scholarly journals Effect of Pulley Therapy on Genurecurvatum in Children with Unilateral Cerebral Palsy: Randomized Controlled Trial

2021 ◽  
Vol 15 (7) ◽  
pp. 1961-1965
Author(s):  
Merhan M. Hamouda ◽  
Nanees E. Mohamed ◽  
Walaa A. Abd el-Nabie

Objectives: Genu recurvatum commonly represents a more challenging problem that interferes with activities of daily living in children with cerebral palsy. This study aimed to investigate the effect of pulley therapy on genu recurvatum in children with unilateral cerebral palsy. Methods: Forty children with unilateral cerebral palsy aged from 3 to 6 years were randomly allocated into two equal groups: control group and study group. Both groups received designed physical therapy program in addition, study group received pulley therapy program instead of using free weights in control group for strengthening hamstring and tibialis anterior muscles. The program's protocol applied for one hour, three times per week for three successive months for each group. Degree of genu recurvatum was assessed pre- and post-treatment by using digital goniometer while, muscle strength of hamstring and tibialis anterior was assessed by using Lafayette manual muscle tester device. Results: Both groups showed significant improvement of all measured variables post treatment. The significant improvement after treatment in degree of genu recurvatum and muscle strength was obtained in favor to study group (p<0.05). Conclusions: Pulley therapy may be used within the rehabilitation program of children with unilateral cerebral palsy to treat genu recurvatum. Key words: Unilateral cerebral palsy, Hemiplegia, Genu recurvatum, Progressive resistance training, Pulley therapy.

2021 ◽  
Vol 15 (7) ◽  
pp. 1994-1998
Author(s):  
Merhan M. Hamouda ◽  
Nanees E. Mohamed ◽  
Walaa A. Abd el-Nabie

Objectives: Genu recurvatum commonly represents a more challenging problem that interferes with activities of daily living in children with cerebral palsy. This study aimed to investigate the effect of pulley therapy on genu recurvatum in children with unilateral cerebral palsy. Methods: Forty children with unilateral cerebral palsy aged from 3 to 6 years were randomly allocated into two equal groups: control group and study group. Both groups received designed physical therapy program in addition, study group received pulley therapy program instead of using free weights in control group for strengthening hamstring and tibialis anterior muscles. The program's protocol applied for one hour, three times per week for three successive months for each group. Degree of genu recurvatum was assessed pre- and post-treatment by using digital goniometer while, muscle strength of hamstring and tibialis anterior was assessed by using Lafayette manual muscle tester device. Results: Both groups showed significant improvement of all measured variables post treatment. The significant improvement after treatment in degree of genu recurvatum and muscle strength was obtained in favor to study group (p<0.05). Conclusions: Pulley therapy may be used within the rehabilitation program of children with unilateral cerebral palsy to treat genu recurvatum. Key words: Unilateral cerebral palsy, Hemiplegia, Genu recurvatum, Progressive resistance training, Pulley therapy.


2021 ◽  
pp. 1-11
Author(s):  
Ragab K. Elnaggar ◽  
Bader A. Alqahtani ◽  
Saud F. Alsubaie ◽  
Rania R. Mohamed ◽  
Mohammed F. Elbanna

BACKGROUND: Children with unilateral cerebral palsy (UCP) experience an asymmetrical gait pattern and poor balance capabilities. Effective interventions, therefore, are needed to facilitate remediation of these functional issues. OBJECTIVE: This study was set out to investigate the emerging role of stretch-shortening cycle (SSC) exercises on gait-symmetry and balance in children with UCP. METHODS: In this randomized controlled trial, 42 children with UCP (age; 8 –12 years) were enrolled and received either standard physical rehabilitation (control group; n = 21) or the SSC exercise program plus physical rehabilitation (SSC group; n = 21). Spatial- and temporal-gait symmetry index (GSI) and specific balance capabilities [reactive balance, directional control, movement synchronization, and sensory organization] were assessed before and after 16 sessions that were carried out twice/week over non-sequential days in an 8-week program. RESULTS: Using the pre-treatment scores as covariates, the post-treatment spatial- (P = 0.006; η p 2 = 0.17) and temporal- GSI (P <  .001; η p 2 = 0.46) scores reduced significantly in the SSC group as compared to the control group, suggesting favorable improvement of gait symmetry. Also, all measures of balance (P <  0.05; η p 2 ranged between 0.10 and 0.29) improved remarkably, post-treatment, in SSC group in comparison with the control group. CONCLUSION: The evidence from this study suggests that SSC exercises besides standard physical rehabilitation appear to be effective for improving gait symmetry and boosting balance capabilities in children with UCP.


2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Mohamed Bedier Ibrahim ◽  
Mahmoud Labib ◽  
Hamed Khozamy ◽  
Wanees Mohamed Badawy

Abstract Background Juvenile idiopathic arthritis (JIA) is one of the serious chronic rheumatic disorders in children and adolescents which results in less physical activities and restlessness hours than their peer. The study aims to assess the efficacy of physical fitness training exercises on aerobic capacity and muscular strength of children with JIA. Sixty-five children with JIA were included in the study, out of a total of 70 children who were screened for eligibility. Children were randomized to a control group (n = 32) who received hot packs, transcutaneous electrical nerve stimulation (TENS), and strengthening exercises, or a study group (n = 33) who received a physical fitness training program (hydrotherapy pool exercises, bicycle ergometer, and treadmill apparatus) in addition to what had been given to the control group. Both groups were engaged in a training program for 12 consecutive weeks for three times per week. Evaluation was done pre- and post-interventions included: peak oxygen uptake (Vo2 peak) during an incremental treadmill test and muscle strength assessed by isokinetic dynamometer. Results The current study showed that there were significant differences between pre- and post-interventions in both groups (P < 0.05). Comparing the two groups, there were statistically significant differences between children in both groups in favor of the study group (P < 0.05). Conclusions Physical fitness exercise training resulted in improved aerobic capacity and muscle strength of children with JIA. The obtained results suggested that children with arthritis could participate in formal exercise testing and structural physical fitness program. Trial registration PACTR, PACTR201907504136763. Registered on May 21, 2019. Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID = 8150.


Author(s):  
Ahmed M. Azam

Objectives: This work was carried out to investigate the efficacy of upsee therapy program with an enriched stimulating active environment on improvement gross, fine motor abilities and weight bearing distribution in spastic diplegic cerebral palsy children. Method: Thirty children were enrolled in this study and randomly assigned into two groups; group A received (upsee therapy program plus specific physiotherapy training) and group B (specific physiotherapy training program only). Gross motor functional measure (GMFCS), pegboard test and weight bearing distribution stages evaluation were used to detect and follow gross, fine motor abilities and weight bearing distribution. This measurement was taken before initial treatment and after 12 weeks of treatment. The children parents in both groups A and B were instructed to complete 3 hours of the home routine program every day. Dependent t-test was used to compare pre to post treatment changes. Results: Data analysis was available on the 30 spastic diplegic cerebral palsied children participated in the study. The difference between pre and post-treatment results was more significant in (GMFCS) upsee group than the control group. Weight-bearing distribution stages evaluation and pegboard test demonstrate representative improvement in the study groups (p=0.0001) while insignificant in the control groups. Conclusion: The addition of upsee therapy program to specific physiotherapy training is recommended in improving gross, fine motor abilities and weight bearing. So this suggested approach may be used as a selective choice for improving walking, hand functions and weight bearing abilities in spastic diplegic cerebral palsy children.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Raheel Sanad ◽  
Shimaa Mohamed Refaat ◽  
Faten Hassan Abdelazeim ◽  
Bassant Meligy

Abstract Background Cough assist devices play an important role with patients in the intensive care unit (ICU), particularly those with neuromuscular diseases which had abnormal muscle tone. It was previously thought to be the main technique for improving cough efficacy, which aids in weaning from mechanical ventilation and improves patient outcomes. So, we selected randomly the odd numbers from Abo El-Reesh hospital records, and 30 children of both sexes with pneumonia were selected, aged from 6 months to 3 years, who were selected from intensive care unit: fifteen children were the control group, who received the selected physical therapy program (postural drainage, percussion and resist diaphragm), and another fifteen children were the study group, who received previous physical therapy program, which was selected, and cough assist device. Results This study revealed the effect of cough assist device on blood gasses and the period of mechanical ventilator on children with pneumonia and general hypotonia. There was a significant decrease in pH, PaCO2, and HCO3 post treatment compared with that pretreatment in the study and control groups (p < 0.05). The percentage of decrease in pH, PaCO2, and HCO3 in study group A were 0.4, 38.26, and 30.28% respectively while that in the control group were 0.4, 32.56, and 25.48% for pH, PaCO2, and HCO3 respectively. There was a significant increase in PaO2 post treatment compared with that pretreatment in the study and control groups (p < 0.001). The percentage of increase in PaO2 in the study group was 32.13% and that in control group was 30.09%. There was no significant difference in pH, PaCO2, and HCO3 between both groups pre-treatment (p ˃ 0.05). Also, there was no significant difference between groups post treatment (p ˃ 0.05). The median (IQR) period of mechanical ventilation in the study group was 5 (7, 4) days while that in control group was 8 (18, 5) days. There was a significant decrease in period of mechanical ventilator of the study group compared with that of control group (p = 0.03). Conclusion The cough assist device and physical therapy program were selected for children in the intensive care unit which have the same effect on arterial blood gasses as they optimize pH, PO2, PCO2, and HCO3, but the cough assist device helps in accelerating weaning of mechanical ventilator so as decrease the period of mechanical ventilator.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 209.2-210
Author(s):  
L. Marchenkova ◽  
V. Vasileva ◽  
M. Eryomushkin

Background:Due to the demand for special rehabilitation programs for patients with osteoporotic vertebral fractures (VFs), it is of interest to study the functional abilities of those patients. The scientific hypothesis suggests that osteoporotic VFs would cause muscle weakness, muscle dysfunction and conditional disturbances.Objectives:to estimate muscle strength, motor function and coordination disorders in patients with VFs in the setting of systemic osteoporosis as a basis for rehabilitation programs developing.Methods:120 patients aged 43−80 with primary osteoporosis were enrolled. Study group comprised of 60 subjects (56 women, 4 men) with at least 1 VF confirmed by X-rays. Control group included 60 subjects (56 women, 4 men) with osteoporosis but without any osteoporotic fracture. The examination program included back muscles tenzodynamometry, balance tests and stabilometry.Results:Muscle strength deficiency was estimated in study group in trunk flexors (TF) — 40.9% and in trunk extensors (TE) — 18.1% with an adequate function of the left lateral flexors (LLF) and in right lateral flexors (RLF). Patients with VFs had the lower muscle strength vs controls of TE (15.64±9.8 vs 27.73±9.9 kg, p=0.00002), TF (14.61±8.98 vs 21.28±8.38 kg, p=0.0006), LLF (13.10±7.2 vs 24.06±8.9 kg, p=0.005) and RLF 13.44±7.43 vs 24.26±7.65 kg, p=0.0003). Patients with VFs lose their balance faster during one-leg-standing test with open eyes (5.0 [1.0; 10.0] vs 7.5 [5.0; 10.5] sec in control group, p=0.03) and with closed eyes (2.0 [0; 3.0] vs 3.5 [3.0; 5.0] sec, p=0.04). Fukuda-Unterberger test showed greater side dislocation in study group — 40° [25; 45] vs controls 30° [10; 45], (p=0.02). According to stabilometry study group was characterized vs control group by lower balance coefficient with open eyes (77.2±7.6 vs 85.7±9.4%, p=0.002) and with closed eyes (67.1±9.8 vs 73.4±9.9%, p=0.03), greater sagittal displacement (6.8 [2.1; 37.7] vs 4.8 [1.8; 10.7] mm, p=0.025) and deviation in the saggital plane (1.2 [-1.07; 1.5] vs -1.2 [-1.5; 1.2] mm, p=0.01), and also less pressure center velocity (9.51±4.4 vs 7.1±2.7 mm/sec, р=0.009).Conclusion:Osteoporotic VFs are associated with reduction of trunk muscles strength and negatively affect static and dynamic balance function that should be taken into account when developing rehabilitation programs for these patients.Disclosure of Interests:None declared.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Rania G. Hegazy ◽  
Amr Almaz Abdel-aziem ◽  
Eman I. El Hadidy ◽  
Yosra M. Ali

Abstract Background Hemiplegic cerebral palsy (CP) enormously affects the quadriceps and hamstring muscles. It causes weakness in the affected lower-extremity muscles in addition to muscle imbalance and inadequate power production, especially in the ankle plantar-flexor and knee extensor muscles. It also causes anomalous delayed myoelectrical action of the medial hamstring. A whole-body vibration (WBV) exercise can diminish muscle spasticity and improve walking speed, muscle strength, and gross motor function without causing unfavorable impacts in adults suffering from CP. Thus, the aim of this study is to investigate the impacts of WBV training associated with conventional physical therapy on the quadriceps and hamstring muscle strength, endurance, and power in children with hemiparetic CP. Results The post-intervention values of the quadriceps and hamstring muscle force, endurance, and power were significantly higher than the pre-intervention values for both groups (p = 0.001). The post-intervention values of the study group were significantly higher than the control group (quadriceps force, p = 0.015; hamstring force, p = 0.030; endurance, p = 0.025; power, p = 0.014). Conclusion The 8 weeks of WBV training that was added to traditional physical therapy was more successful in improving the quadriceps and hamstring muscle strength, endurance, and power in children with hemiparetic CP when compared to traditional physical therapy alone.


2015 ◽  
Vol 58 (3) ◽  
pp. 535-549 ◽  
Author(s):  
Mara R. Kapsner-Smith ◽  
Eric J. Hunter ◽  
Kimberly Kirkham ◽  
Karin Cox ◽  
Ingo R. Titze

PurposeAlthough there is a long history of use of semi-occluded vocal tract gestures in voice therapy, including phonation through thin tubes or straws, the efficacy of phonation through tubes has not been established. This study compares results from a therapy program on the basis of phonation through a flow-resistant tube (FRT) with Vocal Function Exercises (VFE), an established set of exercises that utilize oral semi-occlusions.MethodTwenty subjects (16 women, 4 men) with dysphonia and/or vocal fatigue were randomly assigned to 1 of 4 treatment conditions: (a) immediate FRT therapy, (b) immediate VFE therapy, (c) delayed FRT therapy, or (d) delayed VFE therapy. Subjects receiving delayed therapy served as a no-treatment control group.ResultsVoice Handicap Index (Jacobson et al., 1997) scores showed significant improvement for both treatment groups relative to the no-treatment group. Comparison of the effect sizes suggests FRT therapy is noninferior to VFE in terms of reduction in Voice Handicap Index scores. Significant reductions in Roughness on the Consensus Auditory-Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were found for the FRT subjects, with no other significant voice quality findings.ConclusionsVFE and FRT therapy may improve voice quality of life in some individuals with dysphonia. FRT therapy was noninferior to VFE in improving voice quality of life in this study.


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