scholarly journals Effects of ziclague phytotherapic associated with kinesitherapy on the equine foot of children with spastic cerebral palsy

2020 ◽  
Vol 18 ◽  
pp. 1-8
Author(s):  
Jéssika Da Silva Martins ◽  
Marina Ortega Golin
Keyword(s):  
Cerebral Palsy ◽  
Range Of Motion ◽  
Lower Limb ◽  
Spastic Cerebral Palsy ◽  
Active Movement ◽  
Triceps Muscle ◽  
Modified Ashworth Scale ◽  
Before And After ◽  
The Right ◽  
Ashworth Scale

Background: Spasticity is the most common disorder of Cerebral Palsy (CP) and has the characteristics of decreased active movement,elastic hypertonia and hyperreflexia. Because of this, one of the main purposes of treatment is to decrease hypertonia. Thus, the herbalmedicine Ziclague®, having an antispasmodic action, may offer a new possibility in addition to physiotherapy. Objective: Verify theeffects of the application of the herbal medicine Ziclague on hypertonia of the sural triceps muscle of children with spasticCP. Methods: Ten children, between one and seven years of age, received application of Ziclague® spray on the triceps sural musclebefore the physiotherapy sessions, during the period of twelve weeks. Evaluations were performed using the Modified Ashworth Scale(MAS), Durigon Protocol (DP) and goniometry, before and after application on the first day, after four weeks and at the end of twelveweeks. The four evaluations were compared. Results: After twelve weeks the results were more evident, with a decrease in hypertoniaof the right lower limb (RLL) and left lower limb (LLL) verified by MAS (p= 0.06 and p= 0.13), and by the DP (p= 0.003 and p= 0.007).Goniometry showed increased range of motion for dorsiflexion of the RLL (p= 0.002) and LLL (p= 0.111). Conclusion: The use ofZiclague® associated with physiotherapy had a positive effect in decreasing hypertonia of the sural triceps muscle and in increasing theankle dorsiflexion range of motion.

scholarly journals Non-ambulatory children with cerebral palsy: effects of four months of static and dynamic standing exercise on passive range of motion and spasticity in the hip

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8561
Author(s):  
Åsa B. Tornberg ◽  
Katarina Lauruschkus
Keyword(s):  
Cerebral Palsy ◽  
Exercise Training ◽  
Range Of Motion ◽  
Exercise Intervention ◽  
Daily Exercise ◽  
Modified Ashworth Scale ◽  
Children With Cerebral Palsy ◽  
Before And After ◽  
Parametric Statistics ◽  
Ashworth Scale

Purpose The aim of this study was to compare the effects of four months of two types of structured training regimes, static standing (StS) versus dynamic standing (DyS), on passive range of motion (PROM) and spasticity in the hip among non-ambulatory children with cerebral palsy. Method Twenty non-ambulatory children with cerebral palsy participated in an exercise intervention study with a crossover design. During StS, the Non-ambulatory children with cerebral palsy were encouraged to exercise according to standard care recommendations, including daily supported StS for 30–90 min. During DyS, daily exercise for at least 30 min at a speed between 30 and 50 rpm in an Innowalk (Made for movement, Norway) was recommended. We assessed adaptive effects from the exercise programs through PROM in the hip assessed with a handheld goniometer, and spasticity in the hip assessed with the Modified Ashworth Scale before and after 30 min of StS or DyS. A trained physiotherapist performed the assessments. The exercise test and exercise training were performed in the children’s habitual environment. Non-parametric statistics were used and each leg was used as its own control. Result PROM increased in all directions after 30 min (p < 0.001), and after four months of exercise training (p < 0.001) of DyS. Thirty minutes of DyS lowered the spasticity in the muscles around the hip (p < 0.001) more than 30 min of StS (p < 0.001). Conclusion Thirty minutes of DyS increased PROM and decreased spasticity among non-ambulatory children with CP. Four months of DyS increased PROM but did not decrease spasticity. These results can help inform individualised standing recommendations.

A Study of Effects of Intervention of Botulinum Toxin- A on Lower Limb in Children with Spastic Cerebral Palsy

2015 ◽  
Vol 26 (4) ◽  
pp. 94-101
Author(s):  
U Singh ◽  
Raj Kumar ◽  
Sanjay Wadhwa ◽  
SL Yadav
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Range Of Motion ◽  
Lower Limb ◽  
Stride Length ◽  
Botulinum Toxin A ◽  
Step Length ◽  
Spastic Cerebral Palsy ◽  
Toxin A ◽  
Base Of Support

Abstract Objective Analysis of clinical gait pattern, change in spasticity and range of motion (ROM) in cerebral palsy patient (CP) with spastic lower limb muscle after injecting botulinum toxin- A. Study Design Prospective study Methods 28 children (18 male and 10 female) with spastic CP had problems in normal walking, aged 2–9 years (mean age 4.65 years), consecutively treated in the PMR department over a 2-year period, were prospectively followed-up and clinically assessed pre- and post-treatment (at 2 weeks and 2 months) both objectively and subjectively. Objective assessment included gait parameters -- stride length, cadence, velocity, step length, base of support; active and passive range of motion (ROM), (measured by goniometry) and spasticity on modified Ashworth scale. Subjective assessment was done by asking questionnaire in terms of comfort, ease of care, perineal hygiene, walking. Injections were given using clinical palpatory method on OPD basis. All patients received botulinum toxin-A injections, followed with exercises and activities and orthosis as needed. Results Significant improvement was achieved for spasticity reduction in gastrocnemius (p< 0.001), hamstring and adductor (p=0.050), ankle AROM & PROM (p< 0.001), active knee extension (p=0.009), popliteal angle (p=0.015) and percentage left and right foot contact (p< 0.001), whereas non-significant change was observed in step length, cadence, velocity, stride length, and base of support. Parents felt subjective improvement in most of the cases (>90%). Conclusions Botulinum toxin- A injection is effective in the treatment of spastic lower limb muscles for equinus/ crouching/scissoring gait in cerebral palsy children. The treatment was feasible and easily implemented. Botulinum toxin- A injections were well tolerated, yielded no serious treatment-related adverse events.

scholarly journals Assessment and Treatment of Spasticity in Children with Cerebral Palsy

2014 ◽  
Vol 31 (3) ◽  
pp. 163-169 ◽  
Author(s):  
Lidija Dimitrijević ◽  
Hristina Čolović ◽  
Marija Spalević ◽  
Anita Stanković ◽  
Dragan Zlatanović ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Spastic Cerebral Palsy ◽  
Pharmacological Agents ◽  
Surgical Interventions ◽  
Oral Medications ◽  
Abnormal Movements ◽  
Modified Ashworth Scale ◽  
Assessment And Treatment ◽  
Ashworth Scale

Summary Spastic cerebral palsy (CP) is the most common type of CP. Up to 80% of all individuals with cerebral palsy suffer from some degree of spasticity. Spasticity adversely affects muscles and joints of the extremities, causing abnormal movements, and it is especially harmful in growing children. Several methods have been developed and used to assess spasticity. The most commonly used test in clinical practice is the Modified Ashworth Scale (MAS). The test is based on the assessment of resistance to passive strech of muscle group at one nonspecified velocity. Management of spasticity in CP involves multidisciplinary intervention intended to increase functionality, sustain health, and improve quality of life for children and their carers. This may include: oral medications, intrathecal medications, physiotherapy, occupational therapy, orthoses, surgical interventions, and pharmacological agents such as botulinum toxin.

the Role of ayurveda in the management of cerebral palsy: a case study

2020 ◽  
Vol 8 (02) ◽  
Author(s):  
Babita Mandal ◽  
Manish Ishwarkar
Keyword(s):  
Cerebral Palsy ◽  
Daily Activities ◽  
Spastic Cerebral Palsy ◽  
Motor Disability ◽  
Modified Ashworth Scale ◽  
Therapeutic Measures ◽  
Ayurvedic Treatment ◽  
Ashworth Scale

Cerebral Palsy is defined as permanent, nonprogressive and occasionally evolving, disorders of tone, movement or posture, caused by an insult to the developing brain. It is the most common chronic motor disability in childhood, affecting 2-3 infants per 1000 live births. In Ayurveda there is no single condition or disease which exactly show similarity with Cerebral Palsy. Vata vyadhi is the most similar condition to Cerebral Palsy. Ayurveda mentioned Shodhana and Shamana as two main therapeutic measures in vata vyadhi. The case study being presented is of a 5yr old female patient suffering from diplegic spastic Cerebral Palsy. So, Panchakarma therapy and Shamana chikitsa has been given and assessed on the basis of CNS examination, GMFCS classification and Modified Ashworth scale. The result indicate that the patient improved in presenting features up to 35%-40% as well as daily activities were also performed effectively by her. Ayurvedic treatment modality was effective in improving the milestones of Cerebral Palsy patients.

Reduction in upper-extremity tone after lumbar selective dorsal rhizotomy in children with spastic cerebral palsy

2013 ◽  
Vol 12 (6) ◽  
pp. 588-594 ◽  
Author(s):  
Paul Gigante ◽  
Michael M. McDowell ◽  
Samuel S. Bruce ◽  
Genevieve Chirelstein ◽  
Claudia A. Chiriboga ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Upper Extremities ◽  
Spastic Cerebral Palsy ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Modified Ashworth Scale ◽  
Muscle Groups ◽  
Ashworth Scale

Object Randomized clinical trials have established that lumbar selective dorsal rhizotomy (SDR) reduces lower-extremity tone and improves functional outcome in children with spastic cerebral palsy. Significant data exist to support a secondary effect on upper-extremity function in patients with upper-extremity spasticity. The effects of SDR on upper-extremity tone, however, are not well characterized. In this report, the authors sought to assess changes in upper-extremity tone in individual muscle groups after SDR and tried to determine if these changes could be predicted preoperatively. Methods The authors retrospectively reviewed 42 children who underwent SDR at Columbia University Medical Center/Morgan Stanley Children's Hospital of NewYork-Presbyterian between 2005 and 2011. Twenty-five had upper-extremity spasticity. All underwent pre- and postoperative examination for measuring tone (Modified Ashworth Scale) and assessing functional outcome. Follow-up examinations with therapists were performed at least once at a minimum of 2 months postoperatively (mean 15 months). Results In the upper extremities, 23 (92%) of 25 patients had improvements of at least 1 Ashworth point in 2 or more independent motor groups on the Modified Ashworth Scale, and 12 (71%) of 17 families surveyed reported increases in motor control or spontaneous movement. The mean Modified Ashworth Scale scores for all upper-extremity muscle groups demonstrated an improvement from 1.34 to 1.22 (p < 0.001). Patients with a mean preoperative upper-extremity tone of 1.25–1.75 were most likely to benefit from reduction in tone (p = 0.0019). Proximal and pronator muscle groups were most likely to demonstrate reduced tone. Conclusions In addition to improvements in lower-extremity tone and function, SDR has demonstrable effects on upper extremities. Greater than 90% of our patients with elevated upper-extremity tone demonstrated reduction in tone in at least 2 muscle groups postoperatively. Patients with a mean Modified Ashworth Scale upper-extremity score of 1.25–1.75 may encounter the greatest reduction in upper-extremity tone.

Functional outcomes following selective posterior rhizotomy in children with cerebral palsy

1991 ◽  
Vol 74 (3) ◽  
pp. 380-385 ◽  
Author(s):  
Warwick J. Peacock ◽  
Loretta A. Staudt
Keyword(s):  
Cerebral Palsy ◽  
Range Of Motion ◽  
Muscle Tone ◽  
Functional Mobility ◽  
Spastic Cerebral Palsy ◽  
Range Of Movement ◽  
Content Type ◽  
Before And After ◽  
The Status ◽  
Selective Posterior Rhizotomy

✓ The recent increase in popularity of selective posterior rhizotomy demands objective documentation of surgical outcome. For this reason, the authors have analyzed the status of 25 children with spastic cerebral palsy before and after rhizotomy to determine the effects of this therapy on muscle tone, range of movement, and motor function. Postoperative tests showed a reduction in muscle tone compared with preoperative assessments. Range of motion in the lower extremities was significantly increased and improvements in functional gross motor skills were noted. An increase in range of motion in the knees and thighs during gait was detected in 18 ambulatory patients studied with computerized two-dimensional motion analysis. Preliminary findings indicate that selective posterior rhizotomy reduced spasticity, thereby increasing range of motion and contributing to improvements in active functional mobility.

Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Palliative Rhizotomy: A Novel Technical Application

2020 ◽  
Author(s):  
Vijay M Ravindra ◽  
Patrick J Karas ◽  
Sara Hartnett ◽  
Ilana Patino ◽  
Robert North ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Magnetic Resonance ◽  
Perioperative Complications ◽  
Thermal Therapy ◽  
Spastic Cerebral Palsy ◽  
Technical Application ◽  
Laser Interstitial Thermal Therapy ◽  
Modified Ashworth Scale ◽  
Scale Scores ◽  
Ashworth Scale

Abstract BACKGROUND Spastic cerebral palsy is caused by an insult to the developing brain. Various medical and surgical procedures are used to reduce tone. OBJECTIVE To describe a novel method of magnetic resonance-guided laser interstitial thermal ablation for palliative rhizotomy. METHODS Patients treated at a single institution with percutaneous rhizotomy using magnetic resonance–guided laser interstitial thermal therapy were identified. Preoperative and postoperative Modified Ashworth Scale scores were collected as well as procedural information. RESULTS Two male children (7.8 and 19 yr, respectively) with spastic quadriparesis were treated using this technique. Neither patient experienced surgical or perioperative complications, and both were discharged from the hospital within 48 h. Each of them demonstrated improvement in his Modified Ashworth Scale score with no need for retreatment for spasticity at last follow-up. CONCLUSION These 2 cases illustrate a novel technique for treating spasticity in the setting of cerebral palsy. Further study of this technique in additional patients, and comparison with traditional methods of surgical tone reduction, are warranted.

scholarly journals EFFECTS OF STRETCHING EXERCISES WITH OR WITHOUT BACLOFEN ON SPASTICITY, FLUID INTAKE AND CALORIES INTAKE IN CEREBRAL PALSY CHILDREN

2021 ◽  
Vol 5 (1) ◽  
pp. 203-207
Author(s):  
Muhammad Ahmad ◽  
◽  
Aleem Liaqat ◽  
Nabeela Kanwal ◽  
◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Fluid Intake ◽  
Calorie Intake ◽  
Spastic Cerebral Palsy ◽  
Modified Ashworth Scale ◽  
Significant Difference ◽  
Mean Differences ◽  
Group B ◽  
Ashworth Scale ◽  
Stretching Exercises

Objectives: to find out the effectiveness of stretching exercises and baclofen alone and combined in spastic cerebral palsy children on spasticity, fluid and calorie intake. Material & Methods: A single-blinded, randomized control trial was conducted at Allama Iqbal Hospital, and Idrees Teaching Hospital. The participants between 5-15 years, having spasticity score of 2 or more on Modified Ashworth Scale (MAS). The participants were randomly divided into three treatment groups i.e. group A received baclofen, group B received stretching and group C received both baclofen and sustained stretching. Data were collected by Performa / Questionnaire, which calculated basic demographics, BMI, fluid and calorie intake, and Modified Ashworth Scale (MAS). Results: The result showed significant difference (p<0.05) among group with large effect size while comparing mean differences of Fluid intake {F(df)=2,57(988.603), η2 =0.972, p<0.001} and Calories intake {F(df)= 2,57(166.877), η2 =0.854, p<0.001}. While there was no significant difference in mean difference of spasticity {F(df)= 2,57(2.119), p=0.130}. Conclusion: baclofen along with stretching exercises significantly improved fluid, calorie intake and spasticity.

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