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<p><b>OBJECTIVE</b>To observe the effects of acupuncture at different acupoints in meridians and meridians on lower limb muscle tension in children with spastic cerebral palsy.</p><p><b>METHODS</b>Ninety children with spastic cerebral palsy aged between 2 to 6 years old were divided into a yin-meridian group, a yang-meridian group and a rehabilitation group, 30 cases in each one. The patients in the rehabilitation group were treated with routine rehabilitation treatment; the patients in the yin-meridian group were treated with routine rehabilitation treatment and acupuncture at Xuehai (SP 10), Yinlingquan (SP 9), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) along meridians; the patients in the yang-meridian group were treated with routine rehabilitation treatment and acupuncture at Futu (ST 32), Zusanli (ST 36), Yanglingquan (GB 34), Guangming (GB 37) and Xuanzhong (GB 39) along meridians. All the three groups were treated once each other day, 10 times as one course, and totally 20-day treatment was given. Before and after treatment, modified Ashworth scale (MAS), clinical spasm index (CSI) and integrated electromyography (iEMG) of surface electromyogram of gastrocnemius muscle were evaluated.</p><p><b>RESULTS</b>Compared before treatment, the MAS and CSI in the yin-meridian group and yang-meridian group were improved after treatment (<0.05, <0.01); the differences before and after treatment in the rehabilitation group were not significant (both >0.05). After treatment, the differences between the rehabilitation group and yin-meridian group, yang-meridian group were significant (<0.05, <0.01); the differences of MAS and CSI between the yin-meridian group and yang-meridian group were not significant (both >0.05). Compared before the treatment, the right-side iEMG and left-side iEMG were reduced in the yin-meridian group and yang-meridian group (all <0.05); the right-side iEMG was increased in the rehabilitation group (<0.05). After treatment, the iEMG in the yin-meridian group and yang-meridian group were lower than that in the rehabilitation group (all <0.05); the differences of iEMG before and after treatment in the yin-meridian group and yang-meridian group were higher than that in the rehabilitation group (all <0.05); the differences of iEMG between the yin-meridian group and yang-meridian group were not significant (both >0.05).</p><p><b>CONCLUSION</b>Acupuncture at meridians and meridians could reduce muscle tension of lower limb and improve limb spasticity in children with spastic cerebral palsy, and the two acupuncture methods have similar clinical curative effect.</p>
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@# Objective To observe the effect of Kinesio taping combining with sling exercise therapy (SET) on the motor function for children with spastic hemiplegia. Methods From October, 2014 to April, 2016, 60 children with spastic hemiplegia of cerebral palsy were randomly divided into control group (n=20), SET group (n=20) and observation group (n=20), who accepted routine rehabilitation, routine rehabilitation+SET and routine rehabilitation+SET+Kinesio taping, respectively. They were assessed with Mallet Score, modified Ashworth Scale (MAS), Peabody Developmental Motor Scale-fine motor (PDMS-2FM) and Gross Motor Function Measure (GMFM)-C zone before and three months after treatment. Results The Mallet Score and the scores of PDMS-2FM and GMFM-C improved in all the groups after treatment (t>2.074, P<0.05), and improved the most in the observation group (F>10.032, P<0.001). The score of MAS decreased in the observation group after treatment (t=4.767, P<0.001), and was the least among these groups (F=4.262, P<0.05). Conclusion Kinesio taping combining with SET can improve the motion in the children with spastic hemiplegia, and promote the development of both fine and gross motor function.
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Introducción: Este estudio pretendió determinar los efectos del tratamiento fisioterapéutico con el accesorio Wii Balance Board y el juego Wii Fit Plus -ambos de la consola Wii, de la empresa Nintendo Company Limited- en las alteraciones posturales de niños con hemiparesia espástica. Materiales y métodos: Estudio de caso, realizado con la participación de dos niños con parálisis cerebral, tipo hemiparesia espástica del municipio de Popayán, Cauca, a quienes se les realizó una evaluación de la postura estática con el software APIC V. 2.0. Posteriormente, se ejecutó un programa de ejercicios utilizando el juego Wii Fit Plus con el Wii Balance Board durante 20 sesiones. Resultados: Los dos pacientes presentaron cambios importantes en la lateralización del centro de gravedad, lo que, a largo plazo, puede favorecer la corrección de las alteraciones posturales. Conclusiones: La aplicación del juego con Wii Fit Plus con el Wii Balance Board en fisioterapia es una alternativa útil en la rehabilitación de estos pacientes con hemiparesia, relacionado con una mejor distribución del centro de gravedad. Se debe evitar la sobrecarga de peso y las compensaciones.
Introduction: This study tried to determine the effects on the treatments in physical therapy with the Wii Balance Board and Wii Fit Plus -both of Wii, Nintendo Company Limited- concerning postural changes on children suffering spastic hemiparesis. Material and methods: Case study done with two children, from the municipality of Popayan, suffering cerebral palsy type spastic hemiparesis. These children underwent previously a test on static posture with APIC v. 2.0 software. An exercise program using the Wii Fit plus Balance Board for 20 sessions was performed. Results: Both patients had remarkable changes on the lateralization of the center of gravity.These changes can support corrections of postural alterations later. Conclusions: Implementing the Wii Fit Plus game with Wii Balance Board in physical therapy is a useful alternative in rehabilitation of hemi paretic patients for a better distribution of their center of gravity. Weight overload and compensations should be avoided.
Introdução: Este estudo pretende determinar os efeitos do tratamento fisioterapéutico com o Balance Board Wii e Wii Fit Plus -tanto o Wii, Nintendo Company Limited- nas alterações posturais de crianças com hemiparesea espástica. Materiais e métodos: Estudo de caso feitos com a participação de duas crianças com paralisia cerebral de tipo hemiparesia espástica, de cidade de Popayán, Cauca; avaliou-se a postura estática deles com o software APIC v. 2.0. Depois se executou um programa de exercícios usando o Wii Fit Plus Balance Board por vinte sessões. Resultados: Nenhum dos dois pacientes apresentaram efeitos favoráveis na correção das alterações posturais; embora mostraram-se mudanças importantes na distribuição do centro da gravidade. Conclusões: A aplicação do jogo com o Wii Fit Plus com o Wii Balance Board não tem benéficos nas alterações posturais, po isso poderia recomendar-se fazer estudos com um número maior de participantes e com mais tempo para a intervenção.
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Humans , Child , Cerebral Palsy , Paresis , Posture , Software , Exercise , Physical Therapy Modalities , Colombia , Video GamesABSTRACT
@#Objective To observe the clinical effect of monosialotetrahexosyl ganglioside sodium injection (GM1) on spastic cerebral palsy. Methods 98 children with spastic cerebral palsy were randomly divided into control group (n=50) and treatment group (n=48). Both groups received Bobath approach, and the treatment group received GM1 in addition. They were assessed with Functional Independence Measure for Children (WeeFIM), Gross Motor Function Measure (GMFM) and Gesell Development Schedule (GDS) before and after 90 days of treatment. Results The scores of WeeFIM, all the dimensions of GMFM and the gross motor, fine motor, personal-social and adaption of the GDS improved in both groups after treatment (P<0.05), and improved more in the treatment group than in the control group (P< 0.05). Conclusion GM1 may further improve the recovery of function for children with spastic cerebral palsy.
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@#Objective To observe the effect of acupuncture and massage on tiptoe in children with spastic cerebral palsy. Methods 49 children with spastic cerebral palsy were divided into treatment group (n=24) and control group (n=25) in accordance with the order of visiting. The control group accepted routine rehabilitation, and the treatment group accepted acupuncture and massage in addition. They were assessed with Composite Spasticity Scale (CSS), the angle of ankle passive dorsiflexion before and after treatment. Results The scores of CSS and the angle of ankle passive dorsiflexion improved in both groups after treatment (P<0.001), and improved more in the treatment group than in the control group (P<0.001). The rate of improvement was 95.6% in the treatment group, and 78.26% in the control group (P<0.05). Conclusion Acupuncture and massage may further improve the correcting of the tiptoe in children with spastic cerebral palsy.
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@#Objective To observe the effect of homemade ankle-foot orthopedic band on motor function of lower extremities in children with foot drop post spastic hemiplegic cerebral palsy (CP). Methods 24 spastic hemiplegic CP children were randomly divided into observation group (n=12) and control group (n=12). Both groups accepted roution rehabilitation training. The control group accepted walking training, and the observation group accepted walking training wearing the homemade ankle-foot orthopedic band, for 12 weeks. They were assessed with modified Ashworth Scale (MAS) of gastrocnemius, range of motion (ROM) of ankle active dorsiflexion, and D and E domains of Gross Motor Function Measure (GMFM-88) before and after treatment. Results The score of MAS significantly decreased in both groups after treatment (P<0.01), and decreased more in the observation group than in the control group (P<0.05). ROM and scores of D and E domains of GMFM-88 significantly increased in both groups after treatment (P<0.01), and increased more in the observation group than in the control group (P<0.05). Conclusion Walking training with the homemade ankle-foot orthopedic band may further decrease the muscle tone of gastrocnemius, increase the active range of motion of ankle and improve the motor function of lower extremities in children with foot drop post spastic hemiplegic CP.
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Objective To observe the effects of stationary cycle training on lower limb muscle tension and motor function in children with spastic cerebral palsy.Methods Sixty-seven children with spastic cerebral palsy were divided into a treatment group (n =34) and a control group (n =33).Both were treated with routine rehabilitation therapy,including neurodevelopment treatment,massage and physical agent therapy.The treatment group additionally cycled on a stationary bicycle for 20 min a day,five days a week for 3 months.Muscle tension in the children's adductor,hamstring and gastrocnemius muscles was evaluated using the modified Ashworth scale (MAS),while the adductor angle,popliteal fossa angle and foot dorsiflexion angle were measured using a joint protractor.Moreover,the 88-item version of the Gross Motor Function Measure (GMFM-88) was used to evaluate gross motor function.Results After treatment the average muscle tension of both groups was significantly lower than before treatment.The average muscle tension scores of the adductors,hamstrings and calf muscles of the treatment group [(1.79±0.54),(1.00±0.60),(2.29 ±1.77)] were significantly lower than those of the controls [(1.82 ± 0.53),(1.15 ± 0.44),(2.52 ± 1.89)].The adductor angles,popliteal fossa angles and foot dorsiflexion angles of both groups were significantly larger than before treatment,and the angles in the treatment group [(97.06 ± 19.03) °,(53.38 ± 12.54) ° and (8.38 ± 9.11) ° respectively] were significantly larger on average than those in the control [(98.94 ± 21.42) °,(56.52 ± 12.90) ° and (5.30 ± 14.30) ° respectively].After treatment the total GMFM scores of both groups were better than before treatment,but the treatment group's average score(138.18 ± 54.86) was significantly better than that of the control group(112.21 ± 62.44).Conclusion Three months of stationary cycle training can effectively reduce the muscle tension of children with spastic cerebral palsy and improve their motor function.
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@#Objective To observe the effect of homemade ankle-foot orthopedic band on motor function of lower extremities in children with foot drop post spastic hemiplegic cerebral palsy (CP). Methods 24 spastic hemiplegic CP children were randomly divided into observation group (n=12) and control group (n=12). Both groups accepted roution rehabilitation training. The control group accepted walking training, and the observation group accepted walking training wearing the homemade ankle-foot orthopedic band, for 12 weeks. They were assessed with modified Ashworth Scale (MAS) of gastrocnemius, range of motion (ROM) of ankle active dorsiflexion, and D and E domains of Gross Motor Function Measure (GMFM-88) before and after treatment. Results The score of MAS significantly decreased in both groups after treatment (P<0.01), and decreased more in the observation group than in the control group (P<0.05). ROM and scores of D and E domains of GMFM-88 significantly increased in both groups after treatment (P<0.01), and increased more in the observation group than in the control group (P<0.05). Conclusion Walking training with the homemade ankle-foot orthopedic band may further decrease the muscle tone of gastrocnemius, increase the active range of motion of ankle and improve the motor function of lower extremities in children with foot drop post spastic hemiplegic CP.
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@# Objective To investigate the intelligence level and structure of children with spastic diplegic cerebral palsy. Methods 67 children with spastic diplegic cerebral palsy were evaluated with Wechsler Preschool and Primary Scale of Intelligence and Wechsler Intelligence Scale for Children-Chinese Revised. Results The total intelligence quotients were (71.10±15.95) in the younger children (aged below 6 years and 5 months) and (73.12±16.02) in the older children (aged above 6 years and 5 months). The ratio of mental deficiency (44.78%) was less than that of children with cerebral palsy. For the older children, their verbal intelligence quotient was higher than performance intelligence quotient (P<0.01), and their scores of space and concentration factors were lower than that of conception and acquisition factors (P<0.05). Conclusion The intelligence development delayed in the children with spastic diplegic cerebral palsy, but better than that of children with cerebral palsy, with special structure.
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@#Objective To observe the effects of Traditional Chinese Medicine bubble bath on the children with spastic diplegia cerebral palsy. Methods 13 children with spastic diplegia cerebral palsy received routine rehabilitation and bubble bath (control group), while 14 children received routine rehabilitation and Traditional Chinese Medicine bubble bath (experimental group). All the children were assessed with Gross Motor Function Measure (GMFM-66) and Modified Ashworth Scale (MAS) of triceps surae muscle before and 10 weeks after treatment.Results The total score of GMFM-66 increased (P<0.001) and the MAS score decreased in both groups (P<0.01) after treatment. The dimensions B, D, and E of GMFM-66 only increased in the experimental group (P<0.05). The MAS score decreased more in the experimental group than in the control group after treatment (P<0.05). Conclusion Traditional Chinese Medicine bubble bath can improve gross motor function and reduce triceps surae muscle tension of the children with spastic diplegia cerebral palsy.
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@#Objective To observe the effects of the acupuncture on muscle strain of lower extremities adductors for children with spastic cerebral palsy. Methods 100 children with spastic cerebral palsy were divided into treatment group (n=50) and control group (n=50) randomly.The control group accepted routine rehabilitation, and the treatment group accepted acupuncture in addition. The passive range of motion (ROM) of adductor angle, D and E domains of Gross Motor Function Measure (GMFM-88) were observed before and after treatment. Results ROM and GMFM-88 improved after treatment (P<0.05), and improved more in the treatment group than in the control group (P<0.05). Conclusion Acupuncture can release muscle strain of lower extremities adductors of children with spastic cerebral palsy and improve the motor function.
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@#Objective To explore the theoretical framework and method of community-based rehabilitation assessment for children with cerebral palsy based International Classification of Functioning, Disability and Health (ICF). Methods The system of assessment of community-based rehabilitation was developed based on the theoretical framework ICF, combined with multi-tools and self-compiled work scales.The system was used for 50 rural children with cerebral palsy after 1-year of community-based rehabilitation. Results and Conclusion The system of assessment is applicable for rural community-based rehabilitation of children with cerebral palsy, with satisfactory efficacy and compliance.
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@#ObjectiveTo observe effects of combination of wax therapy and occupational therapy on spastic cerebral palsy with thumb adduction.Methods100 cases of children with spastic cerebral palsy were randomly divided into observation group(n=50) and control group(n=50). The observation group received occupational therapy and wax therapy, while the control group received only occupational therapy. The effect was compared between the two groups 3 months after treatment.ResultsThe two groups improved significantly 3 months after treatment, while the observation group was better than the control group(P＜0.001).ConclusionWax therapy combined with occupational therapy have better effects on thumb adduction in spastic cerebral palsy than simple occupational therapy.
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@#ObjectiveTo observe effects of combination of wax therapy and occupational therapy on spastic cerebral palsy with thumb adduction.Methods100 cases of children with spastic cerebral palsy were randomly divided into observation group(n=50) and control group(n=50). The observation group received occupational therapy and wax therapy, while the control group received only occupational therapy. The effect was compared between the two groups 3 months after treatment.ResultsThe two groups improved significantly 3 months after treatment, while the observation group was better than the control group(P＜0.001).ConclusionWax therapy combined with occupational therapy have better effects on thumb adduction in spastic cerebral palsy than simple occupational therapy.
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@#Objective To observe the effects of electromyographic biofeedback electric stimulation therapy on lower extremities motordysfunction in children with spastic hemiplegic cerebral palsy (CP). Methods According to the consent of the custodians to the new therapy,60 children with spastic hemiplegic CP were divided into treatment group and control group with 30 cases in each group. All children weretreated with motor training, physical therapy and wore the ankle-foot orthosis (AFO). The treatment group was received electromyographicbiofeedback electric stimulation therapy on their lower extremity additionally. Composite Spasticity Scale (CSS) of the hemiplegic lower extremities,the ankle angle of passive dorsiflexion motion, D and E domains of Gross Motor Function Measure (GMFM-88) were performedto comparatively evaluate the effects before and 12 weeks after treatment. Results The outcomes were improved compared with the ones ofpre-treatment (P<0.05), and improved more in the treatment group (P<0.05). Conclusion The electromyographic biofeedback stimulationtherapy in combination with rehabilitation functional training in the treatment for children with spastic hemiplegic CP is more effective onspasticity of the lower extremity, increasing the range of ankle motion, improving gross motor function of lower extremities.
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@# Objective To evaluate the effect of Botulinum Toxin A (BTX-A) on spastic diplegia by surface electromyography (sEMG). Methods 50 children with cerebral palsy following spastic diplegia were recruited and injected with BTX-A in triceps surae. They were assessed with the clinical test and the sEMG before and after the treatment. Results After the treatment, the integrated electromyography(iEMG) of triceps surae and foot dorsiflexion angle all decreased. Conclusion sEMG is an objective tool to assess the change of spasticity in children with diplegia after BTX-A injection.
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@#ObjectiveTo observe the effects of Balance Performance Monitor (BPM) on balance capacity of children with spastic cerebral palsy. Methods96 children (2～5 years old) with spastic cerebral palsy were randomly divided into the experimental group and the control group. BPM training combined with Bobath approach was used in the experimental group, and the Bobath approach was used in the control group. They were assessed with the BPM before and 2 months after training. Results2 months after training, the balance capacity in both groups improved than before（P<0.05）. Furthermore, the index of experimental group is better than those of the control group（P<0.05）. ConclusionBPM can improve the effects of Bobath approach on the balance capacity of the children with spastic cerebral palsy.
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@#ObjectiveTo investigate the effect of Bobath approach combined with acupuncture on spastic cerebral palsy. Methods30 children with cerebral palsy treated with acupuncture combined with Bobath approach were as study group, other 30 children treated with Bobath approach only as the control group. ResultsThere were 27 cases (93%) were effective in study group, and 21 cases (80%) in control. The scores of Gross Motor Function Measure (GMFM) improved in both groups (P＜0.05), but more in the study group (P＜0.05) after treatment. The spasticity alleviated in both study group (76.7%) and control group （50%）. ConclusionThe combination with acupuncture is more effective on spastic cerebral palsy than Bobath approach alone.
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@#ObjectiveTo observe the characteristic of pulmonary function of children with spastic diplegia and the effects of hydrotherapy on it. Methods30 children with spastic diplegia were divided into hydrotherapy group and control group, who received hydrotherapy and routine rehabilitation or routine rehabilitation only. All patients were tested their pulmonary function and the maximum phonation time before and 2 months after treatment. The longest breath holding time in water of the hydrotherapy group were recorded. ResultsThe vital capacity (VC), expiratory reserve volume (ERV), inspiratory capacity (IC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum ventilatory volume (MVV), peak expiratory flow (PEF) in all the children decreased significantly compared with the predicted value (P=0.000), but a second rate (FEV1/FVC) didn't （P=0.141）. After treatment, the VC, FVC, FEV1, FEV1/FVC, MVV, PEF values and their percentage of predicted value improved （P＜0.05）, as well as the maximum phonation time （P＜0.05）. ERV, IC values and their percentage of predicted value improved a little from pre-treatment in the control group （P＞0.05）, but significantly in the hydrotherapy group （P<0.05）. The percentage of predicted value of VC, ERV, IC, FVC, FEV1, FEV1/FVC, MVV, and PEF, and the maximum phonation time improved more in the hydrotherapy group than in the control （P＜0.05）. The longest breath holding time in water improved in the hydrotherapy group after treatment （P=0.000）. ConclusionThe pulmonary function impaired in spastic diplegic children, and can be improved with the rehabilitation, especially with the hydrotherapy in addition.
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@#ObjectiveTo evaluate the effect of electromyography biofeedback on motor function in children with spastic hemiplegia. Methods40 children with spastic hemiplegia were divided into control group (n=20) and treatment group (n=20). Both groups received comprehensive rehabilitation treatment. The treatment group received electromyography biofeedback in addition. They were assessed with Gross Motor Functional Measure (GMFM-88) in D and E items before and after treatment. ResultsThe scores of GMFM-88 in both D and E items were significantly different (P<0.01) before and after treatment in both groups, and significantly different between the treatment group and control group (P<0.05) after treatment. ConclusionElectromyography biofeedback can improve the motor capacity in children with spastic hemiplegia.