Effectiveness of physical therapy interventions for children with cerebral palsy

Cerebral palsy (CP) describes a group of permanent disorders of motor development and posture that cause limiting activity that are attributed to non-progressive dysfunctions occurring in the development of fetal brain or of the child.The main purpose of the paper is to study the clinical and functional aspects with implications in the design and evaluation of the complex recovery therapy of the child with psycho-neuro-motor disabilities diagnosed with infantile cerebral palsy (ICP).The study took place during the period June 2016 - March 2018, is of the type prospectively and comprised 5 children diagnosed with ICP, aged 4 to 12 years. Criteria for inclusion in the recovery group: children diagnosed with infantile cerebral palsy form spastic tetra- spastic, without orthopedic surgery, during the study period. Children have been given a comprehensive assessment of body attitude, upper and lower limb hypertonia, upper limbs functionality, and global motor function.The major objective of recovering the child with infantile cerebral palsy was to improve the quality of life by creating conditions for minimum patient autonomy. The functional recovery program was carried out three times a week using exercises and methods of neuro-motor rehabilitation. Duration of the session was 50-60 min.Due to the results obtained at the initial and final evaluation, a tonus improvement was observed in all the tested muscles, with a decrease in the mobilization resistance of all the muscle groups. In global functional evaluation the total score on the 5 sections of the 5 children with CP had an initial mean value of 34.92 (± 16.60) and a final of 47.72 (± 26.53)Stretching, neuro-motor reeducation methods and active physical exercises help to increase the degree of the functional independence.

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Relationship between modified TUG and WeeFIM in children with cerebral palsy

International Journal of Physiotherapy and Research ◽

10.16965/ijpr.2021.171 ◽

2021 ◽

Vol 9 (5) ◽

pp. 4001-4007

Author(s):

Praveen Baby ◽

◽

Haripriya S ◽

Remya N ◽

Manju Unnikrishnan ◽

...

Keyword(s):

Cerebral Palsy ◽

Motor Development ◽

Brain Lesion ◽

Functional Independence ◽

The Body ◽

Functional Mobility ◽

Spastic Cerebral Palsy ◽

Pearson’S Correlation ◽

Children With Cerebral Palsy ◽

Pearson's Correlation

Background: Cerebral Palsy (CP) refers to permanent, mutable motor development disorders stemming from a primary brain lesion, leading to secondary musculoskeletal alterations, and limitation of activities of daily living. Motor impairment is the main manifestation in children with CP, and it has consequent effects on the biomechanics of the body. The WeeFIM is a short and quick to administer assessment of functional outcome in paediatric rehabilitation. The modified Timed Up and Go test (mTUG) was designed for children with Cerebral Palsy and assesses mobility and requires both static and dynamic balance. Context and Purpose: Determining if a relationship exists between functional mobility and level of functional independence in daily activities will help to design treatment programs which target improvement in functional mobility in order to improve functional independence in children with Cerebral Palsy. The studies done correlating functional balance and functional performance in children with CP have largely yielded inconclusive results. Hence this study was designed with the aim of finding if a relationship exists between functional mobility measured by mTUG and functional independence measured by WeeFIM in children with CP. Methods: It was a correlation study conducted on 20 children with spastic cerebral palsy from different CP centers in and around Mangalore. Participants were evaluated using modified TUG and WeeFIM scales and the scores tabulated and subjected to statistical analysis to determine if there is a relationship exists between mTUG and WeeFIM. Results: When the measured variables were correlated with each other using Pearson’s correlation it was found that the Pearson’s correlation coefficient was - .470, indicating a moderate negative correlation between the mTUG and WeeFIMscores. Conclusion: There exists a positive relationship between functional mobility and functional independence in children with CP. Improving mobility in children with CP can help them to attain better functional independence. KEY WORD: Cerebral Palsy, GMFC, mTUG, WeeFIM.

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Clinical study on motor-development Tuina therapy for infantile cerebral palsy

Journal of Acupuncture and Tuina Science ◽

10.1007/bf02845373 ◽

2005 ◽

Vol 3 (2) ◽

pp. 34-38

Author(s):

Shi Wei ◽

Shi Bing-pei ◽

Liao Yuan-gui ◽

Xu Xiu-juan ◽

Wang Su-juan

Keyword(s):

Cerebral Palsy ◽

Clinical Study ◽

Motor Development ◽

Infantile Cerebral Palsy ◽

Tuina Therapy

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A Path Model for Evaluating Dosing Parameters for Children With Cerebral Palsy

Physical Therapy ◽

10.2522/ptj.20130022 ◽

2014 ◽

Vol 94 (3) ◽

pp. 411-421 ◽

Cited By ~ 47

Author(s):

Mary E. Gannotti ◽

Jennifer B. Christy ◽

Jill C. Heathcock ◽

Thubi H.A. Kolobe

Keyword(s):

Cerebral Palsy ◽

Physical Therapy ◽

Clinical Decision Making ◽

Readiness To Change ◽

Functional Independence ◽

Family Characteristics ◽

Path Model ◽

Community Factors ◽

Children With Cerebral Palsy ◽

Therapy Interventions

Dosing of pediatric rehabilitation services for children with cerebral palsy (CP) has been identified as a national priority. Establishing dosing parameters for pediatric physical therapy interventions is critical for informing clinical decision making, health policy, and guidelines for reimbursement. The purpose of this perspective article is to describe a path model for evaluating dosing parameters of interventions for children with CP. The model is intended for dose-related and effectiveness studies of pediatric physical therapy interventions. The premise of the model is: Intervention type (focus on body structures, activity, or the environment) acts on a child first through the family, then through the dose (frequency, intensity, time), to yield structural and behavioral changes. As a result, these changes are linked to improvements in functional independence. Community factors affect dose as well as functional independence (performance and capacity), influencing the relationships between type of intervention and intervention responses. The constructs of family characteristics; child characteristics (eg, age, level of severity, comorbidities, readiness to change, preferences); plastic changes in bone, muscle, and brain; motor skill acquisition; and community access warrant consideration from researchers who are designing intervention studies. Multiple knowledge gaps are identified, and a framework is provided for conceptualizing dosing parameters for children with CP.

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Looking at General Movements (GM) with a computer-aided approach. First results of a study in progress on the early detection of infantile cerebral palsy (ICP)

Neuropediatrics ◽

10.1055/s-0029-1215862 ◽

2008 ◽

Vol 39 (05) ◽

Author(s):

KS Kim ◽

K Wochner ◽

D Karch ◽

H Philippi ◽

M Hadders-Algra ◽

...

Keyword(s):

Cerebral Palsy ◽

Early Detection ◽

Infantile Cerebral Palsy ◽

Computer Aided ◽

First Results ◽

General Movements

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Clinical Observation on Chiropractic Exercise Therapy for Infantile Cerebral Palsy

Rehabilitation Medicine ◽

10.3724/sp.j.1329.2017.06046 ◽

2017 ◽

Vol 27 (6) ◽

pp. 46

Author(s):

Jiarui LIU ◽

Qiuyang XIANG ◽

Li ZHOU ◽

Lanli LI ◽

Yihong CHEN ◽

...

Keyword(s):

Cerebral Palsy ◽

Exercise Therapy ◽

Clinical Observation ◽

Infantile Cerebral Palsy

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Evaluation of Individualized Functional Electrical Stimulation-Induced Acute Changes during Walking: A Case Series in Children with Cerebral Palsy

Sensors ◽

10.3390/s21134452 ◽

2021 ◽

Vol 21 (13) ◽

pp. 4452

Author(s):

Nicole Zahradka ◽

Ahad Behboodi ◽

Ashwini Sansare ◽

Samuel C. K. Lee

Keyword(s):

Cerebral Palsy ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Physical Therapists ◽

Physical Therapist ◽

Case Series ◽

Phase Detection ◽

Lower Extremity Muscle ◽

Children With Cerebral Palsy ◽

Muscle Groups

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

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