Palsy Assistive Technology

Olama, K.A., & Thabit, N.S. (2010) performed a randomized controlled trial to determine the efficacy of whole body vibration (WBV) and a designed physical therapy program versus suspension therapy and the same designed physical therapy intervention in balance control in children with hemiparetic CP. Criteria for inclusion for the study were children with hemiparesis cerebral palsy from both sexes ages 8 to 10 years old, able to understand commands given to them, able to stand and walk independently with frequent falling, and balance problems ( as confirmed by the Tilt Board Balance Test). The exclusion criteria consisted of presence of any medical condition such as vision and hearing loss, cardiac abnormalities, and musculoskeletal disorders. Children who met the criteria (n=30) were recruited from the outpatient clinic, College of Physical Therapy, Cairo University The randomization was done according to the Gross Motor Function Classification System (GMFCS). Treatment allocations were done by the selection of a closed envelope randomly selected. Parents and children were informed of the treatment allocation after the selection, procedures were explained to both of them and signed assent and consent were obtained.

Typical physical therapy interventions: Maintaining range of motion through stretching and ROM exercises, weightbearing exercises to improve bone density with the use of standing devices or body weight support systems, fitting and teaching children how to use assistive devices in order to walk, orthotics and bracing that may help independent walking such as and AFO or SMO, and hydrotherapy may be helpful in these patients in order to decrease

The researchers had ninety-two children with cerebral palsy that were four to six years old participate in this study. They were randomly assigned to either a hippotherapy group or control group. The children in the hippotherapy group had 30 minutes of hippotherapy, twice a week for eight weeks in addition to conventional physiotherapy. Services were provided indoors with a therapist, horse leader, and two side walkers. The protocol that was used involved muscle relaxation, postural alignment of head, trunk, and lower extremities, independent sitting, and active exercises. The control group consisted of thirty minutes of home aerobic exercise. The Gross Motor Function Classification System-88 was used as an outcome measure as well as the GMFM-66; balance was assessed using the Pediatric Balance Scale. The results of this study were increased scores on the GMFM-88, GMFM-66, and PBS. This study was the first randomized control study that was done in regards to hippotherapy

A study conducted by Mahani, Karmiloo, and Amirsalari (2011) compared the effectiveness of the Modified Adeli Suit therapy (MSAT), Adeli Suit therapy (AST), and Neurodevelopmental therapy (NDT) for children with cerebral palsy. All of the main contributors to this article have received higher-level degrees, and the article was published in a reputable occupational therapy journal. This clinical randomized trial studied a total of thirty-six children that have cerebral palsy and who met the inclusion criteria. The thirty-six children were randomly placed into one of three groups: Modified Adeli Suit therapy, Adeli Suit therapy, and Neurodevelopmental therapy, and each child received their assigned therapy for two hours a day, five days a week for four weeks (Mahani, Karmiloo, & Amirsalari, 2011). The AST group received one hour of prep work, and the second hour was spent wearing the suit where they completed vigorous exercises. In the NDT group, the children spent the entire two hours performing passive and active movements. Lastly, the MSAT group conducted movements similar to the NDT group, during the first hour, and spent the second hour in the suit, where they performed fun and meaningful goal based activities. The Gross Motor Function Measure was used at zero, four, and sixteen weeks to compare the effectiveness of each treatment. The results show that the MSAT was the most effective treatment, and there was no significant difference in outcomes between the AST and NDT groups (Mahani, Karmiloo, & Amirsalari, 2011). However, any of the three intense therapies produced positive improvements. The experimenters believe that the shortened amount of time spent on each movement and the goal based activities correlated with the positive outcomes in the MSAT group (Mahani, Karmiloo, &

The study by Lee, Kim, and Na (2014) compared HT and a horseback riding simulator concerning their effects on static and dynamic balance in children with CP. This study consisted of 26 children ages 8-12 randomly divided into a HT group and a horseback riding simulator group. Both groups completed one hour of exercise, three days a week, for 12 weeks. The intervention consisted of anterior-sitting, posterior-sitting, and side-sitting exercises for ten minutes each. Both groups also received 20 minutes of physical therapy per session. This study used BPM software to measure static balance and the Pediatric Balance Scale (PBS) to measure dynamic balance, pre and post intervention. Data showed significantly decreased sway lengths in static balance

A child with neuromuscular and musculoskeletal problems should be treated if these impairments are interfering with some level of functioning. Gormley (2001) indicated that these impairments should not be treated because of “their mere presence,” but treated if treatment improves some aspect of a child’s quality of life or helps prevent future problems that may be caused by that impairment. This research study examines the use of several treatments as they affect a particular impairment caused by a both a neurological gait or musculoskeletal disorder, and how they aim to improve a child’s quality of life. Primary treatments being discussed are virtual reality (VR) technology, pediatric Gait, Arms, Legs, Spine (pGALS) tool, aquatic training, novel robotic walker, and power wheelchairs. The scope of the study, a description of the participants, and the methodological approach is explained, followed by discussion of the results and an overall conclusion related to the

[1] Lerner Z.F., Damiano D.L., Park H.S., Gravunder A.J., Bulea T.C. (2017). A Robotic Exoskeleton for Treatment of Crouch Gait in Children With Cerebral Palsy: Design and Initial Application. IEEE Trans Neural Syst Rehabil Eng, 25(6), 650-659. doi: 10.1109/TNSRE.2016.2595501. Epub 2016 Jul 27. PubMed PMID: 27479974.

This systematic review utilized three medical databases such as ProQuest Medical, PubMmed, and CINAHL. The keywords used to complete the search were: hippotherapy, children, and cerebral palsy. The search resulted in 15 peer- reviewed articles that showed overall improvements in balance and mobility in children with cerebral palsy.

The rationale for choosing the article by Gibson, Sprod, and Maher (2009) is that it contained many aspects of the PICO question. The participants had a diagnosis of cerebral palsy and were nonambulatory, and the age of the children ranged from 6 to 9 years old. This functional level is characteristic of a Level IV on the GMFCS for the age range between 6 and 12 years old. The study included a comparison for the use of a standing program and not using a standing program. The outcome measure was popliteal angle measurement of hamstring length that correlates to PROM of knee extension.

They can opt between different types of therapies or even surgery. Physical therapy will try to help the patient gain some independence through stretching, flexibility exercises and range-of-motion activities. Occupational therapy will help with the development of skills to perform daily life activities. Most of the time they will focus on strengthening their hands and fingers since they are not able to move the majority of their bodies. A benefit of doing this therapy is that it will improve the patient’s learning abilities, which will make a significant change in their lives. Another type of therapy is speech therapy, which aims to improve basic language and vocabulary development. It is crucial that a patient of cerebral palsy knows how to communicate with their caregivers or anyone who can provide help to them. Fortunately, there is also medication that can help the patients with their condition. Benzodiazepines can be prescribed to alleviate muscle stiffness; Diazepam is mostly used at treating stiffness of the legs. Patients can also undergo surgery; a highly recommended one is the Selective Doral Rhizotomy, which main goal is to relax the muscles and improve mobility in various

"Cerebral palsy is the most common physical disability in children and represents the most frequent diagnosis in children who receive physical therapy" ( "Physical", (n.d) , p.1). Thousands of children are affected by the disability every year, cerebral palsy can be detected as early as when the child is an infant. Physical therapist help these children learn better ways to move and balance, as well as learn to walk, use their wheelchair, and stand up without assistance.("Physical" , (n.d) , p.1). Physical therapy for the people affected by the disability is important, so that when at home they can do things for themselves and not rely on someone to do it for them. Physical therapy for these patients should continue at home through an exercise

Cerebral Palsy (CP) is an example of an upper motor neurone lesion and a general term for a group of neurological conditions that affect movement and co-ordination. It affects around 1 in 400 people, occurring in utero or the first few years of life. Multiple parts of the brain can be affected, resulting in different types and severities. Approximately 80% have upper limb involvement with problems in the wrist and hand being most frequent, which affect activities of daily living (ALDs) such as eating. Around 56% are prescribed upper limb orthoses, with only around half using them. Upper limb orthoses cannot be concealed which may account for this low patient compliance, or upper limb function

After observation, it was determined that each child showed some improvement in some areas, but the children also showed declines in some areas (Bailes, Greve, & Schmitt, 2010). Basically, it was determined that more studies must be performed to determine the exact results suit therapy has on children with cerebral palsy and spastic diplegia. This article appears unbiased; the children were chosen randomly based on specific criteria (spastic diplegia and cerebral palsy diagnosis), and their results were measured using criteria specific to their needs. Different health professionals observed the participants, including physical therapy and occupational therapy, which means, observation and conclusions drawn were based on multiple opinions. These factors cause the article to seem credible and show no bias. A year after this study was published another study was conducted that increased the sample size so the results of suit therapy intervention are more

Hippotherapy is a modern physiotherapy treatment for improving gross motor skills (walking, standing, sitting, etc.), balance, and strength in cerebral palsy children. While child sat on the horse therapist teaches various exercises to the child based on types of impairment. Simultaneously therapist needs to monitor and control the horse while the child is riding horseback. Park et al (2014) State that hippotherapy has a positive effect in gross motor function and reduces muscle tone in children with cerebral palsy.Similarly; Hydrotherapy intervention for children provides functional skills, mobility and reduces spasticity. The main benefit of aquatic therapy is diminishing the hypertonicity in spastic children. The mechanism of hydrotherapy is under some neurological change in nerve fiber activity as the child exposes in warm water. As

Every year, thousands of children are diagnosed with Cerebral Palsy. This congenital neuromuscular disorder affects many children from the day of diagnosis to the end of their life. This incurable disorder can affect a wide array of muscular functions, and will permanently debilitate children through adulthood. This disorder arises from congenital brain injury and possible genetic predisposition. There are several therapy options available for children affected that will assist in independence. However, therapy options are expensive and most people cannot afford them. Therefore, there are government assistance programs that will help with expenses. Most importantly, there is ongoing research being funded to learn more about this disease and finding a cure.