عنوان

تاثیرمداخله اکتیو و پاسیو وستیبولار برتعادل و کارکرد کودکان فلج مغزی اسپاستیک۷ تا ۱۲ ساله

Background and Objectives: Postural control dysfunction is a serious problem in children with cerebral palsy, and the vestibular system is known to play an important role. This Randomized Control Trail study with blinded evaluator was conducted to examine the effect of vestibular intervention on static balance; and the relationship between balance changes and Quality of Life and Activity of Daily Living in school aged cerebral palsy children (CP) aged 7-12 years. Methods: Frothy two children with Spastic CP with 1-2 level of Gross Motor Function Classification System )GMFCS (aged7-12 years were enrolled and randomly assigned in to three groups: control, active and passive. Berg and Bruniniks-Oserstsky Test of Motor Proficiency II (BOT II) and Force Plat (during eyes closed and open) were measured functional and laboratory parameters of balance changes, respectively. Function was assessed by Activities Scale for Kids (ASK) for Activity of Daily Living and Cerebral Palsy Quality of Life questionnaire (CP-QOL) for Quality of Life. Participants in active or passive group received active and passive vestibular stimulation for 20 minutes and traditional Occupational Therapy (OT) program for 40 minutes. Children in control group received traditional OT program for 60 minutes. Interventions were provided 3 d/week for 6 weeks. Participants assessed at three stages: after, before and 8 weeks after intervention. Data analyzed by "Repeated Measure ANOVA and liner Regression. Results: The passive intervention significantly increased Berg scores (p=0/006), decreased the area (P=0.025) and the range of Center of Pressure displacement in Anterior-Posterior plan during eyes closed(P=0.047). Changes score relationship between Berg and ASK (r =0.51 p<0.001), BOT and ASK (r =0.34 p=0.031) were poor to fair. There was no significant relationship between Berg or BOT and CP-QOL scores (P>0.05). Conclusion: This study showed that passive stimulation can improve some balance parameters in children with Spastic CP. It may be related to re-organization of vestibular system with controlled and precise application of stimuli. Keywords: Cerebral Palsy, Active Vestibular Intervention, Passive Vestibular Intervention, Balance, Quality of Life, Activity of Daily Living

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