The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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The Effect of Induced Weight Bearing Method Using a Cane on Weight Bearing Distribution in Children with Spastic Hemiplegic Cerebral Palsy

  • Se-Hee Park (Department of Physical Therapy, Graduate School of Health Science, Cheongju University) ;
  • Ji-Young Choi (Department of Physical Therapy, College of Health Science, Cheongju University) ;
  • Sung-Min Son (Department of Physical Therapy, College of Health Science, Cheongju University)
  • Received : 2023.03.20
  • Accepted : 2023.04.28
  • Published : 2023.04.30
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Abstract

Purpose: This study was undertaken to determine whether the position of cane use affects the distribution of weight-bearing on both feet of children with hemiplegic cerebral palsy in a standing posture. Methods: Twenty participants with cerebral palsy were recruited as volunteers for this study. Using the Zebris FDM-System, weight-bearing distribution according to the method of using a cane was measured under three conditions in randomized order: (1) standing unaided (no cane); (2) standing with the affected side using the cane; and (3) standing with the non-affected side using the cane. The cane was matched by measuring length-from-floor to the greater trochanter of the subject, and was placed 15 cm outward from the little toe on the supporting side. Results: Evaluating the method of using a cane under the three conditions, we determined that pressure of the foot on the affected side was higher in the order: standing with affected side using cane > standing unaided (no cane) > standing with non-affected side using cane (p<0.05). In the post-hoc analysis, a significant difference was observed between (i) standing unaided (no cane) and standing with the affected side using cane, and (ii) standing with affected side using cane and standing with non-affected side using cane (p<0.05). Conclusion: This study suggests that induced weight-bearing methods using a cane on the affected side could increase the weight-bearing capacity on the affected side in children with spastic hemiplegic cerebral palsy, which will have a positive effect on reducing asymmetry weight support.

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References

  1. Bax M, Goldstein M, Rosenbaum P et al. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol. 2005;47(8):571-6. https://doi.org/10.1017/S001216220500112X
  2. Umphred DA. Neurological rehabilitation 3rd ed. St Louis, Mosby-Year Book, 1995:4-6.
  3. Kulak W, Sobaniec W. Comparisons of right and left hemiparetic cerebral palsy. Pediatr Neurol. 2004;31(2):101-8. https://doi.org/10.1016/j.pediatrneurol.2004.01.009
  4. Hoare B, Imms C, Carey L et al. Constraint-induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy: a cochrane systematic review. Clin Rehabil. 2007;21(8):675-85. https://doi.org/10.1177/0269215507080783
  5. Heyrman L, Desloovere K, Molenaers G et al. Clinical characteristics of impaired trunk control in children with spastic cerebral palsy. Res Dev Disabil. 2013;34(1):327-34. https://doi.org/10.1016/j.ridd.2012.08.015
  6. Kim JM, Lee CH. Neurological physical therapy. Seoul, Jeongdam, 2001:536-7.
  7. Long T. Handbook of pediatric physical therapy. Philadelphia, Lippincott Williams & Wilkins, 2018.
  8. Sackley CM, Baguley BI. Visual feedback after stroke with the balance performance monitor: two single-case studies. Clin Rehabil. 1993;7(3):189-95. https://doi.org/10.1177/026921559300700302
  9. Holden MK, Gill KM, Magliozzi MR. Gait assessment for neurologically impaired patients: standards for outcome assessment. Phys Ther Rehabil J. 1986;66(10):1530-9. https://doi.org/10.1093/ptj/66.10.1530
  10. Dickstein R, Nissan M, Pillar T et al. Foot-ground pressure pattern of standing hemiplegic patients: major characteristics and patterns of improvement. Phys Ther Rehabil J. 1984;64(1):19-23.
  11. Lane RE. Facilitation of weight transference in the stroke patient. Physiotherapy. 1978;64(9):260-4.
  12. Carr JH, Shepherd RB. Physiotherapy in disorders of the brain: a clinical guide. Portsmouth, Heinemann Medical Books, 1980:150.
  13. Bobath B. Adult hemiplegia: evaluation and treatment 3rd ed. London, Butterworth-Heinemann, 1990:160.
  14. Pin TW. Effectiveness of static weight-bearing exercises in children with cerebral palsy. Pediatr Phys Ther. 2007;19(1):62-73. https://doi.org/10.1097/PEP.0b013e3180302111
  15. Buurke JH, Hermens HJ, Erren-Wolters CV et al. The effect of walking aids on muscle activation patterns during walking in stroke patients. Gait Posture. 2005;22(2):164-70. https://doi.org/10.1016/j.gaitpost.2004.09.003
  16. Chen CL, Chen HC, Wong MK et al. Temporal stride and force analysis of cane-assisted gait in people with hemiplegic stroke. Arch Phys Med Rehabil. 2001;82(1):43-8. https://doi.org/10.1053/apmr.2001.18060
  17. Davies PM. Steps to follow: the comprehensive treatment of patients with hemiplegia. Berlin, Springer science & business media, 2000:274-5.
  18. Sackley CM, Lincoln NB. Physiotherapy treatment for stroke patients: a survey of current practice. Physiother Theory Pract. 1996;12(2):87-96. https://doi.org/10.3109/09593989609036422
  19. Kellis E. Plantar pressure distribution during barefoot standing, walking and landing in preschool boys. Gait Posture. 2001;14(2):92-7. https://doi.org/10.1016/S0966-6362(01)00129-1
  20. Han JH, Ko JY. Evaluation of balance and activities of daily living in children with spastic cerebral palsy using virtual reality program with electronic games. J DCS. 2010;10(6):480-8.
  21. Sakpal T. Sample size estimation in clinical trial. Perspect Clin Res. 2010;1(2):67-7.
  22. Mochizuki L, Duarte M, Amadio AC et al. Changes in postural sway and its fractions in conditions of postural instability. J Appl Biomech. 2006;22(1):51-60. https://doi.org/10.1123/jab.22.1.51
  23. Cha YJ, Kim K, Lee UH et al. The comparison of weight and plantar pressure distribution regarding the extent of hemineglect in the hemiplegia during quiet standing with the cane. J Spec Educ Rehabil. 2011;50(3):469-82.
  24. Ok JY, Kim JW, Han WS et al. Influence of cane length on the weight distribution. J Kor Phys Ther. 2000;7(1):91-100.
  25. Laufer Y. Effects of one-point and four-point canes on balance and weight distribution in patients with hemiparesis. Clin Rehabil. 2002;16(2):141-8. https://doi.org/10.1191/0269215502cr481oa
  26. Laufer Y. The effect of walking aids on balance and weight-bearing patterns of patients with hemiparesis in various stance positions. Phys Ther Rehabil J. 2003;83(2):112-22. https://doi.org/10.1093/ptj/83.2.112
  27. Neumann DA. Hip abductor muscle activity as subjects with hip prostheses walk with different methods of using a cane. Phys Ther Rehabil J. 1998;78(5):490-501. https://doi.org/10.1093/ptj/78.5.490
  28. Chan GN, Smith AW, Kirtley C et al. Changes in knee moments with contralateral versus ipsilateral cane usage in females with knee osteoarthritis. Clin Biomech. 2005;20(4):396-404. https://doi.org/10.1016/j.clinbiomech.2004.12.005