scholarly journals Myofascial Structural Integration Therapy on Gross Motor Function and Gait of Young Children with Spastic Cerebral Palsy: A Randomized Controlled Trial

2015 ◽  
Vol 3 ◽  
Author(s):  
Elizabeth C. Loi ◽  
Christina A. Buysse ◽  
Karen S. Price ◽  
Theresa M. Jaramillo ◽  
Elaine L. Pico ◽  
...  
2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Qamar Mahmood ◽  
Dr. Shaista Habibullah ◽  
Prof. Dr. Muhammad Naveed Babur

Objective: To evaluate the effects of traditional massage (TM) on spasticity and gross motor function in children with cerebral palsy (CP). Methods: This randomized control trial (RCT) was conducted with recruitment of 86 children (Dropped out= 11; Analyzed= 75) with spastic CP (diplegia) allocated randomly through sealed envelope method to intervention and control group with ages between 2-10 years from September 2016 to August 2018. Both groups received conventional physical therapy (CPT) once daily, five times a week for a period of three months. However, intervention group received TM additionally. Modified Ashworth Scale (MAS), Gross Motor Function Measure (GMFM-88) and Gross Motor Function Classification System (GMFCS) were used to evaluate spasticity and gross motor function at the beginning, after six and 12 weeks of intervention. Data were compared and analyzed through SPSS-20. Results: Mean age in control and intervention group was 6.81±2.31 and 7.05±2.47 years respectively. No statistically significant differences in MAS, GMFM and GMFCS scores were found at base line. The children in intervention group showed statistically significant reduction in MAS scores in all four limbs after six and 12 weeks of intervention (p < 0.05) in comparison with the control group. However, GMFM scores and GMFCS levels did not change significantly in intervention group as compared to control group. Conclusion: It is concluded that TM can effectively reduce the spasticity, does not have harmful effects, so can be administered safely by mothers at home and making it suitable for the management of spastic CP. However, in order to achieve better gross motor function, it should be practiced in conjunction with CPT, functional skills and task oriented approaches. doi: https://doi.org/10.12669/pjms.35.5.478 How to cite this:Mahmood Q, Habibullah S, Babur MN. Potential effects of traditional massage on spasticity and gross motor function in children with spastic cerebral palsy: A randomized controlled trial. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.478 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2015 ◽  
Vol 95 (8) ◽  
pp. 1151-1162 ◽  
Author(s):  
Mattana Angsupaisal ◽  
Baudina Visser ◽  
Anne Alkema ◽  
Marja Meinsma-van der Tuin ◽  
Carel G.B. Maathuis ◽  
...  

Background It is debatable whether adaptive riding (AR) in children with cerebral palsy (CP) improves postural control and gross motor development. Objective The study aim was to explore the feasibility of an extensive assessment protocol for a randomized controlled trial of therapist-designed adaptive riding (TDAR) in children with CP, with the goals of assessing the effect on child outcomes and evaluating working mechanisms of sitting postural control. Design A pretest-posttest group design with 2 baseline measurements was used. Methods Six children (1 girl, 5 boys; age range=6–12 years, median age=8 years 9 months) with bilateral spastic CP (Gross Motor Function Classification System level III) participated. Outcomes were evaluated 3 times (T0, T1, and T2) at 6-week intervals. T0 and T1 were baseline measurements; between T1 and T2, a TDAR intervention including an integrated program of postural challenge exercises (2 times per week for 1 hour) was applied. The complex protocol included the 88-item Gross Motor Function Measure (GMFM-88) and electromyographic (EMG) recording of postural muscle activity during reaching while sitting (EMG recording at T1 and T2 only). Results The protocol was feasible. Median GMFM-88 scores changed from 64.4 at T0 to 66.7 at T1 and from 66.7 at T1 to 73.2 at T2. The change scores for all children exceeded the minimal clinically important difference of the GMFM-88. Five of 6 children showed a decrease in stereotyped top-down recruitment between T1 and T2. Limitations Study limitations included the lack of a control group, small sample size, and potential assessor bias for all but the EMG parameters. Conclusions The feasibility of the complex protocol was established. The data suggested that a 6-week TDAR intervention may improve gross motor function and may reduce stereotyped postural adjustments in children with CP. The limited results warrant replication in a well-powered randomized controlled trial.


2021 ◽  
Author(s):  
Caitlin Hurd ◽  
Donna Livingstone ◽  
Kelly Brunton ◽  
Allison T Smith ◽  
Monica A Gorassini ◽  
...  

Background: Perinatal stroke injures motor regions of the brain, compromising movement for life. Early, intensive, active interventions for the upper extremity are efficacious, but interventions for the lower extremity (LE) remain infrequent and understudied. Objective: To determine the efficacy of ELEVATE – Engaging the Lower Extremity Via Active Therapy Early – on gross motor function, as compared to usual care. Methods: We conducted a single–blind, two–arm, randomized controlled trial (RCT), with the Immediate Group receiving the intervention while the Delay Group served as a three–month waitlist-control. A separate cohort living beyond commuting distance was trained by their parents with guidance from physical therapists. Participants were 8 months to 3 years old, with MRI–confirmed perinatal ischemic stroke and early signs of hemiparesis. The intervention was play–based, focused on weight–bearing, balance and walking for 1 hour/day, 4 days/week for 12 weeks. The primary outcome was the Gross Motor Function Measure–66 (GMFM–66). Secondary outcomes included steps and gait analyses. Final follow–up occurred at age four. Results: Thirty–four children participated (25 RCT, 9 Parent-trained). The improvement in GMFM–66 over 12 weeks was greater for the Immediate than the Delay Group (average change 3.4 units higher) and greater in younger children. Average step counts reached 1370–3750 steps/session in the last week of training for all children. Parent–trained children also improved but with greater variability. Conclusions: Early, activity–intensive LE therapy for young children with perinatal stroke is feasible and improves gross motor function in the short term. Longer term improvement may require additional bouts of intervention.


2012 ◽  
Vol 27 (2) ◽  
pp. 150-159 ◽  
Author(s):  
Elizabeth Bryant ◽  
Terry Pountney ◽  
Heather Williams ◽  
Natalie Edelman

Objective: To determine the effect of a six-week exercise intervention on gross motor function for non-ambulant children with cerebral palsy. Design: A parallel arm randomized controlled trial. Setting: Four special schools. Participants: Thirty-five children aged 8–17 with bilateral cerebral palsy; Gross Motor Function Classification System levels IV–V. Method: Participants were randomly allocated to a static bike group, a treadmill group or control group. Participants in the bike and treadmill groups received exercise training sessions, three times weekly for six weeks. The control group received their usual care. Blinded assessments were performed at baseline and six weeks and followed up at 12 and 18 weeks. Outcome measures: Gross Motor Function Measures GMFM-66, GMFM-88D and GMFM-88E. Results: At six weeks significant differences were found in GMFM-88D scores between the bike group and the control group, and the treadmill group and the control group ( P < 0.05). The mean change (SD) in GMFM-88D score was 5.9 (6.8) for the bike group; 3.7 (4.4) for the treadmill group and 0.5 (1.9) for the control group. No significant differences were found for GMFM-66 or GMFM-88E scores between the bike group and control group, or the treadmill group and control group, although trends of improvement were observed for both exercise groups. The improvements observed declined during the follow-up period. Conclusion: This study provides preliminary evidence that exercising on a bike or treadmill may provide short-term improvements in gross motor function for non-ambulant children with cerebral palsy. This needs to be tested in a large-scale randomized trial.


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