Spastic Hemiplegic Cerebral Palsy Research Articles

Gait Adaptation Is Different between the Affected and Unaffected Legs in Children with Spastic Hemiplegic Cerebral Palsy While Walking on a Changing Slope

Walking on sloped surfaces requires additional effort; how individuals with spastic hemiplegic cerebral palsy (CP) manage their gait on slopes remains unknown. Herein, we analyzed the difference in gait adaptation between the affected and unaffected legs according to changes in the incline by measuring spatiotemporal and kinematic data in children with spastic hemiplegic CP. Seventeen children underwent instrumented three-dimensional gait analysis on a dynamic pitch treadmill at an incline of +10° to −10° (intervals of 5°). While the step length of the affected legs increased during uphill gait and decreased during downhill gait, the unaffected legs showed no significance. During uphill gait, the hip, knee, and ankle joints of the affected and unaffected legs showed increased flexion, while the unaffected leg showed increased knee flexion throughout most of the stance phase compared with the affected leg. During downhill gait, hip and knee flexion increased in the affected leg, and knee flexion increased in the unaffected leg during the early swing phase. However, the ankle plantar flexion increased during the stance phase only in the unaffected leg. Although alterations in temporospatial variables and joint kinematics occurred in both legs as the slope angle changed, they showed different adaptation mechanisms.

Effects of Augmented Reality Intervention on the Range of Motion and Muscle Strength of Upper Extremity in Children with Spastic Hemiplegic Cerebral Palsy: A Randomized Clinical Trial.

Objective: To determine the effects of augmented reality (AR) interventions on the upper extremity's (UE's) range of motion (ROM) and muscle strength in children with spastic hemiplegic cerebral palsy (SHCP). Materials and Methods: Thirty children with SHCP, aged 6 to 12 years, were randomly divided into three interventional groups. Each group received an AR game that is, Balance It, Bubble Pop, or Scoop'd (WonderTree, Pakistan). The UE's ROM and muscle strength were assessed at the baseline and after 8 weeks of intervention through goniometer and manual muscle testing, respectively. Paired-sample t-test and Wilcoxon signed-rank test were used for analyzing the changes in ROM and muscle strength within the groups respectively. One-way analysis of variance (ANOVA) and Tukey's test were used for the differences in ROM, whereas the Kruskal-Wallis test was used for the differences in muscle strength, between the groups. Results: Within-group analysis revealed that all the groups significantly improved in ROM of the majority of joints and in the strength of various muscles of UE (P < 0.05). The elbow extension ROM was significantly different when a comparison was made between the interventional groups (P < 0.05). Balance It group showed more significant improvement in the elbow extension ROM as compared with the Scoop'd group. However, the comparison between the groups showed no significant difference in the muscle strength of UE (P > 0.05). Conclusion: The AR games intervention was beneficial and effective for improving the ROM of majority of the joints and strength of various muscles of UE in children with SHCP. Clinical Trial Registration number: NCT04171232.

Effects of 8 weeks functional training programme on posture control and functional mobility in spastic hemiplegic cerebral palsy.

To determine the impacts of functional training versus conventional training on posture control and functional mobility in spastic hemiplegic cerebral palsy children. The randomised clinical trial was conducted at the Rehab Cure physiotherapy centre, Lahore, Pakistan, from January to September 2020, and comprised children of either gender aged 4-14 years, diagnosed with cerebral palsy, gross motor functional classification system level II or III, and no mental retardation. The subjects were randomised into conventional therapy group A and functional training group B. Intensity of exercises was gradually increased each week, starting from 10 reps to 20 reps. The subjects received treatment 3 times a week for 8 weeks, and each session lasted 45-60 min. Paediatric Balance Scale, Trunk Control Measurement Scale, Five Times Sit to Stand Test and Timed-Up-and-Go test were used at baseline and post-intervention. Data was analysed using SPSS 21. Of the 14 subjects, there were 7(50%) in each of the two groups. Overall, there were 8(57.14%) males and 6(42.86%) females with a mean age of 7.57±1.86 years. Significant improvement was noted in both groups post-intervention (p<0.05), but intergroup differences were not significant (p>0.05). Both functional training and conventional therapy significantly improved postural control and functional mobility in spastic cerebral palsy children, but intergroup differences were not significant. IRCT20200909048676N1.

The effects of hand deformity on upper-limb function and health-related quality of life in children with spastic hemiplegic cerebral palsy

The aim of this study was to investigate the effect of hand deformity on upper-limb function and health-related quality of life (HRQOL) in children with hemiplegic cerebral palsy (CP). The study included 44 children with hemiplegic CP between the ages of 6 and 14 years (mean age, 10.04 years; SD, 3.1; 23 males, 21 females). The Manual Ability Classification System (MACS) and Gross Motor Function Classification System (GMFCS) were used, with the Zancolli classification to characterize hand deformities on the more affected side. Upper-limb function was assessed in terms of unilateral capacity (Quality of Upper Extremity Skills Test: QUEST) and bimanual performance (Children’s Hand-use Experience Questionnaire: CHEQ), while HRQOL was evaluated on the KIDSCREEN-27 questionnaire. Comparison of bimanual performance and unilateral capacity in children with Zancolli level 1 and 2a hemiplegic CP found statistically significant differences (p < 0.01). There was also a significant difference on the HRQOL ‘physical activities and health’ subdomain, in favor of Zancolli level I deformity (p = 0.003), but not on the other HRQOL domains (p > 0.05). Upper-limb function and the HRQOL physical health domain were poorer with greater hand deformity in children with hemiplegic CP.

Effectiveness of a Multi-Modal Exercise Program Incorporating Plyometric and Balance Training in Children With Hemiplegic Cerebral Palsy: A Three-Armed Randomized Clinical Trial

Aim To evaluate the effectiveness of a multimodal exercise program incorporating plyometric and balance training on muscle strength and postural stability in children with spastic hemiplegic cerebral palsy (SHCP). Methods A total of 57 children with SHCP were enrolled in the study and randomly allocated into three treatment-based groups: plyometric exercises (PLYO group; n = 19), balance exercises (BAL group, n = 19), and combined plyometric and balance exercises (PLYO-BAL group; n = 19). The maximum isometric muscle strength (IMSmax) and postural stability [anterior-posterior stability index (AP-SI), mediolateral stability index (ML-SI), and overall stability index (O-SI)] were measured pre- and post-intervention. Results By applying the intention-to-treat analysis, the PLYO-BAL group showed greater post-treatment IMSmax than the PLYO and BAL groups for the quadriceps (p=.03 and p=.0002 respectively), hamstrings (p=.018 and p<.0001 respectively), and dorsiflexors (p=.006 and p<.0001 respectively). Also, the PLYO-BAL group achieved better post-intervention stability scores as compared to PLYO and BAL groups regarding AP-SI (p<.0001 and p=.0001 respectively), ML-SI (p=.001 and p=.015 respectively), and O-SI (p=.011 and p=.04 respectively). Conclusions Incorporation of plyometric and balance exercises in a multimodal rehabilitation program could be an important consideration for enhancing muscle strength and boosting postural stability in children with SHCP.

Occupational therapy with or without combined acupuncture on upper limb pain and hand functions in children with spastic hemiplegic cerebral palsy: A three-arm randomized, placebo-controlled trial: 作业疗法合并或不合并针刺对痉挛型偏瘫脑瘫患儿上肢疼痛及手功能的干预研究:一个三臂随机安慰剂对照临床试验

ObjectiveThis study is conducted to investigate the effects of occupational therapy (OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral palsy. MethodsA total of 90 patients who met the inclusion criteria were enrolled in a three-arm randomized, placebo-controlled trial, and were allocated to mono-occupational therapy (OT) group (patients= 30), OT combined with real-acupuncture (ORA) group (patients= 30), and OT combined with placebo-acupuncture (OPA) group (patients= 30), respectively. In addition to receiving the conventional OT program as the basic treatment for total 8 weeks, patients in ORA and OPA group also received corresponding acupuncture treatment 5 days per week for the first two weeks, 3 days per week for the next two weeks, 2 days per week for another two weeks, and 1 day per week for the last two weeks. Non-communicating children's pain checklist-revised scale (NCCPC-R) was used for assessing the upper limb pain among patients. Squeeze dynamometry, modified Ashworth scale (MAS), manual muscle testing (MMT), Jebsen-Taylor hand function test (JTHFT) and box and block test (BBT) were used for assessing various aspects of upper limb and hand functions among patients. Meanwhile, adverse effects were monitored and recorded. ResultsAfter 8-week treatment, NCCPC-R global scores witnessed a dramatic decline in ORA group (P < 0.05), but not in either OPA (P > 0.05) or OT group (P > 0.05). Dramatic increases were identified in both squeeze dynamometry scores and MMT scores in all three groups (all P < 0.05). Furthermore, the increases of ORA group were more significant than those of another two groups (both P < 0.05). There were no significant changes in MAS global scores in each group (all P > 0.05). The BBT global scores of all three groups significantly increased (all P < 0.05) after treatment. Among them, the increase of the ORA group was more than that of the other two groups (P < 0.05). The 8-week treatment also had a significant impact on several sub-tests of JTFHT in each group. No significant adverse event was reported. ConclusionORA is a potential and promising alternative therapy for mitigating upper limb pain as well as improving both upper limb and hand functions among children with spastic hemiplegic cerebral palsy.

EFFECTIVENESS OF SPECIALIZED KINESITHERAPY IN CHILDREN WITH SPASTIC HEMIPLEGIC CEREBRAL PALSY

Purpose: The aim of this study was to investigate the effect of Doman-Delacato and Perfetti methods in addition to routine kinesitherapy for children with spastic hemiplegic cerebral palsy (CP). Material and Methods: 60 children with a spastic hemiplegic CP were randomly divided into two groups – the control group (CG) received routine kinesitherapy method, and the experimental group (EG) received, in addition, specialized neurodevelopmental methods of Doman-Delacato and Perfetti. For children in both groups, kinesitherapy was applied three times a week for 50 min each procedure. Assessment was done using Ashworth Modified Scale, the Holt and Hoskins - Squires Test and GMFM – 88. The study period ran from April 2018 to November 2018. The evaluation was done before and 8 months later. Data were analyzed using GraphPad Prism version 3.0 andSPSS 19.0. The level of significance was accepted as p&lt;0.05. Results: 60children, 27 girls and 33 boys managed (X±SD) for EG 4.8±1.3 and for CG 5.06±1.4 were included. Muscle spasticity in EG children decreases much earlier and more than in children in CG. Man Witney criteria show statistically significant differences at the end of the treatment (р=0,03&lt;α=0,05). Hottest and GMFM-88dataobtainedalsoreceivedstatisticallysignificantdifferencesof t – criteria between initial and final measurements in EG. Conclusions: EG children improvement is better and occurs much earlier. Therefore, we could assert that our methodology optimizes the treatment of children with CPD and improves their quality of life.

Effect of Physical Guidance on Learning a Tracking Task in Children with Cerebral Palsy.

The purpose of this study was to investigate the effect of physical guidance (PG) frequency on learning a tracking task in children with hemiplegic spastic cerebral palsy (CP). For this purpose, 25 children, aged 7–15 years with CP affecting the left side of the body, who were classified in levels II–III of Manual Abilities Classification System (MACS) and levels III–IV of Gross Motor Function Classification System (GMFCS), were recruited from 10 clinical centers. A pre-test including two blocks of 12 trials of the tracking task without any PG was performed by all participants, after that they were assigned into five homogenous groups (with 100%, 75%, 50%, 25%, and 0% of PG) through blocked randomization according to their age. All participants involved in an intervention consisted of eight sessions (four blocks of 12 trials in each session) practicing a tracking task. The 0% PG group received no PG, the 25% PG group received PG for three trials, the 50% PG group received PG for six trials, the 75% PG group received PG for nine trials, and the 100% PG group received PG for all twelve trials. PG consisted of placing the experimenter’s hand around the child’s less-involved hand guiding to stay on the track and complete the task. Learning was inferred by acquisition and delayed retention tests. The results showed that the higher frequency of PG led to more accurate performance during practice phase. However, the group that received 75% PG had significantly better performance compared to the other groups in the retention phase. It is concluded that optimum level of PG, about 75% of trials, can be helpful for learning a tracking task in children with spastic hemiplegic CP, supporting the challenge point framework.

The Effects of Bilateral Motor Training on the Power of Grip in Affected Hand of Children with Spastic Hemiplegic Cerebral Palsy

The Effects of Bilateral Motor Training on the Power of Grip in Affected Hand of Children with Spastic Hemiplegic Cerebral Palsy

Changes in Muscle Mass after Botulinum Toxin Injection in Children with Spastic Hemiplegic Cerebral Palsy.

We aimed to evaluate muscle mass changes after injection of botulinum toxin (BoNT) in children with spastic hemiplegic cerebral palsy (CP). Children aged between 2 and 12 years who were diagnosed with hemiplegic CP with spastic equinus foot were prospectively recruited and administered BoNT in the affected leg. Lean body mass (LBM) of both legs and total limbs was measured by dual-energy X-ray absorptiometry (DXA) preinjection and 4 and 12 weeks after injection. A total of 15 children were enrolled into the study. LBM of both legs and total limbs increased significantly over 12 weeks of growth. The ratio of LBM of the affected leg to total limbs and to the unaffected leg significantly reduced at 4 weeks after injection compared with preinjection but significantly increased at 12 weeks after injection compared with 4 weeks after injection. In conclusion, the muscle mass of the affected leg after BoNT injection in children with hemiplegic spastic CP decreased at 4 weeks after BoNT injection but significantly recovered after 12 weeks after injection.

The Effects of Virtual Reality Based Rehabilitation on Upper Extremity Function in a Child with Cerebral Palsy: A Case Report

Aim This case report was designed to assess the efficacy of virtual reality (VR) rehabilitation on improving upper extremity function for a child with spastic hemiplegic cerebral palsy. Methods In addition to conventional therapies completed three times per week, the participant engaged in virtual reality rehabilitation with the Neofect Smart Kids five to seven days per week for six weeks totaling just over twelve hours of intervention time. Outcome measures were administered pre-intervention, post-intervention, and 6-weeks post-intervention. Results Varying levels of improvement in motor function, quality of movement, and functional use were observed during intervention evidenced by improved scores on the following standardized assessments: Peabody Developmental Motor Scales, Second Edition; the Quality of Upper Extremity Skills Test; and the Pediatric Evaluation and Disability Inventory—Computer Adaptive Test. The participant maintained improvements in motor skills at 6-weeks post intervention, however, the quality of his movements and overall frequency of use with his affected upper extremity decreased in the 6-weeks following termination of intervention. Conclusions Even though the results are not generalizable, the VR intervention for this child allowed for greater movement repetition and improved functional upper extremity use.

The effect of reciprocal electrical stimulation on handgrip and pinch grip strength in spastic hemiplegic cerebral palsy child

The effect of reciprocal electrical stimulation on handgrip and pinch grip strength in spastic hemiplegic cerebral palsy child

Risk Factors Associated with Epilepsy among Children with Cerebral Palsy

Background: Cerebral Palsy(CP) is a major cause of childhood disability and is more prevalent in the more socioeconomically deprived populations of the world. Epilepsy is said to occur in 15-90% of children with CP and this causes additional economic and psychological stress on affected children and their family.&#x0D; Materials and Methods: This cross sectional case control study was conducted in paediatric neurology OPD of Dhaka Medical College Hospital &amp; BSMMU from July 2008 to June 2009. Four hundred children with CP were included in this study &amp; CP with epilepsy was taken as case and CP without epilepsy as control. Medical records of these patients were reviewed and analyzed.&#x0D; Results: 150 children studied had associated epilepsy, giving a prevalence rate of 37.5%. Epilepsy most commonly affected children with spastic quadriplegia (43.5%). GTCS was more common of epilepsy in spastic quadriplegic CP and partial seizure common in spastic hemiplegic CP. After logistic regression analysis significant positive correlation was found between LBW (OR, 0.428), post-natal CNS infection (OR, 0.416) with occurrence of epilepsy in CP cases. Statistically significant positive correlation was not found between prematurity, neonatal jaundice, neonatal convulsion, neonatal sepsis as a risk factor to develop epilepsy in CP.&#x0D; Conclusion: Among CP cases epilepsy is most common in spastic quadriplegic CP and GTCS is more common type of epilepsy in spastic quadriplegic CP. LBW and postnatal CNS infection significantly increase the risk of epilepsy in CP cases. Prematurity, neonatal jaundice, neonatal convulsion does not increase the risk of developing epilepsy in CP.&#x0D; Bangladesh J Child Health 2020; VOL 44 (2) :92-96

Forced use therapy to improve hand function in spastic cerebral palsy children

Introduction: Prehension, the ability to grasp, hold and manipulate objects is an important hand function. Impairment in hand function makes it difficult to fulfill activities of daily living. Objectives: To assess the effect of forced use therapy (FUT) in improving hand function of hemiplegic cerebral palsy children. Outcome measures: Modified Ashworth scale, Fegl Meyer assessment upper extremity, 9-hole peg board, upper extremity functional index and caregiver functional use survey are the outcome measures. Method: Fifty two children with cerebral palsy were divided into 2 groups A and B, 26 subjects in each group. Group A was given conventional hand function exercise whilst group B was given forced hand use therapy. Both groups received the treatment for 45 minutes for the affected limb for 5 days a week. But the FUT group was administered with gloves to constraint the hand movement for 6 hours daily. They were administered with the protocol for 4 weeks and outcomes were measured pre- and post-treatment duration. Results: FUT showed significantly better improvement over the conventional group in outcome measures (p Conclusions: FUT caused reduction in spasticity and increased functional ability in children with spastic hemiplegic cerebral palsy. Sri Lanka Journal of Child Health, 2020; 49(4): 335-340

Induced Contention Therapy and functional bandage in children with cerebral palsy: Case report

Background: The decrease in the manual activity of hemiparetic children, affects their functionality and independence. Among the therapies used to improve manual function, there is Induced Contention Therapy (ICT) and functional bandaging (FB). Such approaches aim to improve the use and decrease the disuse learned from the upper limb in subjects with hemiparesis. Objective: Identify the effect of ICT, associated with the application of functional bandaging on the affected upper limb, in the function of the upper limb and on the handgrip of a child with spastic hemiplegic cerebral palsy. Methods: A 5-year-old child received ICT for three hours daily for three consecutive weeks associated with FB in the right upper limb. The use of the upper limb was evaluated using the Pediatric Upper Extremity Motor Activity Log (PMAL) scale, the acquisition of new motor standards using the Inventory of New Motor Activities and Program (INMAP) scale, the motor skill by the Pediatric Arm Functional Test (PAFT) and the handgrip strength by the dynamometer. Results: There was an improvement in the quantity and quality of use of the paretic upper limb after the application of ICT, which remained after one month of therapy. In addition, it was observed the acquisition of new motor skills and improvement in handgrip strength. Conclusion: This study had a potential positive effect on handgrip strength, functionality and quality of use of the paretic upper limb of a child with spastic CP after the application of ICT associated with functional bandaging.

The Utility of Gait Deviation Index (GDI) and Gait Variability Index (GVI) in Detecting Gait Changes in Spastic Hemiplegic Cerebral Palsy Children Using Ankle-Foot Orthoses (AFO).

Background: Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations. Clinical gait analysis (CGA) is used to identify, understand and support the management of gait deviations in CP. Children with CP often use ankle–foot orthosis (AFO) to facilitate and optimize their walking ability. The aim of this study was to assess whether the gait deviation index (GDI) and the gait variability index (GVI) results can reflect the changes of spatio-temporal and kinematic gait parameters in spastic hemiplegic CP children wearing AFO. Method: The study group consisted of 37 CP children with hemiparesis. All had undergone a comprehensive, instrumented gait analysis while walking, both barefoot and with their AFO, during the same CGA session. Kinematic and spatio-temporal data were collected and GVI and GDI gait indexes were calculated. Results: Significant differences were found between the barefoot condition and the AFO conditions for selected spatio-temporal and kinematic gait parameters. Changes in GVI and GDI were also statistically significant. Conclusions: The use of AFO in hemiplegic CP children caused a statistically significant improvement in spatio-temporal and kinematic gait parameters. It was found that these changes were also reflected by GVI and GDI. These findings might suggest that gait indices, such as GDI and GVI, as clinical outcome measures, may reflect the effects of specific therapeutic interventions in CP children.

Effect of lidocaine iontophoresis combined with exercise intervention on gait andspasticity in children with spastic hemiplegic cerebral palsy: A randomized controlled trial.

Gait deviations and spasticity are common impairments seen in children with cerebral palsy (CP) and may interfere with functional performance and effective walking pattern. Lidocaine iontophoresis is effective for reducing muscle spasticity in adults. To investigate the effect of lidocaine epinephrine iontophoresis combined with exercises on gait and spasticity in children with spastic hemiplegic cerebral palsy (HCP). Thirty children with spastic HCP aged 4-6 (5.20±0.32) years were randomly assigned to the experimental group (n = 15) and control group (n = 15). Children in both groups received one hour of exercises, three times a week for three months. Children in the experimental group received 2% lidocaine iontophoresis immediately before the exercises. The lidocaine iontophoresis was delivered for 20 minutes (1mA/min). Spatio-temporal gait parameters were assessed within one week before and after the intervention using 3D motion analysis. Surface electromyography was used to assess muscle tone using H/M ratio of the soleus muscle. ANOVA was used to investigate the differences between experimental and control groups. Statistical significance was set at P value less than 0.05. There was no difference between groups at baseline. Post-intervention, the experimental group showed significant improvements when compared to the control group for gait speed (p = 0.03), stride length (p = 0.04), cadence (p = 0.0001), cycle time (p = 0.0001), and H/M ratio (p = 0.02). Lidocaine iontophoresis combined with exercises was effective in improving gait spatiotemporal parameters and reducing spasticity in children with CP.

Functional Strength Training In Children With Spastic Cerebral Palsy

To find out functional strength training exercise on improving gross motor function among the children with spastic hemiplegic cerebral palsy children. Single group pre-experimental research design. The most common cause of movement disability in infancy is cerebral palsy. Cerebral palsy patients have impairments such as spasticity, low muscle strength and selective motor control in their body function. Such deficiencies may limit activity performance and participation in everyday life. Improving and optimising activities and involvement are crucial treatment objectives. Functional strength workouts are vital to overcoming obstacles to improving the functionality of children with neurological issues. 92 subjects of spastic hemiplegic cerebral palsied aged 4-8, male and female with spastic hemiplegic cerebral palsy were selected under purposive sampling technique and received functional strength training exercise for a period of ten weeks. To assess the gross motor function (functional independence) pre and post the exercise program, Gross motor functional measure was used. Results: The pre and post measurements shows significant changes in the gross motor function among children with spastic hemiplegic cerebral palsy. The results of the post-test mean values show improvement in gross motor functions after functional strength training program (p&lt;0.05). The functional strength training program proves that increased gross motor function and thereby improvement in functional abilities among children with spastic hemiplegic cerebral palsy after ten weeks of intervention.

Selective Dorsal Rhizotomy for the Treatment of Spastic Hemiplegic Cerebral Palsy.

BackgroundSelective dorsal rhizotomy (SDR) can remove spasticity in cerebral palsy (CP). Spastic hemiplegia is associated with spasticity in the upper and lower limbs on one side. Only a single report described the outcome of SDR specifically in patients with spastic hemiplegic CP. The effect of SDR on spastic hemiplegia requires further investigation.ObjectivesTo analyze the outcomes of motor functions, the quality of life, and satisfaction of patients who received SDR for the treatment of spastic hemiplegia.MethodsA total of 29 children and 1 adult who received SDR were surveyed. The survey questionnaire asked about demographic information, patient's perception of SDR, functional outcomes, SDR surgical outcomes, pain, braces/orthotics, and post-SDR treatment.ResultsOur study included 30 patients. The age at the time of surgery was 2 to 36 years. The follow-up period ranged from one to six years. Of all parents, 90% of parents reported that SDR benefited their children, and 93% stated that they would recommend the SDR procedure to other families of children with hemiplegic CP. Of all patients, 90% reported improved walking, 63% reported improved sitting, and 87% reported improved balance and posture. In daily life functioning after the SDR, 67% were more independent and confident. Moreover, 33% of patients were pain-free and 43% had reduced pain in their legs and back. In activities of daily living, 93% transferred independently from one position to another. A majority of the patients reported regular strengthening and stretching of the lower limb, and 50% of the patients played sports. A majority (73%) of patients underwent post-SDR orthopedic surgery for heel cord, hamstring, and adductor contractures. Five patients experienced numbness in the small part of the lower limb after SDR. None reported that the numbness affected their daily activities. One child required surgical repair of the cerebrospinal fluid leak.ConclusionsIn our 29 children and 1 adult with spastic hemiplegia, SDR improved motor function and daily life function. Nearly all parents of children and the one adult felt that SDR was beneficial and that they would recommend surgery to other children with spastic hemiplegia.

SEAS Exercise to Treat Scoliosis and Improve Functional Activities in Children with Spastic Cerebral Palsy

SEAS exercise to improve functional activities among the children with spastic hemiplegic cerebral palsy children. Single group pre- post experimental research design. Cerebral paralysis is a static encephalopathy which affects the immature brain and leads to permanent motor disability. Due to a combination of spasticity, muscle weakness and incompletion of muscle control, the spinal deformity occurs in rising patients with CP; it can lead to poor balance in the trunk and significantly limits patient function. SEAS exercise capacity to enhance the self-corrected posture by concentrating during everyday activities. Eighty eight subjects of spastic hemiplegic cerebral palsied children, aged 6-12, male and female with scoliosis were selected under purposive sampling technique and received SEAS exercise training for a period of eight weeks. pre and post outcome measures were assessed using Modified Ashworth scale and Scoliometer to measure the functional activity in the children Pediatric balance scale, functional gait assessment and Gross motor function were used. Significant changes in spasticity and scoliosis were observed, and functional parameters were increased. The results of the post-test mean values for all SEAS variables demonstrated substantial improved balance, reduced scoliosis and gross motor functions in those receiving SEAS protocol (p&lt;0.05). The SEAS exercise proves there was a decrease in scoliosis and their by improvement in functional abilities among children with spastic hemiplegic cerebral palsy after eight weeks of intervention.