The application of the Balance Trainer parapodium in the therapy of children with cerebral palsy

Agata Michalska, Jolanta Dudek, Mieczysława Bieniek, Anna Tarasow-Zych, Kamila Zawadzka

Agata Michalska, Jolanta Dudek, Mieczysława Bieniek, Anna Tarasow-Zych, Kamila Zawadzka – The application of the Balance Trainer parapodium in the therapy of children with cerebral palsy. Fizjoterapia Polska 2011; 11(3); 273-285

Abstract
Inconstant clinical image and functional state of patients with cerebral palsy as well as difficulties in achievements of intended therapy aims put forward the need for constant searching for new improvement methods by the physiotherapists. The Balance Trainer – static-dynamic parapodium equipped with Balance-Soft computer program – is the device which can be applied in the therapy and diagnostics of persons with cerebral palsy. The aim of the thesis is to estimate the possibilities to apply the Balance Trainer device in the therapy of the children with cerebral palsy. Children and youth (7 subjects) with different forms of ICP, assessed using GMFCS (levels I-IV) scale were qualified for the study. The subjects were initially examined using Balance Trainer parapodium. The tests involved assessment of gravity centre location (balance test), deflection test and the assessment of the ability to perform intended movements in the frontal and sagittal plane. Next, their posture was controlled in standing position and the initially performed tests were repeated. All the results were statistically analysed. In children with lower GMFCS levels (I-II) the treatment brought about better results than in these with higher levels of impairment (III-IV), although a therapeutic success was achieved in each case.Using the Balance Trainer device in the treatment of children with cerebral palsy one can improve both the postural control and movement coordination. The improvement level depends on the form of cerebral palsy and the functional deficiency.
Key words:
Cerebral Palsy, Postural control, static-dynamic parapodium
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Effects of Thera Togs suit on postural stability in patients with central hypotonia. Preliminary report

Agata Michalska, Jolanta Dudek, Michał Linowski, Anna Tarasow-Zych

Agata Michalska, Jolanta Dudek, Michał Linowski, Anna Tarasow-Zych – Effects of Thera Togs suit on postural stability in patients with central hypotonia. Preliminary report. Fizjoterapia Polska 2012; 12(3); 275-284

Abstract
Postural hypotonia is one of the many factors adversely affecting postural stability, understood as the attitude of resistance to interference of endogenous and exogenous interferences. It evokes a number of compensatory responses allowing the stabilization of the body and entailing changes in the reciprocal positioning of the key points: the head, the shoulders and the pelvis. This affects the spatial position of the overall center of mass (COM), changing the base of the support and physiological limits of stability. Thera Togs suit is an orthotic equipment applicable in the treatment of postural hypotonia. Through the compression it provides incentives for proprioceptors, affecting body awareness and postural stability. The paper attempts to assess the impact of Thera Togs suit on postural stability of the studied sample. The sample comprised 8 of Rehabilitation-Education-Pedagogical Centre in Kielce, diagnosed with postural hypotonia who were able to maintain an upright position. In order to evaluate the therapeutic effect of Thera Togs suit, triple stability measurements was carried out, first before putting the suit on and next after one hour and six hours of wearing the suit. A statistically significant improvement in postural stability was observed in each patient, expressed by a decrease in size and area of the confidence ellipse and reduction of the number of postural sways. The corrective effect, resulting from application of the tape, aimed at restoring a symmetrical load distribution between the feet, was not obtained. The preliminary results show an improvement in postural stability in the study group of patients.
Key words:
postural hypotonia, postural stability, orthotic equipment, Therapeutic effects
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A Current Approach to Postural Care for Patients with Cerebral Palsy

Agata Michalska, Zbigniew Śliwiński, Justyna Pogorzelska, Marek Grabski

Agata Michalska, Zbigniew Śliwiński, Justyna Pogorzelska, Marek Grabski – A Current Approach to Postural Care for Patients with Cerebral Palsy. Fizjoterapia Polska 2018; 18(3); 102-112

 

Abstract
Introduction. Rehabilitation is an essential component of therapeutic treatment in cerebral palsy (CP). One of its objectives is to prevent secondary musculoskeletal deformities. The use of various techniques to minimize postural abnormalities and enhance functions is defined as postural care (or postural management). It encompasses proper patient positioning in the lying, sitting and standing positions combined with physical therapy.
Purpose. The purpose of the study is to present a current approach to postural care based on the review of source literature.
Conclusions. No generally accepted recommendations on supporting lying, sitting and standing positions have not been developed under the postural management programme so far. The majority of studies related to this field are conducted on not very numerous groups, with short periods of observations only. Thence it is difficult to assess the effectiveness of the postural management programme, although some study results indicate it as the promising method of neurogenic hip dislocation prevention. Appropriate postural support is deemed to facilitate CP patients’ activity and participation, improve their sense of competency and motivate them to act. Due to changes in equipment designs and new solutions launched, there is an urgent need to continue related research.

Key words:
postural managment, cerebral palsy

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