Effects of a core stability exercise program on balance and coordination in children with cerebellar ataxic cerebral palsy.

OBJECTIVE: To evaluate the effects of a core stability exercise program on balance, coordination, and severity of ataxia in children with cerebellar ataxic cerebral palsy (CP). METHODS: Forty children with cerebellar ataxic CP (mean age: 6.75±1.35 years) were randomly assigned to a control group and an intervention group for 2 months of follow-up. The control group received a standard physical therapy program three times weekly (1 h per session), while the intervention group received a core stability program for 30 min, in addition to the selected physical therapy program. Both groups were evaluated pre-treatment and post-treatment using the Scale for the Assessment and Rating of Ataxia, the Balance Error Scoring Systems scale, Bruininks-Oseretsky tests of motor proficiency, and HUMAC balance system scores. RESULTS: We found statistically significant reductions in the severity of ataxia, as well as improved balance and coordination in both groups, with stronger effects observed in the intervention group (P<0.05). CONCLUSION: The core stability program can improve balance and coordination in children with cerebellar ataxic CP when incorporated with a standard physical therapy program.

Clinical evaluation of the effectiveness of interferential current therapy in the treatment of children with pelvic floor dyssynergia-type constipation: a randomized controlled study.

BACKGROUND: Despite several treatment modalities being described for pelvic floor dyssynergia-type constipation, the clinical evaluation of interferential current therapy (IFC) has not been examined. We aimed to examine the clinical effects of IFC therapy in the treatment of children with pelvic floor dyssynergia-type constipation. METHODS: Between May 2018 and July 2019, this randomized controlled study included sixty-two children (46 boys and 16 girls) with pelvic floor dyssynergia-type constipation; their ages ranged between 7 and 15 years. The children were randomly divided into either the IFC group (n = 31) who received an active IFC therapy to stimulate the pelvic floor and external anal sphincter muscles, three times per week for four successive weeks, or the control group (n = 31) who received sham IFC stimulation. Stool-incontinence frequency per week, stool type, pelvic floor excursion, and myogenic activity of external anal sphincter were evaluated at the baseline, post-treatment, and three months after treatment termination. RESULTS: The baseline evaluation showed non-significant differences between the IFC and control groups (p > 0.05). The post-treatment results showed a statistically significant difference between both groups regarding all variables, favoring the IFC group (p < 0.05). Further, the favorable effect of IFC on all variables continued at the follow-up, three months later. CONCLUSIONS: IFC therapy appears to improve stool-incontinence frequency, stool type, pelvic floor excursion, and myogenic activities of the external anal sphincter in children with pelvic floor dyssynergia-type constipation. These results suggest that adding IFC therapy to the medical treatment could improve the main features of pelvic floor dyssynergia-type constipation.

Shoulder Function and Bone Mineralization in Children with Obstetric Brachial Plexus Injury After Neuromuscular Electrical Stimulation During Weight-Bearing Exercises.

OBJECTIVE: The purpose of this study was to evaluate the effects of neuromuscular electrical stimulation during weight-bearing exercises on shoulder function and bone mineral density (BMD) in children with obstetric brachial plexus injury (OBPI). DESIGN: This study was a randomized controlled trial. Forty-two children with OBPI were recruited. Their ages ranged from 3 to 5 years. They were randomly assigned either to control group (received a selected program) or study group (received the same program as the control group and neuromuscular electrical stimulation during weight bearing). Mallet grading system and dual-energy x-ray absorptiometry were used to evaluate shoulder function and BMD respectively at entry and after intervention (3 months later). RESULTS: No significant differences of the outcome measures were detected at entry. Significant differences were observed within both groups when the pre and post treatment scores within each group were compared. Finally, significant differences favoring the study group were recorded when their post treatment scores were compared. CONCLUSION: Neuromuscular electrical stimulation during weight bearing exercises is an effective and simple method to improve shoulder function and BMD in children with OBPI.