Role of three side support ankle-foot orthosis in improving the balance in children with spastic diplegic cerebral palsy

Cerebral palsy [CP] is a heterogeneous group of permanent, non-progressive motor disorders of movement and posture. Ankle-foot orthoses [AFOs] are frequently prescribed to correct skeletal misalignments in spastic CP. The present study aims to evaluate the effect of the three side support ankle-foot orthosis on standing balance of the spastic diplegic CP children. Thirty spastic diplegic CP children participated in this study from both sexes. They were divided randomly into two age and sex matched groups: [Group I: study group and Group II: control group]. The degree of spasticity was evaluated by passive movement for both limbs, while the child was completely relaxed. The Biodex stability system, was used for the assessment of the dynamic postural control of all diplegic children. Also the system measures the subject's ability to control the platform's angle of tilt. The patient's performance is noted as stability index which represents the variance of the platform displacement in degrees. Every patient in the study group was exercised on three side support ankle-foot orthosis for 30 min, three times weekly, for 6 months, also they received the same therapeutic exercise program which was given to the control group. The results revealed no significant difference as regards the pre-treatment mean values of all stability indices in both the control and the study groups [P < 0.05]. However comparison between post-treatment mean values of all stability indices in both groups showed significant improvement in favor of the study group [p < 0.05]. Uses of the three side support ankle-foot orthosis in addition to physical exercise program is highly useful in rehabilitation of spastic diplegic cerebral palsy children as they enabled them to gain more balance control and postural reactions

Low bone density management via capacitively coupled electrical fields and low intensity pulsed ultrasound in hemiparetic cerebral palsy

Osteoporosis is being increasingly recognized in pediatric practice as a consequence of several factors. These include the increasing complexity of chronic conditions and the associated treatments managed by pediatricians. In addition, the improved care provided to children with chronic illness has led to many of them living long enough to develop osteoporosis. Many children with cerebral palsy have diminished bone mineral density and the application of capacitively coupled electrical fields and low intensity pulsed ultrasound aim to improve the formation of bone cells and so may be helpful in the management of such cases. In this study, capacitively coupled electrical fields and low intensity pulsed ultrasound was conducted to investigate its effect on bone mineral density in spastic diaplegic cerebral palsy. Twenty spastic hemiparetic children were the sample of this work. There were divided randomly into two equal groups. Bone mineral densities were measured before and after six months of the application of the treatment program. Group A [control] received the physiotherapy program, while group B [study] received capacitively coupled electrical fields and low intensity pulsed ultrasound in addition to the same treatment program given to group A. Significant improvement were observed in all measuring variables when comparing the post-treatment results in both groups in favor of group B. Capacitively coupled electrical fields and low intensity pulsed ultrasound therapy may be considered as one of the most helpful methods of physiotherapy in management of low bone density in spastic hemiparetic cerebral palsied children

Endurance exercises versus treadmill training in improving muscle strength and functional activities in hemiparetic cerebral palsy

Weakness of the sound side in hemiparetic cerebral palsy is one of the serious complications which affect these children. Many children with hemiparetic cerebral palsy have diminished muscle power in the neglected sound side, and the application of strengthening exercises aim to improve the muscle strength and function activities and so may be helpful in the management of such cases. In this study, endurance exercises and treadmill training was conducted to investigate its effect on increasing the strength of the quadriceps femoris and hamstring muscles of the sound side in spastic diaplegic cerebral palsy in comparison to the effect of an endurance exercise program. Thirty spastic hemiparetic children were the sample of this work. There were divided randomly into two equal groups. The ratio of peak torque of quadriceps femoris muscle and the hamstring muscle and balance were measured before and after six months of the application of the treatment program. Group A received the physiotherapy program and treadmill training, while group B received endurance exercise in the form of DeLorme resistance exercise in addition to the same physiotherapy program given to group A. Significant improvement were observed in all measuring variables when comparing the post-treatment results in both groups. Walking training may be considered as one of the most helpful methods in management of muscle weakness in the sound side and balance in spastic hemiparetic cerebral palsied children