Overview of Physical Therapy for Children with Cerebral Palsy

Abstract

Purpose This study was to find out proper concept and intervention to treat in physical therapist' s perspective according to recognize the changing definition of cerebral palsy, and to investigate the several classification and intervention for children with cerebral palsy. Methods The electronic journal site was searched by terms "cerebral palsy", "intervention", physical therapy". We analyzed and descript the total 24 cited articles from 9 articles in Science Direct, and 16 articles in K-RISS from 20 Oct. 2018 to 7 Jan. 2019. Results Later definition of cerebral palsy emphasized secondary musculoskeletal problem over time in children with cerebral palsy. In early definition emphasized person's function or neurological disability. Prevalence rate of cerebral palsy were 6~8% from perinatal asphyxia, the overall prevalence of cerebral palsy has remained constant in recent years despite increased survival of at-risk preterm infants. Gross Motor Function Classification System (GMFCS) has been widely employed internationally to group individuals with cerebral palsy into one of five levels based on functional mobility or activity limitation. The treatment must be goal oriented, such as to assist with mobility, reduce or prevent contractures, improve positioning and hygiene, and provided comfort. Each member of the child's multidisciplinary team, including the child and both parents, should participate in the serial evaluation and treatment planning. Conclusion We found that the definition of cerebral palsy is changing to focus on secondary problem over time and the children with cerebral palsy is best cared for with an individualized treatment plan that provides a combination of interventions.Purpose The aim of this study was to determine the effect of Whole-Body Vibration on gross motor function and balance, gait of children with cerebral palsy. Methods The Design is ABA design of single-subject experimental design. This study participate 2 subjects for 7 years old who were diagnosed children with spastic cerebral palsy. Baseline(A) and Baseline(A') phases were received not WBV, Intervention(B) phase provided with 30 minutes WBV in 10 session. All subjects were measured with the Gross Motor Function Measure(GMFM-66), Pediatric Balance Scale(PBS), One leg standing, Gait analysis in session and at follow-up. Results The results showed that the subjects increased GMFM-66 score and remained in the assessment after the intervention. But the subject 2 was decrease again after baseline(A'). PBS of both subjects increased until after intervention but decreased during baseline(A'). In the one leg standing, both subjects increased after the baseline(A). Especially, the sessions exceeding the two standard deviation in the intervention process were 5 times and 8 times, respectively. The gait symmetry index of both subjects increased after intervention. Conclusion WBV was effective in improving gross motor and balance, gait in children with cerebral palsy.

Lower-Limb Orthoses

“…goals was developed(Owen 2016(Owen , 2020 and visually represented with a Pictorial Tool. These tools incorporated all areas of the International Classification of Functionating, Disability, and Health (ICF 2001, ICF-CY 2007) and ISO clinical objectives for orthoses (ISO 8551:2020), and were structured in an approach that is understandable to families and children, considering in four columns: (1) Bones, Joints, Ligaments; (2) Muscle, Tendon, Skin; (3) Motor Control, Learning and Development of Standing and Walking; and (4) Functioning, Activities and Participation, and pain.…”