Cerebral Palsy Research - Symptoms, Causes, Types

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Assessment of the short-term effect of antispastic positioning on spasticity.

Akbayrak T, Armutlu K, Gunel MK, Nurlu G

School of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazari, Ankara, Turkey.

BACKGROUND: This study was performed in order to investigate the effect of antispastic positioning on spasticity by using different assessment methods. METHODS: A total of 16 patients (11 males [68.75%] and five females [31.25%]), diagnosed as spastic diplegic and referred to the School of Physical Therapy and Rehabilitation, Paediatric Rehabilitation Unit for treatment, were included in this study. The mean age of patients was 6.43 +/- 1.99 years (range, 4-13 years). Passive dorsi-flexion movement was measured by using goniometer and intensity of spasticity was determined by using Modified Ashworth Scale (MAS) and electromyography. For the objective measurement of severity of spasticity, Hoffman reflex (H) and Hoffman reflex/motor response (H/M) ratios were used. Children were placed in an antispastic position for 20 min. The patient was placed in a sitting position, by a physiotherapist, with hips abducted at a 45 degrees angle and externally rotated, knees extended, and ankles placed in a neutral position. RESULTS: The decrease in H responses, H/M ratios, MAS values and the increase in goniometric measurement values were found statistically significant after antispastic positioning (P < 0.05). CONCLUSION: Our study supports that antispastic positioning can be used with neurodevelopmental treatment approaches when it is required. Antispastic positioning may help exercises to be performed more easily, and also has importance in a home exercise program to prevent muscle contractures and joint limitation in children with long-term spastic diplegia.

Published 10 August 2005 in Pediatr Int, 47(4): 440-5.
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