Effect of backward walking training on postural balance in children with hemiparetic cerebral palsy: a randomized controlled study.

OBJECTIVE: To study the effect of additional backward walking training on postural control in children with hemiparetic cerebral palsy. DESIGN: Randomized controlled study. SETTING: Physical therapy clinics. SUBJECTS: Thirty spastic hemiparetic cerebral palsied children of both sexes (10-14 years, 14 girls and 16 boys). INTERVENTION: Children were randomly assigned into two equal groups: experimental and control groups. Both groups received a traditional physical therapy program for 12 weeks. Experimental group additionally received backward walking training which was provided 25 min/day, 3 days/week for 3 successive months. OUTCOME MEASURES: Baseline and post-treatment assessment for overall, anteroposterior, and mediolateral stability indices were evaluated by using Biodex balance system. RESULTS: After treatment; two way ANOVA revealed significant improvement in overall, anteroposterior and mediolateral stability indices of experimental group at the most stable level (level 12) and moderately unstable level (level 7) (1.40 ± 0.44 and 1.73 ± 0.51; 1.11 ± 0.34 and 2.13 ± 0.52; 1.93 ± 0.51 and 2.68 ± 0.52) respectively, than control group (1.77 ± 0.44 and 2.17 ± 0.56; 1.44 ± 0.44 and 2.54 ± 0.49; 2.39 ± 0.65 and 3.11 ± 0.49) respectively, (P < 0.05). There were significant improvement in all measured variables for both groups at both levels (P < 0.05). CONCLUSION: Additional backward walking training to traditional physical therapy program yields improvement in postural stability indices in children with spastic hemiparetic cerebral palsy than traditional physical therapy alone.

Effect of postural balance training on gait parameters in children with cerebral palsy.

OBJECTIVE: The aim of this study was to evaluate the effect of dynamic bilateral postural stability on balance control and gait parameters in children with cerebral palsy. DESIGN: Thirty children with spastic diplegia (8-10 yrs) were included in this study. The children were randomly assigned into two groups: control group A and study group B. The children in both groups received traditional physical therapy program, 2 hrs per day for group A and 1.5 hrs followed by 30 mins of dynamic postural stability training program using the Biodex Stability System for group B. The treatment frequency was three sessions per week for 8 consecutive weeks on two stability levels (7 and 8). The participating children received pretreatment and posttreatment assessments using the Biodex Stability System to evaluate the stability indices (anteroposterior, mediolateral, and overall) at the two stability levels (7 and 8) and three-dimensional motion analysis system (pro-reflex system) to evaluate the spatiotemporal parameters including step length, velocity, cycle time, stance, and swing phase percentage. RESULTS: The children in both groups showed significant improvements in the mean values of all measured variables after treatment indexed by a significant reduction in stability indices and improvement in gait parameters. The results also showed significant differences in all measured parameters in favor of group B, when compared with those in group A (P < 0.01). CONCLUSIONS: Balance training on the Biodex Stability System could be a useful tool in conjunction with traditional physical therapy program for improving balance control and gait functions in children with spastic diplegic cerebral palsy.