Tag: GMFM

The Influence of the Soft Torso Orthosis on Motor Functions of Children with Cerebral Palsy – Preliminary Research

Anna Kosiecz, Agnieszka Zdzienicka-Chyła, Jolanta Taczała, Krzysztof Krasowicz, Marta Kuśmierz, Jarosław Napiórkowski

A. Kosiecz, A. Zdzienicka-Chyła, J. Taczała, K. Krasowicz, M. Kuśmierz, J. Napiórkowski – The Influence of the Soft Torso Orthosis on Motor Functions of Children with Cerebral Palsy – Preliminary Research. Fizjoterapia Polska 2020; 20(1); 86-91

Abstract
Introduction. Soft orthopaedic equipment is increasingly used in therapy of children with cerebral palsy. The primary goal of using soft orthoses is to improve the patient’s functioning – their contribution to central stabilization and postural control is emphasized. The principal aim of applying soft orthotics is to enhance the patient’s functioning in everyday life.
Objective. Examination of the influence of using soft torso orthoses on motor skills of children with cerebral palsy.
Material and methods. Four children with cerebral palsy who could walk independently – level I or II according to the Gross Motor Function Classification System (GMFCS) – were qualified for the preliminary research. Motor skills were evaluated in accordance with the Gross Motor Function Measure (GMFM). Evaluation of the functional condition was repeated every 3 months for half a year. The children used soft torso orthoses for about 4 hours a day and participated in rehabilitation exercises with the same frequency as before the study.
Results: Improvement on motor functions, confirmed with an increase in GMFM score by 2.5% on average, was observed in all the children during 6 months.
Conclusions. A positive influence of using soft torso orthoses on improvement in the patients’ functional condition was observed, confirmed with higher GMFM scores.

Key words:
soft orthoses, cerebral palsy, gross motor skills, GMFM

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Effect of Functional Trunk Training Program on Gait Harmony in Children with Spastic Diplegia: A Randomized Controlled Trial

Rasha Atef Saad El Metwally, Kamal El Sayed Shoukry, Amira El Sayed El Bagalaty

Rasha Atef Saad El Metwally, Kamal El Sayed Shoukry, Amira El Sayed El Bagalaty – Effect of Functional Trunk Training Program on Gait Harmony in Children with Spastic Diplegia: A Randomized Controlled Trial. Fizjoterapia Polska 2019; 19(4); 162-170

DOI: https://doi.org/10.56984/8ZG1A35D2

Abstract
Purpose. To determine the effect of functional trunk training on gait harmony in children with spastic diplegic CP by using the core stability and gait training program through strengthen the core area and the modified walker tool. Design. Single blind randomized controlled trial. Methods. Thirty children with CP spastic diplegia participated in this study with ages between four to seven years. They were randomly and equally divided into two groups (A and B), the control and study group respectively. Group A received selected physical therapy program for two hours aiming to improve functional gait ability while group B received the same as group A for only one hour plus the intervention program. The intervention program which is aiming to improve gait harmony consists of two fundamental parts. Firstly, core training and mobility exercises for half an hour. Secondly, gait training on different surfaces by using Modified walker for half an hour. Treatment was conducted for 3 times per week for a successive 3 months for both groups (control A & study B). Modified Ashworth scale (MAS) was used for sample selection. Gait harmony was measured by golden ratio equations which determine the spatiotemporal data from tracker motion analysis program version 5.0.6. Results. By using descriptive analysis to show mean ± standard deviation (SD) for all comparative variables, non-parametric test (chi square) to express the MAS values pretreatment for selection, paired t-test for measuring the pre and post treatment results within group and independent t-test between both groups (control and study) for measuring the results of Gross Motor Function Measure score (GMFM) for walking domain that showed a significant difference between both groups (A & B) post treatment. Usage of multivariate analysis (MANOVA) multivariate to determine the effect of independent variables (side, time and the intervention in both groups A&B) on the dependent variables equation (a, b, and the difference between both equations). There was a significant difference in the following: the proportion of stance/ swing phase time (equation a), the proportion of gait cycle/ stance phase time (equation b) and the difference between the values of both proportions (equation a and b) between both groups. Conclusion. It can be concluded that functional trunk training program in conjunction with a selected physical therapy program improved the gait harmony significantly in children with spastic diplegic CP. Which is obvious in gait harmony equations.

Key words:
cerebral palsy, spastic diplegia, gait harmony, golden ratio, GMFM, MAS

 

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Evaluation of functional status of children with cerebral palsy using selected scales and tests

Małgorzata Kilon, Martyna Ruszkiewicz, Jan W. Raczkowski

M. Kilon, M. Ruszkiewicz, J. W. Raczkowski – Evaluation of functional status of children with cerebral palsy using selected scales and tests. Fizjoterapia Polska 2018; 18(4); 86-93

Abstract
Objective. The aim of the study was to assess the functional status of children with Cerebral Palsy (CP) using selected scales and tests and to analyze the factors affecting the results.
Material and methods. The study involved 33 children diagnosed with CP, aged 4 to 18 years, attending selected rehabilitation centers in the Lodz region. The research tools included: an original questionnaire, the Gross Motor Function Measure (GMFM) and the Gross Motor Function Classification System (GMFCS) to evaluate the gross motor skills and the Manual Ability Classification System (MACS) for fine motor skills.
In the statistical analysis, the influence of quantitative variables on the scale results was determined on the basis of Pearson and Spearman correlation coefficient depending on the distribution. The one-way ANOVA or the non-parametric Kruskal-Wallis test was used to assess the effect of qualitative variables on the functional efficiency of children.
Results. Seven children showed none or extremely low physical fitness. They were children with paralysis of four limbs – tetraparesis. The results of the tests were influenced by the length of pregnancy, birth weight, age and height and verbal-logical contact. No correlation was found between qualitative variables such as gender and coexisting epilepsy. A strong correlation was observed between fine and gross motor activity.
Conclusions. The examined children presented varying levels of functional fitness in the used scales and tests. The number of scores obtained by them was strictly related to the type of CP. Children in better verbal and logical contact achieved better scores in the assessed scales. Subjective assessment of children’s performance according to parents was in compliance with the test results.

Key words:
cerebral palsy, MACS, GMFM, GMFCS

 

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