[ effect of foot serial casting along with botulinum toxin type-A injection on spasticity in children with cerebral palsy]

The goal of this study was to determine the effect of foot serial casting along with botulinum toxin type-A injection on spasticity in children with cerebral palsy. This study was a randomized clinical trial performed as a pre-post, double blind study. It was performed on 25 children with hemiplegia and diplegia [2-8 years] in Tehran city, who were referred to valiasr rehabilitation foundation. Participants were chosen by simple randomized sampling and were matched for age, Gross Motor Function Classification System [GMFCS] and type. They were randomly divided into two groups. The first group [n=13] underwent BTX-A injection alone and the second group [n=12] had BTX-A injection and foot serial casting after the injection. Clinical assessments were done using the GMFCS and Modified Ashworth Scale before and at 1, 3, 6 and 12 months after the interventions. Data were analyzed by Wilcoxon signed rank test and mann-whitney U. Comparison of two groups in regard to the right and left knee spasticity at, 1, 3, 6 and 12 months after injection showed no significant difference in comparison to those before interventions. Furthermore, comparison of right and left ankle spasticity before injection with that at 1, and 3 months follow ups did not show statistically significant difference, but significant differences were found when compared with 6 and 12 month follow-ups [P<0.05] It seems, one of the proper approaches to reduce spasticity in children with cerebral palsy is foot serial casting along with botulinum toxin type-A injection and it can decrease the muscle tone when applied more than six months

impacts of hinged and solid afos on standing and walking functions in 4-8 year old children with spastic cerebral palsy

Standing and walking are the most common activities of people on a daily basis. In children with cerebral palsy [CP], lesion in central nervous system could cause impairment in these functions. One way to improve their standing and walking functions is the use of Ankle Foot Orthoses [AFOs]. This study was performed to compare the effects of hinged and solid AFOs on standing and walking functions in 4-8 year old children with CP spastic. This quasi-experimental and interventional study was performed on 30 children [4-8 years old] with CP spastic in vali-Asr rehabilitation foundation of Tehran. Children were divided into 3 groups [often children each group] randomly; groupe 1 received hinged AFO, groupe 2 solid AFO, and group 3 [control group] received no AFOs for 3 months. Standing and walking functions were evaluated by Gross Motor Function Measure-88. There were significant differences in standing and walking functions after intervention in the 3 groups [p=0.005]. There were also significant differences between the 3 groups in terms of mean differences of total scores before and after the intervention [p= 0.015]. There were significant differences between the two groups hinged AFO and solid AFO and between hinged AFO group and control group, [p= 0.000], but between the two groups, solid AFO and control, there was no differences. Hinged AFO showed more improvement in standing and walking functions among children with CP spastic, and could be recommended for children with CP, especially, for those who could stand up or walk with or without assistive devices

effects of simultaneous activation of exteroception and proprioception on function of upper extremity in children with diplegic spastic cerebral palsy, 3-7 years old

The role of function of upper extremity in activity of daily living is critical and any impairment of function could cause major problems for diplegic spastic cerebral palsy [CP] patients. So, the application of rehabilitation protocols that could regain the hand function is very important. The purpose of this study was to explore the effects of simultaneous activation of exteroception and proprioception on function of upper extremity in children with diplegic spastic CP, 3-7 years old. Thirteen CP patients [3-7 years; mean: 4.92 years; 4 boys and 9 girls] were participated in this study. Simultaneous activation of exteroception and proprioception were done 3 times a week [for 8 weeks]. Function of upper extremity was evaluated by Quest Test and the degree of spasticity in wrist was evaluated by Modified Ashworth Scale. The results of this study showed that after simultaneous activation of exteroception and proprioception, function of upper extremity was significantly improved [P<0.001]. In addition, degree of spasticity in wrist muscles was significantly decreased [P<0.022]. Based on results of current study, it might be suggested that simultaneous activation of exteroception and proprioception could improve the function of upper extremity and decrease of spasticity. This in respect could reduce the disabilities of patients. So, the application of current protocols for the patients is suggested