Izvodljivost i učinak učestalosti robotom potpomognutog treninga hoda na funkcije hoda kod djece s cerebralnom paralizom – Jednostruko slijepa, randomizirana pilot studija

Moza Obaid Saeed Alyahyaee, Jinwoong Cheong, Meeyoung Kim

Moza Obaid Saeed Alyahyaee, Jinwoong Cheong, Meeyoung Kim – The feasibility and effect of robot-assisted gait training frequency on gait functions in children with cerebral palsy – A single blinded, randomized pilot study –  Fizjoterapia Polska 2024; 24(1); 297-303

DOI: https://doi.org/10.56984/8ZG2EF8iRS

Sažetak
Uvod. Cilj ove studije je istražiti izvodljivost i učinak učestalosti robotom potpomognutog treninga hoda (RAGT) na funkcije hoda kod djece s diplegičnom cerebralnom paralizom (CP). Pretpostavili smo da će RAGT s povećanom učestalošću (4 puta tjedno) rezultirati većim poboljšanjima nego RAGT s uobičajenom učestalošću (2 puta tjedno).
Materijali i metode. Četrnaest sudionika s diplegičnom CP podijeljeno je u dvije grupe koje su primale samo RAGT na različitim učestalostima. Grupa za tretman (TG) primila je 24 sesije, dok je kontrolna grupa (CG) primila samo 12 sesija tijekom 6 tjedana. Procjenjivane su mjere bruto motoričke funkcije (GMFM) D, GMFM E, hodna udaljenost (test hoda od 6 minuta), brzina (test hoda od 10 metara), ravnoteža (Pedijatrijska skala ravnoteže) i kvaliteta hoda (Edinburška vizualna ocjena hoda). Podaci su prikupljeni dva puta, prije i nakon perioda intervencije RAGT. Također, izvodljivost je procijenjena sigurnošću te stopama regrutacije, usklađenosti i pridržavanja.
Rezultat. Došlo je do značajnog poboljšanja u GMFM D, GMFM E, hodnoj udaljenosti, ravnoteži i kvaliteti hoda u obje grupe (p < 0.05). Brzina hoda značajno se poboljšala samo u TG. Razlika u kvaliteti hoda je veća u TG (p < 0.01) u usporedbi s CG (p < 0.05). Stopa regrutacije bila je 70%. 100% regrutiranih sudionika usklađeno je s intervencijom i pridržavalo se iste. Nisu prijavljeni nikakvi neželjeni događaji.
Zaključak. RAGT s povećanom učestalošću mogao bi inducirati veće poboljšanje funkcija hoda od RAGT-a s uobičajenom učestalošću kod djece s diplegičnom CP.
Ključne riječi
rehabilitacija, robotika, hodanje, cerebralna paraliza
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Virtualna stvarnost naspram ravnotežne grede u hodanju djece s cerebralnom paralizom spastične hemiplegije: Randomizirano kontrolirano usporedno ispitivanje

Mohanad M. Madboly, Khaled A. Olama, Hamada E. Ayoub, Doha H. Al-Afify, Doaa Saeed, Walaa A. Abd El-Nabie

Mohanad M. Madboly, Khaled A. Olama, Hamada E. Ayoub, Doha H. Al-Afify, Doaa Saeed, Walaa A. Abd El-Nabie – Virtual reality versus balance beam on walking performance in children with spastic hemiplegic cerebral palsy: A randomized controlled comparative trial –  Fizjoterapia Polska 2024; 24(1); 222-228

DOI: https://doi.org/10.56984/8ZG2EF8E30

Sažetak
Pozadina. Virtualna stvarnost i ravnotežna greda široko su priznati kao izuzetno uspješan pristup poboljšanju ravnoteže kao i performansi hodanja među djecom koja pate od cerebralne paralize spastične hemiplegije (CP). Svrha. Cilj ove studije bio je usporediti utjecaj virtualne stvarnosti i ravnotežne grede na performanse hodanja (ravnotežu i funkcionalni kapacitet hodanja) u djece s hemiplegijskom CP. Sudionici i metode. Ukupno sedamdeset petoro djece s hemiplegijskom CP, uključujući 31 dječaka i 44 djevojčice, u dobi od 7 do 11 godina oba spola, uključeno je u ovu studiju. Sudionici su nasumično raspoređeni u tri grupe (n = 25), A (kontrolna grupa) i B, C (grupe za studiju). Sva djeca primila su dizajnirane programe fizioterapije temeljene na neurološkoj razvojnoj tehnici, uz dodatak vježbi ravnoteže i hodanja za kontrolnu grupu A, trening virtualne stvarnosti za grupu B i trening ravnotežne grede za grupu C. Program liječenja primjenjivan je tri puta tjedno tijekom tri uzastopna mjeseca, trajajući jedan sat po sesiji. Sva djeca su klinički pregledana prije i poslije tretmana korištenjem HUMAC sustava za ravnotežu i nagib, te testa hodanja od 6 minuta (6mWT) za procjenu ravnoteže, odnosno funkcionalnog kapaciteta hodanja. Rezultati. Došlo je do značajnog poboljšanja u ravnoteži i 6MWT kod sve tri grupe nakon tretmana u usporedbi s predtretmanom (p < 0.001). Štoviše, mjerene varijable grupa B i C pokazale su znatno poboljšanje u odnosu na grupu A (p < 0.01), dok između grupa B i C nije bilo značajne razlike (p > 0.05). Zaključci. Trening virtualne stvarnosti i ravnotežne grede imaju učinkovit utjecaj na poboljšanje ravnoteže i performansi hodanja.
Ključne riječi
ravnotežna greda, cerebralna paraliza, funkcionalni kapacitet hodanja, hemiplegičan, virtualna stvarnost
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Effect of Minds in Motion program on vestibular function and balance in children with hemiplegia: A randomized controlled study

Dina Mohammed Mustafa Abdelhamid, Emam Hassan El Negmy, Hoda Ishac AbuMoussa, Samah Attia El Shemy


Dina Mohammed Mustafa Abdelhamid, Emam Hassan El Negmy, Hoda Ishac AbuMoussa, Samah Attia El Shemy – Effect of Minds in Motion program on vestibular function and balance in children with hemiplegia: A randomized controlled study. Fizjoterapia Polska 2022; 22(3); 170-178

Abstract
Purpose. To investigate the effect of Minds in Motion (MiM) program on vestibular function and dynamic balance in children with hemiplegia.
Methods. Thirty children with hemiplegic cerebral palsy (CP) of both genders with age ranged from 6-12 years were randomly assigned into two groups of equal number; Group (A) (control group), received specially designed physical therapy program for 3 months, Group (B) (study group), received MiM vestibular exercise program in addition to the specially designed physical therapy program given to the control group for 3 months. Vestibular functions and stability indices were assessed for all children before and after treatment using cervical vestibular evoked myogenic potentials (cVEMPs) device and biodex balance system (BBS) respectively.
Results. The results of the present study showed statistically significant improvement within both groups when comparing their pre and post-treatment mean values of stability indices and VEMP amplitude. Post-treatment significant improvement was also observed in the amplitude asymmetry ratio (AAR) in the study group compared with the pre-treatment mean values while no significant change was detected in the control group. Also, no significant changes were detected in P1, and N1 latencies in both groups after treatment. Statistically significant differences were observed in all measured variables between both groups in favor of the study group while there was no significant difference between both groups when comparing the post-treatment mean values of P1 and N1 latencies.
Conclusion. Minds in motion program is an effective modality that can be used for improving the vestibular functions and balance capabilities in children with hemiplegic CP.

Key words:
cerebral palsy, hemiplegia, minds in motion, vestibular function, balance

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Influence of biofeedback training time on muscle torque and knee excursion following semitendinosus release in spastic quadriplegic children with cerebral palsy: A randomized controlled trial

Heba A. Bahey El- Deen, Radwa S. Abdul-Rahman, Magda Ramadan Zahran, Shaimaa Abdalaleem Abdelgeleel

Heba A. Bahey El- Deen, Radwa S. Abdul-Rahman, Magda Ramadan Zahran, Shaimaa Abdalaleem Abdelgeleel – Influence of biofeedback training time on muscle torque and knee excursion following semitendinosus release in spastic quadriplegic children with cerebral palsy: A randomized controlled trial. Fizjoterapia Polska 2021; 21(5); 166-171

Abstract
Background. Medial hamstring shortening represents a serious common complication in children suffering from spastic quadriplegic cerebral palsy. Objective. The purpose of the study was to examine the efficacy of biofeedback training timing following tendon release in spastic quadriplegic cerebral palsied children. Design. a prospective, single-blind, randomized controlled trial. Setting: several hospitals across Giza and Cairo, where children were operated. Methods. Thirty spastic quadriplegic cerebral palsied children of both genders, with their ages ranged from 7 to 9 years (x ̅  = 8.2 ± 0.86 yr.) were randomly assigned into two equal groups (A and B). The control group (A) was trained using electromyographic biofeedback daily for two weeks after removal of plaster cast, in addition to an hour/ day of a designed physical therapy program, while the study group (B) was trained by electromyographic biofeedback during the immobilization period and for two weeks after removal of the cast along with the same physical therapy program as the group (A). The knee extensors’ peak torque and knee excursion angle were measured immediately and two weeks following cast removal by MERAC isokinetic system and electro-goniometer, respectively. Results. The findings exhibited a significant increase (P < 0.05) in the peak torque of knee extensors and an increase in knee excursion in the group (B) immediately and after two weeks of the cast removal when compared with the results of the group (A) after the same period. Conclusion. Applying electromyographic biofeedback training at the two-week immobilization period resulted in a strengthening of the quadriceps and maintaining the obtained range of knee extension following semitendinosus muscle release in spastic quadriplegic children with cerebral palsy.
Key words:
cerebral palsy, spastic quadriplegia, biofeedback, dynamometer
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Whole body vibiration versus pulsed magentic field on bone denisty in spastic diplegic children: A randomized controlled trial

Mahmoud N.Khattab, Gehan H.El Meniawy, Eman I.El Hadidy, Rokia A.El Banna

Mahmoud N.Khattab, Gehan H.El Meniawy, Eman I.El Hadidy, Rokia A.El Banna – Whole body vibiration versus pulsed magentic field on bone denisty in spastic diplegic children: A randomized controlled trial. Fizjoterapia Polska 2021; 21(5); 82-88

Abstract
Background and Purpose. Despite the well-known benefits of whole body vibration and pulsed magnetic field on bone density in spastic diplegic children, none of the former studies had evaluated the difference between both techniques on bone density in spastic diplegic children. Therefore the aim of this study was to evaluate the difference between whole body vibration and pulsed magnetic field during the application of a selected exercises program on bone density in children with spastic diplegic cerebral palsy. Materials and Methods. Thirty spastic diplegic children participated in this study. They were classified randomly into two groups of equal numbers, group A and group B. DEXA was used to evaluate bone density and muscle lean in the two groups before and after three successive months of application of the treatment programs. Group A received whole body vibration and selected exercises program. Group B received the same exercises program given to group A plus pulsed magnetic field. Results. Comparing The pre-treatment results revealed non significant difference in all the measuring variables between the two groups. In comparing the pre and post-treatment results for both groups revealed significant improvement in all measured variables. Post treatment results between two groups show no difference. Conclusion. It can be concluded that, whole body vibration and pulsed magnetic field can be considered as an effective modality in improving bone mineral density and can be used safely in the treatment program of spastic diplegic cerebral palsied children.
Key words:
cerebral palsy, diplegia, bone density, whole body vibration, pulsed magnetic field
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Hippotherapy as one of the elements of comprehensive pediatric rehabilitation at the Zgorzelec Rehabilitation Center

Zbigniew Śliwiński, Anna Morawska, Bartłomiej Halat

Zbigniew Śliwiński, Anna Morawska, Bartłomiej Halat – Hippotherapy as one of the elements of comprehensive pediatric rehabilitation at the Zgorzelec Rehabilitation Center. Fizjoterapia Polska 2002; 2(3); 250-256

Abstract
The hyppotherapy is one of the form rehabilitation in the ICP. This manner of treat used only one kind of horse’s walk which name is walk. The horse riding normalizes the tension of muscles . It is connected with the correct position on horse , the rhythmic movement of rider, alternately flex and relax of muscle and the temperature of horse. The horse riding for children who don’t walk to let the felling the location own body in air space. In the hyppotherapy the authors distinguish ; therapeutic horse riding, horse’s rehabilitation, therapy by the contact with horse, pedagogic and therapeutic bareback riding, the horse riding for disabled people. The authors presented the indication to the horse riding- neurological syndromes, faulty posture genetic illness eg Down’ syndrome, myelomeningocele. They described also the contraindication eg. mental handicap, epilepsy, osteoporosis, injures on the of skin, retinodialises, injures or column, rethrolisteses and allergy to horse’s fur, sweat or odour. The authors presented also the rules comprehensive rehabilitation for children with ICP which is used in the Rehabilitation Center in Zgorzelec.

Key words:
ICP, hipotherapy form, idication and contridication

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Postoperative three-dimensional gait analysis in a child with cerebral palsy – ankle and knee joint kinematics

Wiesław Chwała, Dorota Pamuła

Wiesław Chwała, Dorota Pamuła – Postoperative three-dimensional gait analysis in a child with cerebral palsy – ankle and knee joint kinematics. Fizjoterapia Polska 2006; 6(4); 322-327

Abstract
The aim of this study was to assess ankle joint kinematics in a child with hemiplegic cerebral palsy after multiple soft tissue surgery. Gait analysis was performed using a video-based 3-dimensional gait analysis system (VICON). The gait of the child differed significantly at ankle and knee joints from that seen in a normal population. The stance phase was prolonged in both lower extremities. At the ankle significant differences were found in preswing, initial contact, loading response and terminal swing. Gait analysis demonstrated increased dorsiflexion, especially at preswing, most likely due to the prior surgery. The stance length was prolonged (by over 10%). At the knee significant differences were found in preswing, initial contact, loading response and terminal swing. The hemiparetic leg commonly presents as a functional shortening of two muscles: the rectus femoris and the tibialis anterior during the GC and little concentric action of the gastrocnemius muscle in preswing. The observed changes in muscle length confirm inadequate extension of the knee and increased dorsiflexion during stance.

Key words:
three-dimensional gait analysis, cerebral palsy, ankle and knee joints

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ffect of locomotor training with a robotic-gait orthosis (lokomat) In Spasticity Modulation of Spastic Hemiplegic Children: A Randomized Controlled Trial

Mohamed Serag Eldein Mahgoub, Wagdy William Amin, Samah Saad Zahran

Mohamed Serag Eldein Mahgoub, Wagdy William Amin, Samah Saad Zahran – Effect of locomotor training with a robotic-gait orthosis (lokomat) In Spasticity Modulation of Spastic Hemiplegic Children: A Randomized Controlled Trial. Fizjoterapia Polska 2020; 20(4); 94-101

Abstract
Background. Studying of robotic-assisted locomotor training (lokomat) in spasticity modulation on cerebral palsied hemiplegic children is a strategy for determining its efficacy in reducing spasticity.
Objective. To investigate the efficacy of robotic-assisted locomotor training (lokomat) in spasticity modulation. Methods. Thirty spastic hemiplegic cerebral palsied children of both genders ranged in age from 7 to 14 years contributed in this study, they were being randomly selected from comprehensive rehabilitation center and assigned into two equal groups (15 children each). Control group (A) underwent traditional exercise treatment, while Study group (B) underwent lokomat gait training in addition to traditional exercise program. Lokomat training was performed 3 days/week for 4 weeks with up to 45 minutes of training per session. The 3-D kinematics gait analysis was carried out before and after intervention and used as an indicator for improvement and reduction of spasticity.
Results. there was a statistically significant improvement in the study group in comparison to control group. Conclusion. Lokomat gait training is an effective additional tool for physical therapy program in treatment of hemiparetic C.P. children as it plays an important role in decreasing spasticity and improving patient gait pattern.

Key words:
cerebral palsy, spasticity, 3-D measurement, Lokomat gait training

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Impact of Hand-Arm Bimanual Intensive Therapy Versus Shock Wave Therapy on Hand Function and Grip Strength in Children with Hemiplegic Cerebral Palsy

Amr A. Abo Gazya, Abdel Aziz A. Serief, Ayman Gouda Matar, Wael Shendy, Hamada Ahmed Hamada

Amr A. Abo Gazya, Abdel Aziz A. Serief, Ayman Gouda Matar, Wael Shendy, Hamada Ahmed Hamada – Impact of Hand-Arm Bimanual Intensive Therapy Versus Shock Wave Therapy on Hand Function and Grip Strength in Children with Hemiplegic Cerebral Palsy. Fizjoterapia Polska 2020; 20(1); 92-98

Abstract
Background and purpose. Children with hemiplegic cerebral palsy have impairments in fine motor skills above and beyond their unilateral impairments. The current study was conducted to compare the effect of hand-arm bimanual intensive therapy (HABIT) versus shock wave therapy on the affected upper extremity in children with hemiplegic cerebral palsy. Materials and methods. Thirty hemiplegic children ranged in age from 4 to 8 years with hand spasticity ranged between 1 and 1+ grades according to the Modified Ashworth Scale participated in this study. They were assigned randomly into two equal study groups. Group A received a designed physical therapy program and shock wave therapy one session 2000 shock, while the group B received the same physical therapy program in addition to bimanual arm therapy. Both groups received treatment sessions three times per week for three successive moths. Each child in the two groups was evaluated before and after the suggested treatment duration for detecting the level of hand performance using the Peabody Developmental Test of Motor Proficiency while, hand grip strength by a hand held dynamometer and active abduction and external rotation range of motion were measured by a standard universal goniometer. Results. The results revealed non-significant differences when comparing the pre-treatment mean values of all measuring variables for the two groups (p > 0.05), while significant improvement was observed in the two groups when comparing their pre and post treatment mean values. Also, significant differences were observed when comparing the post treatment results of the two groups in favor of the group B (p < 0.05). Conclusion. The results suggested that, hand-arm bimanual intensive therapy appears to have a positive impact on hand function in children with hemiplegic cerebral palsy.

Key words:
Cerebral palsy, Hemiplegic, Hand-arm bimanual intensive therapy, shock wave therapy

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