Effect of position on gross motor function and spasticity in spastic cerebral palsy children.

OBJECTIVES: To evaluate the effect of positioning on gross motor function and spasticity in spastic quadriplegic cerebral palsy children with Gross Motor Function Classification System level IV and V. METHODS: A quasi-experimental study was conducted at two Paediatric Physical Therapy Centres from November 2018 to July 2019. The study comprised of seventy four children with quadriplegic cerebral palsy aged between 3 to 8 years. Data was obtained and gross motor functional abilities and spasticity were assessed by GMFM-88 and Modified Ashworth Scale, respectively. Twenty four-hour positioning in specific seats, night positioning and standing frames for six months. The child was being positioned 24 hours according to his challenges for the period of six months. Semi reclined positioning was performed to manage aspiration, oral leak and to develop retention. Prone positioning was done to develop righting reactions, functional sitting position was used in the treatment regime to attain better upright position and neutral pelvic standing using standing frames. SPSS 24 was used to analyse the data. RESULTS: Paired t-test reported significant improvement in the test scores in lying position, rolling, sitting position, crawling, kneeling, standing, walking or running. Fifty-nine subjects exhibited improvement in spasticity before and after interventional procedures, while 15 showed no improvement (p<0.05). CONCLUSIONS: Twenty-Four-hour proper body positioning and postural techniques improved gross motor functioning in all five dimensions of functioning. The overall spasticity in quadriplegic cerebral palsy children was also reduced due to appropriate positioning techniques.

Effect of Positioning on Tonic Labyrinthine Reflex in Cerebral Palsy: A Single-centre Study from Lahore.

OBJECTIVE: To evaluate the effect of positioning on tonic labyrinthine reflex in children with cerebral palsy. METHODS: The quasi-experimental study was conducted at the Institute of Psychological Services and Physical Rehabilitation, Lahore, from July 2016 to June 2017, and comprised children with spastic and athetoid cerebral palsy aged six months to three years. Gross Motor Functional Classification Scale level V was taken as baseline measure. Data was obtained and functional motor abilities were assessed by Motor Function Measure-20 Scale. Participants received intervention in the form of positioning in hammock for 10 hours, in-between sitting in cerebral palsy chair with harness along with sensory motor integration techniques. The readings were compared before the intervention and after the treatment strategies. SPSS 21 was used to analyse the data. RESULTS: Of the 30 subjects, 18(60%) were boys, and 7(23%) had athetoid cerebral palsy. The overall mean age was 18.13±7.33 months. Motor function variables significantly improved post-intervention (p<0.05). CONCLUSIONS: Positioning provided significant improvement and positive effect in tonic labyrinthine reflex of spastic and athetoid cerebral palsy children.