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Background and aim: Rehabilitation treatments have significant role in reducing the disabilities of Cerebro Vascular Accident (CVA). Due to great role of upper limb in the function of individuals particularly in Activity of Daily Living and the effect of stability of shoulder girdle on hand function, the aim of this study was to study the effects of Progressive Resistive Exercise on shoulder extensor and abductor muscles isometric strengths in adult hemiplegic.                                                                                  

Material and methods: 17 adult hemiplegics patients (50-70yrs., mean =60.52, SD=7.22) with RT side dominancy and 6 months after stroke, participated in this study. All procedures were approved by ethical committee of TUMS and written consents were also taken. Patients were familiarized with the procedure and shoulder extensor and abductor muscles isometric strengths were measured by dynamometer.                                            

Results: According to results of our study, shoulder extensor and abductor muscles isometric strengths showed significant differences between mean scores of pre and post intervention (P<0.05). Progressive Resistive Exercise improved 34% in shoulder extensor muscles isometric strength and 27% shoulder abductor muscle isometric strength.                                 

Conclusion: Results of our research showed that progressive resistive exercise approach is a useful method for increasing the isometric strength of shoulder extensor and abductor muscles. Therefore, it might be concluded that improvement of strength of shoulder muscles could result in stability in shoulder girdle and consequently might affect on hand function in hemiplegic patients.                                                             

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Background and Aim: in hemiplegic children Postural tone of the two sides of body is different. Once, asymmetric stance is a typical state in individuals' with unilateral pain and/or paresis and standing is with weight bearing on the stronger side. Obviously, an asymmetric stance with majority of weight bearing on the affected side can counter faces individual with the falling risk and causes instability. It seems coordinating of the two sides of body is the most vitally important therapeutic exercises in hemiplegic patients. Although stable stance is a simple postural task but it's controlled semi-automatically by cortical and spinal centers. It is established that stable standing, also demands cognition resources. So, postural control demands the interaction between musculoskeletal and nervous systems.
Material and method: In this clinical trial (before-after) 17 children 5-12 years old with spastic hemiplegia were participated. The subjects stayed in the center of force plate with the most stable standing position while using /not-using lateral wedge and in each state with/without doing cognition task. Short- memory test of digit span used as dual task condition. The mean range of fore-after and mediolateral sway and velocity and area as postural control independent variables and error measures in recalling of randomized digit chain as cognition task independent variables were registered.
Results: The wedge affected Rsw (P=0.015), Area (P=0.007) and Vm (P=0.005) significantly. Dual task also had significant effect on Rfa (P=0.014), Rsw (P=0.014), Area (P=0.002) and Vm (P=0.002). But the wedge declines its effect properly.
Conclusion: The results represent that a 5º lateral wedge applied to the unaffected limb, can improve factors of postural control even in Dual tasking thus The wedge can be used with a good effect on the posture of hemiplegic children.

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Background and Aim: Cerebral palsy is a non progressive disorder and the most common movement problem in children. Many children with cerebral palsy are of hemiplegic type. One of the important problems of this children is unilateral upper limb dysfunction, that not using the affected side causes forgetfulness and more problems on this side. In this study, effectiveness of Constraint-Induced Therapy(CIT) and the maintainance of this technique on spasticity and performance of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old have been investigated. 

Materials & Methods: In this pretest - posttest quasi experimental study, 20 cerebral palsy hemiplegic children 6 to 12 years old (15 boys and 5 girls) with  8.7   years mean age were selected. Interventions were performed about 8 weeks and patients were followed for 4 weeks. Spasticity on the affected side in wrist and elbow were tested by Modified Ashworth Scale and upper extremity function by the Box & Block test. The data were analyzed with the Wilcoxon and paired t- tests.

Results: Constraint-Induced Therapy in the affected limb decreases significantly the spasticity of wrist (p = 0.00) and elbow (p = 0.005) and significantly increases performance score (p = 0.00), and the recovery significantly maintained one month after the interventions.

 conclusion: Constraint-Induced Therapy of affected upper extremity could possibly decrease limb spasticity and increase function with two mechanisms: Fierstly, The reduction of not using the plegic side and secondly, neuroplasticity in CNS. This improvement may remain viable in the affected limb. 

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  Abstract

  

Background and Aim: Cerebral palsy is a sensory and motor disease that affected control of posture and movement. Children with cerebral palsy show dysfunction in body such as spasticity, decreased muscle strength and selective control of movement that may limit functional activity and participation in daily life . The purpose of this study is to investigate effects of 8-Weeks progressive resistance training program on physical and motor status in children with hemiplegic cerebral palsy.

  

Materials and Methods: This study was semi-experimental with the interventional approachon16children of 4-12 years old with hemiplegic cerebral palsy in the first and second level of GMFCS classification that referred to rehabilitation center in Ilam city . Protocol of training was consisted of 16 one-hour sessions progressive resistance training in the case muscle group s ( 8 subjects) . Upper extremity muscles strength were measured by digita l dynamometer and gross motor function were evaluated by Gross Motor Function Measure (GMFM-88) at before and after intervention.

  

Results: The strength of dominant hand muscle groups was improved significantly after the intervention , also the scores of stand ing, walking , running and jumping were increased (p<0.05). There was no significant effect in strength of involved hand.

  

Conclusion: The results of this study indicate that progressive resistance training improve gross motor function and increase isometric strength in the dominant hand

 

Keywords: Hemiplegic cerebral palsy, Physical status, Motor function, Progressive resistive excercises (PRE).

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Background and Aim: Cerebral palsy is a common cause of inability in childhood that effects on posture and motor development and leads in activity limitation. One of the difficulty of cerebral palsy is impairment in arm and hand function. Splints and orthosis are used to improve position, range of motion and hand function. The aim of this study was to investigate the effects of static anti-pronation splint on spasticity, range of motion, grip and pinch strength and function of affected hand of spastic hemiplegic children of 8-12 years old.

Materials and Methods: This is an interventional study. Twenty spastic hemiplegic 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 randomly divided into intervention and control group. Patients in intervention group used a static anti-pronation splint for two months, 6 hours daily. In this study the Jebsen Taylor test was used to evaluate hand function, the Modified Ashworth Scale was used to assess spasticity of wrist, forearm and elbow, ROM of wrist, forearm and elbow were measured with goniometer and grip and pinch strength were evaluated with MIE.

Results: Results in intervention group showed a significant improvement in hand function (p<0.003), in wrist`s spasticity (p<0.005), forearm`s spasticity (p<0.003), wrist`s ROM (p<0.001), forearm ROM (p<0.003), grip strength (p<0.001) and pinch strength (p<0.003) in intervention group. The data did not show significant improvement on elbow`s joint ROM (p<0.343) and spasticity (p<0.157).In control group, significant improvement did not seen (p>0.05).

Conclusion: Information from present research shows that using static anti-pronation splint for 2 months ,6 hours a day, can be an effective method to improve hand function, wrist and  forearm spasticity and range of motion, strength of grip and pinch in hemiplegic CP children.

Keywords: Static anti-pronation splint, Hand function, Spastic hemiplegic, Cerebral palsy.