Functional Balance In Children Research Articles

PENGGUNAAN ANKLE FOOT ORTHOSIS (AFO) TERHADAP KESEIMBANGAN FUNGSIONAL PADA ANAK PENDERITA CEREBRAL PALSY

Children with cerebral palsy will experience problems with their movements. Cerebral palsy affects muscles and a person's ability to control them. One of the disorders that occur in children with CP is disturbances in walking balance, which ultimately results in disturbances in walking motor skills, so children experience disturbances in daily living (ADL) activities in their daily lives. This research aims to determine the effect of using Anke Foot Orthosis on children's functional balance. Cerebral Palsy. Method: This type of research uses a Quasy Experiment with a pretest-posttest with a control group design. The total sample for this study was 10 respondents. Data collection was carried out using observation sheets. Analysis of this research data using univariate and bivariate analysis with Wilcoxon. Results: The influence of using Anke Foot Orthosis on the functional balance of Cerebral Palsy children, data taken before and after treatment with a value > 0.05. The conclusion is that there is no significant effect between using Anke Foot Orthosis and functional balance in children with cerebral palsy.

The Effect Insole Usage on Children Balance with Flatfoot Condition

Background: Flatfoot conditions cause children to experience balance problems due to musculoskeletal disorders of the foot. Cases of flatfoot are prevalent in many children and can interfere with their growth and development, potentially reducing their quality of life in the future. Therefore, efforts are needed to improve children's balance. This study aims to determine whether the usage of insoles has an effect on the balance of children with flatfoot conditions at Banyuanyar 3 Elementary School. Methods and Subjects: By implementing gross motor training for children and utilizing arch support insoles, the study seeks to enhance children's balance ability. The research design is a quantitative experimental design with Randomized Controlled Trials (RCT), employing Single Blinding, and data collection through Pre-test and Post-test. The purposive sampling technique was used, with an intervention period of 30 days. The subjects included students from SD Negeri Banyuanyar 3, with a selected sample of 30 children from a population of 119 with flatfoot conditions. Standard interventions, such as rhythmic gymnastics, function as efforts to improve children's balance abilities and are applied to both the control and intervention groups, each comprising 15 children. The Pediatric Balance Scale (PBS) was used in this study to measure the level of functional balance in children. Results: The Wilcoxon test results for the treatment group indicated a P-value of 0.002 (<0.05), signifying a difference in balance ability between the pre-test and post-test in the treatment group. This indicates an improvement in balance among children using EVA insoles. Conversely, the control group's test results showed a P-value of 0.067 (P>0.05), suggesting no difference in balance ability between the pre-test and post-test in the control group. Therefore, based on this study, it can be concluded that the use of EVA insoles with arch support was found to improve the balance of children with flatfoot conditions.

Long-Term Effect of Hyperbaric Oxygen Therapy on Gait and Functional Balance Skills in Cerebral Palsy Children—A Randomized Clinical Trial

This study aimed to explore the long-term effects of hyperbaric oxygen therapy on spatiotemporal gait parameters and functional balance in children with cerebral palsy. Thirty-nine children with hemiplegic cerebral palsy were randomly allocated to one of two groups: control or study. The children in both groups received traditional physical therapy three times per week for six months. In addition, the children in the study group received hyperbaric oxygen therapy five times/week for eight weeks. The GAITRite system and pediatric balance scale were used to assess spatiotemporal gait parameters and functional balance at baseline, post-intervention, and six months after the cessation of hyperbaric oxygen therapy. Post-intervention means of all measured parameters were significantly higher than pre-intervention means, but only for the study group (p < 0.05). However, both groups' means at the six-month follow up were significantly greater than those at pre-intervention (p < 0.05). At the post-intervention and follow-up evaluations, comparisons between groups revealed a statistically significant difference in all measured parameters for the study group against the control group (p < 0.05). It can be concluded that adding hyperbaric oxygen therapy to physical therapy rehabilitation could be effective in improving spatiotemporal gait parameters and functional balance in children with cerebral palsy.

Assessment of functional balance in children with sensory impairments undergoing hippotherapy

Objective: To evaluate the functional balance of children with sensory impairments submitted to hippotherapy. Methods: 24 children of both genres equally participated in three groups: cerebral palsy (CP), Down syndrome (DS), and intellectual disability (ID) with the respective age groups (10.71 ± 2.69 years), (12.83 ± 2.64 years), and (11 ± 1.69 years).There were 15 attendances in hippotherapy with riding materials specific to each group. The Pediatric Balance Scale (EEP) was used before the 1st and after the 15th hippotherapy session (pre and post moments) to assess functional balance. The data were analyzed using the Shapiro-Wilk tests (normality), Bartlett test (homogeneity), and, between the pre- and post-care times, the paired t-test (intra-groups) and ANOVA with Bonferroni's multiple comparison tests (between groups), with statistical significance for p &lt; 0.05. Results: in the post-attendance, there was an increase in the EEP score for the three groups (intra groups) with significance for children with ID (p = 0.003) and DS (p = 0.033); the CP group had a lower score (inter groups) in both times, pre (p = 0.003) and post (p = 0.002) attendance. Conclusion: hippotherapy contributed to the functional balance of children with distinct sensory impairments, according to the clinical diagnosis and riding material specific to the group, thus being able to be considered a therapeutic method with relevant benefits regarding the sensory aspects of the population.

Nintendo Wii Balance Board therapy for postural control in children with cerebral palsy: a systematic review and meta-analysis.

To analyse the efficacy of Nintendo Wii therapy (NWT) on functional balance in children with cerebral palsy (CP). A systematic review with meta-analysis (PROSPERO identification number CRD42020169510) was performed using randomized controlled trials (RCTs) that examined the effect of NWT on functional, dynamic, and static balance in children with CP, assessed with the Pediatric Balance Scale, the Timed Get Up and Go Test, and the One Leg Stance Test respectively. The pooled effect was calculated using the Cohen's standardized mean difference (SMD). Eleven RCTs with 270 children (when sex was reported: 43% females, 57% males) with CP (mean age [SD] 10y 1mo [1y 1mo], range 5-16y) were included. On functional balance, we found very low-quality evidence with a large effect of NWT compared with no intervention (SMD 0.95, 95% confidence interval [CI] 0.02-1.89) and moderate-quality evidence for using NWT plus conventional physical therapy (CPT) versus CPT (SMD 0.78, 95% CI 0.20-1.35) in sessions of approximately 30 minutes (SMD 0.86, 95% CI 0.20-1.52) and interventions lasting longer than 3 weeks (SMD 1.03, 95% CI 0.58-1.47). For dynamic balance, very low-quality evidence for a medium effect for using NWT plus CPT versus CPT (SMD 0.70, 95% CI 0.12-1.29) was found. NWT can be considered an effective treatment for improving functional and dynamic balance in children with CP, especially when combined with CPT in 30-minute sessions with interventions lasting longer than 3 weeks. What this paper adds Moderate-quality evidence with a large effect of Nintendo Wii therapy (NWT) on functional balance, compared with conventional physical therapy (CPT). Moderate-quality evidence with medium effect of NWT plus CPT on functional and dynamic balance, compared with CPT. Appropriate NWT sessions should be equal to or slightly less than 30 minutes. NWT interventions must be longer than 3 weeks.

Investigation of the Functional Balance in Children With Sensory Impairment Aged 6 to 14 Years Old

Objective: The balance of human body is maintained by a complex process involving visual, vestibular, and proprioceptive systems. Since the postural control require information from all of these three sensory systems to maintain optimal postural stability, lack of information in one system may affect body sway during maintaining balance .The purpose of this study is to investigate the functional balance in boys with severe-to-profound vision and hearing impairments aged 6-14 years. Methods: This descriptive analytical study was conducted on 30 visually-impaired, 30 hearing-impaired and 30 healthy boys who were selected by purposive sampling method. The Timed Up and Go Test was used for functional balance assessment. One-way ANOVA and Scheffe’s post hoc test were used to analyze data in SPSS V. 20 software, considering the significance level at P≤0.05 Results: Functional balance was significantly different in visually-impaired, hearing-impaired and healthy boys (P=0001) where it was poorer in visually-impaired boys compared to visually-impaired and healthy groups (P=0.000). There was no significant difference between hearing-impaired and healthy boys (P=0.001 ). Conclusion: It seems that vision and hearing impairments can reduce functional balance in boys. Visually-impaired boys have poorer balance than the hearing-impaired and healthy boys.

The Effect of the combination of active vestibular interventions and occupational therapy on Balance in Children with Bilateral Spastic Cerebral Palsy: A pilot randomized Controlled trial.

The current study aimed to examine the effect of the combined administration of active vestibular interventions and occupational therapy on balance and the relationship between balance changes and Activity of Daily Living in school-aged children with cerebral palsy (CP). Twenty-four children with Spastic CP, at the level I and II (according to the "Gross Motor Function Classification System) aged 7-12 years were enrolled and randomly assigned into control and intervention groups. Pediatric Balance Scales and Bruininks-Oseretsky Test of Motor Proficiency II were employed to assess the functional balance changes as well as Force Plate (eyes closed and open) to assess changes in the parameters of balance (e.g. center of pressure excursion). The activity of Daily Living was assessed by "Activity Scales for Kids (performance version)". Participants in the intervention group received active vestibular intervention for 20 min and a regular occupational therapy program for 25 min. The control group received a regular occupational therapy program for 45 min. Interventions were provided 3 d/week for 6 weeks in each group. The participants were assessed in three stages: baseline, immediately after, and eight weeks after the intervention. Data were analyzed by ANOVA and linear regression. The results demonstrated that only functional balance, according to Pediatric Balance Scales scores, was significantly increased in the active vestibular interventions group (p=0.02). There was no significant association between functional balance and Activity of Daily Living (P>0.05). The combined administration of active vestibular interventions and occupational therapy could improve the functional balance in children with spastic CP. It may be related to the reorganization of the vestibular system with a controlled and precise application of stimuli.

Test-retest & Inter-rater Reliability of Persian Version of Pediatric Balance Scale in Children with Spastic Cerebral Palsy.

Children affected with spastic cerebral palsy suffering a lot of movement and balance difficulties. Balance is one of the essential variables of movement, which facilitates functional skills. The main purpose of this study was inter-rater & test-retest reliability of Pediatric Balance Scale (PBS) in children with spastic cerebral palsy. In this analytical-descriptive research performed in the rehabilitation centers, south of Tehran, Iran in 2016, psychometric method was used. For investigating the inter-rater reliability, two examiners performed the scale simultaneously with 50 children with spastic cerebral palsy. Moreover, to investigate the test-retest reliability, the scale was implemented by one examiner, in two different sessions, among 50 children with spastic cerebral palsy. There was a two-week period between the first and the second session. The inter-rater reliability (ICC=0.99), as well as the test-retest reliability (ICC=0.99), was quite high. Standard Error of Measurement (SEM) was acceptable for either test-retest or inter-rater reliability. PBS is appropriate for measuring functional balance in children with spastic cerebral palsy with mild to moderate motor impairment.

Association between upper limb function and functional balance in children with spastic cerebral palsy: A pilot study

Association between upper limb function and functional balance in children with spastic cerebral palsy: A pilot study

Visual impairment affects functional balance in children with cerebral palsy

Visual impairment affects functional balance in children with cerebral palsy

Effect of Transcranial Direct Current Stimulation Combined With Virtual Reality Training on Balance in Children With Cerebral Palsy: A Randomized, Controlled, Double-Blind, Clinical Trial

ABSTRACTThe authors' aim was to investigate the effects of continuous transcranial direct current stimulation (tDCS) combined with virtual reality training on static and functional balance in children with cerebral palsy (CP). Twenty children with CP (6 girls and 14 boys; M age = 7 years 6 months ± 2 years) were randomly allocated to two groups. The experimental group received active tDCS and the control group received sham stimulation during the 10 sessions of virtual reality mobility training protocols. The children were evaluated on 3 occasions (preintervention, postintervention, and 1-month follow-up). Static balance was evaluated using a force plate under 4 conditions: feet on force plate with (a) eyes open and (b) with eyes closed, and feet on foam mat with (c) eyes open and (d) with eyes closed. Functional balance was evaluated using the Pediatric Balance Scale and the Timed Up and Go Test. The analyses demonstrated statistically significant postintervention and follow-up effects favoring the experimental group over the control group with regard to the Pediatric Balance Scale, Timed Up and Go Test, and area of oscillation of the center of pressure when standing on the force plate with eyes open. The present findings suggest that tDCS can potentiate the effects of virtual reality training on static and functional balance among children with CP.

The Role of Antigravity Treadmill in Haemophilic Children Aged 8 to 11 Years with Unilateral Knee Haemarthrosis without Radiological Involvement

Background: Recurrent joint bleeding in children with hemophilia leads to joint damage with pain, loss of range of motion and function. Antigravity treadmill (AGT) allows unloading of the lower extremities during exercise in a pressurized treadmill chamber. Aim: To investigate the effect of AGT on muscle strength and functional balance in children with hemophilic knee arthritis. Study Design: Prospective, randomized controlled study. Place and Duration of Study: The outpatient clinic, Medical rehabilitation hospital, and King Fahd Hospital, Almadinah Almonawarah, Kingdom of Saudi Arabia, between January 2015 and Mars 2015. Methods: Thirty hemophilic male children with unilateral knee heamarthrosis in the age ranged from 8 to 11 years old were randomly allocated into two equal groups. The control group (group A) received traditional exercise program, while the study group (group B) received AGT gait training added to the same exercise program of group A. Training was applied three times per week for twelve consecutive weeks. All children were assessed at baseline and after 36-session. Original Research Article Emara; BJMMR, 10(2): 1-10, 2015; Article no.BJMMR.19132 2 Assessment included peak torque of quadriceps and hamstring muscles using Biodex Isokinetic Dynamometer and functional balance using Pediatric Berg balance scale (PBBS). Results: Significant differences were observed in both groups when comparing their pre and post treatment mean values of all measuring variables (p<0.05). Peak torque of the quadriceps changed from (32.60±1.183, 32.933±1.533) to (38.40±1.681, 40.466±1.060) and peak torque of the hamstring changed from (25.00±1.81265, 25.933±2.0517) to (32.533±2.474, 35.933±2.631) for the control and study group respectively, indicating more improvement in favor of the study group. Both groups demonstrated a significant increase in functional balance, with more improvement in favor of group B. Conclusion: It can be concluded that gait training using AGT may be used as a therapeutic intervention for improving muscle performance and functional balance in children with hemophilic knee arthritis. Although our sample was not large, the effect size was moderate to large (0.85 and 0.83) for the knee extensors and flexors respectively and 0.553 for PBBS.

Effect of postural insoles on static and functional balance in children with cerebral palsy: a randomized controlled study.

BACKGROUND:Improved gait efficiency is one of the goals of therapy for children with cerebral palsy (CP). Postural insoles can allow more efficient gait by improving biomechanical alignment. OBJECTIVE:The aim of the present study was to determine the effect of the combination of postural insoles and ankle-foot orthoses on static and functional balance in children with CP. METHOD:A randomized, controlled, double-blind, clinical trial. After meeting legal requirements and the eligibility criteria, 20 children between four and 12 years of age were randomly allocated either to the control group (CG) (n=10) or the experimental group (EG) (n=10). The CG used placebo insoles and the EG used postural insoles. The Berg Balance Scale, Timed Up-and-Go Test, Six-Minute Walk Test, and Gross Motor Function Measure-88 were used to assess balance as well as the determination of oscillations from the center of pressure in the anteroposterior and mediolateral directions with eyes open and closed. Three evaluations were carried out: 1) immediately following placement of the insoles; 2) after three months of insole use; and 3) one month after suspending insole use. RESULTS:The EG achieved significantly better results in comparison to the CG on the Timed Up-and-Go Test as well as body sway in the anteroposterior and mediolateral directions. CONCLUSION:Postural insoles led to an improvement in static balance among children with cerebral palsy, as demonstrated by the reduction in body sway in the anteroposterior and mediolateral directions. Postural insole use also led to a better performance on the Timed Up-and-Go Test.

Functionality level and its relation to postural control during sitting-to-stand movement in children with cerebral palsy

In this study we studied functional performance and functional balance in children with cerebral palsy (CP) and typically developing (TD) children. The relationship between these components and postural control during sit-to-stand movement (STS) was also investigated. Ten children with CP (GMFCS I and II) and 27 TD children, ages 5-12 years, were included in the study. The Pediatric Evaluation of Disability Inventory (PEDI) and the Pediatric Balance Scale (PBS) were used to measure functional performance and functional balance, respectively. Postural control during STS was assessed by means of a force plate. Participants were asked to stand from a chair with feet over a force plate. Children with CP exhibited lower scores than TD children in the PBS and in the mobility Functional Skills and Caregiver Assistance domains of the PEDI (p≤0.05). In both groups postural control during STS movement was correlated with mobility Caregiver Assistance scores of the PEDI. The results demonstrate that although the participants had mild to moderate motor impairment, they exhibit deficits in their level of functional performance and functional balance compared to typical children. Moreover, it was observed that impairments in postural control during the STS movement are related to functional performance in both groups. This result demonstrates the importance of the structure and function components to the level of activity in children.

Effect of treadmill gait training on static and functional balance in children with cerebral palsy: Randomized controlled clinical trial

Effect of treadmill gait training on static and functional balance in children with cerebral palsy: Randomized controlled clinical trial

A comparison of treadmill training and overground walking in ambulant children with cerebral palsy: randomized controlled clinical trial

Objective: Compare the effects of treadmill training and training with overground walking (both without partial weight support) on motor skills in children with cerebral palsy. Design: Randomized controlled clinical trial. Setting: Physical therapy clinics. Subjects: Thirty-six children with cerebral palsy (levels I–III of the Gross Motor Functional Classification System) randomly divided into two intervention groups. Interventions: Experimental group (17 children) submitted to treadmill training without partial weight support. Overground walking group (18 children) submitted to gait training on a fixed surface (ground). Training was performed for seven consecutive weeks (two sessions per week), with four subsequent weeks of follow-up. Results: Both groups demonstrated improvements on the 6-minute walk test (experimental group from 227.4 SD 49.4 to 377.2 SD 93.0; overground walking group from 222.6 SD 42.6 to 268.0 SD 45.0), timed up-and-go test (experimental group from 14.3 SD 2.9 to 7.8 SD 2.2; overground walking group from 12.8 SD 2.2 to 10.5 SD 2.5), Pediatric Evaluation Disability Inventory (experimental group from 128.0 SD 19.9 to 139.0 SD 18.4; overground walking group from 120.8 SD 19.0 to 125.8 SD 12.2), Gross Motor Function Measure-88 (experimental group from 81.6 SD 8.7 to 93.0 SD 5.7; overground walking group from 77.3 SD 7.0 to 80.8 SD 7.2), Berg Balance Scale (experimental group from 34.9 SD 8.5 to 46.7 SD 7.6; overground walking group from 31.9 SD 7.0 to 35.7 SD 6.8) after treatment. The experimental group demonstrated greater improvements than the overground walking group both after treatment and during follow up (p < 0.05). Conclusion: Treadmill training proved more effective than training with overground walking regarding functional mobility, functional performance, gross motor function and functional balance in children with cerebral palsy.

Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial

Treadmill gait training as a therapeutic resource in the rehabilitation of children with cerebral palsy has recently been the focus of many studies; however, little is still known regarding its effect on static and functional balance in children. The aim of the present study was to compare the effects of treadmill training and over ground gait training in children with cerebral palsy. A randomized controlled trial with blinded evaluator was conducted with children with cerebral palsy between three and 12 years of age categorized in Levels I to III of the Gross Motor Function Classification System. Assessments were performed before and after the intervention and involved the Berg balance scale as well as the determination of oscillations from the center of pressure in the anteroposterior and mediolateral directions with eyes open and closed. The experimental group was submitted to treadmill training and the control group performed gait training over the ground. The intervention consisted of two 30-minute sessions per week for seven weeks. Both groups exhibited better functional balance after the protocol. The experimental group had higher Berg balance scale scores and exhibited lesser mediolateral oscillation with eyes open in comparison to the control group. Treadmill training had a greater effect on functional balance and mediolateral oscillation in comparison to over ground gait training in children with cerebral palsy. RBR-5v3kg9.(Brazilian Registry of Clinical Trials).

Static balance and function in children with cerebral palsy submitted to neuromuscular block and neuromuscular electrical stimulation: Study protocol for prospective, randomized, controlled trial

BackgroundThe use of botulinum toxin A (BT-A) for the treatment of lower limb spasticity is common in children with cerebral palsy (CP). Following the administration of BT-A, physical therapy plays a fundamental role in potentiating the functionality of the child. The balance deficit found in children with CP is mainly caused by muscle imbalance (spastic agonist and weak antagonist). Neuromuscular electrical stimulation (NMES) is a promising therapeutic modality for muscle strengthening in this population. The aim of the present study is to describe a protocol for a study aimed at analyzing the effects of NMES on dorsiflexors combined with physical therapy on static and functional balance in children with CP submitted to BT- A.Methods/DesignProtocol for a prospective, randomized, controlled trial with a blinded evaluator. Eligible participants will be children with cerebral palsy (Levels I, II and III of the Gross Motor Function Classification System) between five and 12 years of age, with independent gait with or without a gait-assistance device. All participants will receive BT-A in the lower limbs (triceps surae). The children will then be randomly allocated for either treatment with motor physical therapy combined with NMES on the tibialis anterior or motor physical therapy alone. The participants will be evaluated on three occasions: 1) one week prior to the administration of BT-A; 2) one week after the administration of BT-A; and 3) four months after the administration of BT-A (end of intervention). Spasticity will be assessed by the Modified Ashworth Scale and Modified Tardieu Scale. Static balance will be assessed using the Medicapteurs Fusyo pressure platform and functional balance will be assessed using the Berg Balance Scale.DiscussionThe aim of this protocol study is to describe the methodology of a randomized, controlled, clinical trial comparing the effect of motor physical therapy combined with NMES on the tibialis anterior muscle or motor physical therapy alone on static and functional balance in children with CP submitted to BT-A in the lower limbs. This study describes the background, hypotheses, methodology of the procedures and measurement of the results.Trial registrationRBR5qzs8h