The effect of patient-specific factors on responsiveness to robot-assisted gait training in patients with bilateral spastic cerebral palsy

2021 ◽  
pp. 1-15
Author(s):  
Stanislava Klobucká ◽  
Robert Klobucký ◽  
Branislav Kollár
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gait Training ◽  
Patient Specific ◽  
Spastic Cerebral Palsy ◽  
Robot Assisted ◽  
Gross Motor ◽  
Motor Functions ◽  
Gross Motor Function ◽  
Severity Of Disability

BACKGROUND: No general recommendations are yet available for the application of robot-assisted treadmill therapy for children with cerebral palsy regarding the length and intensity of the intervention. OBJECTIVE: The aim of the study was to evaluate patient-specific determinants of responsiveness to robot-assisted gait training (RAGT) in patients with bilateral spastic cerebral palsy. METHOD: During 12 months, the patients underwent 1–4 blocks of RAGT, representing 16–82 TUs. The following parameters were evaluated before (V0) and after each therapeutic block (V1–V4): dimension A (lying and rolling), B (sitting), C (crawling and kneeling), D (standing), E (walking, running and jumping) of the Gross Motor Function Measure (GMFM-88). We evaluated the change in motor functions in relation to the severity of disability, age, gender and number of therapeutic units. RESULTS: Ninety-seven patients aged between 3.7 and 27 years (mean age 10.02 years (SD±5.29); Gross Motor Function Classification System level I [n = 5], II [n = 25], III [n = 48], IV [n = 19]) underwent 16–82 TUs (overall average number 34.06 TUs, SD±16.41) of RAGT. In the patient group, we recorded clinically meaningful improvement and statistically significant improvement (p <  0.001) in gross motor functions with gradual increase in the effect size after each therapeutic block. Using correlation and regression analysis, we found a statistically significant associations between the number of therapeutic units, severity of disability, and improvement in motor functions after RAGT. CONCLUSION: We have identified two determinants –the severity of disability and the number of therapeutic units –which could have a decisive and predictive character in setting rehabilitation/designing programmes. The duration of the applied RAGT period, frequency and intensity could be a crucial factor for the potential of improvement in children with BS-CP.

Effect of robot-assisted gait training on motor functions in adolescent and young adult patients with bilateral spastic cerebral palsy: A randomized controlled trial

2020 ◽  
Vol 47 (4) ◽  
pp. 495-508
Author(s):  
Stanislava Klobucká ◽  
Robert Klobucký ◽  
Branislav Kollár
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Conventional Therapy ◽  
Gait Training ◽  
Adult Patients ◽  
Robot Assisted ◽  
Gross Motor ◽  
Motor Functions ◽  
Gross Motor Function ◽  
Significant Difference

BACKGROUND: Robot-assisted gait training (RAGT) allows an intensive gait training in patients with cerebral palsy (CP). There are few evidences on the effectiveness of RAGT in adults with CP. OBJECTIVE: To assess the effect of RAGT on gross motor function in adolescent and adult patients with bilateral spastic CP and to compare the effect of RAGT with conventional kinesiotherapy. METHODS: Forty-seven patients (mean age 21.2±5.33 years) with bilateral spastic CP were divided into two groups. Twenty-one patients underwent 20 therapeutic units of RAGT and 26 patients underwent 20 therapeutic units of conventional therapy/training (CON). The following parameters were evaluated before (V1) and after the therapy (V2): dimension A (lying and rolling), B (sitting), C (crawling and kneeling), D (standing), E (walking, running and jumping) of the Gross Motor Function Measure (GMFM-88). In patients in the experimental RAGT group, these parameters were also evaluated 3–4 months later (V3). RESULTS: Comparing the mean improvements in endpoints in both groups (RAGT vs. CON) after 20 TUs, we observed the statistically significant difference (p < 0.001) and large effect size in all GMFM dimensions and total GMFM improvement in favour of the RAGT group. In RAGT patients, the improvement persisted even 3–4 months after RAGT (p < 0.001). CONCLUSION: We demonstrated that the intensive RAGT regimen is more effective than conventional therapy in terms of improvements in gross motor functions in adolescent and adult patients with bilateral spastic CP.

scholarly journals EFFECT OF HYDROTHERAPY ON SPASTICITY AND GROSS MOTOR FUNCTIONS AMONG SPASTIC CEREBRAL PALSY CHILDREN

2019 ◽  
Vol 8 (1) ◽  
pp. 13-18
Author(s):  
Zeenat Fatima ◽  
Yarmiyah Rashaquat
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Muscle Tone ◽  
Spastic Cerebral Palsy ◽  
Gross Motor ◽  
Motor Functions ◽  
Motor Functioning ◽  
Gross Motor Function ◽  
Quasi Experimental ◽  
Protocol Study

OBJECTIVES To determine the effects of hydrotherapy therapy on spastic cerebral palsy children using Modified ashworths scale and Gross motor functional classification scale after 32 weeks of training protocol. STUDY DESIGN Quasi experimental study STUDY SETTING Liaquat National Hospital PARTICIPANTS Spastic (diplegic, hemiplegic and quadriplegic) cerebral palsy children INTERVENTIONS 58 Spastic Cerebral Palsywere assessed on the basis of modified Ashworth scale and gross motor function measure for spasticity and change in gross motor function respectively. Assessment was done, before and at the end of 10th week. Each therapy session was of 40-45 minutes thrice a week in a pool with the temperature maintained at 32°C-34°C and at the end cool down activities were performed. RESULTS Results indicated marked improvement in Muscle tone and Gross Motor Functioning of the enrolled children with p=0.001. CONCLUSIONS It was concluded that pool therapy is effective in reducing spasticity and improving gross motor functions among CP.

scholarly journals Short-Term and Long-Term Effects of Riding for Children with Cerebral Palsy Gross Motor Functions

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
L. Žalienė ◽  
D. Mockevičienė ◽  
B. Kreivinienė ◽  
A. Razbadauskas ◽  
Ž. Kleiva ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Long Term Effects ◽  
Short Term ◽  
Gross Motor ◽  
Motor Functions ◽  
Gross Motor Skills ◽  
Gross Motor Function ◽  
Group I

Aim. To evaluate the effects of riding for beginners (short-term) and advanced (long-term) riders with cerebral palsy on their whole mobility. The study involved 15 subjects (two girls and eleven boys). The subjects were aged from 3 to 19 years (8.73 years ± 5.85). All of the subjects had been diagnosed with a spastic form of cerebral palsy. The duration of the participation differed as follows: the advanced subjects had been riding for 1-4 years (2.66 years ± 1.16), while the beginners have been riding for two weeks (10 sessions). Group I (advanced riders) consisted of eight subjects (7 boys and 1 girl) who had therapy sessions regularly once a week and differed only in terms of the duration of their participation in the experiment. Group II (beginners) consisted of seven children (1 girl and 6 boys) who participated in only 10 riding sessions. All of the subjects were assessed according to the Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System for CP (GMFCS) both before the investigation and after it. Conclusions. Ten riding lessons did not have an influence on the beginner riders with cerebral palsy gross motor functions and their gross motor function level did not change. However, in half of the advanced riders with cerebral palsy, the gross motor functions significantly improved. Meanwhile, the level of the performance of the gross motor skills in the four advanced riders increased, but this difference was not statistically significant.

Effect of position on gross motor function and spasticity in spastic cerebral palsy children

2021 ◽  
pp. 1-14
Author(s):  
Wardah Rauf ◽  
Samia Sarmad ◽  
Iqra Khan ◽  
Muhammad Jawad ◽  
Admin
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
System Level ◽  
Spastic Cerebral Palsy ◽  
Sitting Position ◽  
Gross Motor ◽  
Motor Functioning ◽  
Five Dimensions ◽  
Gross Motor Function ◽  
Quasi Experimental

Abstract Objective: To evaluate the effect of positioning on gross motor function and spasticity in spastic quadriplegic cerebral palsy children with Gross Motor Function Classification System level IV and V. Methods: A quasi-experimental study was conducted at two Paediatric Physical Therapy Centres from November 2018 to July 2019. The study was comprised of seventy four children with quadriplegic cerebral palsy aged between 3 to 8 years. Data was obtained and gross motor functional abilities and spasticity were assessed by GMFM-88 and Modified Ashworth Scale respectively. Twenty four-hour positioning in specific seats, night positioning and standing frames for six months. The child was being positioned in 24 hours according to his challenges for the period of six months. Semi reclined positioning was performed to manage aspiration, oral leak and to develop retention. Prone positioning was done to develop righting reactions, functional sitting position was used in the treatment regime to attain better upright position and neutral pelvic standing using standing frames. SPSS 24 was used to analyse the data. Results: Paired t-test reported significant improvement in the test scores in lying position, rolling, sitting position, crawling, kneeling, standing, walking or running. n=59 subjects exhibited improvement in the spasticity before and after interventional procedures, while n=15 showed no improvement as the value of p<0.05. Conclusion: Twenty-Four-hour proper body positioning and postural techniques improved gross motor functioning in all of the five dimensions of functioning. The overall spasticity in quadriplegic cerebral palsy children was also reduced due to appropriate positioning techniques.  Continuous....

Gambaran Peningkatan Fungsi Motorik Kasar Pada Anak Cerebral Palsy Spastik Setelah Pemberian Hippotherapy: Literature Review

2021 ◽  
Vol 1 ◽  
pp. 430-438
Author(s):  
Khusnah Khauliya ◽  
A Abdurrachman
Keyword(s):  
Cerebral Palsy ◽  
Literature Review ◽  
Motor Function ◽  
Google Scholar ◽  
Spastic Cerebral Palsy ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Review Analysis ◽  
Gross Motor Function Measure ◽  
Function Measure

AbstractSpastic Cerebral Palsy is a type of Cerebral Palsy that experiences stiffness or tightness of the muscles. These muscles become stiff because messages to the muscles are conveyed incorrectly by the damaged part of the brain. The presence of spasticity will affect gross motor function disorders in children with cerebral palsy. One of the physiotherapy approaches to improve gross motor function is hippotherapy. This literature review study aims to describe gross motor function in Spastic Cerebral Palsy children after giving hippotherapy from several articles. The selection of articles in this study was a literature review analysis using the PICO method, five articles were obtained for review from several data bases such as PubMed (n=2) and Google Scholar (n=3). The measuring instrument uses GMFM (Gross Motor Function Measure) to measure gross motor function in Spastic Cerebral Palsy children. The results of the literature review analysis in these five articles indicate that hippotherapy can improve gross motor function in Spastic Cerebral Palsy children with an average value before the action of 63.65 and after the action of 66.68. From the results of the literature review of these five articles, it shows that hippotherapy is proven to improve gross motor function in Spastic Cerebral Palsy children before and after giving intervention with hippotherapy modality with an average difference of 3.03. Hippotherapy can be used as a reference material for interventions or research materials or physiotherapy research, especially in pediatric cases.Keywords: GMFM; spastic cerebral palsy; hippotherapy AbstrakCerebral Palsy Spastik merupakan salah satu jenis Cerebral Palsy yang mengalami kekakuan atau keketatan otot-otot. Otot ini menjadi kaku karena pesan pada otot disampaikan secara tidak benar oleh bagian otak yang rusak. Adanya spastisitas akan berpengaruh terhadap gangguan fungsi motorik kasar pada anak Cerebral Palsy. Salah satu pendekatan fisioterapi untuk meningkatkan fungsi motorik kasar adalah hippotherapy. Penelitian literature review ini bertujuan untuk mengetahui gambaran fungsi motorik kasar pada anak Cerebral Palsy Spastik setelah pemberian hippotherapy dari beberapa artikel. Pemilihan artikel pada penelitian ini yaitu analisis literature review dengan metode PICO, didapatkan lima artikel untuk direview dari beberapa data base sepertiPubMed (n=2) dan Google Scholar (n=3). Alat ukur menggunakan GMFM (Gross Motor Function Measure) untuk mengukur fungsi motorik kasar pada anak Cerebral Palsy Spastik. Hasil analisis literature review pada kelima artikel ini menunjukkan bahwa hippotherapy dapat meningkatkan fungsi motorik kasar pada anak Cerebral Palsy Spastik dengan nilai rata-rata sebelum tindakan 63,65 dan sesudah tindakan 66,68. Dari hasil literature review kelima artikel ini menunjukkan bahwa hippotherapy terbukti dapat meningkatkan fungsi motorik kasar pada anak Cerebral Palsy Spastik sebelum dan sesudah pemberian intervensi dengan modalitas hippotherapy dengan hasil selisih rata-rata sebesar 3,03. Hippotherapy dapat digunakan sebagai bahan acuan untuk intervensi maupun bahan riset atau penelitian fisioterapi khususnya pada kasus pediatric.Kata kunci : GMFM;cerebral palsy spastik;hippotherapy

scholarly journals Effects of the Inerventions method on gross motor function in children with spastic cerebral palsy

2018 ◽  
Vol 52 (5) ◽  
pp. 581-586
Author(s):  
Indre Bakaniene ◽  
Gintare Urbonaviciene ◽  
Kristina Janaviciute ◽  
Audrone Prasauskiene
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Spastic Cerebral Palsy ◽  
Gross Motor ◽  
Gross Motor Function

scholarly journals The Effect of Robot-Assisted Gait Training on Locomotor Function and Functional Capability for Daily Activities in Children with Cerebral Palsy: A Single-Blinded, Randomized Cross-Over Trial

2020 ◽  
Vol 10 (11) ◽  
pp. 801
Author(s):  
Li Hua Jin ◽  
Shin-seung Yang ◽  
Ja Young Choi ◽  
Min Kyun Sohn
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gait Training ◽  
Daily Activities ◽  
Robot Assisted ◽  
Functional Capability ◽  
Gross Motor ◽  
Children With Cerebral Palsy ◽  
Carry Over

Purpose: The effectiveness of robot-assisted gait training (RAGT) in children with cerebral palsy (CP), especially in terms of improving the performance of daily activities, remains unclear. Therefore, we aimed to investigate the effectiveness of RAGT in children with CP. Methods: In this single-center, single-blinded, randomized cross-over trial, we enrolled 20 children with CP with Gross Motor Function Classification System (GMFCS) levels II–IV (13 males; age range, 6.75 ± 2.15 years). The participants were randomized into the RAGT/standard care (SC) (n = 10) and SC/RAGT/SC sequence groups (n = 10). Using a Walkbot-K system, the RAGT program comprised 3 × 30-min sessions/week for 6 weeks with a continued SC program. The SC program comprised 2–4 conventional physiotherapy sessions/week for 6 weeks. The Gross Motor Function Measure-88 (GMFM-88), the pediatric functional independence measure (WeeFIM), and the Canadian occupational performance measure (COPM) scores were assessed pre- and post-RAGT or SC periods and treatment, period, follow-up, and carry-over effects were analyzed. Energy expenditure and body composition were measured pre- and post-RAGT. Results: Significant treatment effects were observed in dimensions D and E of the GMFM (D: p = 0.018; E: p = 0.021) scores, WeeFIM mobility subtotal (p = 0.007), and COPM performance (p < 0.001) and satisfaction (p = 0.001) measure scores. The period, follow-up, and carry-over effects were not statistically significant. The gross energy cost significantly decreased (p = 0.041) and the skeletal muscle mass increased (p = 0.014) at post-RAGT assessment. The factors associated with functional outcomes showed significant improvements in the GMFM D scores and were mainly observed in children with GMFCS levels II–III compared to those classified at level IV (p = 0.038). Conclusion: RAGT had training benefits for children with CP. Specifically, it improved locomotor function and functional capability for daily activities. These effects were better in ambulatory children with CP. However, as SC interventions continued during the RAGT period, these improvements may be also related to multiple treatment effects.

scholarly journals Functional Strength Training In Children With Spastic Cerebral Palsy

2020 ◽  
Vol 11 (4) ◽  
pp. 5158-5163
Author(s):  
Sathish G ◽  
Swarnakumari P ◽  
Mridhula K Abraham
Keyword(s):  
Cerebral Palsy ◽  
Strength Training ◽  
Training Program ◽  
Motor Function ◽  
Functional Independence ◽  
Spastic Cerebral Palsy ◽  
Gross Motor ◽  
Training Exercise ◽  
Gross Motor Function ◽  
Hemiplegic Cerebral Palsy

To find out functional strength training exercise on improving gross motor function among the children with spastic hemiplegic cerebral palsy children. Single group pre-experimental research design. The most common cause of movement disability in infancy is cerebral palsy. Cerebral palsy patients have impairments such as spasticity, low muscle strength and selective motor control in their body function. Such deficiencies may limit activity performance and participation in everyday life. Improving and optimising activities and involvement are crucial treatment objectives. Functional strength workouts are vital to overcoming obstacles to improving the functionality of children with neurological issues. 92 subjects of spastic hemiplegic cerebral palsied aged 4-8, male and female with spastic hemiplegic cerebral palsy were selected under purposive sampling technique and received functional strength training exercise for a period of ten weeks. To assess the gross motor function (functional independence) pre and post the exercise program, Gross motor functional measure was used. Results: The pre and post measurements shows significant changes in the gross motor function among children with spastic hemiplegic cerebral palsy. The results of the post-test mean values show improvement in gross motor functions after functional strength training program (p<0.05). The functional strength training program proves that increased gross motor function and thereby improvement in functional abilities among children with spastic hemiplegic cerebral palsy after ten weeks of intervention.

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