Abstract
The function of the affected side in the hemiplegic cerebral palsy is influenced by muscle tone abnormality, change of proprioception, diminished power, and decreased the speed of movement, weak grasp, and release functions. Mirror therapy (MT) is a therapeutic technique that uses the interaction of visuomotor-proprioception inputs to improve movement performance of the affected limb. This study was done to investigate the effects of mirror visual feedback exercises on upper extremity function and on the alternation of wrist proprioception in children with hemiparesis. Thirty-two children with spastic hemiparesis from both sexes ranging in age from five to seven years represented the sample of the study. They were assigned randomly into two groups of equal number (control and study). Every child in both groups was evaluated at baseline and after 3 months of intervention using The Quality of Upper Extremity Skills Test to evaluate movement patterns and hand function. Also, electro-goniometer was used to assess repositioning error through Active Reproduction of Active Positioning test (ARAP). The control group received a selected exercise program, while the study group received mirror visual feedback (MVF) exercises program training in addition to the same exercise program given to control group. Comparison of the pre-treatment results of the two groups revealed no significant differences in all variables, while significant improvements were observed in all the measuring variables of the two groups when comparing their pre and post-treatment mean values. Significant differences were also observed when comparing the post-treatment results of the two groups in favor of the study group. MVF exercises could be used together with a therapeutic exercise program for the enhancement of hand function and wrist proprioception in children with hemiparesis.
Highlights
Cerebral palsy (CP) can be defined as a range of disorders of the motor and postural development that cause functional limitations caused by non-progressive lesions arising in the developing fetal or infant brain [1, 2].Hemiplegia is one of the most common types of cerebral palsy and constitutes a major form among spastic types
Upper limb function problems in children with CP are associated with deficits in motor control, weakness, dystonia, sensation and the persistence of the grasp reflex [5]
While the impact of upper limb dysfunction varies from child to child, it has been well documented that this has a International Journal of Neurologic Physical Therapy 2017; 3(4): 28-34 pronounced effect on their self-care activities [7], leading to an inability to accomplish activities of daily living and becoming independent [8]
Summary
Hemiplegia is one of the most common types of cerebral palsy and constitutes a major form among spastic types It accounts about one-third of all cerebral palsy children as a result of unilateral brain lesion [3]. Upper limb function problems in children with CP are associated with deficits in motor control, weakness, dystonia, sensation and the persistence of the grasp reflex [5]. This can result in abnormal joint postures, reduced muscle extensibility and disuse which further limits upper limb function that is associated with difficulties with reaching, pointing, grasping, releasing and manipulating objects [6]. If the child cannot interact with the environment or is dependent on someone else for that interaction to occur, occupational deprivation becomes apparent, resulting in poor quality of life for the child and their caregivers [9]
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