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The Effect of Task-oriented Training on Mobility Function, Postural Stability in Children with Cerebral Palsy

  • Received : 2017.07.17
  • Accepted : 2017.08.04
  • Published : 2017.08.31

Abstract

PURPOSE: The purpose of this study is to examine how task-oriented training focused on lower extremity strengthening can affect mobility function and postural stability. METHODS: The study's subjects included 10 children with cerebral palsy: 7 girls and 3 boys between the ages of 4 and 9 whose Gross Motor Functional Classification System (GMFCS) level was I or II. Their functional mobility was gauged using the Gross Motor Function Measurement (GMFM), and their postural stability was evaluated using a force platform. Participants received task-oriented training focused on lower extremity strengthening for 5 weeks. The study used a paired t-test to investigate the difference in mobility function and postural stability of children with cerebral palsy before and after the lower extremity strengthening exercise. RESULTS: The GMFM dimensions D (standing) (p<.02) and E (walking) (p<.001) improved significantly between the pre-test and post-test. A significant increase in the posturographic center of pressure (CoP) shift and surface area of the CoP were found overall between the pre-test and post-test (p<.001). CONCLUSION: The present study provides evidence that an 8-week task-oriented training focused on strengthening the lower extremities is an effective and feasible strategy for improving the mobility function and postural stability of children with cerebral palsy.

Keywords

References

  1. Ahl LE, Johansson E, Granat T, et al. Functional therapy for children with cerebral palsy: an ecological approach. Dev Med Child Neurol. 2005;47(9):613-9. https://doi.org/10.1111/j.1469-8749.2005.tb01213.x
  2. Barbeau H. Locomotor training in neurorehabilitation: emerging rehabilitation concepts. Neurorehabil Neural Repair. 2003;17(1):3-11. https://doi.org/10.1177/0888439002250442
  3. Bax M, Goldstein M, Rosenbaum P, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol. 2005;47(8):571-6. https://doi.org/10.1017/S001216220500112X
  4. Blundell SW, Shepherd RB, Dean CM, et al. Functional strength training in cerebral palsy: a pilot study of a group circuit training class for children aged 4-8 years. Clin Rehabil. 2003;17(1):48-57. https://doi.org/10.1191/0269215503cr584oa
  5. Chen J, Woollacott MH. Lower extremity kinetics for balance control in children with cerebral palsy. J Mot Behav. 2007;39(4):306-16. https://doi.org/10.3200/JMBR.39.4.306-316
  6. Cho C, Hwang W, Hwang S et al. Treadmill training with virtual reality improves gait, balance, and muscle strength in children with cerebral palsy. Tohoku J Exp Med. 2016;238(3):213-8. https://doi.org/10.1620/tjem.238.213
  7. Bunton EE, Pitney WA, Cappaert TA et al. The role of limb torque, muscle action and proprioception during closed kinetic chain rehabilitation of the lower extremity. J Athl Train. 1993;28(1):10-20.
  8. Domagalska-Szopa M, Szopa A, Czamara A. Dependence of Gait Deviation on Weight-Bearing Asymmetry and Postural Instability in Children with Unilateral Cerebral Palsy. PLoS One. 2016;11(10):e0165583. https://doi.org/10.1371/journal.pone.0165583
  9. Johnson P. The Acquisition of Skill. London. Academic Press. 1984.
  10. Katz-Leurer M, Rotem H, Keren O et al. The effects of a 'home-based' task-oriented exercise programme on motor and balance performance in children with spastic cerebral palsy and severe traumatic brain injury. Clin Rehabil. 2009;23(8):714-24. https://doi.org/10.1177/0269215509335293
  11. Ko JY, Kim MY. Inter-rater reliability of the K-GMFM_88 and the GMPM for children with cerebral palsy. Ann Rehabil Med. 2012;36(2):233-39. https://doi.org/10.5535/arm.2012.36.2.233
  12. Ko MS, Chung JH, Jeon HS. Correlation between pediatric balance scale and gross motor function measurement scores in children with cerebral palsy. J Korean Soc Phys Med. 2010;5(2):637-45.
  13. Lee MS, Choi JD. The effects of task oriented training with suspension device on trunk stability and gross motor function of children with spastic diplegia cerebral palsy. J Korean Soc Phys Med. 2013;8(4):637-45. https://doi.org/10.13066/kspm.2013.8.4.637
  14. Magill RA. Motor Learning: Concepts and Applications (7th ed). Boston. McGraw-Hill. 2004.
  15. Mulligan H, Abbott S, Clayton S, et al. The outcome of a functional exercise programme in an adolescent with cerebral palsy: a single case study. NZ J Physiother. 2004; 32(1):30-8.
  16. Papavasiliou AS. Management of motor problems in cerebral palsy: a critical update for the clinician. Eur J Paediatr Neurol. 2009;13(5):387-96. https://doi.org/10.1016/j.ejpn.2008.07.009
  17. Pavao SL, Nunes GS, Santos AN et al. Relationship between static postural control and the level of functional abilities in children with cerebral palsy. Braz J Phys Ther. 2014;18(4):300-7. https://doi.org/10.1590/bjpt-rbf.2014.0056
  18. Peungsuwan P, Parasin P, Siritaratiwat W et al. Effects of Combined Exercise Training on Functional Performance in Children With Cerebral Palsy: A Randomized-Controlled Study. Pediatr Phys Ther. 2017;29(1):39-46. https://doi.org/10.1097/PEP.0000000000000338
  19. Salem Y, Godwin EM. Effects of task-oriented training on mobility function in children with cerebral palsy. NeuroRehabilitation. 2009;24(4):307-13.
  20. Schneiberg S, McKinley PA, Sveistrup H et al. The effectiveness of task-oriented intervention and trunk restraint on upper limb movement quality in children with cerebral palsy. Dev Med Child Neurol. 2010;52(11):e245-53. https://doi.org/10.1111/j.1469-8749.2010.03768.x
  21. Stackhouse C, Shewokis PA, Pierce SR et al. Gait initiation in children with cerebral palsy. Gait Posture. 2007;26(2):301-8. https://doi.org/10.1016/j.gaitpost.2006.09.076
  22. Thorpe D. The role of fitness in health and disease: status of adults with cerebral palsy. Dev Med Child Neurol. 2009;51(s4):52-8. https://doi.org/10.1111/j.1469-8749.2009.03433.x
  23. Vincer MJ, Allen AC, Joseph KS et al. Increasing prevalence of cerebral palsy among very preterm infants: a population-based study. Pediatrics. 2006;118(6): e1621-6. https://doi.org/10.1542/peds.2006-1522
  24. Wallard L, Dietrich G, Kerlirzin Y et al. Balnace control in gait children with cerebral palsy. Gait Posture. 2014; 40(1):43-7. https://doi.org/10.1016/j.gaitpost.2014.02.009

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