[Purpose] The aim of this study was to investigate differences in selective voluntary motor control of the lower extremities by objective assessment and determine the relationship between selective voluntary motor control and knee extensor strength in children with spastic diplegia. [Subjects and Methods] Forty individuals who had spastic cerebral palsy, with Gross Motor Function Classification System levels ranging from I to III, were assessed using the Selective Control Assessment of the Lower Extremity and by testing the maximum knee extensor strength. The unaffected side was defined as the lower limb with the higher score, and the affected side was defined as the lower limb with the lower score. [Results] The Selective Control Assessment of the Lower Extremity score on the affected side had a lower average than that on the unaffected side. The scores showed a significant inverse correlation with the maximum knee extensor strength. [Conclusion] There was bilateral difference in the selective voluntary motor control of the lower extremities in children with spastic diplegia, and the selective voluntary motor control of the lower extremity was related to maximum knee extensor strength.

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[Purpose] The aim of this study was to translate the Selective Control Assessment of the Lower Extremity (SCALE) tool from English to Japanese and to assess the reliability and validity of the Japanese version of the SCALE (SCALE-J) tool in Japanese patients with spastic cerebral palsy. [Subjects and Methods] The SCALE tool was translated into Japanese in accordance with the published guidelines. In total, 55 patients with spastic cerebral palsy were enrolled in the present study. Reliability by internal consistency (Cronbach’s α), intrarater reliability, inter-rater reliability, and convergent validity by comparing Gross Motor Function Classification System (GMFCS) scores were examined. [Results] The Cronbach’s α value of the SCALE-J tool was 0.97–0.98, whereas that of the intrarater and inter-rater reliability ranged from 0.93 to 0.96. The Spearman correlation coefficient revealed a good relationship between the SCALE tool and the GMFCS. [Conclusion] The SCALE-J tool was found to be reliable and valid; therefore, the SCALE tool may be useful for evaluation in clinical practice.

BackgroundThe recognition of required treatments for cerebral palsy (CP) patients, including orthopedic surgery, differs according to region. This study was performed to identify factors associated with satisfactory changes in physical function after orthopedic surgery.Methods358 patients were selected for the questionnaire survey. The following information was collected: gender, primary disease, age of initial surgery, total procedural count, operated sites, satisfaction of postoperative rehabilitation frequency, ideal amount of postoperative rehabilitation sessions per week, frequency of voluntary home training per week, satisfaction of the timing of surgery and the current satisfaction with the changes in physical function after the orthopedic surgery. We classified the patients into the satisfied and dissatisfied group according to satisfactory changes in physical function after the surgery. We performed unpaired t-tests and chi-square tests to determine the variables that differed significantly between the groups. Variables with a p value of <0.2 were included in the multivariate logistic regression analysis.ResultsThe logistic model was revised and summed up to two potential predictors of postsurgical satisfaction with physical function: satisfaction with the frequency of postoperative rehabilitation sessions and the orthopedic surgery of the hip (distinction hit ratio, 75.4%).ConclusionsThis study demonstrated that the frequency of postoperative rehabilitation and history of hip surgery seemed to be related to the satisfaction with the changes in physical function after orthopedic surgery.

[Purpose] Hip dislocation and subluxation are common in patients with cerebral palsy (CP). Hip abduction orthoses are used to prevent and treat these problems. This study investigated the effects of an underwear-type hip abduction orthosis on sitting balance and sit-to-stand (STS) activity in children with spastic CP. [Participants and Methods] This trial had a cross-over design. Eight children aged 6 to 18 years old with spastic CP and Gross Motor Function Classification level III and IV were randomly allocated to groups with or without use of the underwear-type hip orthosis. The trunk impairment scale (TIS) score was evaluated and the 5-times sit-to-stand test (FTSST) was conducted with and without the underwear. [Results] The dynamic sitting balance scores in the TIS and FTSST showed significant improvement with use of the orthotic underwear. [Conclusion] The dynamic sitting balance scores of the TIS and FTSST were higher, thus indicating better stability, when wearing the orthosis underwear. Thus, it was suggested that underwear-type hip abduction orthoses are effective for promoting sitting balance and STS activities in children with spastic CP.