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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).