Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Growrh and Development Disorders in Pediatrics

Background: Muscle weakness of the lower extremities is a common symptom in children with spastic diplegic cerebral palsy, which may lead to limitations in standing, walking ability, and other gross motor activities. This expected effect has led to the concept that increasing lower-extremity muscle strength through specific strength training may improve motor activities in this patient group. Purpose: The purpose of this study was to determine the effect of progressive resistive functional strength training from a plantigrade foot position on gross motor function and muscle strength in children with spastic diplegia. Methods: Forty-six spastic diplegic cerebral palsy children of both genders with an age range of seven to ten years were randomly allocated into two equal groups.The control group (A) received a designed physical therapy program. Whereas the study group (B) received the same designed physical therapy program as the control group. In addition, they received progressive resistive functional strength training in the plantigrade foot position.Treatment was conducted for two hours, three times/week for three successive months. All children were assessed before and after the treatment program by using a Medical Commander Echo Manual Muscle Tester dynamometer to measure isometric muscle strength of the hip flexors/extensors/abductors and knee flexors/extensors muscles on both sides. Gross Motor Function Measure was also used to assess standing and walking, running, and jumping abilities, domains. Results: Significant improvement was recorded within both groups in all measured variables. A significant difference was found between control and study group when comparing post treatment mean values in all measured variables except Lt knee flexors.Despite that, there was a higher percent of improvement in favor of the study group

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