RESUMO
Cerebral palsy is characterized by non-progressive abnormalities in the developing brain that creates a cascade of motor deficits and finally affects functional activities. Limited hand function is a characteristic of the movement disorders in children with cerebral palsy which leads to disability in performing activities of daily living, work and play. The purpose of this study was to investigate the effects of wrist Kinesio Taping on hand function of children with spastic diplegic cerebral palsy. In this randomized clinical trial and single-blind study, 26 children [3-6 years old] with spastic diplegic cerebral palsy were selected by convenient and simple sampling and randomly divided into two intervention and control groups. During the study for 12 days, control group received only common occupational therapy treatment or Neuro-Developmental Treatment [NDT]. Intervention group received both NDT and wrist Kinesio Taping for 24 hours a day on both wrists. Assessment tool was QUEST for evaluating quality of upper extremity skills and Modified Ashworth Scale for assessing spasticity of wrist before and after intervention in both groups. Data were analyzed by independent t-test and Wilcoxon rank sum. The results showed significance increase of total QUEST score [P=0.029] and significance difference in domains of dissociated movements [P=0.003] and grasp [P=0.008] in Kinesio Taping group. However, there were no significant differences in weight bearing [P=0.46] and protective extension [P=0.89] domains. The data showed that wrist Kinesio Taping was effective in reducing spasticity of right wrist[P=0.004] but no significant difference for left wrist[P=0.06]. Wrist Kinesio Taping technique revealed to be effective in increasing quality of upper extremity skills of spastic diplegic cerebral palsy children in domains of dissociated movements and grasp. Moreover, it was concluded that this technique can be effective in reducing spasticity of right hand due to more active use of dominant hand.
RESUMO
The common mechanism for lateral ankle sprain is inversion, plantar flexion, or the combination of both, if untreated successfully can lead to chronic ankle instability. It seems that the foot position, while touching the ground, has an effective role to cause ankle sprain. Thus it is possible to prevent ankle sprain through limiting foot position. Therefore the aim of this research is to study the effect of plantar flexion and eversion on mediolateral ground reaction force while landing in individuals who suffering from functional ankle instability. In this case-control research study 32 subjects [17 subjects with unilateral functional ankle instability [FAI] and 15 control subjects], aged from 18 to 35 years, were tested. All subjects in instability group were selected by the orthopedic physician, then the anterior drawer and talar tilt tests were performed for diagnosis of functional ankle instability and other physical examinations. Control group were matched with instability group by age, weight, height, gender and body mass index. The subjects standing with single leg on a 40 cm high platform in 25 cm front of a force-plate while the test leg relaxed and non-weight bearing. The subject landed on the test leg on the center of the force-plate. The subjects landed according to four types of position: A: neutral position of ankle and lateral foot wedge, B: neutral position of ankle, C: positive heel and lateral foot wedge and D: positive heel. Among control group, medial ground reaction force increased in the "C" position relative to "B" position [p=0.007] and "C" position relative to "D" position [p=0.018]. In FAI group, lateral ground reaction force increased in "C" position relative to "B" position [p=0.001] and "C" position relative to "A" position [p=0.002]. Also in FAI group medial ground reaction force decreased in "D" position relative to "A" position [p=0.014]. According to the findings, applying lateral foot wedge, while the ankle is in plantar flexion, increases the mediolateral ground reaction forces. Based on the results, position of plantar flexion is more possibly effective than inversion in ankle sprain. According to the study, the lateral foot wedge in ankle plantar flexion position may be more effective than in neutral one to change mediolateral ground reaction forces.