Effectiveness of Bobath therapy on balance in cerebral palsy

Abstract

Öz Purpose: Weakness on balance control is one of the most common problems for children with cerebral palsy. Present study aimed to investigate the effectiveness of 8 week-Bobath therapy on balance in children with diparetic or hemiparetic cerebral palsy. Materials and Methods: A total of 15 cerebral palsy diagnosed children (8 diparesis, 7 hemiparesis) aged 5-14 years, were included in this study. Children could walk independently or by using a walking aid. The demographic data were saved for each case. Gross Motor Function Classification System and Gross Motor Function Measure were used to determine level of motor function. 1 Minute Walking Test, 10-meter Walking Test, Pediatric Balance Scale for balance ability and Functional Independence Measure for children (WeeFIM) for assessing of independence in activities of daily living were used. Bobath therapy were applied to children one 60-minute session, 2 days a week and 8 weeks in total. All evaluations were performed before treatment and repeated after treatment program. Results: After 8-week Bobath therapy, the results showed that improvement in motor function, level of functional independence and balance scores were statistically significant. Conclusion: Bobath therapy improves functional motor ability, independence level on daily living activities, and also balance ability in children with cerebral palsy. Amaç: Serebral palsili çocuklarda en sık karşılaşılan sorunlardan biri, denge kontrolündeki zayıflıktır. Bu çalışmada, diparetik veya hemiparetik serebral palsili çocuklarda 8 haftalık Bobath terapisinin denge üzerine etkisini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya 5-14 yaşlarında toplam 15 serebral palsi tanılı (8 diparezi, 7 hemiparezi) çocuk dahil edildi. Çocuklar bağımsız olarak veya yürüme yardımcısıyla yürümektedir. Demografik veriler kaydedildi. Motor fonksiyon seviyesini belirlemek için Kaba Motor Fonksiyon Sınıflandırma Sistemi ve Kaba Motor Fonksiyon Ölçümü kullanıldı. Denge yeteneği için 1 Dakika Yürüme Testi, 10 metre yürüme testi ve Pediatrik Denge Ölçeği ve günlük yaşam aktitivitelerindeki bağımsızlığı değerlendirmek için Çocuklar için Fonksiyonel Bağımsızlık Ölçeği (WeeFIM) kullanıldı. Bobath therapisi toplam 8 hafta boyunca, haftada 2 gün ve bir seansı 60 dakika olacak şekilde uygulandı. Tüm değerlendirmeler tedavi öncesi ve tedaviden sonra yapıldı. Bulgular: 8 haftalık Bobath terapisinden sonra, motor fonksiyonlarda, fonksiyonel bağımsızlık düzeyi ve denge skorlarında istatistiksel olarak anlamlı iyileşmeler olduğu gösterildi. Sonuç: Serebral palsili çocuklarda Bobath terapisi fonksiyonel motor yeteneği, günlük yaşam aktivitelerinde bağımsızlık düzeyi ve denge yeteneğini geliştirir.

Effects of Exercise Therapy With the Bobath Method on Balance in a Child With Spastic Diplegic Cerebral Palsy: A Case Report

“…Balance is a necessary ability to explore and interact with the environment. Balance is likened to an anchor for directed movement and functional activity in children with CP (Kavlak et al, 2018). The problem with CP is the presence of spasticity which will affect postural muscle tone abnormalities.…”

“…Thus the control of static and dynamic balance will be disturbed which results in limitations in motor development (Lazzari et al, 2017). Balance control is important for most functional abilities, one of which is helping children reduce unexpected balance disorders, such as slipping, tripping, and self-induced instability during movement (Kavlak et al, 2018).…”

“…The aim of the approach is to influence muscle tone, improve postural alignment with specific handling techniques, work for better active participation and exercise specific and relevant functional skills. According to a study conducted by Kavlak et al in 2018 bobath therapy is considered appropriate to treat any motor control disorder in the CP spectrum (Kavlak et al, 2018). In addition, research conducted by (Arı & Kerem Günel, 2017) states that an exercise program based on the Bobath method can improve functional balance as indicated by an increase in the Pediatric Berg Balance Scale (PBBS) score.…”

The Effectiveness Of Pilates Exercises On Sitting And Standing Balance In Children With Cerebral Palsy

“…In addition, diplegic cerebral palsy has decreased neuromotor perceptual function, slow anticipatory responses, and inaccurate preparation of activation [8].Impaired trunk muscle activity occurs due to increased coactivation of agonist and antagonist muscles and lack of muscle strength, [9], [13], so that the postural control of sitting is disturbed and significantly affects the motor development of children [11], [12].Postural control of children with cerebral palsy involves controlling and orienting the body to achieve balance stability [14]. Trunk stability is very important to maintain balance when changes occur during movement [10], [17]. When the trunk is stable, the upper and lower limbs can be used freely for activities, but children with cerebral palsy show symptoms of hypotonicity, weakness of trunk muscles, increased muscle tone of the upper and lower extremities, loss or delay of postural reflexes and loss of body stability so that children have difficulty sitting such as playing while sitting, eating and living activities.…”

“…Research on this usually uses games and virtual to train trunk [20]. Various physiotherapy intervention methods that can be used in cases of cerebral palsy include bobath exercises, perceptual motor programs, neurosensomotor, passive stretching, core stability, trunk mobilization, bobath exercises and massage [9], [11], [13], [15], [16], [17].Pilates Exercises are effective in improving balance and gross motor function in cerebral palsy diplegia [4], [19] and according to A. N. Dos Santos, S. S. Serikawa, and N. A. C. F. Rocha (2016) stated that Pilates can be an alternative rehabilitation technique to improve strength and postural control. 20].By understanding the effectiveness of the Pilates method on sitting and standing balance, children with cerebral palsy can help physiotherapists determine the appropriate treatment modality and which will provide the most effective benefits in a rehabilitation program specifically for children with cerebral palsy.…”