Standing Programs to Promote Hip Flexibility in Children With Spastic Diplegic Cerebral Palsy

Macias-Merlo, Lourdes; Bagur-Calafat, Caritat; Girabent-Farrés, Montserrat; Stuberg, Wayne

doi:10.1097/pep.0000000000000150

Cited by 17 publications

(10 citation statements)

References 31 publications

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“…We suggest regular use of standing equipment for positioning as part of an active intervention program, to potentially decrease hip migration percentage and maintain hip abduction range of motion. [89][90][91] Children Clinicians should provide coaching and education to increase knowledge and impart support for parents and caregivers. 3.…”

Section: Key Pointsmentioning

confidence: 99%

Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy

et al. 2021

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IMPORTANCECerebral palsy (CP) is the most common childhood physical disability. Early intervention for children younger than 2 years with or at risk of CP is critical. Now that an evidence-based guideline for early accurate diagnosis of CP exists, there is a need to summarize effective, CP-specific early intervention and conduct new trials that harness plasticity to improve function and increase participation. Our recommendations apply primarily to children at high risk of CP or with a diagnosis of CP, aged 0 to 2 years. OBJECTIVE To systematically review the best available evidence about CP-specific early interventions across 9 domains promoting motor function, cognitive skills, communication, eating and drinking, vision, sleep, managing muscle tone, musculoskeletal health, and parental support. EVIDENCE REVIEWThe literature was systematically searched for the best available evidence for intervention for children aged 0 to 2 years at high risk of or with CP. Databases included CINAHL, Cochrane, Embase, MEDLINE, PsycInfo, and Scopus. Systematic reviews and randomized clinical trials (RCTs) were appraised by A Measurement Tool to Assess Systematic Reviews (AMSTAR) or Cochrane Risk of Bias tools. Recommendations were formed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and reported according to the Appraisal of Guidelines, Research, and Evaluation (AGREE) II instrument.FINDINGS Sixteen systematic reviews and 27 RCTs met inclusion criteria. Quality varied. Three best-practice principles were supported for the 9 domains: (1) immediate referral for intervention after a diagnosis of high risk of CP, (2) building parental capacity for attachment, and (3) parental goal-setting at the commencement of intervention. Twenty-eight recommendations (24 for and 4 against) specific to the 9 domains are supported with key evidence: motor function (4 recommendations), cognitive skills (2), communication (7), eating and drinking (2), vision (4), sleep (7), tone (1), musculoskeletal health (2), and parent support (5).CONCLUSIONS AND RELEVANCE When a child meets the criteria of high risk of CP, intervention should start as soon as possible. Parents want an early diagnosis and treatment and support implementation as soon as possible. Early intervention builds on a critical developmental time for plasticity of developing systems. Referrals for intervention across the 9 domains should be specific as per recommendations in this guideline.

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Section: Key Pointsmentioning

confidence: 99%

Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy

et al. 2021

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“…7 Standing can be divided in several sessions per day for each child; the total time spent standing is counted. [8][9][10] The hip surveillance program and quality register (CPUP)* includes the entire population of children with CP born in Sweden in 2000 and later. 4 The program includes a standardized follow-up including gross motor function classified according to the Gross Motor Function Classification System (GMFCS-E&R), 11 passive range of motion (ROM), 12 movement abilities, time and frequency of positioning, and other treatments such as hip surgery.…”

Section: Introductionmentioning

confidence: 99%

Abducted Standing in Children With Cerebral Palsy: Effects on Hip Development After 7 Years

Martinsson

Himmelmann

2021

Pediatric Physical Therapy

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Purpose: The effects of abducted standing on hip migration percentage (MP) and range of hip and knee motion in children with cerebral palsy were studied for more than 7 years in 2 case-control groups. One group had adductor-psoas tenotomy and the other did not. Methods: Case participants performed 15°to 30°of abduction per hip. Controls performed 0°to 10°of abduction and were matched on age, surgery, and follow-up time. Results: Median MP decreased 7.0% in the participants without surgery, increased 6.5% in their matched participant, and decreased 3.5% in the participants who had adductor-psoas tenotomy. Migration percentage decreased 18% in participants who after surgery performed abducted standing. Range of motion was greater after surgery in participants who performed standing abduction. Conclusions: Standing abduction at 15°to 30°for 10 h/wk reduces MP and preserves range of motion for up to 7 years. This is a new contribution to research for children with cerebral palsy.

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“…Pada anak Cerebral Palsy spastik diplegi, umumnya memiliki pemendekan otot dan penurunan range of motion (ROM) dari otot-otot ekstremitas bawah, kelainan soft tissue karena ketidakseimbangan otot antara fleksor, adduktor, hip internal rotator, kelemahan otot ekstensor hip, external rorator dan abduktor, dikombinasi dengan defisit keseimbangan, gangguan kontrol motorik, yang keseluruhan menyebabkan kerusakan keterampilan fungsional berdiri (Macias-Merlo et al, 2015 (Kim et al, 2017). Terlihat pada beberapa responden penelitan kelompok perlakuan apabila diinstruksikan berdiri setelah beberapa kali menjalani treatment dari peneliti, responden dapat menyeimbangkan ekstremitas atas dan ekstremitas bawahnya pada saat berdiri dengan waktu yang cukup lama dibandingkan sebelumnya.…”

Section: Pendahuluanunclassified

Pelvic Tilting Dalam Terapi Konvensional Pada Anak Cerebral Palsy Diplegi Di Yayasan Pembinaan Anak Cacat

Pristianto¹,

Nadia

Setiyaningsih³

2019

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Cerebral Palsy (CP) merupakan kelainan neurologis permanen yang bersifat non-progresif akibat adanya lesi pada otak yang bisa didapat selama masa prenatal, perinatal atau postnatal. Permasalahan anak CP diplegi adalah kekakuan, spastisitas otot pada kaki dan gangguan distribusi tonus postural menyebabkan permasalahan gross motor yaitu anak kesulitan untuk berdiri. Anak CP diplegi identik dengan gangguan keseimbangan ekstremitas bawah daerah sekitar pelvis. Tujuan penelitian untuk mengetahui pengaruh pemberian pelvic tilting terhadap kemampuan gross motor berdiri pada anak Cerebral Palsy diplegi. Jenis penelitian Quasy Experimental dengan menggunakan Two Pre-Test and Post-Test with Control Group Design. Sampel berjumlah 20 responden dibagi rata menjadi dua kelompok perlakuan terapi konvensional (berupa brain gym) dengan pelvic tilting exercise dan kelompok kontrol terapi konvensional saja. Frekuensi 5 kali seminggu selama 4 minggu. Instrumen pengukuran melalui hitungan waktu menggunakan stopwatch digital untuk mengetahui durasi lamanya anak dapat mempertahankan posisi tegak berdirinya. Adanya pengaruh pemberian pelvic tilting terhadap kemampuan gross motor berdiri dengan p<0,05. Uji Paired Sample t-Test pada kelompok perlakuan diperoleh p-value 0,000 dan pada kelompok kontrol diperoleh 0,002. Terdapat pengaruh pemberian pelvic tilting terhadap kemampuan gross motor berdiri pada anak Cerebral Palsy diplegi.

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Standing Programs to Promote Hip Flexibility in Children With Spastic Diplegic Cerebral Palsy

Abstract: This small difference was not clinically significant, but did demonstrate that it was possible to maintain hip abduction ROM in the spastic adductor muscles of children with cerebral palsy with a daily standing program during the children's first 5 years of development.

Cited by 17 publications

References 31 publications

Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy

Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy

Abducted Standing in Children With Cerebral Palsy: Effects on Hip Development After 7 Years

Pelvic Tilting Dalam Terapi Konvensional Pada Anak Cerebral Palsy Diplegi Di Yayasan Pembinaan Anak Cacat

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