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Background: Children with spastic diplegia experience tonicity, lack of selective motor control, subnormal postural stability and delayed motor development. Selective dorsal rhizotomy followed by physical therapy is a permanent procedure aimed to alleviate hypertonicity., Objective: To explore the efficacy of selective dorsal rhizotomy (SDR) followed by a physical training on gross motor function (GMF), functional balance, walking capacity, selective motor control (SMC) and energy cost of walking (ECW) of ambulant children with spastic diplegia., Methods: Forty-two children with spastic diplegia aged 5 to 8 years were randomly assigned into the control or SDR-group. Both groups received a designed physical training of progressive functional strength training and standard orthotic management (SOM) 3 times a week for 6 months. GMF, functional balance, ECW, functional capacity and SMC were assessed by gross motor function measure (GMfM-88), pediatric balance scale (PBS), energy expenditure index (EEI), six-minute walking test (6MWT) and selective control assessment of lower extremity (SCALE), respectively. Assessment was carried out before the treatment (baseline), after 6 months (post I) and 1-year follow-up (post II)., Results: From baseline to post I and post II assessments, changes of GMF, functional balance, ECW, functional capacity and SMC within the control and SDR groups showed significant improvements (P < 0.001). Moreover, group comparison showed significant differences in favor of the SDR group., Conclusion: Integrated physical training followed SDR demonstrated qualitative changes and enhancement in motor function, achieved by spasticity reduction.

Aim: To evaluate the effectiveness of a multimodal exercise program incorporating plyometric and balance training on muscle strength and postural stability in children with spastic hemiplegic cerebral palsy (SHCP)., Methods: A total of 57 children with SHCP were enrolled in the study and randomly allocated into three treatment-based groups: plyometric exercises (PLYO group; n  = 19), balance exercises (BAL group, n  = 19), and combined plyometric and balance exercises (PLYO-BAL group; n  = 19). The maximum isometric muscle strength (IMS max ) and postural stability [anterior-posterior stability index (AP-SI), mediolateral stability index (ML-SI), and overall stability index (O-SI)] were measured pre- and post-intervention., Results: By applying the intention-to-treat analysis, the PLYO-BAL group showed greater post-treatment IMS max than the PLYO and BAL groups for the quadriceps ( p =.03 and p =.0002 respectively), hamstrings ( p =.018 and p <.0001 respectively), and dorsiflexors ( p =.006 and p <.0001 respectively). Also, the PLYO-BAL group achieved better post-intervention stability scores as compared to PLYO and BAL groups regarding AP-SI ( p <.0001 and p =.0001 respectively), ML-SI ( p =.001 and p =.015 respectively), and O-SI ( p =.011 and p =.04 respectively)., Conclusions: Incorporation of plyometric and balance exercises in a multimodal rehabilitation program could be an important consideration for enhancing muscle strength and boosting postural stability in children with SHCP.

Background: Children with cerebral palsy show various degrees of dysphagia causing late development of oral motor skills AIM: The aim of this study is to investigate effect of oral sensorimotor stimulation on oropharyngeal dysphagia in children with spastic quadriplegia., Design: This was a double-masked, randomized controlled clinical trial., Setting: Outpatient Clinics of Faculty of Physical Therapy, Cairo University and Modern University of Technology and Information., Population: A convenient sample of 71 children age ranged from 12 to 48 months diagnosed with spastic quadriplegia, were randomly assigned into two groups., Methods: Children in the control group received 90 minutes conventional physical therapy training five times/week for four successive months while those in the experimental group received 20 minutes of oral sensorimotor stimulation before the same program as in control group. Oral motor function, body weight, segmental trunk control and gross motor function were assessed at base-line and after completing treatment., Results: Overall, 64 (32 in the experimental group, 32 in the control group) children completed treatment and data collection. The baseline assessment showed non-significant difference regarding all measured variables while with-in group comparison showed significant improvement in the two groups. The post-treatment comparisons revealed significant difference the oral motor function and physical growth in favor of the experimental group (P<0.05). Finally, there was non-significant difference regarding segmental trunk control and gross motor function (P>0.05)., Conclusions: Oral sensorimotor stimulation has the capability to improve feeding in children with spastic cerebral palsy diagnosed with oropharyngeal dysphagia., Clinical Rehabilitation Impact: OSMS has effect on some of the essential oral motor skills that contribute toward the improvement of feeding performance in children with spastic CP. The results of our study offer remarkable clinical importance for the children and their families.

This study aimed to compare between the impact of virtual reality and mirror therapy on balance, muscle strength and quality of life in unilateral cerebral palsy children. Materials and methods This study involved 36 children of both sexes with unilateral cerebral palsy. Their ages ranged between 6 to 10 years and their motor function ability fell between levels I and II on Growth Motor Functional Classification System (GMFCS). Their grade of spasticity on Modified Ashworth scale was from 1+ to 2. They were allocated to one of two study groups (A and B). A designated physical rehabilitation program was given to both groups. furthermore, group A received a wii fit virtual reality-based program while, group B received mirror therapy. Children in both groups received treatment for three consecutive months, three days per week, 60 minutes per day. Balance, muscle strength and quality of life were assessed using biodex balance system, lafayette hand-held dynamometer and pediatric quality of life inventory cerebral palsy Module respectively for each child in two groups pre and post treatment program. Results Children in the two groups demonstrated a noticeable improvement in the post-treatment average scores of all evaluated outcomes (p 0.001) when compared to pre-treatment average scores. By comparing posttreatment values of both groups, group A showed a noticeably greater improvement than group B (p 0.05). Conclusions Both virtual reality and mirror therapy may be recommended to enhance balance, muscle strength and quality of life in children with unilateral cerebral palsy. Virtual reality is more beneficial in enhancing balance, muscular strength and quality of life among those children. [ABSTRACT FROM AUTHOR]

BACKGROUND: Trunk-pelvic mal-alignment and postural control deficit are common problems facing children with cerebral palsy (CP). OBJECTIVE: The aim of this study was to investigate the relation of trunk and pelvic alignment with postural control in children with diplegic CP. METHODS: Seventy seven children with spastic diplegic CP, aged from 6 to 8 years with level II on Gross Motor Function Classification System, participated in this study. Trunk imbalance, lateral deviation of the spine and pelvic tilt were evaluated by using Formetric instrumentation system while postural control was assessed by using Pediatric Balance Scale. RESULTS: The results showed that there was a moderate negative correlation of trunk imbalance, lateral deviation of the spine and pelvic tilt with postural control (- 0.44, - 0.59 and - 0.57, respectively). CONCLUSIONS: Increased trunk imbalance, lateral deviation of the spine and pelvic tilt may be associated with decreased postural control ability in children with diplegic CP. [ABSTRACT FROM AUTHOR]