Efficacy of Balance Training Program on Improvement of Knee Flexion Deformity in Spastic Diplegic Cerebral Palsied Children
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- Category: Vol. 78, December 2010
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Efficacy of Balance Training Program on Improvement of Knee Flexion Deformity in Spastic Diplegic Cerebral Palsied Children,AHMED M. AZZAM, MOHAMED B. EBRAHIM and ABD EL-AZIZ A. ABD EL-AZIZ
Abstract
Objective: The aim of this work was to show the effect of balance training program on improvement of motor control of knee joint, tightness of hamstring, gastrocnemius, gracillis and passive range of knee extension.
Methods: Thirty children were enrolled in this study and randomly assigned into two groups of equal number. Both groups had tightness of knee flexors, decreased extension ROM, all of the child can stand with support and all children who had surgical release of tightness were excluded from the study. Standard plastic goniometer was used to detect and follow knee extension from the point of flexion deformity, flexibility tests was used to detect hamstring, gastrocnemius and gracillis muscles flexibility in addition to tape measurement was used alternatively to measure distance between the heel to buttock at the point of extension limitation. These measure-ments were taken before initial treatment and after 12 weeks of treatment. The Group A (study group) include 15 spastic diplegic C.P. children who received a course of balance training program that include static and dynamic postural stability training plus traditional physiotherapy program. Group B (control group) include 15 spastic diplegic C.P. children who received a traditional physiotherapy program only. children parents in both groups were instructed to wear both knee immobilizers during standing and sleep. The children in group A were advised to perform balance training program as a home routine.
Results: Data analysis were available on 30 spastic diplegic C.P. children and there was insignificant difference in the variables related to age and sex (p>0.05). The mean value of knee flexion pre and post treatment showed highly statistical significant difference (p<0.01) for the right lower limb in group (A) also statistically significant difference(p<0.05) to the right lower limb in group (B). On the other hand there was a highly statistical significant difference of the (Lt) lower limb pre and post treatment in the study group (p<.01) while non significant difference to the (Lt) lower limb in the control group (p>0.05). The mean value of pre and post treatment revealed that distance between buttock and heel being highly statistical significant pronounced (p<0.01) in Rt and Lt side of study group than control one (p<0.05).
Conclusion: The use of balance training program plus traditional physiotherapy program are superior to traditional physiotherapy alone for all measurement that include knee mobility and hamstring, gastrocnemius and gracillis flexibility after 12 weeks follow up.