Does chest mobilization affect trunk control and balance in children with spastic cerebral palsy
DOI:
https://doi.org/10.18203/2320-6012.ijrms20251295Keywords:
Activities of daily living, Balance, Impairments, SpasticityAbstract
Background: Chest mobility has been reported to be reduced in children with spastic cerebral palsy (CP). This study was conducted to determine the effectiveness of chest wall mobilisation on trunk control and balance in children with CP.
Methods: The 32 children who participated in this single-blind trial were divided into two groups at random. Group A (n=16) received conventional intervention and chest mobilisation, while group B (n=16) received only conventional intervention. For a period of six weeks, the intervention was carried out three days a week. After six weeks of therapy, participants were reassessed using the paediatric berg balance scale (PBS) for evaluating balance and the trunk control measurement scale (TCMS) for evaluating trunk control.
Results: The Wilcoxon test was used to assess differences within the group, while the Mann Whitney 'U' test was used to determine whether there were any differences between the two groups. The pre- and post-treatment scores of the variables TCMS and PBS were used to illustrate the results as a mean and standard deviation. Comparison of each group's outcome metrics before treatment revealed no significant differences. While, comparing the results of chest mobilisation with conventional physiotherapy in group A showed a notable improvement in the ability to maintain balance and trunk control (p<0.05)
Conclusions: In children with CP, chest mobilisation has a positive effect and can be combined with conventional physiotherapy techniques to enhance balance and develop trunk control.
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References
Levitt S, Addison A. Treatment of cerebral palsy and motor delay. John Wiley & Sons. 2018. DOI: https://doi.org/10.1002/9781119373902
Aisen ML, Kerkovich D, Mast J, Mulroy S, Wren TA, Kay RM, et al. Cerebral palsy: clinical care and neurological rehabilitation. The Lancet Neurol. 2011;10(9):844-52. DOI: https://doi.org/10.1016/S1474-4422(11)70176-4
Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med and Child Neurol. 2005;47(8):571-6. DOI: https://doi.org/10.1017/S001216220500112X
Johnson A. Prevalence and characteristics of children with cerebral palsy in Europe. Developmental Med and Child Neurol. 2002;44(9):633-40. DOI: https://doi.org/10.1111/j.1469-8749.2002.tb00848.x
Oskoui M, Coutinho F, Dykeman J, Jetté N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta‐analysis. Dev Med & Child Neurol. 2013;55(6):509-19. DOI: https://doi.org/10.1111/dmcn.12080
Chauhan A, Singh M, Jaiswal N, Agarwal A, Sahu JK, Singh M. Prevalence of cerebral palsy in Indian children: a systematic review and meta-analysis. The Indian J of Pediatrics. 2019;86:1124-30. DOI: https://doi.org/10.1007/s12098-019-03024-0
El-Basatiny HMY, Abdel-Aziem AA. Effect of trunk exercises on trunk control, balance and mobility function in children with hemiparetic cerebral palsy. International J of Therapies and Rehabilitation Res. 2015;4(5):236. DOI: https://doi.org/10.5455/ijtrr.00000094
Apaydin U, Aribas Z, Erol E, Aydin Y, Kocyigit M, Elbasan B. The Effects of Trunk Control on Respiratory Muscle Strength and Activities of Daily Living in Children with Cerebral Palsy. Iranian Journal of Pediatrics. 2018;28(6):34. DOI: https://doi.org/10.5812/ijp.69849
Parmar D, Parmar S, Bagalkot PS, Joshi S, Shah L. Effectiveness of Rib Cage Mobility Exercises versus Conventional Physiotherapy on Trunk Impairment in Children with Neurodevelopmental Disorders: A Randomized Trial. Critical Reviews™ in Physical and Rehabilitation Medicine. 2022;34(4). DOI: https://doi.org/10.1615/CritRevPhysRehabilMed.2022044801
Woollacott MH, Shumway-Cook A. Postural dysfunction during standing and walking in children with cerebral palsy: what are the underlying problems and what new therapies might improve balance? Neural plasticity. 2005;12(2-3):211-9. DOI: https://doi.org/10.1155/NP.2005.211
Shumway-Cook A, Woollacott M, Shumway-Cook A, Woollacott M. Mobility function. Motor control: theory and practical applications Philadelphia: Lippincott Williams & Wilkins. 2001:305-37.
Talgeri AJ, Nayak A, Karnad SD, Jain P, Tedla JS, Reddy RS, et al. Effect of Trunk Targeted Interventions on Functional Outcomes in Children with Cerebral Palsy-A Systematic Review. Developmental Neurorehabilitation. 2023;26(3):193-205. DOI: https://doi.org/10.1080/17518423.2023.2193265
Panibatla S, Kumar V, Narayan A. Relationship between trunk control and balance in children with spastic cerebral palsy: a cross-sectional study. Journal of clinical and diagnostic research: JCDR. 2017;11(9):5. DOI: https://doi.org/10.7860/JCDR/2017/28388.10649
McCrum-Gardner E. Sample size and power calculations made simple. International Journal of Therapy and Rehabilitation. 2010;17(1):10-4. DOI: https://doi.org/10.12968/ijtr.2010.17.1.45988
Heyrman L, Molenaers G, Desloovere K, Verheyden G, De Cat J, Monbaliu E, et al. A clinical tool to measure trunk control in children with cerebral palsy: the Trunk Control Measurement Scale. Res in Dev Disab. 2011;32(6):2624-35. DOI: https://doi.org/10.1016/j.ridd.2011.06.012
Heyrman L, Desloovere K, Molenaers G, Verheyden G, Klingels K, Monbaliu E, et al. Clinical characteristics of impaired trunk control in children with spastic cerebral palsy. Research in developmental disabilities. 2013;34(1):327-34. DOI: https://doi.org/10.1016/j.ridd.2012.08.015
Her JG, Woo JH, Ko J. Reliability of the pediatric balance scale in the assessment of the children with cerebral palsy. Journal of Physical Therapy Science. 2012;24(4):301-5. DOI: https://doi.org/10.1589/jpts.24.301
Chen C, Shen I, Chen C, Wu C, Liu W, Chung C. Validity, responsiveness, minimal detectable change and minimal clinically important change of pediatric balance scale in children with cerebral palsy. Research in Develop Disab. 2013;34(3):916-22. DOI: https://doi.org/10.1016/j.ridd.2012.11.006
Dean E, Frownfelter DL. Cardiovascular and pulmonary physical therapy: Evidence and practice: Mosby St. Louis, MO, USA. 2006.
Leelarungrayub D. Chest mobilization techniques for improving ventilation and gas exchange in chronic lung disease, chronic obstructive pulmonary disease. Current Concepts and Practice. 2012;2:400. DOI: https://doi.org/10.5772/28386
Bennett JA. The consolidated standards of reporting trials (CONSORT): Guidelines for reporting randomized trials. Nursing Res. 2005;54(2):128-32. DOI: https://doi.org/10.1097/00006199-200503000-00007
Azam AM. Efficacy of specialized trunk training program in improving thorax circumference and functional reaching skill in quadriparesis cerebral palsied children. Int J Physiother Res. 2017;5(6):2566-71. DOI: https://doi.org/10.16965/ijpr.2017.250
El Banna EH, El Hadidy EI, Ali WM. Effect of respiratory therapy on pulmonary functions in children with cerebral palsy: a systematic review. Bulletin of Faculty of Physical Therapy. 2020;25(1):1-11. DOI: https://doi.org/10.1186/s43161-020-00016-6
Diwan SJ, Bansal AB, Chovatiya H, Kotak D, Vyas N. Effect of anterior chest wall myofascial release on thoracic expansion in children with spastic cerebral palsy. Int J Contemp Pediatr. 2014;1(2):94-9. DOI: https://doi.org/10.5455/2349-3291.ijcp20140802
Liang X, Tan Z, Yun G, Cao J, Wang J, Liu Q, et al. Effectiveness of exercise interventions for children with cerebral palsy: A systematic review and meta-analysis of randomized controlled trials. J Rehabil Med. 2021;53(4):176. DOI: https://doi.org/10.2340/16501977-2772
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