Analysis of the hand function of a child with spastic hemiparesis pre- And postphysiotherapeutic treatment: Case study

Abstract

Hand function impairment is one of the most disabling symptoms of spastic hemiparesis resulting from Cerebral Palsy. Patients may present neuromusculoskeletal disorders on the affected upper extremity, such as increase of the muscle tone, decrease of strength and losses on fine motor skills. Based on that, the goal of this study is to evaluate the effects of Physical Therapy on the hand function of a child with spastic hemiparesis. Quasi-experimental design, case-study research, with comparative analysis before and after the treatment. The sample was composed of a six-year-old patient with spastic hemiparesis on the right side. The intervention protocol was constituted of twelve Physical Therapy sessions, performed weekly and with 50 minutes duration. The Physical Therapy was based on the Constraint-induced Movement Therapy, Bobath Concept and Game Therapy. In order to measure outcomes before and after the intervention, the Pediatric Motor Activity Log (PMAL) scale was applied on the first and last session for assessment of the frequency and quality of movement on the affected upper limb. The PMAL's results showed an increase in the average movement frequency score and in the average movement quality score. This case study showed that Physical Therapy resulted in greater upper limb functionality to the child and favored the acquisition of new motor skills. Besides the diversity of stimuli for motor learning, the family contribution was determinant for the success of the treatment.