Upper limb weight-bearing effect on the body alignment of individuals with cerebral palsy who have spastic hemiparesis: a randomized clinical trial

Abstract

Introduction: Cerebral Palsy (CP) patients who have spastic hemiparesis usually present asymmetrical weight shift between the affected and non-affected side. Objective: To assess the effects of upper limb (UL) weight-bearing exercises on trunk symmetry, weight shift to the affected side and possible secondary effects on gait (speed and quality). Method: eleven participants with CP were randomized into two groups: Intervention Group (IG) and Control Group (CG); IG (n = 6) performed stretching exercises of the major muscle groups of UL and lower limbs (LL) and UL weight-bearing exercises in prone and seated position for 12 weeks. The CG (n = 5) did not undergo any kind of motor therapy during the study period but received the same exercises that IG after the study. The variables analyzed were: Gross Motor Function Measure (GMFM-88); Pediatric Berg Scale; Trunk Impairment Scale (TIS); Six-minute walking test (6MWT); Ten meters walking test (10MWT); Timed Up & Go (TUG); Edinburgh Visual Gait Scale (EVGS); and ground reaction force. Results: The IG showed improvement on 6MWT, TUG, TIS and Pediatric Berg Scale (p < 0.01), and CG showed improvement on GMFM-88 (p < 0.04) only for the intragroup analysis. Conclusion: The exercises were effective to improve static and dynamic balance, increasing gait speed and identifying a trend of improvement on body alignment and weight shift to the affected side.

Uso de prancha de baixo custo para avaliação do equilí­brio de indiví­duos hemiparéticos

“…As perturbações geradas pela hemiparesia, como a inadequada descarga de peso nos membros inferiores, geram déficits em habilidades posturais, tais como no equilíbrio postural estático e dinâmico [3,4]. Tais sequelas são resultados de alterações nos fatores que contribuem para o equilíbrio e o controle postural, em que a lesão afeta a integração adequada entre os sistemas musculares, sensoriais, nervosos centrais e esqueléticos [5].…”