The Effect of Using Anti spastic Orthosis on the Reduction of Spasticity in Diplegic Spastic Children

Document Type : Original article

Authors

1 MSc of Occupation Therapy. Faculty of Rehabilitation Sciences. Shahid beheshti University of Medical Sciences. Tehran, Iran (corresponding author)

2 MSc of Audiology. Faculty of Rehabilitation Sciences. Shahid beheshti University of Medical Sciences. Tehran, Iran

3 PhD in Occupational Therapy and the member of scientific Core of O.T group in Social Welfare and Rehabilitation University. Tehran, Iran

Abstract

Background and aim: Cerebral palsy is a non progressive brain disorder and, cerebral plasy is the most common type of spastic paralysis which can be the cause of motor and postural deficits during child development. The purpose of this study was to investigate the effect of using Anti spastic Orthosis on the Reduction of Spasticity and in diplegic spastic children between 2 – 5 years in Tehran.
Materials & Methods: 20 diplegic spastic children between 2- 5 years were selected randomly and divided into two groups. The first lower limb spasticity was assessed by a neurologist, and then by an experienced occupational therapist whitout being aware of research process before the intervention, The experimental group went under treatment using positioning therapeutic intervention and neurodevelopmental treatment, while the control group was treated and only with NDT. The research Instrument used was the Modified Ashworth scale (MAS) and the H-Reflex and, H/M ratio in the lower limb spasticity was assessed, Utilizing Experimental pretest - post test with control group design. The data of this study was analyzed using t Test k square test and the findings showed meaningful differences between the two groups.
Result: The findings of this study reveraled meaningful differences between the two groups, scores of mean spasticity in interference group was significantly less than control group (p=0/003)

Conclusion: Application of Anti spastic Orthosis before rehabilitation exercises is recommended for diplegic spastic children

Keywords


  1. Karimzadeh P, Sajedi F. A surrvey (200) cases of cerebral palsy in welfare and rehabilitation centers of Tehran. HAKIM. 2000; 3(2); 161-172.
  2. Charles J, Gordon AM. Development of hand-arm bimanual intensive training (HABIT) for improving bimanual coordination in children with hemiplegic cerebral palsy. Dev Med Child Neurol. 2006 Nov; 48(11):931-6.
  3. Hagberg B, Hagberg G, Olow I. The changing panorama of cerebral palsy in Sweden. VI. Prevalence and origin during the birth year period 1983-1986. Acta Paediatr. 1993; 82(4):387-93.
  4. Sweeney KJ. Neonates of developmental risk. In unphred DA (ED). Neurological Rehabilitation. The CV Mosby Company, St. Luis, Toronto, 1985; 237-9
  5. Morris C. A review of the efficacy of lower-limb orthoses used for cerebral palsy. Dev Med Child Neurol. 2002; 44(3):205-11
  6. Rodgers MM, Albert MC, Schrag DR, Glaser RM:  Assessment of orthotics in cerebral palsy - kinematic and kinetic responses.  Developmental Medicine & Child Neurology, pp. 15-6, 1992.
  7. Kerem M, Livanelioglu A, Topcu M. Effects of Johnstone pressure splints combined with neurodevelopmental therapy on spasticity and cutaneous sensory inputs in spastic cerebral palsy. Dev Med Child Neurol. 2001; 43(5):307-13.
  8. Lou HC. Cerebral palsy and hypoxic-hemodynamic brain lesions in the newborn. In: Coffey CE, Brumbock RA (EDS). Textbook of pediatric Neuropsychiatry, American Psychiatric Association, Washington, DC, 1998; 1073-92
  9. Blasko PA. Pathology of cerebral palsy. In: Sussman M (Ed). The diplegic children Evaluation and Management. American Academy of Orthopedic Surgeons, Park Bridge, IL, 1992; 3-44
  10. Kalantary M. The Effect of Using of Anti spastic Orthosis onspasticity in diplegic spastic (2-8) in Tehran. Pejouhandeh. 2009; 15(3):  95-99. [In persian]
  11. Akbayrak T, Armutlu K, Gunel MK, Nurlu G. Assessment of the short-term effect  of antispastic positioning on spasticity. Pediatr Int. 2005; 47(4):440-5.
  12. Richards CL, Malouin F, Dumas F. Effects of a single session of prolonged plantarflexor stretch on muscle activations during gait in spastic cerebral palsy. Scand J Rehabil Med. 1991; 23(2):103-11.
  13. Bobath K, Bobath B. the neurodevelopmentan traetment. Ic: Scrutton D (ed). Manegement of motor disorders of children with cerebral palsy. J. M. Lipincot, Philadelphia, 1984; 8-70
  14. Brown G T, Burns S A. The efficacy of neurodevelopmental treatments in children: a systematic review. British Journal of occupational therapy. 2001 ; 64(5) : 235 – 244 
Volume 1, Issue 3 - Serial Number 3
September and October 2012
Pages 1-8
  • Receive Date: 12 December 2011
  • Revise Date: 06 April 2012
  • Accept Date: 22 August 2012
  • First Publish Date: 22 September 2012