study was conducted in 15 patients in accordance to random clinical trial during the treatment operation, the patients were asked to restrict their upper extremity movement with orthopedics sling for 3 days per week and each day for 8 hours. They were asked to practice on affected upper extremity for 2 hours while their hands were restricted. Additionally, the present study was conducted for 6 weeks. The statistical analysis illustrated that quality of life was significantly changed which measured by SF36 test [p=0.008]. Furthermore, the upper extremity function which was assessed by Box and Black test was statistically analyzed by t-coupled; in this regard, it showed a significant change when the treatment ended up [p=0.009]. However, active range of motions in wrist extension and elbow extension did not significantly changed [p=0.227]. Based on the results, it can be implied that constraint-induce movement therapy is an effective method for improvement of life quality and the upper extremity function .Three mechanisms are discussed: involvement of non used affected limbs, neural plasticity in CNS, and amelioration of mental and physical health of patients can be resulted in life quality and patients' hand improvement

effects of palmar static splint on hand function, spasticity and wrist and elbow range of motion of 8 to 12 years old spastic cerebral palsy children

Upper limb dysfunction is a common and disabling consequence of cerebral palsy. Any functional disorder in the hand can cause a person's independence to be disrupted and therefore his or her social independence is threatened. The purpose of this study was to determine the effects of volar static splint on hand function, spasticity and wrist and elbow range of motion of 8 to 12 years old spastic children. The design of this study was clinical trial and before after. Fourteen 8 to 12 spastic cerebral palsy children that have the inclusion criteria of study were selected from rehabilitation clinics of Tehran. The patient used a volar static splint [10 degree of wrist extension, full extension of fingers and abduction and opposition of thumb] for 2 mounts [2 hours during day and 4 to 6 hours at night]. In this study Jebsen Taylor Hand Function Test was used to evaluate hand function. Modified Ashworth Scale was used to evaluate spasticity. A Goniometer was used to measure range of motion. The results of this study showed significant improvement in hand function [P<0/001] Significant reduction in wrist spasticity [P<0/001] and elbow spasticity [P<0/009] and significant increase in wrist range of motion [P<0/001] The data did not show any significance in elbow range of motion [P<0/336]. Our findings suggested that 2 months using of volar static splint in children with spastic cerebral palsy can improve hand function, wrist and elbow spasticity and wrist range of motion

Immediate effect of lateral-wedged insole on postural control in children with hemiplegic cerebral palsy

Cerebral palsy [CP] is the most common motor impairment in childhood and affects 2 in 1000 live births, in which postural and motor control involved. In hemiplegic type, two sides of the body have differences in postural tone that cause weight shift to the intact side. In these children postural disorders appear as postural stability disorder. The aim of this study is to assess the effect of lateral wedge insole on postural control in cerebral palsy children. Sixteen hemiplegic children attended in this program and stood in two conditions on the force plate with and without lateral wedge on the hard plate. Center of pressure displacement measured for medio-lateral and antro-posterio directions. Every test took 20 seconds. It was repeated 3 times. Range of sideways decreased significantly with use of 5° wedge. Also a shoe wedge of 5° provided symmetrical weight distribution. The results represent that a 5° lateral wedge applied to the unaffected limb, can improve factors of postural control and gain the symmetry in hemiplegic children

effects and maintenance of constraint-induced therapy on spasticity and function of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old

Cerebral palsy is a non progressive disorder and the most common movement problem in children. Many children with cerebral palsy are of hemiplegic type. One of the important problems of this children is unilateral upper limb dysfunction, that not using the affected side causes forgetfulness and more problems on this side. In this study, effectiveness of Constraint-Induced Therapy [CIT] and the maintainance of this technique on spasticity and performance of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old have been investigated. In this pretest - posttest quasi experimental study, 20 cerebral palsy hemiplegic children 6 to 12 years old [15 boys and 5 girls] with 8.7 years mean age were selected. Interventions were performed about 8 weeks and patients were followed for 4 weeks. Spasticity on the affected side in wrist and elbow were tested by Modified Ashworth Scale and upper extremity function by the Box and Block test. The data were analyzed with the Wilcoxon and paired t- tests. Constraint-Induced Therapy in the affected limb decreases significantly the spasticity of wrist [p = 0.00] and elbow [p = 0.005] and significantly increases performance score [p = 0.00], and the recovery significantly maintained one month after the interventions. Constraint-Induced Therapy of affected upper extremity could possibly decrease limb spasticity and increase function with two mechanisms: Fierstly, The reduction of not using the plegic side and secondly, neuroplasticity in CNS. This improvement may remain viable in the affected limb

effects of simultaneous activation of exteroception and proprioception on function of upper extremity in children with diplegic spastic cerebral palsy, 3-7 years old

The role of function of upper extremity in activity of daily living is critical and any impairment of function could cause major problems for diplegic spastic cerebral palsy [CP] patients. So, the application of rehabilitation protocols that could regain the hand function is very important. The purpose of this study was to explore the effects of simultaneous activation of exteroception and proprioception on function of upper extremity in children with diplegic spastic CP, 3-7 years old. Thirteen CP patients [3-7 years; mean: 4.92 years; 4 boys and 9 girls] were participated in this study. Simultaneous activation of exteroception and proprioception were done 3 times a week [for 8 weeks]. Function of upper extremity was evaluated by Quest Test and the degree of spasticity in wrist was evaluated by Modified Ashworth Scale. The results of this study showed that after simultaneous activation of exteroception and proprioception, function of upper extremity was significantly improved [P<0.001]. In addition, degree of spasticity in wrist muscles was significantly decreased [P<0.022]. Based on results of current study, it might be suggested that simultaneous activation of exteroception and proprioception could improve the function of upper extremity and decrease of spasticity. This in respect could reduce the disabilities of patients. So, the application of current protocols for the patients is suggested