[ 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

[ 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 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