Objectives. Standing and walking serve an individual’s basic needs to move from place to place, and both are the most common activities that people do daily. So, this study aims to investigate the combined effect of botulinum A injection and ankle weight on excessive knee flexion in diplegic children with crouch gait. Methods. Sixty children with spastic diplegia walking with a crouch gait were included in this study. They were divided equally into three groups (twenty in each): group A received classical gait rehabilitation, group B received the same gait training while adding ankle weights, and group C received the same as group A and B plus botulinum A injection. The modified Ashworth scale (MAS) and Hoffman reflex/Myogenic response (H/M ratio) were used to evaluate the spasticity of the hamstring and gastrocnemius muscles, while two-dimension gait analysis was used to record knee flexion angles during gait. The assessment was held one day before starting the treatment and after completing three months of the treatment program. Results. There was no significant difference between groups before treatment regarding all measured variables. group A revealed a statistically nonsignificant improvement after treatment. Patients in group B showed significant improvement after treatment for both knees regarding the H/M ratio and MAS, which was reflected in the right and left knee range of motion at initial contact ( P values 0.030 and 0.001, respectively) and midstance ( P values 0.030 and 0.006, respectively). However, more significant improvement was detected regarding all studied variables in both knees after treatment in group C patients with a P value <0.001. Conclusion. The combination of botulinum A injection and ankle weights was more effective in controlling excessive knee flexion in diplegic children with a crouch gait.

Background: Children with Unilateral Cerebral Palsy (UCP) usually have obvious impairment of hand function and limited active supination, which causes restrictions of upper extremity functions. Objective: This aimed to compare between Kinesiotaping and wrist wheel effect on forearm supination range of motion and its reflection on functions of upper limb in children with UCP. Patients and Methods: Forty-eight children with UCP their age from 6 to 8 years were divided randomly into 2 groups with twenty-four in each, Kinesiotaping (KT) and Wrist Wheel (WW). KT group children were treated by a designed physical therapy program after forearm Kinesiotaping application, while children in WW group were treated by the same designed physical therapy program while using wrist wheel. Treatment program was conducted for three successive months at frequency of 3 sessions per week. Before the commencement and after the study completion forearm supination range of motion was measured using digital goniometer and Shriners Hospital Upper Extremity scale was used to evaluate upper extremity functions in the affected upper limb. Results: A statistically significant change was observed in each group after treatment application when comparing before and post treatment mean values (P < 0.001). Also, a statistically significant change was noticed when comparing after treatment results between both groups in favor to wrist wheel group. Conclusion: Both Kinesiotaping and Wrist Wheel can improve supination ROM and upper extremity functions of children with UCP, with more effectiveness to Wrist Wheel.

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Background Adequate and efficient standing postural balance is key for functional walking and handling abilities in children with spastic diplegia. This study was designed to evaluate the effect of kinesiotape applied on ankle dorsiflexor muscles on balance in children with spastic diplegia. Thirty children with spastic diplegia of both genders participated in the study: 16 boys and 14 girls between 4 and 10 years old. They were divided randomly and equally into two groups: a control group, in which children received the standard physical therapy program for children with diplegia; and the study group, who received the same physical therapy program as in the control group but after kinesiotape application over the ankle dorsiflexor muscles. Both groups received the treatment program for 1 h, three times per week, for three successive months. Postural stability was assessed through evaluation of three stability index (anteroposterior, mediolateral, and overall) for all children by the Biodex Balance System before and after treatment. Results Statistical analysis of results before and after treatment was performed by mixed MANOVA to compare effects both within and between groups on stability indexes, and post hoc tests were carried out for subsequent multiple comparison. The level of significance for all statistical tests was set at p < 0.05. Before treatment, there was no significant difference in the stability index between both groups (p > 0.05). Comparison between both groups post-treatment revealed a significant decrease in the measured variables of the study group compared with that of the control group (p < 0.05). Conclusion Adding ankle kinesiotaping over dorsiflexor muscles in conjunction with a balance and gait training exercise program for children with diplegia can enhance postural stability and decrease sway. This study suggests that it should be added to the treatment program for children with diplegia. Trial registration This study was registered retroactively. Identifier: NCT04243928

Background: Gait speed and postural stability are indicators of community level ambulation and may be a valuable measure of disability. Objectives: to investigate the relation between the distribution of weight on both lower extremities and gait speed in children with spastic cerebral palsy. Methods: Evaluation for weight distribution on both lower limbs and speed during gait for sixty children with spastic diplegia and forty-five children with hemiplegia was carried out by the Biodex gait trainer. Pearson correlation test was conducted to determine the relation of the symmetry index and the percent of weight bearing to speed. Results: A significant weak positive correlation was found between speed and symmetry index in diplegic group, while there was a non-significant weak negative correlation between speed and symmetry index was noticed in hemiplegic group. Nonsignificant weak positive correlation between speed and weight on most affected side was recorded in diplegic group. While in hemiplegic group, there was significant weak negative correlation between weight on affected side and speed. Conclusion: Children with cerebral palsy demonstrate asymmetrical weight distribution during walking. Physical therapy training should be directed to enhance weight bearing distribution thus improving gait and postural stability. Keywords: Physical Therapy Modalities; Pediatrics; Rehabilitation.