Effects of the neurodevelopmental treatment (NDT) on the mobility to children with cerebral palsy and adults with neurological disorders

The purpose of the research was to test the effectiveness of NDT method (Bobath) in children with CP and people with neurological disorders. 20 children with cerebral palsy (7 with quadriplegia, 6 with diplegia and 7 with hemiplegia) and 20 adults (11 with multiple sclerosis and 9 with hemiplegia) took part in the study. It was also tested and determined the reliability of the tests PEDI, GMFM and TUG (Greek version) in children with cerebral palsy and the tests BBS, TMT, TUG and MAS (Greek version) in adults with neurological disorders. All tests were conducted twice on two separate days, under the same conditions. While for the effectiveness of NDT, children and adults followed an 8-week program and 3 measurements were made, one at the beginning, one at the end and one month after the end of the intervention. The results showed that the tests have a high reliability. Specifically for GMFM, PEDI, TUG, BBS and TMT, was ICC>0.936 and MAS K = 0.502 0,936 ενώ για τη MAS ήταν K=0.502 (p<.001). Στα παιδιά η παρέμβαση NDT έδειξε, ότι βελτίωσαν σημαντικά τις επιδόσεις τους στην κλίμακα GMFM-88 και TUG μεταξύ (Τ1) και (Τ3) μέτρησης και διατήρησαν αυτή ένα μήνα μετά (Τ4) (F2,36=69,778, p<.001), ενώ στο PEDI δεν είχε καμία στατιστικά σημαντική επίδραση (F2,36=0,844, p=.438). Στα άτομα με νευρολογικές διαταραχές η NDT βελτίωσε σημαντικά τις επιδόσεις τους στα τεστ BBS και TINETTI μεταξύ (Τ1) και (Τ3) μέτρησης, ενώ στα τεστ TUG και MAS δεν διαπιστώθηκαν στατιστικά σημαντικές διαφορές (p<.05). Συμπερασματικά υπήρξε ισχυρή αξιοπιστία για όλα τα τεστ: PEDI, GMFM, TUG, BBS, TMT και MAS (p < .05). Επιπλέον, η αποτελεσματικότητα της μεθόδου NDT-Bobath στη βελτίωση της κινητικότητας των παιδιών και ενηλίκων, επιβεβαιώθηκε για ορισμένες μόνο δοκιμασίες αξιολόγησης σε παιδιά με εγκεφαλική παράλυση (GMFM και TUG) και σε άτομα με νευρολογικές διαταραχές (TMT και BBS). Αντίθετα, δεν βρέθηκαν σημαντικές επιδράσεις της μεθόδου σε άλλες δοκιμασίες αξιολόγησης της κινητικότητας. Κατά συνέπεια δεν μπορεί να δοθεί σαφής απάντηση στο ερώτημα περί της καθολικής θετικής συνεισφοράς της μεθόδου NDT-Bobath στην βελτίωση της κινητικότητας παιδιών με εγκεφαλική παράλυση και ατόμων με νευρολογικές διαταραχές

The effectiveness of partial body weight support treadmill training on walking in people with cerebral palsy : A systematic review

Background: People with Cerebral Palsy (CP) face daily motor, sensory, and cognitive impairments that significantly impact their quality of life. This systematic review aimed to investigate RCTs regarding the effectiveness of treadmill walking with partial body weight support (PBWSTT) in individuals with CP. Methods: A search was performed in PubMed, Scopus and Research Gate. The study selection process was conducted by two separate reviewers. The quality of the final studies included in the systematic review was assessed using the PEDro scale. Results: Out of the 673 studies initially identified, 6 studies were included. The results showed that (PBWSTT) leads to an increase in scores on the GMFM scale, as well as improvement in walking pattern, speed, endurance, and rhythm. The method of PBWSTT in comparison to conventional physiοtherapy did not show better results, as the included studies in this review showed conflicting results. Conclusion: The effect of therapeutic exercise with partial body weight support has a positive impact on improving the gross motor function of patients with Cerebral Palsy. However, the question of whether PBWSTT is more effective than conventional physiotherapy and over-ground walking exercise cannot be conclusively answered yet, highlighting the importance of conducting further research in this field

Evaluation of the strength of the upper extremity and the balance in pediatric population with hemiplegia after stroke

Introduction: The brain is a system with multidimensional organization and architecture and requires a continuous blood supply to function normally. If blood flow is interrupted for more than a few seconds, the brain is deprived of blood and oxygen, causing death in nerve cells in the affected area. The stroke in children after birth appears even more rarely than in adults. Methods: For the study, 20 children with hemiplegic cerebral palsy (14 boys and 6 girls) participated (mean age 10,9 years), from the “General Hospital Hippocratio” of Thessaloniki, according to the inclusion criteria. The strength of the upper extremity was measured using the Jamar dynamometer. To assess the balance, the Pediatric Balance Scale (PBS) Affected and contralateral hands results were analyzed and compared with norms for age and sex and related to the affected balance. Results: It was found that the strength of the non-affected upper extremities was also reduced according to the data of the normal children and the balance was also affected because of the stroke. Discussion: Physiotherapy programs may include exercises that emphasize the non-affected upper extremities, more similar research must be done on a bigger population

Evaluation of the strength of the upper extremity in children with hemiplegia after stroke: a case series study

The brain is a system with multidimensional organization and architecture and requires a continuous supply of blood in order to normally function. If blood flow is interrupted for more than a few seconds, the brain is deprived of blood and oxygen, causing death in nerve cells in the affected area. Stroke in children after birth appears even more rarely than in adults. For the study, 10 children with hemiplegic cerebral palsy (7 boys and 3 girls) participated (mean age 10, 9 years), from the “General Hospital Hippocratio” of Thessaloniki, according to the inclusion criteria. The strength of the upper extremity was measured using the Jamar dynamometer and for the assessment of the balance the pediatric balance scale (PBS) affected and contralateral hands, results were analyzed and compared with norms for age and sex and related to the affected balance. It was found that the strength of the non-affected upper extremities was also reduced according to the data of the normal children and the balance was also affected because of the stroke. Physiotherapy programs may include exercises that give emphasis on the non-affected upper extremities, more similar research must be done on a bigger population.</jats:p