ABSTRACT
Objective To study the effect of functional electrical stimulation(FES) with innovative static state combined assistance pattern on lower extremity muscle status,motor function and walking function in children with spastic diplegic cerebral palsy.Methods A total of 40 children with spastic diplegic cerebral palsy were randomly divided into a observation group (20 cases) and a control group (20 cases),which were selected from the Third Affiliated Hospital of Jiamusi University from March 2016 to July 2016.The observation group included 11 males and 9 females,aged 3 to 6 years old,on the average of (4.80 ± 1.06) years;the control group including 7 males and 13 females,aged 3 to 6 years old,with mean age (4.75 ± 0.96) years.The control group was only treated with conventional rehabilitation therapy such as kinesitherapy and occupational therapy.On the basis of routine rehabilitation therapy,the observation group was treated with functional electrical stimulation with innovative static state combined with intelligent assistance patterns.All the therapies including conventional and FES treatment were conducted once per day,5 times per week,total for 8 weeks totally.The outcomes before treatment,4 weeks after treatment and 8 weeks after treatment for all the subserved objects were evaluated by modified Ashworth scale(MAS),including joint range of motion(ROM),manual muscle assessment (MMT),gross motor function scale (GMFM-88 D and E regions),gait analysis and musculoskeletal ultrasound (measured muscle thickness).All the data were collected and analyzed by SPSS 17.0 statistical software.Results After 4 weeks to 8 weeks of treatment,2 groups of children with joint range of motion of lower limbs,muscle strength,muscle tension,GMFM-88 score of D and E regions,muscle thickness and gait in 2 groups of children were improved than those before treatment (P ＜ 0.05),after 4 to 8 weeks of treatment,2 groups of children with lower limb joint activity,muscle strength,muscle tension,GMFM-88 score,D and E regions of the muscle thickness and gait in 2 groups of children were improved than those before treatment,and the differences were significant (P ＜ 0.05).The evaluation index of the observation group,Ashworth [left (1.80 ± 0.52) scores,right (3.40 ± 0.88) scores],ROM [left (19.5 ± 2.8) °,right (19.4 ± 1.5) °],muscle strength [left (1.80 ± 0.52) grade,right (2.O0 ± 0.56) grade] and muscle thickness[left gastrocnemius (32.35 ± 1.79) mm,right gastrocnemius (32.95 ± 2.63) mm,left anterior tibial muscle (30.60 ± 1.00) mm,right anterior tibial muscle (30.05 ± 1.8) mm],were all significantly better than those of the control group (all P ＜ 0.05).Step length (23.75-3.19) cm and step speed (0.45 ± 0.01) m/s compared with the control group improved significantly compared with the control group (P ＜ 0.05),the GMFM scores [D regions (31.30 ± 1.46) scores,E regions (48.95 ± 1.40) scores] was significantly higher than those of the control group (P ＜ 0.05).Conclusions The FES with innovative static state combined with intelligent assistance pattern can effectively improve the lower limb muscle state and motor function in children with spastic diplegic cerebral palsy.
ABSTRACT
Objective To study the effect of functional electrical stimulation(FES) with innovative static state combined assistance pattern on lower extremity muscle status,motor function and walking function in children with spastic diplegic cerebral palsy.Methods A total of 40 children with spastic diplegic cerebral palsy were randomly divided into a observation group (20 cases) and a control group (20 cases),which were selected from the Third Affiliated Hospital of Jiamusi University from March 2016 to July 2016.The observation group included 11 males and 9 females,aged 3 to 6 years old,on the average of (4.80 ± 1.06) years;the control group including 7 males and 13 females,aged 3 to 6 years old,with mean age (4.75 ± 0.96) years.The control group was only treated with conventional rehabilitation therapy such as kinesitherapy and occupational therapy.On the basis of routine rehabilitation therapy,the observation group was treated with functional electrical stimulation with innovative static state combined with intelligent assistance patterns.All the therapies including conventional and FES treatment were conducted once per day,5 times per week,total for 8 weeks totally.The outcomes before treatment,4 weeks after treatment and 8 weeks after treatment for all the subserved objects were evaluated by modified Ashworth scale(MAS),including joint range of motion(ROM),manual muscle assessment (MMT),gross motor function scale (GMFM-88 D and E regions),gait analysis and musculoskeletal ultrasound (measured muscle thickness).All the data were collected and analyzed by SPSS 17.0 statistical software.Results After 4 weeks to 8 weeks of treatment,2 groups of children with joint range of motion of lower limbs,muscle strength,muscle tension,GMFM-88 score of D and E regions,muscle thickness and gait in 2 groups of children were improved than those before treatment (P ＜ 0.05),after 4 to 8 weeks of treatment,2 groups of children with lower limb joint activity,muscle strength,muscle tension,GMFM-88 score,D and E regions of the muscle thickness and gait in 2 groups of children were improved than those before treatment,and the differences were significant (P ＜ 0.05).The evaluation index of the observation group,Ashworth [left (1.80 ± 0.52) scores,right (3.40 ± 0.88) scores],ROM [left (19.5 ± 2.8) °,right (19.4 ± 1.5) °],muscle strength [left (1.80 ± 0.52) grade,right (2.O0 ± 0.56) grade] and muscle thickness[left gastrocnemius (32.35 ± 1.79) mm,right gastrocnemius (32.95 ± 2.63) mm,left anterior tibial muscle (30.60 ± 1.00) mm,right anterior tibial muscle (30.05 ± 1.8) mm],were all significantly better than those of the control group (all P ＜ 0.05).Step length (23.75-3.19) cm and step speed (0.45 ± 0.01) m/s compared with the control group improved significantly compared with the control group (P ＜ 0.05),the GMFM scores [D regions (31.30 ± 1.46) scores,E regions (48.95 ± 1.40) scores] was significantly higher than those of the control group (P ＜ 0.05).Conclusions The FES with innovative static state combined with intelligent assistance pattern can effectively improve the lower limb muscle state and motor function in children with spastic diplegic cerebral palsy.
ABSTRACT
Background: Play therapy has become an important part of physiotherapy treatment program to improve functional outcome in children with cerebral palsy. This study is to examine the effectiveness of play therapy together with conventional therapy to improve the hand function ability in children with spastic diplegic cerebral palsy. Methods: 30 spastic diplegic cerebral palsy children were divided into two groups, Group-I received conventional physiotherapy alone where as Group-II received play therapy and conventional therapy (n=15) both. The treatment was given 3 days a week for 6 weeks continuously for both the groups. Results: After the treatment period Group II who received play therapy in addition to conventional therapy scored significantly higher on the Box and block test and Nine hole peg test for grasp and release showing p<0.05. Conclusion: Play therapy along with conventional physiotherapy was found to be much effective in improving the hand function in children with spastic diplegic cerebral palsy. This study may help the physiotherapist to utilize and evaluate the functional outcomes using play therapy in cerebral palsy children.
ABSTRACT
OBJECTIVE: To evaluate the changes of kinematic gait patterns at long-term follow up study after selective posterior rhizotomy (SPR) in children with spastic diplegic cerebral palsy. METHOD: Eighteen children with spastic diplegic cerebral palsy participated in this study. Gait patterns on sagittal plane were studied before and at average 3.5 years after SPR. Kinematic and temporospatial data were obtained by the VICON 370 system. RESULTS: The spasticity of hip adductor and ankle plantar flexor were improved significantly after SPR. The maximal angle of pelvic tilt, ankle dorsiflexion angle at initial contact, peak ankle dorsiflexion angle during stance phase, at toe-off and during swing phase, mid-range point of flexion-extension motion on ankle were significantly improved after SPR. The temporospatial data tended to improve after SPR at long-term follow up. CONCLUSION: The SPR reduced spasticity and the gait pat terns were improved in children with spastic diplegic cere bral palsy at long-term follow up.