EFFECTS OF PROGRESSIVE RESISTANCE EXERCISE ON SPASTICITY AND SMARTPHONE-MEASURED GAIT PARAMETERS IN CHILDREN WITH SPASTIC DIAPLEGIC CEREBRAL PALSY

Abstract

Background: CP affects the muscle tone, strength, balance and walking. Spastic diaplegic CP primarily involves the lower limbs and may cause restricted functional mobility. Progressive resistance exercise could be beneficial in enhancing gait and strength in addition to conventional physiotherapy. Objective: To assess the impact of PRES on spasticity, gross motor function and functional gait parameters in children with cerebral palsy (CP) spastic diaplegia. Methods: We randomly selected 40 children aged 1 to 7 with spastic diaplegic cerebral palsy. The subjects were randomly divided into Group A (n=20) who were treated with progressive resistance exercise along with conventional therapy and Group B (n=20) who were treated with conventional therapy only. The intervention was 6 weeks in length with 3 sessions a week for about 45 minutes each session. Evaluation was done before and following intervention. The Modified Ashworth Scale (MAS), the Gross Motor Function Measure (GMFM-66), Dynamic Gait Index, and Gait Parameters were used to assess spasticity, gross motor function, dynamic gait and gait parameters, respectively, using a smartphone. Results: Group A demonstrated greater improvement than Group B. Right lower-limb MAS decreased from 2.10 ± 0.45 to 1.25 ± 0.44 in Group A and from 2.15 ± 0.49 to 1.90 ± 0.46 in Group B (p<0.001). GMFM-66 increased from 52.80 to 63.90 in Group A compared with 51.90 to 55.20 in Group B. Walking speed improved from 0.76 to 0.97 m/s in Group A and from 0.74 to 0.80 m/s in Group B. Post-intervention cadence, right stride length, left stride length, and gait symmetry were 114.3 steps/min, 86.8 cm, 86.1 cm, and 93.1% in Group A, compared with 104.7 steps/min, 77.6 cm, 76.8 cm, and 86.5% in Group B.

Conclusion: Conventional therapy alone was not as effective as progressive resistance exercise and conventional therapy in reducing spasticity, gross motor function and gait performance in children with spastic diaplegic cerebral palsy.