Functional Mobility In Children Research Articles

Effectiveness of a smartphone-based virtual reality intervention on balance and functional mobility in children with acute lymphoblastic leukemia: A pre-post experimental study

Abstract Background: The odds of survival of children with acute lymphoblastic leukemia (ALL) has increased markedly owing to a better understanding of pathogenesis, adoption of risk stratification therapy, and availability of newer therapeutic agents. These drugs, however, may affect balance and functional mobility, leading to activity restrictions. Virtual reality (VR) is a promising rehabilitation program for motor difficulties. The study, therefore, aimed to determine the effect of a smartphone-based VR intervention on balance and functional mobility in children with ALL. Methods: The pre-post experimental study included 32 children with ALL between 4 and 18 years of age. They received smartphone-based VR intervention every day for a period of 2 weeks, with each session lasting for 30 minutes. Each session included five VR games that were played by the child for 5 minutes each, with 1 minute rest between the games. Pre- and post-intervention, balance and functional mobility were evaluated using the balance subset of Bruininks Oseretsky Test of Motor Proficiency, second edition (BOT-2) and the Timed Up and Go (TUG) test, respectively. Results: Children with ALL demonstrated a significant improvement in balance post-intervention, with a mean difference of 2.22 ± 1.75 (P < 0.0001). Functional mobility improved with a mean difference of 1.12 ± 1.09 (P < 0.0001). There was an improvement of 8.04% and 11.04% in balance and functional mobility, respectively. Conclusion: The study concluded that a 2-week smartphone-based VR intervention is effective in improving balance and functional mobility in children with ALL.

Psychometric Evaluation of the Persian Version of the Functional Mobility Scale: Assessing Validity and Reliability

Aim This study aimed to assess the content, concurrent validity, test-retest, and intra-rater reliability of the Persian version of the Functional Mobility Scale (FMS) for evaluating functional mobility in children and adolescents with cerebral palsy (CP). Methods Following international standards for measurement translation, we developed a Persian version of the FMS. A total of 160 participants took part in this study. Concurrent validity was assessed using Spearman’s coefficient to correlate with the Gross Motor Function Classification System (GMFCS). Test-retest (n = 30) and intra-rater (n = 30) reliability of the FMS were also examined by Cohen’s weighted kappa coefficient. Results Concurrent validity ranged from −0.912 to −0.941 for children and −0.912 to −0.936 for adolescents. Test-retest ranged from 0.902 to 1. Intra-rater ranged from 0.933 to 0.987. Conclusion The Persian version of the FMS demonstrates very strong validity and almost perfect reliability for assessing and classifying functional mobility in children and adolescents with CP. These findings suggest that this tool could be a useful addition to clinical practice and research for the Persian-speaking population.

Effect of Task Specific Circuit Training on Gait and Functional Mobility among Spastic Diplegic Cerebral Palsy

Background and Need for the Study: Spastic diplegic cerebral palsy is the most prevalent and common formof the cerebral palsy. Gait, balance, and coordination are all negatively impacted because it mostly affects thebilateral lower extremities.Purpose of the Study: The purpose of the research was to find out the effectiveness of task specific circuit trainingon gait and functional mobility in children with spastic diplegic cerebral palsy.Methods: In this research, selected 30 children according to inclusion and exclusion criteria. All the Childrenparticipating in the study were separated into two groups, Task specific circuit training group and Conventionalgroup, children’s parents were explained about the safety and procedure. Inform assent was provided to thechildren’s parents after explaining about the intervention and study procedure.Results: Pre-test measurements and Post-test measurements of the gait and functional independence, assessedusing the Edinburgh visual gait scale (EVGS) and GMFM-88. Paired t-test and unpaired t-tests were used forcalculating the mean and standard deviation.Conclusion: The research eventually reached the conclusion that task-specific circuit training is an efficient methodfor improving gait and functional mobility when used in conjunction with regular physiotherapy.

Effect of Backward Treadmill Training Versus Conventional Therapies to Improve Functional Mobility in Children with Spastic Diplegic Cerebral Palsy

Effect of Backward Treadmill Training Versus Conventional Therapies to Improve Functional Mobility in Children with Spastic Diplegic Cerebral Palsy

Effectiveness of Sensory Integration Therapy on Functional Mobility in Children With Spastic Diplegic Cerebral Palsy.

Background A set of non-progressive brain abnormalities and nervous system dysfunctions are referred to as cerebral palsy (CP). Due to this,the child's mobility, eyesight, learning, and thought processes are affected. It can evolve before, through birth, or the firstyear of a child's life.The activity through which the brain organizes and analyses external sensations like touch, motion, body awareness, vision, hearing, and gravity is indicated as sensory integration. The use of sensory integration therapy (SIT)necessitates that the sensorimotor exercises target the specific parts of difficulties that the child experiences daily. This study aims tostudy the effectiveness of SIT on functional mobility in children with spastic diplegic CP. Methods In this study, 40 children of CP with spastic diplegic who met the inclusion and exclusion criterion were enlisted and were separated into two groups, with Group A (n=20) receiving SITfor 25 minutes along with conventional physiotherapy for 20 minutes, and Group B (n=20) were given conventional physiotherapy for 45 minutes. A four-week therapy plan was followed. Short sensory profile (SSP) and Gross Motor Function Classification System (GMFCS), Pediatric mini-mental state examination (MMSE), and Modified Ashworth Scale were taken as outcome measures. Results SIT along with traditional treatment is described in the study protocol which aids CP children to improve themselves. Following a four-week protocol, combined therapy of SIT and conventional physiotherapy show an effect on the motor function of the children. After therapy, scores in GMFCS and SSP improved. By using Student's paired t-test, a statistically significant difference was found in GMFCS score at pre and post-test treatment in group A (7.28, p=0.0001) and group B (4.48, p=0.0001),in SSP score at pre and post-test treatment in group A (27.91, p=0.0001) and group B (11.31, p=0.0001), in MMSE score at pre- and post-test treatment in group A (6.89, p=0.0001) and group B (6.32, p=0.0001). The significance threshold was p<0.0001. Conclusion Under the study's experimental conditions, both groups showed substantial improvements in the functional mobility of children. When the efficacy of SIT along with conventional physiotherapy was examined, the impact resulted in a significantly greater improvement in the functional mobility of spastic diplegic CP children.

Evaluation of functional mobility, balance, and executive functions in children with epilepsy

ObjectiveIt is known that motor skills and executive functions are interrelated in healthy children. The study aims to evaluate the functional mobility, balance and executive functions in children who are diagnosed with epilepsy and to determine whether they are related to each other. MethodsThe study included 21 children who were diagnosed with epilepsy and have no additional comorbidities and 21 healthy children who had similar age and sex to those diagnosed with epilepsy. Their demographic data were collected using a descriptive information form. In addition, the Timed Up and Go Test (TUG) and the Stair Climb Test (SCT) were used to evaluate their functional mobility, the Pediatric Berg Balance Scale (PBSS) to evaluate their balance, and the Behavior Evaluation Inventory for Executive Functions Parent Form (BRIEF-P) to evaluate their executive functions. ResultsOur study found a statistically significant difference between the children with epilepsy and their healthy peers in terms of functional mobility and executive functions (p < 0.05). However, there was no statistically significant difference between them in terms of balance parameters (p > 0.05). In addition, a statistically significant difference was found between the executive functions and functional mobility in children with epilepsy (p < 0.05). The coefficient of determinations (R2) indicating how differences in T and SCT scores explained by executive function domains were found as 0.718 and 0.725, respectively. ConclusionsEpilepsy can negatively affect several aspects of functional mobility and executive functions in childhood. According to the results of our study, it is important to recognize the motor skills and executive functions problems of children with epilepsy who do not have additional comorbidities, and to direct them to appropriate healthcare programs. Our results support the need to raise awareness in both health professionals and families to encourage children with epilepsy to be more active.

Functional mobility in children and young adults with Dravet syndrome.

This cohort study aimed to describe functional mobility in Dravet syndrome, a developmental and epileptic encephalopathy. Functional mobility was assessed in individuals (aged 3-25 years), diagnosed with Dravet syndrome, using the Functional Mobility Scale (FMS), Mobility Questionnaire 28 (MobQues28), and estimated walking distance. Secondary outcome variables were Gait Profile Score (GPS), walking velocity, age at independent walking, intellectual disability, seizure frequency, genetic variant type, and body mass index (BMI). Forty participants aged 3 years to 24 years 2 months (mean=12 years 2 months) had a median MobQues28 of 79%, median scores of 5, 5, and 4 for the FMS 5 m, 50 m, and 500 m and a median estimated walking distance of 1 km to 3 km. Most difficulties were seen in walking up and down the stairs, walking over obstacles, kicking a ball, and running. MobQues28 scores showed a significant decrease (-6.6%, p=0.016) in the age category of young adults (≥18 years). After correcting for age, MobQues28 was correlated to age at independent walking (-0.485, p=0.002), GPS (-0.460, p=0.003), and walking velocity (0.334, p=0.038). Analysis of variance showed a significant effect of intellectual disability and BMI on MobQues28 (p=0.029, p=0.049). No effect of seizure frequency or genetic variant was found (p=0.579, p=0.337). Functional mobility limitations were observed mainly in dual tasks and activities requiring stability, with limitations increasing from the age of 18 years. Age at independent walking, gait impairments, intellectual disability, and BMI can impact functional mobility in Dravet syndrome. Most limitations were seen in dual task activities and activities that required more stability. Deterioration in functional mobility occurred in young adults. The more gait impairments, the more functional mobility limitations. Age at independent walking, intellectual disability, and body mass index can impact functional mobility.

Comparison of Integrated Task Oriented Bodyweight Supported Overground Training with Body-Weight Supported Treadmill Training to Improve Functional Mobility in Children with Spastic Diplegic Cerebral Palsy - A Single Blinded Randomized Control Trial

Functional gait training in cerebral palsy can involve over ground gait training or treadmill-based gait training which incorporates partial body weight support (PBWS) system. Insufficient clinical evidence prevails to recommend the superiority over the other intervention. ICF model has created a paradigm shift in understanding motor learning mechanisms, with the use of repetitive, task-specific movements beneficial to restructuring motor pathways. The primary aim of the study was to compare the effect of integrated task oriented Body Weight Supported overground Training (BWSOGT) against the Body Weight Supported Treadmill Training (BWSTT) and the conventional gait training protocols to improve the functional mobility in Cerebral Palsy. Methods: A Single-blinded, randomised control design. Sixty-children with GMFCS Level of III, IV were recruited in the study with an age ranges between 4 to 14 years (mean age = 9). Participants were randomly assigned into three groups using simple randomisation method with 20 subjects in each group for 8 weeks. The training programme consists of Group A with 40% of body weight supported walker with overhead pulley system which allows multiple degrees of freedom. Body weight- supported treadmill training (Group B) in a closed environment and conventional gait protocol using standard walkers (Group C). Outcome measures: Gross Motor Function Measure dimension-88 (GMFM-88) score. Gait kinematics (Stride length, Step length, Cadence) and 10 meter walk test. Tukey’s Post Hoc for group and time interactions, Krushkal Wallis test for overall significance and Mann Whitney’s U test to compare the significance between the groups. BWSOGT group showed significance over the BWSTT and Control group in GMFM score with p = 0.000 p = 0.002, respectively. Step length of gait parameter remained unchanged in all the three groups. Integrated task oriented BWSOGT might be an effective intervention to improve functional ambulation in children with spastic cerebral palsy due to the usage of a context specific environment and the training protocol.

Effect of single-event multilevel surgery on functional mobility of children with cerebral palsy

Introduction. Movement disorders are one of the most common complaints of patients with cerebral palsy. The attending physician needs to evaluate the motor activity of patients after treatment. The Functional Mobility Scale (FMS) is a clinically feasible tool to quantify changes after SEMLS in children with cerebral palsy.Purpose of the study. To evaluate the effect of simultaneous multilevel operations in combination with early rehabilitation treatment on the functional mobility of children with cerebral palsy in comparison with standard surgery.Materials and methods. The criterion for inclusion in the study was age at the time of examination less than 18 years, spastic cerebral palsy, surgical treatment due to orthopedic complications of cerebral palsy in two groups: after SEMLS and standard surgery. All subjects were assessed motor activity on the FMS scale.Results. The analysis performed showed no statistically significant changes in the assessment of functional mobility at a distance of 5 meters after surgical treatment in both study groups (p = 0.143; p = 0.083). A statistically significant improvement in functional mobility according to the FMS scale was found in children after simultaneous multilevel operations at distances of 50 and 500 meters (p = 0.025; p &lt; 0.001). No statistically significant changes were noted after standard operating procedures were carried out at distances of 50 and 500 meters (p = 0,063; p = 0,058).Conclusion. In children with cerebral palsy after simultaneous multilevel operations in combination with a complex of rehabilitation measures, the level of functional mobility improves. The use of the functional mobility scale allows the attending physician to objectify the dynamics of the motor function of patients with cerebral palsy after surgical treatment.

Variation in Functional Mobility Within Gross Motor Function Classification System Levels.

Variation in walking performance within Gross Motor Function Classification System (GMFCS) levels for patients with cerebral palsy (CP) is often unrecognized. The Functional Mobility Scale (FMS) rates mobility at household, school, and community distances. This study evaluated the variability of walking performance within GMFCS levels as measured by the FMS. Retrospective review of gait analysis records for ambulatory patients with CP. FMS rating distribution at each distance was examined for GMFCS levels I-IV within age groups (below 12 or above 12 y) and compared among levels using χ2 tests. A total of 788 patients (499 male; age 11.2, SD 3.9 y) were included. FMS score distribution differed significantly among GMFCS levels for all distances (P<0.001). I-Children walked independently on all surfaces at home and school distances at all ages. In all, 5% to 7% used wheeled mobility in the community. II-Most walked at home and school distances. Some younger children crawled at home, and 5% to 8% of all subjects used walls and furniture. Approximately 50% of subjects in both age groups used some form of walking aids or a stroller/wheelchair in the community. III-Twenty-five percent to 30% walked unaided at home, requiring walking aids or wheeled mobility at school or in the community. Forty-five percent of younger and 18% of older subjects crawled at home. Eight percent of younger and 28% of older subjects used wheelchairs at school. Seventy-three percent to 75% of all subjects used strollers/wheelchairs in the community. IV-Sixty-two percent of younger and 43% of older subjects crawled at home. Approximately 15% of all subjects did some aided walking at home. Twenty-seven percent of younger children did some aided walking at school, while only 1 older subject did so. All used strollers/wheelchairs in the community. Mobility function varies within each GMFCS level with the most variability in GMFCS II at school and community distances and GMFCS III at household distances. These findings highlight the importance of using both the GMFCS and FMS when assessing functional mobility in children with CP. Level III-retrospective study.

Efficacy of Task Oriented Training vs. Group Circuit Training Programme to Improve Functional Mobility in Children with Cerebral Palsy

Introduction: Cerebral palsy (CP) refers to a group of non-progressive neurological disorders that appear in infancy or early childhood. Since CP in children causes structural and functional changes in the neuromusculoskeletal system they are mostly presented with motor disorders, sensory disturbances which leads to impairment in functional mobility, several physical rehabilitation techniques benefited the children with CP in improving their physical health and mental wellbeing. The aim of the study is to analyse the effectiveness of group circuit training and task oriented training on functional mobility in children with cerebral palsy.&#x0D; Materials and Methods: This study design is a comparative study design and was done in physiotherapy OP department in KGH hospital, RK mission cerebral palsy clinic in Visakhapatnam. Based on the inclusion and exclusion criteria a study sample of 30 subjects was selected. The subjects were allocated into two groups through random sampling method, group A(n=15) received Task oriented training along with conventional physiotherapy, and group B(n=15) received circuit training along with conventional physiotherapy 3 sessions/week for 5 weeks for 30-40 minutes. Functional mobility was assessed by using the outcome measures GMFM 88 scale and TUG test.&#x0D; Results: The findings of the study revealed improved clinical outcomes in both groups. There was a statistical significance difference between the circuit training group and task oriented training in all the outcome variables at (P&lt;0.05).&#x0D; Conclusion: The study concluded that there was improvement in functional mobility in both groups. However the task oriented training was more effective than circuit training in improving the functional mobility in children with cerebral palsy.

Reliability of the Clinical Outcome Variables Scale for children with cerebral palsy

Background/aims It can be difficult for rehabilitation professionals to use lengthy scales and different outcome measures for diverse clinical conditions in busy outpatient settings. The Clinical Outcome Variables Scale is a functional mobility measure that is applied to various neurological conditions. Determining the inter- and intra-rater reliability of clinical outcome variable scale for children with cerebral palsy will further enhance its utility. Methods A total of 30 children aged between 3 and 16 years with cerebral palsy, who could obey single-step commands, were recruited for the study. Two independent assessors scored the children using the Clinical Outcome Variable Scale to determine inter-rater reliability. A repeat assessment was done by the principal assessor after 24 hours to establish intra-rater reliability. Reliability was estimated using intra-class correlation coefficient values. Results The Clinical Outcome Variables Scale had high Inter- and intra-rater reliability for the composite score (intraclass correlation coefficient=1), the general mobility subscale (intraclass correlation coefficient=0.99), and the ambulation subscale (intraclass correlation coefficient=0.99). The intraclass correlation coefficient for the individual test items were also showed a high correlation, with the variance between the tests and physiotherapists ranging from 0.95 to 1. Conclusions The Clinical Outcome Variables Scale demonstrated high inter- and intra-rater reliability when assessing functional mobility in children with cerebral palsy. Further studies should establish criterion validity and minimally clinically important difference values to maximise the use of the scale.

Physical functions and gait performance in school-aged children born late preterm

BackgroundChildren born late preterm (LP) have an increased risk of poor developmental motor outcomes. AimsThis study aimed to assess physical functions and gait performance in school-aged children born LP. Study designCross-sectional study. SubjectsPhysical functions and gait performance were evaluated in 277 children aged 6–10 years born LP (n = 22) and full-term (FT) (n = 255). Outcome measuresPhysical function tests consisted of five times sit-to-stand test (FTSST), one-leg standing time, and grip strength. FTSST was used to assess the functional muscle strength of the lower limbs and dynamic balance function. Gait performance tests included gait quality, spatiotemporal gait parameters, and gait variability. Clinical data, physical functions, and gait performance were compared between two groups. Furthermore, logistic regression analysis was performed to assess the association between all variables and LP birth. ResultsIn physical function tests, children born LP showed poorer FTSST than those born FT (p = 0.039). No significant difference in gait performance tests were identified between the two groups. Logistic regression analysis of FTSST for LP (adjusted for age at assessment) revealed that FTSST was significantly associated with LP birth (p = 0.004, odds ratio = 1.579, 95% confidence interval = 1.160–2.149). ConclusionsWe demonstrated the physical functions and gait performance in school-aged children born LP. Our findings indicate that it is important to focus on the decreased functional muscle strength of the lower limbs and reduced dynamic balance function related to LP birth to improve functional mobility in children born LP.

Neuromuscular Electrical Stimulation Improves Muscle Strength, Biomechanics of Movement, and Functional Mobility in Children With Chronic Neurological Disorders: A Systematic Review and Meta-Analysis.

Chronic neurological disorders (CNDs) generally produce deleterious effects on the musculoskeletal system and can affect physical activity and increase sedentary behavior in children, hindering the execution of training programs and the attainment of a correct dose of exercise. The purpose of this systematic review was to analyze the effect of neuromuscular electrical stimulation (NMES) on skeletal muscle and then on biomechanics of movement, functional mobility, strength, spasticity, muscle architecture, and body composition of children and adolescents with CNDs and chronic diseases. The search was conducted in April 2020 in PubMed, MEDLINE, Scopus, the Cochrane Library, and Web of Science, without publication period restriction. Publications investigating the effect of NMES on children and adolescents with CNDs and other chronic diseases were independently selected by 2 researchers. One author independently extracted data from the studies selected, and a second author cross-checked. Eighteen studies with 595 participants aged between 3 and 14years were included. Quality assessment showed that 50% of the studies presented a low risk of bias. The pooled effect of NMES on gross motor functional measure, calculated as a standardized mean difference using a random effects model, was 0.41 (95% CI = 0.19-0.64). The use of NMES programs for children diagnosed with cerebral palsy, spinal muscular atrophy, and obstetric injury of the brachial plexus was effective in improving muscle strength, biomechanics of movement, and functional mobility. NMES can be a useful tool to prevent the reduction of mobility that results from CNDs.

Knee flexion contracture impacts functional mobility in children with cerebral palsy with various degree of involvement: a cross-sectional register study of 2,838 individuals

Background and purpose — The impact of knee flexion contracture (KFC) on function in cerebral palsy (CP) is not clear. We studied KFC, functional mobility, and their association in children with CP. Subjects and methods — From the Swedish national CP register, 2,838 children were defined into 3 groups: no (≤ 4°), mild (5–14°), and severe (≥ 15°) KFC on physical examination. The Functional Mobility Scale (FMS) levels were categorized: using wheelchair (level 1), using assistive devices (level 2–4), walking independently (level 5–6). Standing and transfer ability and Gross Motor Function Classification (GMFCS) were assessed. Results — Of the 2,838 children, 73% had no, 14% mild, and 13% severe KFC. KFC increased from 7% at GMFCS level I to 71% at level V. FMS assessment (n = 2,838) revealed around 2/3 were walking independently and 1/3 used a wheelchair. With mild KFC (no KFC as reference), the odds ratio for FMS level 1 versus FMS level 5–6 at distances of 5, 50, and 500 meters, was 9, 9, and 8 respectively. Correspondingly, with severe KFC, the odds ratio was 170, 260, and 217. In no, mild, and severe KFC 14%, 47%, and 77% could stand with support and 11%, 25%, and 33% could transfer with support. Interpretation — Knee flexion contracture is common in children with CP and the severity of KFC impacts function. The proportion of children with KFC rose with increased GMFCS level, reduced functional mobility, and decreased standing and transfer ability. Therefore, early identification and adequate treatment of progressive KFC is important.

Neuroradiologic Features Associated With Severe Restriction of Functional Mobility in Children With Cerebral Palsy in North India.

Few studies have focused on magnetic resonance imaging (MRI) brain findings associated with functional mobility in cerebral palsy. To determine association between MRI findings and Gross Motor Functional Classification System (GMFCS) levels in cerebral palsy. Prospective-observational study conducted in Pediatric Neurology Clinic at a public teaching hospital, Northern India. First 3 new cases of cerebral palsy were enrolled on particular neuro-clinic day per week for 1 year. Functional mobility was classified according to GMFCS. Association between MRI findings, cerebral palsy type, and GMFCS levels were evaluated using χ2 test. A total of 138 cases (mean age 2.71 [SD = 1.91] years; male [64.5%]) were enrolled. Reported types of cerebral palsy were as follows: spastic quadriplegia (47.8%), spastic diplegia (28.35%), spastic hemiplegia (11.6%), extrapyramidal (6.5%), and ataxic/hypotonic (5.8%). GMFCS were classified into level 1 (13%), level 2 (7.2%), level 3 (4.3%), level 4 (10.9%), and level 5 (64.5%). Spastic quadriplegia and extrapyramidal cerebral palsy were significantly associated with higher (severe) levels (IV and V), whereas spastic diplegia and hemiplegia were significantly associated with lower (mild) levels (I-III) of GMFCS. MRI features of periventricular white matter injury, deep gray matter injury, basal ganglia and thalamic changes, and superficial gray matter injury were significantly associated with severe levels of GMFCS (V and IV). MRI was normal in 8 children (5 = mild category, 3 = severe category). Severe cerebral palsy is most often associated with spastic quadriplegia, extrapyramidal cerebral palsy, superficial gray matter lesions, deep gray matter lesions, and periventricular white matter injury. This information is useful for anticipating and addressing the needs of children with cerebral palsy and for prognostication.

Effects of Whole-Body Vibration-Assisted Training on Lower Limb Blood Flow in Children With Myelomeningocele.

This study investigated the effectiveness of whole-body vibration (WBV) training incorporated into a conventional physiotherapy (PT) program (WBV-assisted training) in improving blood flow in the lower limbs and range of motion in the lower limb joints of children with myelomeningocele (MMC). A total of 31 children with MMC (7–15 years old) underwent a 6 weeks treatment program consisting of 2 weeks of conventional PT followed by 4 weeks of WBV-assisted training. The assessment comprised two parts: evaluation of lower limb joint range of motion and Doppler ultrasonography of the superficial femoral, popliteal, and anterior tibial arteries and was performed three times for each of the participants (at baseline, after 10 sessions of PT but before WBV-assisted training, and after 20 sessions of WBV-assisted training). Our results showed that WBV-assisted training significantly improved lower limb circulation in patients with MMC, increasing velocity and reducing resistivity in all tested arteries. Moreover, WBV-assisted training alleviated lower-extremity contractures, especially of the knee. Thus, WBV-assisted training is effective as an adjunctive rehabilitation program for improving functional mobility in children with MMC.

Effect of Dual Task Training on Balance and Functional Mobility in Children with Cerebral Palsy

Research background. It was found that dual task training improves functional abilities in subjects with neurological disorders, however it is not known how dual task training affects balance and functional mobility in children with cerebral palsy (CP).The aim. To determine the effectiveness of dual motor tasks training and basic physiotherapy programme on balance and functional mobility in children with spastic diplegic CP.Methods. The study included 20 children with spastic diplegic CP. Subjects were randomly assigned into two groups: control group (40 min basic physiotherapy programme) and experimental group (20 min basic physiotherapy programme and 20 min dual motor task training). Physiotherapy was applied for 3 weeks (5 times a week). Balance and functional mobility were assessed at baseline and at the end.Results. There was a statistically significant improvement in balance and functional mobility in both the control and experimental groups after three weeks of physiotherapy (p &lt; 0.05). Comparing two groups with each other, there was a statistically significant improvement in the experimental group on balance and walking (p &lt; 0.05).Conclusion. Dual task training can be used as an effective intervention to improve balance and walking in children with spastic diplegic CP.Keywords: motor tasks, cerebral palsy, balance, functional mobility.

Translation, reliability and validity of the Greek functional mobility scale (FMS) for children with cerebral palsy

Purpose To translate and investigate the reliability and validity of the Greek version of the Functional Mobility Scale (FMS). Methods FMS was translated into Greek. Test-retest reliability (Cohen’s weighted kappa coefficient, κw ) and concurrent validity (Spearman’s rank correlation coefficient, rs) of the Greek version of FMS were assessed in children with Cerebral Palsy (CP). Sixty children (mean age 7.82 ± 3.20 years) were recruited. Physical therapists administered the FMS by interviewing parents about their children’s mobility status. The Gross Motor Function Classification System (GMFCS) was additionally used for testing concurrent validity. Results The translation of the FMS was deemed easy to understand and administer. The Greek FMS was demonstrated to have almost perfect test-retest reliability (κw =0.98–1.00), and very strong correlation with the GMFCS (–0.85 ≤ rs ≤ −0.89, p < 0.001). Conclusions The Greek version of the FMS was shown to be a reliable and valid classification system for CP and can be used with confidence by Greek physical therapists. Implications for rehabilitation The FMS provides a very simple and practical outcome measure of functional mobility in children with CP. The use of the reliable and valid Greek FMS will enhance the physical therapy assessment process in the Greek population, by offering the feasibility to detect the motor performance changes in children with CP as they grow or following interventions. The current study renders the Greek FMS available for utilization by physical therapists in order to quantify the independent mobility in children with CP.

The effect of trunk kinesio taping on static and dynamic balance and functional mobility in children with cerebral palsy

Cerebral palsy (CP) is a non-progressive neurological disease that causes the loss of normal motor function. The aim of this study was to investigate the effect of trunk kinesio taping on static and dynamic balance and functional mobility in children with CP. In an experimental study with pre-test and post-test, 38 children with spastic CP were randomly divided into intervention (n = 19) and control (n = 19) groups. In the intervention group, kinesio taping was applied on the thoracic and lumbar regions. Taping was employed in control group in a sham mode. Berg balance scale (BBS), forward functional reach (FFR), and timed up and go (TUG) tests were used prior to taping application, immediately, 2 days after taping application, and 2 days after removed kinesio tape. Results showed a significant increase in BBS (P < 0.001) and TUG (P < 0.001) short time after application and after remove of taping in the intervention group. However, non-significant changes perceived in BBS (P = 0.58), FFR (P = 0.32), and TUG (P = 0.32) immediately after application of kinesio taping in intervention group. No significant change has been observed in the control group in any different interval application. According to the results of this study, kinesio taping seems to be effective in improving dynamic balance and functional mobility in children with spastic CP. Therefore, kinesio taping can be used in the neurorehabilitation of CP as a complementary therapy.