Effect of treadmill training combined with ankle weight on balance in spastic cerebral palsied children: A randomized controlled trial
Resumen
The aim of this study was to examine the impact of treadmill training combined with ankle weights on balance and dorsiflexor muscle strength in children with spastic hemiparetic cerebral palsy (CP). This clinical, randomized trial included forty boys and girls suffering from spastic hemiparetic cerebral palsy, ranging in age from 6 to 9 years old. They were split into two equal groups (control group = 20, study group = 20). Both groups received a program of physiotherapy in addition to treadmill exercise, while the study group also received ankle weights for eight weeks. The Biodex stability system was employed to evaluate stability indices, including the overall stability index (OASI), anteroposterior stability index (APSI), and mediolateral stability index (MLSI). Functional balance was measured using the Pediatric Balance Scale (PBS). A Lafayette manual muscle tester (MMT) was used to record the peak force of ankle dorsiflexor muscle strength for both groups, pre- and post-therapy. Post-therapy results showed a significant decrease in all stability indices at stability levels 8 and 4, and a significant increase was observed in functional balance and ankle dorsiflexor muscle strength in both groups (p<0.05). The study group showed a more significant improvement in all outcome measures after therapy than the control group (p<0.05). The program of physiotherapy, treadmill training, and ankle weights was effective in improving balance and dorsiflexor muscle strength among children with spastic hemiparetic cerebral palsy, with ankle weights contributing to greater progress.
Descargas
Citas
Abd El-Nabie, W. A., & Attia, M. A. (2019). Immediate effect of maximal treadmill walking on muscle fatigue and postural stability in children with cerebral palsy. Bulletin of Faculty of Physical Therapy, 24, 79–84. https://doi.org/10.4103/bfpt.bfpt_26_18
Ahmed, H. I., El-Negmy, E. H., Olama, K., A., & Hendawy, A. S. (2019). Effect of Ankle Weight during Gait Training on Dorsiflexors Strength in Hemiparetic Children. The Medical Journal of Cairo University, 87, 3619-3624. https://doi.org/10.21608/mjcu.2019.69905
Alsakhawi, R. S., & Elshafey, M. A. (2019). Effect of Core Stability Exercises and Treadmill Training on Balance in Children with Down Syndrome: Randomized Controlled Trial. Advances in Therapy, 36(9), 2364–2373. https://doi.org/10.1007/s12325-019-01024-2
Ameer, M., A., & Khallaf, M., E. (2017). Effect of Treadmill Gait Training on Diplegic Children Swing Phase Gait Parameters. International Journal of Physiotherapy and Research, 5(1), 1829-35. http://doi.org/10.16965/ijpr.2016.200.
Bahar-Özdemir, Y., Ünal-Ulutatar, Ç., Karali-Bingül, D., & Karadağ-Saygı, E. (2021). Efficacy of foot-ankle orthosis on balance for children with hemiplegic cerebral palsy: An observational study. Turkish Journal of Physical Medicine and Rehabilitation, 67(3), 336–343. https://doi.org/10.5606/tftrd.2021.5175
Bakırhan, S., Elibol, N., Özkeskin, M., & Özden, F. (2021). The relationship between knee-ankle muscle strength and performance tests in young female adults with flexible pes planus. Bulletin of Faculty of Physical Therapy, 26(4), 1-7. https://doi.org/10.1186/s43161-021-00021-3
Bohannon, R. W., & Smith, M. B. (1987). Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy, 67(2), 206–207. https://doi.org/10.1093/ptj/67.2.206
Cachupe, W., J., C., Shifflett, B., Kahanov, L., & Wughalter, E. H. (2001). Reliability of biodex balance system measures. Measurement in Physical Education and Exercise Science, 5(2), 97-108. http://doi.org/10.1207/S15327841MPEE0502_3.
Chen, C. L., Shen, I. H., Chen, C. Y., Wu, C. Y., Liu, W. Y., & Chung, C. Y. (2013). Validity, responsiveness, minimal detectable change, and minimal clinically important change of Pediatric Balance Scale in children with cerebral palsy. Research in Developmental Disabilities, 34(3), 916–922. https://doi.org/10.1016/j.ridd.2012.11.006
Daubney, M. E., & Culham, E. G. (1999). Lower-extremity muscle force and balance performance in adults aged 65 years and older. Physical Therapy, 79(12), 1177–1185. https://doi.org/10.1093/ptj/79.12.1177
Duarte, N. A., Grecco, L. A., Franco, R. C., Zanon, N., & Oliveira, C. S. (2014). Correlation between Pediatric Balance Scale and Functional Test in Children with Cerebral Palsy. Journal of Physical Therapy Science, 26(6), 849–853. https://doi.org/10.1589/jpts.26.849
Duclos, C., Nadeau, S., Bourgeois, N., Bouyer, L., & Richards, C. L. (2014). Effects of walking with loads above the ankle on gait parameters of persons with hemiparesis after stroke. Clinical Biomechanics, 29(3), 265–271. https://doi.org/10.1016/j.clinbiomech.2013.12.012
El-Basatiny, H. M., & Abdel-Aziem, A. A. (2015). Effect of backward walking training on postural balance in children with hemiparetic cerebral palsy: a randomized controlled study. Clinical Rehabilitation, 29(5), 457–467. https://doi.org/10.1177/0269215514547654
El-Gohary, T. M., Emara, H. A., Al-Shenqiti, A., & Hegazy, F. A. (2017). Biodex balance training versus conventional balance training for children with spastic diplegia. Journal of Taibah University Medical Sciences, 12(6), 534–540. https://doi.org/10.1016/j.jtumed.2017.07.002
Elnaggar R. K. (2022). Effects of plyometric exercises on muscle-activation strategies and response-capacity to balance threats in children with hemiplegic cerebral palsy. Physiotherapy Theory and Practice, 38(9), 1165–1173. https://doi.org/10.1080/09593985.2020.1833389
Fujimoto, M., Hsu, W. L., Woollacott, M. H., & Chou, L. S. (2013). Ankle dorsiflexor strength relates to the ability to restore balance during a backward support surface translation. Gait & posture, 38(4), 812–817. https://doi.org/10.1016/j.gaitpost.2013.03.026
Heneidy, W. E., Eltalawy, H. A., Kassem, H. I., & Zaky, N. A. (2020). Impact of task-oriented training on balance in spastic hemiplegic cerebral palsied children. Physiotherapy Quarterly, 28(2), 52-56. https://doi.org/10.5114/pq.2020.89808
Holmbäck, A. M., Porter, M. M., Downham, D., Andersen, J. L., & Lexell, J. (2003). Structure and function of the ankle dorsiflexor muscles in young and moderately active men and women. Journal of Applied Physiology, 95(6), 2416–2424. https://doi.org/10.1152/japplphysiol.00517.2002
Hwang, J. W., Lee, S. K., Park, J. S., Ahn, S. H., Lee, K. J., & Lee, S. J. (2017). The effects of ankle weight loading on the walking factors of adults without symptoms. Journal of Exercise Rehabilitation, 13(4), 425–429. https://doi.org/10.12965/jer.1734954.477
Joshua, A. M., D'Souza, V., Unnikrishnan, B., Mithra, P., Kamath, A., Acharya, V., & Venugopal, A. (2014). Effectiveness of progressive resistance strength training versus traditional balance exercise in improving balance among the elderly - a randomized controlled trial. Journal of Clinical and Diagnostic Research, 8(3), 98–102. https://doi.org/10.7860/JCDR/2014/8217.4119
Jung, D. E., & Kim, K. (2015). The effects of ankle load on balance ability during one-leg stance. Journal of Physical Therapy Science, 27(5), 1527–1528. https://doi.org/10.1589/jpts.27.1527
Lee, S. K. (2018). Effect of Weight Loads Applied to the Ankle on Walking Factors of a Stroke Patient. PNF and Movement, 16(2), 179–185. https://doi.org/10.21598/JKPNFA.2018.16.2.179
Olama, K., A., & Thabit, N. S. (2012). Effect of vibration versus suspension therapy on balance in children with hemiparetic cerebral palsy. The Egyptian Journal of Medical Human Genetics, 13(2), 219-226. https://doi.org/10.1016/j.ejmhg.2011.11.001
Olama, K., A. (2011). Endurance exercises versus treadmill training in improving muscle strength and functional activities in hemiparetic cerebral palsy. The Egyptian Journal of Medical Human Genetics, 12(2), 193-199. https://doi.org/10.1016/j.ejmhg.2011.07.002
Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galuppi, B. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine and Child Neurology, 39(4), 214–223. https://doi.org/10.1111/j.1469-8749.1997.tb07414.x
Park, S. I., Kim, M. S., & Choi, J. D. (2016). Effects of concentric and eccentric control exercise on gross motor function and balance ability of paretic leg in children with spastic hemiplegia. Journal of Physical Therapy Science, 28(7), 2128–2131. https://doi.org/10.1589/jpts.28.2128
Park, J. H., Hwangbo, G., & Kim, J. S. (2014). The Effect of Treadmill-based Incremental Leg Weight Loading Training on the Balance of Stroke Patients. Journal of Physical Therapy Science, 26(2), 235–237. https://doi.org/10.1589/jpts.26.235
Saghaei, M. (2004). Random allocation software for parallel group randomized trials. BMC Medical Resarch Methodology, 4, 26. https://doi.org/10.1186/1471-2288-4-26
Sherief, A., A., Abo Gazya, A., A., & Abd El Gafaar, M. A. (2015). Integrated effect of treadmill training combined with dynamic ankle foot orthosis on balance in children with hemiplegic cerebral palsy. Egyptian Journal of Medical Human Genetics, 16(2), 173-179. https://doi.org/10.1016/j.ejmhg.2014.11.002
Shin, S. H., & Lee, M. Y. (2014). Effect of gait training with additional weight on balance and gait in stroke patients. Physical Therapy Rehabilitation Science, 3(1), 55-62. https://doi.org/10.14474/ptrs.0000.3.1.55
Simão, C. R., Regalado, I. C. R., Spaniol, A. P., Fonseca, D. O. S., Ribeiro, T. S., & Lindquist, A. R. (2019). Immediate effects of a single treadmill session with additional ankle loading on gait in children with hemiparetic cerebral palsy. NeuroRehabilitation, 44(1), 9–17. https://doi.org/10.3233/NRE-182516
Simão, C. R., Galvão, E. R. V. P., Fonseca, D. O. S., Bezerra, D. A., Andrade, A. C., & Lindquist, A. R. R. (2014). Effects of adding load to the gait of children with cerebral palsy: a three-case report. Fisioterapia e Pesquisa, 21(1), 67-73. https://doi.org/10.1590/1809-2950/470210114
Sisto, S. A., & Dyson-Hudson, T. (2007). Dynamometry testing in spinal cord injury. Journal of Rehabilitation Research and Development, 44(1), 123–136. https://doi.org/10.1682/jrrd.2005.11.0172
Sung, E. S., & Kim, J. H. (2018). Relationship between ankle range of motion and Biodex Balance System in females and males. Journal of Exercise Rehabilitation, 14(1), 133–137. https://doi.org/10.12965/jer.35146.573
Supriya, S., J., & Mandar, M. (2020). Effect of Ankle Dorsiflexors Facilitation on Gait in Cerebral Palsy. Indian Journal of Forensic Medicine & Toxicology, 14(3), 730–734. https://doi.org/10.37506/ijfmt.v14i3.10454
Thabet, N., S., Zaky, N., A., & Banoub, M. B. (2017). Underwater Exercises Versus Treadmill Training on Gait in Children with Spastic Hemiparetic Cerebral Palsy. International Journal of Physiotherapy and Research, 5(5), 2385-91. https://dx.doi.org/10.16965/ijpr.2017.214
van den Beld, W. A., van der Sanden, G. A., Sengers, R. C., Verbeek, A. L., & Gabreëls, F. J. (2006). Validity and reproducibility of hand-held dynamometry in children aged 4-11 years. Journal of Rehabilitation Medicine, 38(1), 57–64. https://doi.org/10.1080/16501970510044043
Yoon, S. W., Lee, J. W., Kim, Y. N., Kim, Y. S., Cho, W. S., & Park, C. B. (2011). Change in ankle dorsiflexion range of motion and ultrasonographic images of the tibialis anterior with age. Journal of Physical Therapy Science, 23(5), 813-815. https://doi.org/10.1589/jpts.23.813.
Zaky, N., A., Thabet, N., S., & Banoub, M. B. (2019). Role of two therapeutic interventions on balance in children with spastic diplegia and hemiparasis: A comparative study. Physical Therapy Rehabilitation, 6(2), 1-9.
Las obras que se publican en esta revista están sujetas a los siguientes términos:
1. El Servicio de Publicaciones de la Universidad de Murcia (la editorial) conserva los derechos patrimoniales (copyright) de las obras publicadas, y favorece y permite la reutilización de las mismas bajo la licencia de uso indicada en el punto 2.
© Servicio de Publicaciones, Universidad de Murcia, 2013
2. Las obras se publican en la edición electrónica de la revista bajo una licencia Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España (texto legal). Se pueden copiar, usar, difundir, transmitir y exponer públicamente, siempre que: i) se cite la autoría y la fuente original de su publicación (revista, editorial y URL de la obra); ii) no se usen para fines comerciales; iii) se mencione la existencia y especificaciones de esta licencia de uso.
3. Condiciones de auto-archivo. Se permite y se anima a los autores a difundir electrónicamente las versiones pre-print (versión antes de ser evaluada) y/o post-print (versión evaluada y aceptada para su publicación) de sus obras antes de su publicación, ya que favorece su circulación y difusión más temprana y con ello un posible aumento en su citación y alcance entre la comunidad académica.
