EFFECTIVENESS OF SUSTAINED MUSCLE STRETCH WITH TILT TABLE VERSUS PASSIVE EXERCISES IN CHILDREN WITH SPASTIC CEREBRAL PALSY: A CLINICAL STUDY

Abstract

Background: The control of spasticity is habitually a major problem in the management of children with cerebral palsy which hinders in achieving the mobility and operational ability in such children. Purpose: To determine the outcome of sustained muscle stretch or passive exercises to reduce spasticity and increase the ankle dorsiflexion range of motion which may enhance the milestone/ambulatory capacity of children with spastic cerebral palsy. Materials and Methods: Thirty spastic diplegia and quadriplegia children according to Modified Ashworth Scale range between 1-3from both sexes ranging in age from three to eight years were randomly assigned. The children were distributed into two groups of equal number. Control group received passive exercises for 30 minutes per session per day for five days a week and study group received sustained muscle stretch of the plantar-flexors of the ankle for 30 minutes per session per day for five days a week on tilt table with ankle dorsiflexed. Spastic hypertonia was evaluated using Modified Ashworth scale as well as ankle dorsiflexion range of motion were assessed using the Universal goniometer before and after two weeks of treatment. Results: The results show statistically significant improvement in bilateral ankle dorsiflexion range of motion in both the groups, i.e. group A receiving sustained muscle stretch and group B receiving passive exercises (p<0.005). However, statistically significant improvement was seen in spasticity of ankle plantar flexors on Modified Ashworth Scale score within the groups (p>0.005). Comparing the pre-and post-treatment mean values between two groups, there was a minimal significant difference in improvement of ankle dorsiflexion range of motion and Modified Ashworth Scale score. Conclusion: There is minimal statistical significant in the difference in the level of spasticity showing that both treatment techniques have an equal effect on spasticity. It is further concluded that both the techniques are equally effective in increasing the range of motion of ankle dorsiflexors.