Increased trunk imbalance, lateral deviation of the spine and pelvic tilt may be associated with decreased postural control ability in children with diplegic CP.

BackgroundWalking aids and ankle-foot orthoses (AFOs) are designed to address gait problems. These devices are common among children with cerebral palsy (CP), as those children's ability to ambulate is a big concern for their parents, and its improvement is considered primary focus of therapeutic modalities addressing motor disorders of this population. However, empirical support for walking aids and AFO is limited. The aim of this review was to assess the quality of research on the effect of walking aids and AFO on energy expenditure in children with CP. Materials and methodsFour electronic databases using predefined terms were searched by two independent reviewers. All study designs except case reports were included. Nineteen studies involving 509 participants met inclusion criteria and were involved in this review. ResultsHeterogeneity was observed across included studies in measurement, implementation, and study rigor. ConclusionThere is a need for high-quality studies to draw a clear conclusion on the effect of walking aids and AFO on energy expenditure in children with CP; the typical flaws of existing studies included weak experimental designs, insubstantial treatment outcomes, and high risk of bias.

Background Children with spastic diplegia experience gait abnormalities and problems caused by deficits in balance, motor control, and spasticity. Abnormal pelvic inclination is common in patients with diplegia which may result in poor pelvic balance. Purpose This study was conducted to investigate the relation between pelvic inclination and standing balance in children with spastic diplegia. Subjects and methods Thirty children with spastic diplegic cerebral palsy from both sexes, aged from 5 to 14 years participated in this study. Their degree of spasticity ranged from 1 to 1+ according to Modified Ashworth Scale and they were on level I or II on Gross Motor Function Classification System. Pelvic inclination angle was measured by using the formetric instrumentation system during standing position while standing balance was assessed by the Biodex Balance System. Results There was a statistically significant relation between pelvic inclination and the overall, anteroposterior, and mediolateral stability indices of standing balance (P < 0.05). Conclusion The obtained results suggested that there was significant correlation between balance and pelvic inclination in children with diplegic cerebral palsy.

Background: Independent efficient ambulation and postural stability are two main objectives in the rehabilitation program for children with cerebral palsy (CP). Purpose: The purpose of the present study was to investigate the effect of treadmill training on energy cost of walking, functional walking capacity and postural stability in children with hemiplegic CP. Method: Fifty-one (30 boys and 21 girls) children with hemiplegic CP with their ages ranged from eight to ten years were included. They were randomly classified into two groups; experimental and control groups. Both groups received designed physical therapy programs, while,the experimental group received treadmill training program instead of traditional gait training, at a frequency of three times per week for three months. Pre and post-treatment assessment of energy cost of walking (energy expenditure index), functional walking capacity (6-minutes walking test) and postural stability via pediatric reaching test (anterior and lateral reaching tests) were conducted. Results: Both groups showed; significant increase in 6-minutes walking test, anterior and lateral reaching tests(p<0.001) and significant decrease in energy expenditure index (p<0.001) after treatment protocols. The significant improvement after treatmentin all measured variables was obtained in favor to experimental group(p>0.001). Conclusion: Treadmill training may improve energy cost of walking, functional walking capacity and postural stability in children with hemiplegic CP.A common cause of motor impairments among children is CP, which is caused by damage in the brain occurring before, during or immediately after birth. It is also, often characterized by group of developmental motor and postural disorders [1]. Motor disorders affecting children with CP allow them to walk with slower speed and higher energy expenditure (EE), than age-matched children without CP [2,3]. Spastic hemiplegia is a unilateral paralysis which represents 20% to 30% of all types of CP. In children with hemiplegia, motor impairments predominate in the upper limbs that restrict the functional activity and overall independency while, foot inversion and planter flexion are most common impairments in the lower limbs [4,5].Motor impairments such as; spasticity, motor control deficit and joint contractures which affect children with CP may lead to an increase in energy cost(EC) of walking and consequently CrossMark ← Click for updates Abd El-nabie et al, Physical Therapy and Rehabilitation 2019,

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