Ann Rehabil Med.  2019 Jun;43(3):289-296. 10.5535/arm.2019.43.3.289.

The Role of Regular Physical Therapy on Spasticity in Children With Cerebral Palsy

• Lee H
• Kim EK
• Son DB
• Hwang Y
• Kim JS
• Lim SH
• Sul B
• Hong BY

• KMID: 2453918
• DOI: http://doi.org/10.5535/arm.2019.43.3.289

Abstract

OBJECTIVE
To investigate the effect of physical therapy (PT) intervention on spasticity in patients with cerebral palsy (CP), and to assess the degree of deterioration of spasticity when regular PT is interrupted in those patients.
METHODS
We recruited 35 children with spastic CP who visited our hospital for PT, and whose Modified Tardieu Scale (MTS) scores were serially recorded including before and after a 10-day public holiday time frame period. The outcome measures were the angle of range of motion (ROM) of dorsiflexion of the ankle joint (R1 and R2) in the knee flexion and extension positions as assessed using the MTS.
RESULTS
The range of dorsiflexion of the ankle joint (R1 and R2) after the holiday period was significantly decreased as compared with that measured ROM noted before the holiday period, regardless of the knee position, age, or gross motor function. The dynamic component of the MTS (R2-R1) showed a slight decrease in the knee flexion position.
CONCLUSION
Interruption of regular PT aggravated spasticity and decreased ankle joint ROM in children with spastic CP. Our findings suggest that regular PT in the care continuum for children with CP is crucial for the maintenance of ROM in the spastic ankle joints.

Keyword

Cerebral palsy; Muscle spasticity; Physical therapy; Ankle joint; Range of motion

MeSH Terms

Ankle Joint
Cerebral Palsy*
Child*
Continuity of Patient Care
Holidays
Humans
Knee
Muscle Spasticity*
Outcome Assessment (Health Care)
Range of Motion, Articular

Figure

• 

  Fig. 1. The range of motion of ankle dorsiflexion decreased after the holiday compared to before the holiday period. The vertical axis of the graph indicates the ankle dorsiflexion angle (‘+’ dorsiflexion, ‘–’ plantarflexion, ‘0’ neutral position). The solid and dotted lines indicate mean values. MTS, Modified Tardieu Scale.

• 

  Fig. 2. The range of dorsiflexion of the ankle joint showed the decreasing tendency across the holiday regardless of GMFCS levels. The vertical axis of the graph indicates the ankle dorsiflexion angle (‘+’ dorsiflexion, ‘–’ plantarflexion, ‘0’ neutral position). The solid and dotted lines indicate mean value. GMFCS, Gross Motor Function Classification System.

• 

  Fig. 3. Divided into two groups among GMFCS levels, I–III and VI–V, the range of dorsiflexion of the ankle joint was also decreased in the knee flexion and the knee extension, but no significant difference in decrement of the area of R1 and R2 is noted between the two groups. GMFCS, Gross Motor Function Classification System.

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