Cerebral Palsy, Spastic Diplegia
Conditions
Keywords
gait, diplegia, ankle weight, botox injection
Brief summary
Background: Standing and walking serve an individual's basic need to move from place to place, and both are the most common activities that people do on a daily basis. Aim: to investigate the combined effect of botulinum toxin A (BoNT-A) injection and ankle weight on the gait of diplegic children who are using Ankle foot orthoses.
Detailed description
Methods: Sixty children with spastic diplegia were included in this prospective, controlled trial. Children were divided into three groups, each with 20 patients: Group 1 received classical gait rehabilitation; Group 2 received the same gait training while adding ankle weight ; and Group 3 received the same as group 2 plus botulinum toxin injection. The Modified Ashworth Scale (MAS),knee range-of-motion measures, and Hoffman /Myogenic reflex ratio were used to examine patients before the commencement of treatment and post-treatment.
Interventions
OTHERgait training
walking forward, sideway and backward walking on balance board
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
5 Years to 10 Years
Healthy volunteers
No
Inclusion criteria
* diagnosed as spastic diplegia. * They were able to follow simple verbal instructions. * The use of Ankle Foot Orthoses. * Spasticity grade of 1+ or 2 in both calf and hamstring muscles according to modified Ashworth's scale (MAS). * level I or II on the Gross Motor Function Classification System (GMFCS).
Exclusion criteria
* fixed contractures or deformities in the lower limbs. * surgical orthopedic intervention. * Botulinum A injection or use of neuromuscular blockers in the previous 6 months before the start of study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| measurement of knee excursion during gait | after 3 months of the treatment program. | evaluation of knee flexion range of motion during gait using two dimension gait analysis. |
| evaluation of spasticity: modified ashowrth scale scores | after 3 months of the treatment program. | hamstring and calf muscles evaluation of spasticity through passive movement .the score ranged from 0 ( nearly normal) to 5 (rigid in flexion or extension) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| electromyography to asses spasticity in hamstring and calf muscles | after 3 months of the treatment program. | Hoffman/Myogenic reflex to assess spasticity ratio |
Countries
Egypt
Outcome results
None listed