Turkish Journal of Physical Medicine and Rehabilitation 2006 , Vol 52 , Num 1
Functional Outcomes of Rehabilitation in Ambulatory Spastic Cerebral Palsy
Aynur BAŞARAN 1 ,Ece Aydoğ 2 ,Alev Çevikol Demirel 3 ,Kıymet İkbal Karabulut 4 ,Aytül Çakcı 5
1 Clinic of Physical Medicine and Rehabilitation, Konya Beyhekim State Hospital, Konya, Turkey
2 Clinic of Physical Medicine and Rehabilitation, Yeditepe University Hospital, İstanbul, Turkey
3 Sağlık Bakanlığı Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara
4 Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara
5 Sağlık Bakanlığı Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye

Objective: Objective determination of motor functions, energy expenditures, muscle weakness, and clinical effectiveness of rehabilitation program in ambulatory spastic cerebral palsy.

 

Materials and Methods: Sixteen ambulatory spastic diplegic cerebral palsy (CP) patients aged between 6-14 years were recruited to study. Measurement of gross motor function measure (GMFM), energy expenditure index (EEI), and concentric strength of knee extensor and flexor muscle groups for both extremities were performed before and after rehabilitation program. Statistical analyses were performed to determine the significance of changes in GMFM, EEI and muscle strength parameters.

 

Results: Statistically significant increase in GMFM score was observed between pre- and post measurements (89.13%±7.71-90.26%±7.53 p<0.05). Mean EEI was evaluated as 1.56±1.31 beat/metre, which has decreased to 1.42±1.12 beat/meter after the program (p=0.052). Muscle strength measurements of right (R) and left (L), flexor (F) and extensor (E) knee muscle groups showed significant increases; RF pre: 12.82±3.54 N-M, post: 15.44±6.43 N-M; LF pre: 12.51±3.39 N-M, post: 14.88±5.94 N-M; RE pre: 19.25±8.01 N-M, post: 24.38±11.42 N-M; LE pre: 19.55±7.95 N-M, post: 23.89±12.76 N-M (p<0.05).

 

Conclusion: Muscle weakness is a well-known finding in spastic CP. In this study isokinetic dynamometer enabled us to determine clinical evaluation objectively. Muscle strength measurements and strengthening exercises should be included in the rehabilitation programs for children with spastic CP. 

Keywords : Cerebral palsy, motor function, energy metabolism, torque