Taş SA, Çankaya T. Effects of structured training on spinal posture and selective motor control in children with unilateral spastic cerebral palsy.
Gait Posture 2024;
109:22-27. [PMID:
38244393 DOI:
10.1016/j.gaitpost.2024.01.007]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/09/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND
Children with Unilateral Spastic Cerebral Palsy (USCP) have an asymmetrical postural pattern. Although functional limitations are less, deteriorations in spinal posture are observed.
RESEARCH QUESTION
What is the effect of structured training on spinal posture and selective motor control of upper extremity?
METHODS
Forty five children with USCP were included in the study. Participants were children ages 3-18 with GMFCS levels 1 and 2. Spinal posture and mobility was assessed by Spinal Mouse (SM) and the Spinal Alignment and Range of Motion Measure (SAROMM), and selective motor control of upper extremity was evaluated by the Selective Control of the Upper Extremity Scale (SCUES). Children were divided into two groups: structured training group (STG) (n = 22) and conventional physiotherapy group (CPG) (n = 23). Groups received treatment sessions lasting 45 min, 2 days a week for 8 weeks. Evaluations were made baseline and after treatment.
RESULTS
In sagittal plane, there was a significant decrease in the degree of thoracic kyphosis after treatment in the STG (p = 0.004). A significant difference was found in total spine angulation (p = 0.015) and mobility from flexion to extension in the STG group. There was a difference in total spine angulation (p = 0.014) in the CPG group, but no difference in spinal mobility. Post-training differences were found in thoracic angulation (p = 0.006) and lateral flexion mobility to the affected side in the STG in thoracic (p = 0.020), lumbar (p = 0.035) and total spine (p = 0.008) in the frontal plane. When SCUES-shoulder, elbow, wrist, total scores changes was significant in CPG (p < 0.001), SCUES-forearm (p = 0.002) and fingers (p = 0.007) changes was significant in STG.
SIGNIFICANCE
This study showed that although children with USCP are more mildly affected, there are adverse effects on their selective motor control and spinal posture. This study reveals the contribution of structured training in terms of selective movement, spinal smoothness and mobility in children.
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