Effect of PNF in Improving Lower Extremity Function in Adolescent with Spastic Diplegic Cerebral Palsy-A Case Report (original) (raw)
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https://ijshr.com/IJSHR\_Vol.6\_Issue.1\_Jan2021/IJSHR-Abstract.05.html, 2021
The research focused on assessing the effectiveness of PNF training on lower limb coordination on a Male child with spastic diplegia Cerebral Palsy. Mental and physical dysfunctioning along with the growth, sensation and gait disturbances is termed as Cerebral Palsy. This is unconditional neurological problem that has severe effect on the control and coordination of muscles. This generally occurs at early childhood age or infancy. This research is a case study in which subject was a child with dysfunctioning arms and legs. The branch of Cerebral Palsy that deals with dysfunctioning of arms and legs is termed as Spastic Diplegia. The patient underwent PNF on both lower limbs (hip, knee, foot), followed by hot fermentation. After the intervention, significant improvement is seen in all the outcome measures (gait parameter, BBS score, GFMC score) .As the result affected lower limb improved in terms of coordination, execution and accurateness of the movement, number of jerks, and duration of clonus. Improvement was seen in preciseness and accurateness of coordinated movement at the different ranges of motion for lower limbs. PNF seems to be a promising intervention for improving lower limb movement coordination in Cerebral palsy children. Further investigations are certainly needed to assess.
Biomedicine, 2021
Introduction and Aim: One of the most significant and common clinical finding in a majority of children with (CP) is difficulty in walking and exhibiting poor balance control which results in poor gait and reaching movements as maintenance of stability is critical. There are numerous approaches, protocols and treatment strategies to improve balance and gait control. The aim of this study was to compare the effects of task-oriented training and proprioceptive neuromuscular facilitation exercises (PNF)on mobility and balance in spastic cerebral palsy. Methodology: This was a comparative study design with pre-post type 20 samples were selected based on the inclusion criteria and were divided into two groups. Group A received task-oriented training and group B proprioceptive neuromuscular facilitation and Pre & post measurements were done using paediatric balance scale and timed up and go test. Results:On comparing the post-test values of group A and group B both the group showed significant difference with the pre-test, on comparing the post-test values of group A and group B, group A showed better significance than group B. Conclusion: The present study concluded that there seems to be evidence that task-oriented training is more beneficial in training program for increasing the mobility and balance in spastic cerebral palsy comparing to proprioceptive neuromuscular facilitation.
Cureus
Cerebral palsy (CP) is a condition caused by a non-progressive lesion in the developing brain. CP has a wide range of prevalence, ranging from 1.5 to three cases per 1,000 persons. Newborns weighing less than 2,500 grams now account for half of all incidences of CP. Clinical management in physical therapy is a paradigm for enhancing organizational capacity, integrating evidence-based best practices, and enhancing outcomes. This is a case report of a 21-month-old male child with a history of sudden onset of seizure, fever, drowsiness, frothing from the mouth, and up rolling of eyes. He had a global developmental delay with microcephaly and breakthrough seizures with anemia under evaluation. Magnetic resonance imaging (MRI) brain revealed the possibility of hypoxic-ischemic insult. The child was managed conservatively using medications i.e., ibuprofen (7.5mL/6hrly), cephalosporin (450mg/day in divided doses), and phenytoin. Physiotherapy management was provided with integrative approaches including Neurodevelopmental treatment principles, passive stretching, static weight-bearing exercises, and task-oriented approaches. The evaluation was done using the Modified Ashworth Scale and Gross Motor Function Measure-88 (GMFM-88). Early physiotherapy with integrative approaches helps in the improvement of gross motor developmental milestones in children with Spastic diplegic CP.
Physical Rehabilitation of a Spastic Diplegic Cerebral Palsy Patient -A Case Study
https://www.ijhsr.org/IJHSR\_Vol.12\_Issue.3\_March2022/IJHSR-Abstract.015.html, 2022
Cerebral palsy (CP) is a group of motor deficits induced by non-progressive brain damage in children. CP is a geographic ailment that affects both developed and developing countries with equal frequency. The study's purpose is to help Cerebral Palsy patients better their rehabilitation. The child's problems are being unable to stand without assistance due to truncal imbalance, having poor cognitive and social conduct, and being unable to do daily living activities independently. Children with CP usually have normal anatomic hip alignment when they are born. A variety of factors influence development, including delayed motor milestones and soft tissue anomalies, such as a muscle tone imbalance with strong hip flexors and adductors vs weaker hip extensors and abductors. When the GMFCS was used to evaluate the patient, the diagnosis of Spastic Diplegia cerebral palsy was confirmed. Physiotherapy intervention has been demonstrated to be useful in minimizing problems and improving patient outcomes. Results: These studies revealed the difficulty of evaluating children with cerebral palsy. Clinical PTs must be aware of these complications and the fact that more than one assessment may be required to capture the children with CP's specific skills and behaviors. Conclusion: Because of PT therapy, the patient was able to control his posture, regulate his head and neck, and stand with limited assistance despite wearing a KAFO.
Effect of vibration in the treatment of children with spastic diplegic cerebral palsy
Journal of Vibroengineering, 2017
Cerebral palsy is one of the leading causes of movement and posture disorders. Recently, Vibration, as a treatment method in clinical practice has been used as a complementary approach. The aim of this intervention was to determine the effect of vibration in addition to conventional therapy on spasticity, range of motion and gross motor functions in children with cerebral palsy. A total of 20 children with spastic diplegic cerebral palsy (7-10 years old) were randomly divided into two equal groups (conventional therapy-Control group, and conventional therapy plus Vibration-Vibration group), and participated in a 3-week physiotherapy program. The same exercise program was prescribed for children of both groups; frequency of intervention-five times a week, one session lasted for 45 min. Children in the vibration group apart from conventional therapy also received treatment on a special vibration equipment set at 15 Hz frequency. Ashwort scale was used to assess spasticity, goniometry-range of motion, and Gross Motor Function Measure (GMFM) 88 domain-to assess standing (D) and mobility (E-walking, jumping, and running) functions. Both interventions significantly increased range of motion, decreased spasticity in legs and improved standing and mobility functions (0.05). No statistical differences were found between the two groups after interventions.
Proceedings of the International Conference on Health Informatics and Medical Application Technology, 2019
Spastic cerebral palsy is a type of brain damage that occurs in the extreme part of the pyramids that results in an increase in reflexes that make muscle tone higher than normal. This study aims to look at the effect of a combination of Trunk Mobilization and Neuro Development Treatment on reducing spasticity in spastic type cerebral palsy children. The research design used was one group pre and post test design. Test Results for the results of reducing spasticity in cerebral palsy children before and after the intervention of Trunk Mobilization and Neuro Development Treatment, it can be seen that the value of p = 0.157 which means greater than 0.05 (p> 0.05) so that the null hypothesis (Ho) accepted and the alternative hypothesis (Ha) was rejected. So the conclusion with the acceptance of Ho means there is no effect of a combination of Trunk Mobilization and Neuro Development Treatment to reduce spasticity in children with cerebral palsy after intervention.
Indian Journal of Physiotherapy and Occupational Therapy an International Journal, 2011
To see the effectiveness ofAnkle Foot Orthosis on plantarflexor tone and gross motor functional abilities in children with hemiplegic cerebral palsy Method A total of 30 subjects coming to OPD, Dept of Physical Medicine and Rehabilitation and Paediatrics with a diagnosis of hemiplegic cerebral palsy were included and baseline evaluation was done for tone in ankle and lower extremity (using MAS) and gross motor functional abilities (using GMFM-66). The subjects were allocated equally among group A and group B by convenient sampling scheme with 15 subjects each. ln group A, Ankle Foot orthosis (AFO) along with conventional therapy and in group B, conventional treatment with no Ankle Foot orthosis were used for a period of 3 months followed by reevaluation. Result: The two groups were compared for their scores. These were found to be statistically significant with p value ranging from.003 to <.0001. Conclusions: lt can be concluded thatAnkle Foot orthosis (AFO) helps in normalizing the tone in ankle (plantar-flexors) and lower extremity and can be used as an adjunct to the treatment / therapeutic process to enhance gross motor functional abilities in hemiplegic cerebral palsy children.
Journal of Riphah College of Rehabilitation Sciences , 2023
To evaluate the effect of constraint-induced movement therapy along with conventional therapy and conventional therapy alone on upper extremity spasticity and quality of life in children with cerebral palsy. Methodology: Quasi experimental study. The research was carried out at Faisal Hospital and Children Hospital & Institute of Child Health in Faisalabad from April, 2022 to July 2022. After informed consent and complete evaluation, individuals who fulfill the inclusion criteria were considered for the study. A sample size of 46 were allocated within two groups with one receiving constraint induced movement therapy along with conventional therapy and other receiving conventional therapy alone three times a week for 4 weeks. The results were assessed at the first (week 0), second (week 2), and fourth (week 4) weeks following therapy using the modified Ashworth scale and the cerebral palsy quality of life questionnaire. Results: The mean MAS scores (pre-treatment p > 0.05) was significantly at the second and fourth weeks following therapy (post treatment p < 0.05). Also, at the second and fourth post-treatment readings, (pre-treatment p > 0.05) there was a statistically significant improvement in the mean CPQOL scores (post treatment p < 0.05) Conclusion: Both groups were proven efficient in reducing spasticity and demonstrated improvement in quality of life, however substantial improvement in results was reported in CIMT group.
Peripheral Magnetic Stimulation to Decrease Spasticity in Cerebral Palsy
Pediatric Neurology, 2012
Muscle spasticity in pediatric cerebral palsy limits movement and disrupts motor performance, thus its reduction is important in rehabilitation to optimize functional motor development. Our pilot study used repetitive peripheral magnetic stimulation, because this emerging technology influences spinal and cerebral synaptic transmission, and its antispastic effects were reported in adult neurologic populations. We tested whether five sessions of tibial and common peroneal nerve stimulation exerted acute and long-term effects on spasticity of the ankle plantar flexor muscles in five spastic diparetic children (mean age, 8 years and 3 months; standard deviation, 1 year and 10 months). Muscle resistance to fast stretching was measured with a manual dynamometer as a spasticity indicator. A progressive decrease was observed for the more impaired leg, reaching significance at the third session. This sustained reduction of spasticity may reflect that the peripheral stimulation improved the controls over the spinal circuitry. It thus suggests that a massive stimulation-induced recruitment of sensory afferents may be able to influence central nervous system plasticity in pediatric cerebral palsy.