Abd El-Kafy Ehab Mohamed, El-Basatiny Heba M Youssr M
From the Department of Physical Therapy for Disturbances of Growth and Developmental Disorders in Children and Its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt (EMAE-K, HMYME-B); and Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia (EMAE-K).
Am J Phys Med Rehabil. 2014 Nov;93(11):938-47. doi: 10.1097/PHM.0000000000000109.
The aim of this study was to evaluate the effect of dynamic bilateral postural stability on balance control and gait parameters in children with cerebral palsy.
Thirty children with spastic diplegia (8-10 yrs) were included in this study. The children were randomly assigned into two groups: control group A and study group B. The children in both groups received traditional physical therapy program, 2 hrs per day for group A and 1.5 hrs followed by 30 mins of dynamic postural stability training program using the Biodex Stability System for group B. The treatment frequency was three sessions per week for 8 consecutive weeks on two stability levels (7 and 8). The participating children received pretreatment and posttreatment assessments using the Biodex Stability System to evaluate the stability indices (anteroposterior, mediolateral, and overall) at the two stability levels (7 and 8) and three-dimensional motion analysis system (pro-reflex system) to evaluate the spatiotemporal parameters including step length, velocity, cycle time, stance, and swing phase percentage.
The children in both groups showed significant improvements in the mean values of all measured variables after treatment indexed by a significant reduction in stability indices and improvement in gait parameters. The results also showed significant differences in all measured parameters in favor of group B, when compared with those in group A (P < 0.01).
Balance training on the Biodex Stability System could be a useful tool in conjunction with traditional physical therapy program for improving balance control and gait functions in children with spastic diplegic cerebral palsy.
本研究旨在评估动态双侧姿势稳定性对脑瘫患儿平衡控制和步态参数的影响。
本研究纳入了30名痉挛型双侧瘫患儿（8 - 10岁）。这些患儿被随机分为两组：对照组A和研究组B。两组患儿均接受传统物理治疗方案，A组每天2小时，B组每天1.5小时，随后使用Biodex稳定性系统进行30分钟的动态姿势稳定性训练。治疗频率为每周三次，连续8周，在两个稳定水平（7级和8级）上进行。参与研究的患儿在治疗前后使用Biodex稳定性系统进行评估，以测量两个稳定水平（7级和8级）下的稳定性指标（前后向、内外侧和整体），并使用三维运动分析系统（pro-reflex系统）评估时空参数，包括步长、速度、周期时间、站立期和摆动期百分比。
两组患儿治疗后所有测量变量的平均值均有显著改善，表现为稳定性指标显著降低，步态参数得到改善。结果还显示，与A组相比，B组所有测量参数均有显著差异（P < 0.01）。
在传统物理治疗方案的基础上，使用Biodex稳定性系统进行平衡训练可能是改善痉挛型双侧瘫脑瘫患儿平衡控制和步态功能的有效方法。
