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Background and Aim: Cerebral Palsy (CP) children are the most clients referred to occupational therapy settings. Hand function is important in Activities of Daily living .There is a hand dysfunction in most cerebral palsy children. Orthosis and splints are commonly used to improve the position, range of motion, quality of movement and function of a person's arm or hand. The aim of this study was to investigate the effects of static cock up c-bar splint on strength,spasticity, range of motion, and dominant hand function in spastic diplegic children with 8 to 12 years old. 

Materials and Methods: This interventional study is in a before-after design. Thirteen spastic diplegic cerebral palsy children with 8 to 12 years old were selected through students who studied in physical disabled schools in Tehran city and had the inclusion criteria. Patients used a static cock up c-bar splint (wrist in 10 degrees of extension and thumb in palmar abduction and opposition) for two months, 2 hours daily and 4-6 hours at night. In this study the Jebsen Taylor test was used to evaluate hand function, the Modified Ashworth Scale was used to assess spasticity of thumb, wrist and elbow, ROM of thumb, wrist and elbow were tested with goniometer and power grip was evaluated with dynamometer.  

 Results : Results showed a significant improvement in hand function (p<0.001), in wrist`s spasticity (p<0.001), elbow`s spasticity(p<0.008), palmar abduction of thumb spasticity (p<0.002), wrist`s ROM (p<0.001), Palmar abduction of thumb ROM(p<0.001) and power grip(p<0.001). The data did not show significant improvement on elbow`s joint ROM. 

Conclusion: Information from present research shows that using static cock up c-bar splint for 2 months, 2 hours a day and 4 to 6 hours nightly, can be an effective method to improve power grip, hand function, thumb, wrist and elbow spasticity and range of motion of thumb and wrist of spastic diplegic CP children.

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Background and Aim: One of the impaired senses in patients with chronic hemiparesis is the sole cutaneous sense. The role of this sense in maintaining the functional balance and mobility is still controversial in these patients. The aim of this study was to investigate the relationship between the threshold of sole cutaneous sense and functional balance and mobility tests in patient with chronic hemiparesis.

 

Material and Methods: In this correlational study, seventeen chronic stroke patients by mean age of 59.10 (13.31) years and mean time after injury of 31.70 (23.61) months were selected by simple non– probability method. Functional Reach with ankle and hip strategy (FR), Step Test (ST) in affected and non- affected foot, Bend– Reach test (BR), Timed Up and Go test (TUG) and Berg Balance Scale (BBS) were used for assessment of functional balance and mobility and Semmes- Weinstein monofilaments test was used to measure the cutaneous sense of seven different points of sole in affected and non– affected foot.

 

Results: The main effect of foot (affected and non– affected foot) and points (seven different points of sole) of cutaneous sense threshold was significant (P˂0.0001) and interaction effect of foot ˣ points not significant (P=0.2).

The cutaneous sense threshold in all seven points of affected sole showed significant (p˂0.05) low to high correlation (r= 0.24-0.81) with all of functional balance and mobility tests. There was not significant correlation between cutaneous sense threshold in seven points of non- affected foot and any of functional balance and mobility tests, with the exception of cutaneous sense threshold of the little toe floor with total, dynamic and static score of BBS, FR with ankle and hip strategy and TUG; cutaneous sense threshold of big toe with static score of BBS and FR with hip strategy; and medial border of sole with static score of BBS and FR with ankle strategy.

 

Conclusion: The cutaneous sense threshold of affected sole has a more correlation with functional balance and mobility tests. The cutaneous sense threshold of sole in big toe and medial border points has a significant role in functional balance and mobility tests in patients with hemiparesis.

 

Keywords: Functional balance and mobility, Cutaneous sense threshold, Hemiparesis

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Background and Aim: Balance impairment in patients with stroke leads to dependence in activities of daily living. Appropriate, accurate and inexpensive tools are necessary to assess the severity of balance impairment. In order to identify individuals with chronic stroke who have balance impairment and to apply proper treatment, the aim of this study was to examine the sensitivity and specificity of Timed Up and Go (TUG) and Functional Reach (FR) tests, Bend Reach test (BRT) and Step test (ST) in functional balance assessment of patients with chronic cerebrovascular accident.

Materials and Methods: In this cross-sectional comparative study, eighty-one patients with chronic stroke by mean age of 58.82 (±13.48) years and the mean past duration of disease 36.33 (28.27) months were selected by simple non-probability method. Functional balance and mobility tests including TUG, FR, BRT and ST were used as index test and the Berg Balance Scale (BBS) was used as reference test.

Results: All of functional balance and mobility tests including TUG, FR, BRT and ST have a significant ability to identify individuals with chronic stroke subjected to the balance impairment compared with BBS(p<0.0001). Sensitivity of functional balance and mobility tests including TUG, FR, BRT and ST in intact and affected feet at the moderate or above threshold were 90, 90, 88, 88 and 90 percent respectively and at the sever threshold were 60, 85, 58, 88 and 60 percent respectively. Specificity of these tests at the moderate or above threshold were 56, 85, 65, 57 and 53 percent, respectively and at the sever threshold were 89, 90, 92, 30 and 92 percent respectively. TUG functional balance and mobility test had the highest agreement with BBS balance test.

Conclusion: TUG functional balance and mobility test are the best tool to identify chronic stroke patients with balance impairment in both moderate or above and severe threshold.

Keywords: Chronic stroke, Balance, Sensitivity, Specificity