Suitable time of prolonged stretch to control spasticity in children with hemiplegia / Rana Nabil Hussein ; Supervised Amira Mohamed Eltohamy , Kamal Elsaid Shoukry , Hossam Mohamed Emam

Thesis (M.Sc.) - Cairo University - Faculty of Physical Therapy - Department of Growth and Developmental Disorder Pediatrics

Background:This study was performed in order to investigate the effect of quadruped position in form of prolonged stretch on spasticity in children with spastic hemiplegia by using different assessment methods. Purpose: of this study was to determine the effect of quadruped position on spasticity and to determine the time needed to control spasticity by quadruped position in children with spastic hemiplegia. Methods: A total of thirty five children diagnosed as spastic hemiplegia participated in this study. Their ages were 4-8 years. The degree of spasticity was determined by using Modified Ashworth Scale (MAS). For the objective measurement degree of spasticity, Hoffman reflex (H) and Hoffman reflex/motor response (H/M) ratios was used, the time was determined by using EMG .H/M ratio measured before and after quadruped position, and the time evaluated during children placed in quadruped position. Results: the decrease in H/M ratios, MAS values were found statistically significant after quadruped positioning, and the inhibition time of upper limb was 10.31 ± 2.48 minutes, with maximum value of 15 minutes and minimum value of 6 minutes and the inhibition time of lower limb was 13.13 ± 2.09 minutes, with maximum value of 16 minutes and minimum value of 9 minutes. Conclusion: Our study supports that the effect of quadruped positioning in controlling spasticity can be used with neurodevelopmental treatment approaches when it is required. Quadruped positioning may help exercises to be performed more easily, and to prevent muscle contractures and joint limitation in children with spastic hemiplegia

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