The early motion effect on the function of spastic diplegia children with cerebral palsy following Surgery and immobilization In lower limb with two methods: bandage and casting

Document Type : Original article

Authors

1 1. Student Research Office, MSc of Ocupational Therapy, Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Occupational Therapy, Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Phd Student in Neuroscience, Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Assistant Professor of Occupational Therapy, Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Orthopaedic Surgeon, Orthopaedic Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran

6 MSc in Biostatistics, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background and Aims: Cerebral palsy is a non-progressive neurological and developmental disability. One of the treatments for cerebral palsy is multi-level surgery in one session (SEMLS). After surgery, bandages and casting techniques are used for immobilization. Compared with the casting, bandage is a new method and no similar study is reported using bandage technique for immobilization after surgery. In the recent years, long-term immobilization after surgery is avoided because of muscle weakness, stiff joints, slow recovery and rehabilitation, and delayed return without restriction to daily activity. The aim of the present study was to evaluate the effect of early movements on the performance of children with cerebral palsy with spastic diplegia following surgery and immobilization in lower limb using two methods: bandage and casting.
Materials and Methods: In the present cross-sectional study, 100 children with hemiplegic and diplegia cerebral palsy, aged 7-12 years old, with indications for surgery, were randomly selected and evaluated using Gross Motor Function Questionnaire (GMFM66). The children underwent surgery using two methods of bandages and casting according to an orthopedic surgeon's opinion. Then, based on the type of immobility used, two groups of 40 were randomly selected. In the first and the third month after the surgery, both groups were evaluated using GMFM66 questionnaire. To compare the two groups, ANOVA and nonparametric Mann-Whithney tests were used.
Results: The mean ratio of gross motor function Based on Gross Motor Function Measure (GMFM66) changes in the first month after surgery was 0.0019 in the cases with bandage. The change was not statistically significant (P=0.42). Because in the first month of the child's leg in plaster, in casting group, the mean ratio changes of gross motor function was not measured. Three months after surgery, the mean ratio changes of gross motor function in both methods of casting and bandage after surgery increased significantly (P<0.001); however, the difference mean ratio changes of gross motor function were not observed to be significant compared with each other (P=0.128). 
Conclusion: In the first month after surgery in bandaged group, children had mobility, but in the casting group, children were immobile. In the third month after surgery, improvement was observed in both methods and statistical results were similar in both groups. 

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The Scientific Journal of Rehabilitation Medicine
Volume 5, Issue 2
July and August 2016
Pages 218-225

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History

  • Receive Date: 05 August 2015
  • Revise Date: 29 January 2016
  • Accept Date: 27 April 2016
  • First Publish Date: 21 June 2016

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