Relation between balance and pelvic alignment in diplegic cerebral palsy children

Ahmed Abdelmonem  Ibrahim; Gehan Hassan Elmeniawy; Naglaa Ahmed  Zaky Aly; Amr A. Azzam

doi:10.53730/ijhs.v6nS1.8197

Authors

Ahmed Abdelmonem Ibrahim Master of Physical Therapy for Pediatrics, Faculty of Physical Therapy Cairo University, Physiotherapist at National Institute of Neuromotor System
Gehan Hassan Elmeniawy Professor of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Dean of Faculty of Physical Therapy, Cairo University
Naglaa Ahmed Zaky Aly Professor of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University
Amr A. Azzam Consultant of Orthopedic Surgery, Former Dean of the National institute of Neuromotor system

Keywords:

cerebral palsy, diplegia, balance, pelvic alignments

Abstract

Background: Diplegia is one of the most common types of CP in which lower limbs are affected more than upper limbs, Pelvic malalignment is common in growing patients with diplegic CP develops due to the combination of spasticity, muscle weakness, as well as incompetent muscle control, this can result in poor pelvic control and significantly limits the patient’s ability to maintain balance. Aim of the Study: This study was conducted to study the relationship between balance and pelvic alignment in diplegic cerebral palsy children. Materials and Methods: Fifty children with diplegic cerebral palsy from both sexes (18 girls and 32 boys) grade I (33) and grade II (17) according to gross motor function classification system and 1 (23), 1+(15) and 2 (12) according to modified Ashowrth scale. Their ages ranged from 7-10 years, postural deviations were evaluated using the 3D measurement system Formetric while balance was assessed using Biodex balance system. Results: There was a statistically significant relation between overall stability index (OASI) and pelvic alignment (pelvic tilt- pelvic inclination). Conclusion: The obtained results suggested that there was significant correlation between balance and pelvic alignment in diplegic cerebral palsy children.

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References

Jin S., Lewis S., Bakhtiari S., Zeng X., Sierant M., Shetty S., Nordlie S., Elie A., Corbett M., Norton B., and van E.: Mutations disrupting neuritogenesis genes confer risk for cerebral palsy. Nature genetics. 2020 Oct;52(10):1046-56.

Woodward S., & Waterhouse C.: Oxford handbook of neuroscience nursing. Oxford University Press; 2021 Jan 14.

Krewer C, SK B., DTU H., TUM T., SK M., Hu R., Zhao C., Guttler J., TUM M., Valk C., and Lu Y.: Formalized results of final testing and optimization activities: Summarization of testing and evaluation of final testing of continuously improved system in the form of prototypes in real world environments and presentation of optimization measures, 2020.

Derouin A.: The Development and Validation of a Three-Dimensional Visual Target Acquisition System to Assess the Performance Effects of Head Supported Mass (Doctoral dissertation, Queen's University Canada, 2020.

Rodrigues M & Voos M.: Movement Disorders in Pediatrics. In Movement Disorders Rehabilitation 2017 (pp. 129-154).

Stowell M.: The effect of wearing shoes on the outcome of selected balance measures in children with typical development and with mild motor dysfunction (Doctoral dissertation, Stellenbosch: Stellenbosch University) 2020.

Franki I., Bar O., Molenaers G., Van C., Craenen K., Desloovere K., Feys H., Pauwels P., De C., and Ortibus E.: Tone reduction and physical therapy: strengthening partners in treatment of children with spastic cerebral palsy. Neuropediatrics. 2020 Apr;51(02):089-104.

Palisano R., Rosenbaum P., Bartlett D., Livingston M., Walter S., and Russell D. GMFCS-E&R.: CanChild Centre for Childhood Disability Research, McMaster University. 2007;200(7).

Gregson J., Leathley M., Moore A., Sharma A., Smith T., and Watkins C.: Reliability of the Tone Assessment Scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity. Archives of physical medicine and rehabilitation. 1999 Sep 1;80(9):1013-6.

Zaky N., Thabet N., and Banoub M.: Role of two therapeutic interventions on balance in children with spastic diplegia and hemiparasis: A comparative study. Physical Therapy and Rehabilitation. 2019;6(1):2.

Yousef A., Hanfy H., and Elshamy F.: Postural changes during normal pregnancy Journal of American Science. 2011; 7(6).

Rose J., Wolff D., Jones V., Bloch D., Oehlert J., and Gamble J.: Postural balance in children with cerebral palsy. Dev Med Child Neurol 2002; 44: 58–63.

Woollacott M., & Shumway C.: Postural dysfunction during standing and walking in children with cerebral palsy: what are the underlying problems and what new therapies might improve balance? Neural Plast 2005; 12: 211–9.

Butler P.: A preliminary report on the effectiveness of trunk targeting in achieving independent sitting balance in childreia with cerebral palsy. Clin Rehabil , 1998.: 12:281-293.

Giannoni P., & Zerbino L.: The Child with Bilateral Spastic Cerebral Palsy. InCerebral Palsy 2022 (pp. 27-125). Springer, Cham.

Bobath B.: Adult hemiplegia: evaluation and treatment, 3rd ed. Oxford: William Heinemann Medical Books, 1990, pp 20–57.

Kong S., Jeong Y., and Kim J.: Correlation between balance and gait according to pelvic displacement in stroke patients. Journal of physical therapy science. 2015;27(7):2171-4.

Nichols D., Glenn T., and Hutchinson K.: Changes in the mean center of balance during balance testing in young adults. Phys Ther, 1995, 75: 699–706.

Mihara M., Miyai I., Hattori N., Hatakenaka M., Yagura H., Kawano T., and Kubota K.: Cortical control of postural balance in patients with hemiplegic stroke. Neuroreport. 2012 Mar 28; 23(5):314-9.

James H., & Hardy D.: Spinal deformity in neurological and muscular disorders. Saint Louis: The C. V Company; 1974, p. 192–195.

Graham H.: The managements of spastic diplegia. Curr Orthop 2003.;17:88–104.

Holm I., Tveter A., Fredriksen P., and Vøllestad N.: A normative sample of gait and hopping on one leg parameters in children 7–12 years of age. Gait & posture. 2009 Feb 1;29(2):317-21.

Dusing S., &Thorpe D.: A normative sample of temporal and spatial gait parameters in children using the GAITRite® electronic walkway. Gait & posture. 2007 Jan 1;25(1):135-9.

Persson-Bunke M, Hägglund G, and Lauge-Pedersen H.: Windswept hip deformity in children with cerebral palsy. Journal of Pediatric Orthopaedics B. 2006 Sep 1;15(5):335-8.

Lonstein J.: Spine deformities due to cerebral palsy. In: Weinstein SL, editor. The pediatric spine: principles and practice. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 797–807.

Jeong H., &Yoon J.: The effects of pelvic tilt exercise on balance of hemiplegic patients. Phys Ther Kor, 2006, 13: 41–48.

Pai Y., Rogers M., Hedman L., and Hanke T.: Alterations in weight-transfer capabilities in adults with hemiparesis. Physical Therapy. 1994 Jul 1;74(7):647-57.

Trueblood P., Walker J., Perry J., and Gronley J.: Pelvic exercise and gait in hemiplegia. Physical Therapy. 1989 Jan 1; 69(1):18-26.

Kirker S., Jenner J., Simpson D., and Wing A.: Changing patterns of postural hip muscle activity during recovery from stroke. Clinical rehabilitation. 2000 Dec;14(6):618-26.

Verheyden G., Ruesen C., Gorissen M., Brumby V., Moran R., Burnett M., and Ashburn A.: Postural alignment is altered in people with chronic stroke and related to motor and functional performance. Journal of Neurologic Physical Therapy. 2014 Oct 1;38(4):239-45.

Messier S., Bourbonnais D., Desrosiers J., and Roy Y.: Dynamic analysis of trunk flexion after stroke. Archives of physical medicine and rehabilitation. 2004 Oct 1;85(10):1619-24.

Kim M., Kim S., Shin Y., Choi E., and Choe Y.: The relationship between anterior pelvic tilt and gait, balance in patient with chronic stroke. Journal of physical therapy science. 2017;30(1):27-30.

Choe Y., Kim K., and Kim M.: Relationship between Gait, Static Balance, and Pelvic Inclination in Patients with Chronic Stroke. Journal of the Korean Society of Physical Medicine. 2021;16(1):17-22.

Kong S., Jeong Y., and Kim J.: Correlation between balance and gait according to pelvic displacement in stroke patients. Journal of physical therapy science. 2015;27(7):2171-4.

Karthikbabu S., Chakrapani M., Ganesan S., and Ellajosyula R.: Relationship between pelvic alignment and weight-bearing asymmetry in community-dwelling chronic stroke survivors. Journal of neurosciences in rural practice. 2016 Dec;7(S 01):S037-40.