Effect of Translatoric Joint Mobilization on Knee Joint Range of Motion in Spastic Diplegic Children– A Clinical Trial

Abstract

Background Cerebral palsy ( CP) is a non progressive but often changing, motor impairements due lesions of the Central Nervous System (CNS). Knee flexion contractures are a common secondary complication experienced by spastic children. The purpose of this study was to examine the effects of Translatoric Joint Mobilization (TJM) program to address bilateral knee flexion contractures in diplegic Cerebral Palsy (CP) children. The use of translatoric joint mobilization along with other common Physical Therapy (PT) interventions in this population remains controversial. Objectives 1. To establish the effectiveness of Kaltenborn’s Translatoric Joint Mobilization in improving knee joint range of motion in spastic diplegia and 2. To see improvement in functional mobility as measured by GMFM (88) scoring. Methodology Examination of function and impairment of 30 children with spastic diplegia included Popliteal Angle, Gross Motor Function Measure (GMFM)1 total score and dimension D and E of GMFM. Physiotherapy intervention consisted of Kaltenborn’s Translatoric knee joint mobilization and NDT for group A (experimental), and for group B (control) only NDT. The treatment was given for 6 days a week for 3 weeks. Results After 3 weeks of mobilization, there was significant improvement in popliteal angle and GMFM scoring seen in group A as compared to group B. Conclusion Translatoric joint mobilization proved to be a safe and effective addition to standard PT interventions for knee flexion contractures for the children in this study. The functional impact of improved knee extension was seen as an improvement in GMFM scores.