Category: Dosing

Posted on by

Effects of the standing program with hip abduction on hip acetabular development in children with spastic diplegia cerebral palsy.

date: 2016 Jun;38(11):1075-81
author: Macias-Merlo L1, Bagur-Calafat C2, Girabent-Farrés M3, A Stuberg W4.
publication:Disabil Rehabil.
pubmed_ID: 26517269

 

Abstract

PURPOSE:

Early identification and intervention with conservative measures is important to help manage hip dysplasia in children with a high adductor and iliopsoas tone and delay in weight bearing. The effect of a daily standing program with hip abduction on hip acetabular development in ambulatory children with cerebral palsy was studied.

METHOD:

The participants were 26 children with spastic diplegia cerebral palsy (CP), classified at Level III according to the Gross Motor Function Classification System (GMFCS). Thirteen children stood with hip abduction at least 1 h daily from 12 to 14 months of age to 5 years with an individually fabricated standing frame with hip abduction.

RESULTS:

At the age of 5 years, radiologic results of the study group were compared with a comparison group of 13 children with spastic diplegia CP who had not taken part in a standing program. The migration percentage in all children who stood with abduction remained within stable limits (13-23%) at 5 years of age, in comparison to children who did not stand in abduction (12-47%) (p < 0.01).

CONCLUSIONS:

The results indicate that a daily standing program with hip abduction in the first 5 years may enhance acetabular development in ambulatory children with spastic diplegia CP. Implications for Rehabilitation Abnormal acetabular development is a problem related to mobility problems and spasticity muscles around the hip. The literature suggests that postural management and standing programs could reduce levels of hip subluxation and increase function in children with cerebral palsy. A standing program with hip abduction can be a beneficial to develop more stable hips in children with spastic diplegic GMFCS level III.

Posted on by

Effect of weight-bearing in abduction and extension on hip stability in children with cerebral palsy.

date: 2011 Summer;23(2):150-7
author: Martinsson C1, Himmelmann K.
publication:Pediatr Phys Ther.
pubmed_ID: 21552077

 

Abstract

PURPOSE:

: To study the effect of 1 year of daily, straddled weight-bearing on hip migration percentage (MP) and muscle length in children with cerebral palsy who were nonambulatory.

METHODS:

: Participants stood upright in maximum tolerated hip abduction and hip and knee extension ½ to 1½ hours per day for 1 year. Controls, matched for age, motor ability, and surgery, were derived from a national cerebral palsy follow-up program.

RESULTS:

: Participants using straddled weight-bearing after surgery had the largest decrease in MP (n = 3, 20 controls; P = .026). Children using straddled weight-bearing at least 1 hour per day for prevention also improved (n = 8, 63 controls; P = .029). Hip and knee contractures were found only in controls.

CONCLUSION:

: Straddled weight-bearing, 1 hour per day, may reduce the MP after adductor-iliopsoas-tenotomies or prevent an MP increase and preserve muscle length in children with cerebral palsy who did not need surgery. Larger studies are needed to confirm the results.

Posted on by

Factors affecting prescription and implementation of standing-frame programs by school-based physical therapists for children with impaired mobility

date: 2009 Fall;21(3):282-8. doi: 10.1097/PEP.0b013e3181b175cd
author: Taylor K.
publication: Pediatr Phys Ther.
pubmed_ID:19680071

 

Abstract

PURPOSE:

The purpose of this study was to investigate factors considered in the prescription and implementation of standing–frame programs by school–based physical therapists.

METHODS:

A 20-item survey was mailed to 500 members of the APTA Pediatric Section and School–Based Special Interest Group. Survey questions addressed standing–frame program prescription and perceived benefits.

RESULTS:

Response rate was 77.2%. A majority of respondents rated ambulatory status for the prescription of standing–frame programs and a child‘s specific needs in the selection of a specific standing frame as very important. Respondents identified multiple benefits with pressure relief rated very important most frequently. More than 50% of respondents indicated social and educational benefits are very important. A majority of respondents prescribed standing–frame programs for 30-45 minutes daily.

CONCLUSIONS:

Variation does exist, but the majority of school–based physical therapists agree on several key factors in the prescription and implementation of standing–frame programs.