Journal of Paramedical Sciences & Rehabilitation

Journal of Paramedical Sciences & Rehabilitation

Efficacy of the “Smart Dynamic Body-Weight Support System” in the Functional ‎ Performance of Children with Cerebral Palsy‏ ‏and other Neurological Disorders

Document Type : Original Article

Authors
R Lotfi 1
H Barmaki 2
M Lotfi 2
H.R Kobravi 3
A.R Shadman 4
A Zeinalzadeh 5
1 Department of Electrical Engineering, Faculty of Engineering, Ferdowsi University of Mashhad, Payame Avaran Shargh Art and Technology Knowledge Foundation
2 Payam Avaran Shargh Art and Technology Knowledge Foundation Company
3 Department of Biomedical Engineering, Mashhad Branch, Islamic Azad University, Mashhad, Iran
4 Department of Industrial Engineering, Faculty of Engineering, Ferdowsi University of Mashhad, Mashhad, Iran
5 Department of Physiotherapy, School of Paramedical Sciences, University of Medical Sciences, Mashhad, Iran
10.22038/jpsr.2022.60438.2312
Abstract
Purpose:
Gait is one of the most basic necessities of a child's daily life. Elimination of gait from child’s life leads to various complications. Therefore, in the process of rehabilitation of children with cerebral palsy, gait phase is always of special importance. Today, with the advancement of existing technologies in the field of rehabilitation, the use of new equipments based on modern science to accelerate the process of walking will be very necessary. The purpose of the present study is to investigate the effectiveness of smart dynamic body-weight support system on functional performance and gait improvement in children with cerebral palsy or other neurological diseases.
Methods:
Eleven children with cerebral palsy, motor delay, and other genetic or acquired neurological diseases were recruited for this study. Before starting an intervention, functional tests consisted of five-repetition sit-to-stand tests, Timed Up and Go Test, Lateral Step Up Test and Berg Balance Scale were taken from participants. The functional tests were taken from the participants at the end of the tenth and twentieth sessions. Training sessions were 20 which consisted of 10 general exercises sessions at first and 10 advanced exercises sessions at the end. The duration of each training session was 20 minutes. Exercises were carried out by smart dynamic body-weight support system. The data were analyzed via Wilcoxon signed-rank tests and Marginal Homogeneity test by SPSS software in 0.1 p-value.
Results:
The results showed that the significant difference in Berg Balance Scale exists between first and third assessments (P=0.003, m=12.364), first and second (P=0.003, m=8.636) and also second and third (P=0.028, m=3.727). In 5×SS and TUDS tests the significant difference exists between first and third assessments and first and second times but in TUG test the only significant difference is between first and third times.
Conclusion:
The results of study showed that the exercises which were carried out by smart dynamic body-weight support system have led to improvement in functional performance and gait in children.
Keywords
Smart dynamic body-weight support system
Balance
Gait
Functional performance
Cerebral palsy
‎Neurological disease
  1. Eng JJ, Tang PF. Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Expert review of neurotherapeutics 2007; 7(10): 1417-1436.
  2. Siderowf A, McDermott M, Kieburtz K, Blindauer K, et al. Parkinson Study Group. Test–retest reliability of the unified Parkinson's disease rating scale in patients with early Parkinson's disease: results from a multicenter clinical trial. Movement disorders 2002; 17(4): 758-763.
  3. Hobart JC, Lamping DL, Freeman JA, Langdon DW, et al. Evidence-based measurement: which disability scale for neurologic rehabilitation?. Neurology 2001; 57(4): 639-644.
  4. Hobart J, Freeman J, Lamping D, Fitzpatrick R, Thompson A. The SF-36 in multiple sclerosis: why basic assumptions must be tested. Journal of Neurology, Neurosurgery & Psychiatry 2001; 71(3): 363-370.
  5. Nelke KH, Pawlak W, Gerber H. Dandy-Walker syndrome with severe velopharyngeal dysfunction: a contraindication for Le Fort I surgery?. Journal of Craniofacial Surgery 2015; 26(1): e42-44.
  6. Levitt S, Addison A. Outline of treatment approaches. In: Treatment of cerebral palsy and motor delay. John Wiley & Sons; 2018: 71-92.
  7. Darragh AR, Huddleston W, King P. Work-related musculoskeletal injuries and disorders among occupational and physical therapists. American Journal of Occupational Therapy 2009; 63(3): 351-362.
  8. Cromie JE, Robertson VJ, Best MO. Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, and responses. Physical therapy 2000; 80(4): 336-351.
  9. Nordin NA, Leonard JH, Thye NC. Work-related injuries among physiotherapists in public hospitals: a Southeast Asian picture. Clinics 2011; 66: 373-378.
  10. Sharan D, Ajeesh PS. Injury prevention in physiotherapists-a scientific review. Work 2012; 41(Supplement 1): 1855-1859.
  11. Valentín‐Gudiol M, Mattern‐Baxter K, Girabent‐Farrés M, Bagur‐Calafat C, et al. Treadmill interventions in children under six years of age at risk of neuromotor delay. Cochrane Database of Systematic Reviews 2017; 7(7): CD009242.
  12. Glowinski S, Blazejewski A. SPIDER as A Rehabilitation Tool for Patients with Neurological Disabilities: The Preliminary Research. Journal of personalized medicine 2020; 10(2): 33-43.
  13. Selfslagh A, Shokur S, Campos DS, Donati AR, et al. Non-invasive, brain-controlled functional electrical stimulation for locomotion rehabilitation in individuals with paraplegia. Scientific reports 2019; 9(1): 1-7.
  14. Hidler JM, Brown DA. Robotic devices for overground gait and balance training. In: Neurorehabilitation Technology. Springer 2012; 2(1): 397-409.  
  15. Morris C, Bartlett D. Gross motor function classification system: impact and utility. Developmental medicine and child neurology 2004; 46(1): 60-65.
  16. Hosseini SM, Fatorehchy S, Hosseini SA, Haghgoo HA, Hosseinzadeh S. Designing a Gait Enhancer and Determining its Effect on Standing Ability and Gait Speed of Children with Cerebral Palsy Spastic Diplegia. Archives of Rehabilitation 2020; 21(4): 436-453.
  17. Martin L, Baker R, Harvey A. A systematic review of common physiotherapy interventions in school-aged children with cerebral palsy. Physical & occupational therapy in pediatrics 2010; 30(4): 294-312.
  18. Clutterbuck G, Auld M, Johnston L. Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy: a systematic review. Disability and rehabilitation 2019; 41(10): 1131-1151.
  19. Toovey R, Bernie C, Harvey AR, McGinley JL, Spittle AJ. Task-specific gross motor skills training for ambulant school-aged children with cerebral palsy: a systematic review. BMJ paediatrics open 2017; 1(1): 15-93.
  20. Valentin‐Gudiol M, Mattern‐Baxter K, Girabent‐Farrés M, Bagur‐Calafat C, et al. Treadmill interventions with partial body weight support in children under six years of age at risk of neuromotor delay. Cochrane Database of Systematic Reviews 2011; 12: CD009242
  21. Wang TH, Liao HF, Peng YC. Reliability and validity of the five-repetition sit-to-stand test for children with cerebral palsy. Clinical rehabilitation 2012; 26(7): 664-671.
  22. Verbecque E, Vereeck L, Boudewyns A, Van de Heyning P, Hallemans A. A modified version of the Timed Up and Go Test for children who are preschoolers. Pediatric Physical Therapy 2016; 28(4): 409-415.
  23. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs test: preliminary reliability and validity of a new measure of functional mobility. Pediatric Physical Therapy 2004; 16(2): 90-98.
  24. Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatric physical therapy 2003; 15(2): 114-128.
  25. Malone A, Kiernan D, French H, Saunders V, O'brien T. Obstacle crossing during gait in children with cerebral palsy: cross-sectional study with kinematic analysis of dynamic balance and trunk control. Physical therapy 2016; 96(8): 1208-1215.
  26. Blundell SW, Shepherd RB, Dean CM, Adams RD, Cahill BM. Functional strength training in cerebral palsy: a pilot study of a group circuit training class for children aged 4–8 years. Clinical rehabilitation. 2003; 17(1): 48-57.
  27. Stevens Shortland AP. Selective motor control correlates with gait abnormality in children with cerebral palsy. Gait & posture 2017; 52: 107-109.
  28. Utley A, Steenbergen B, Astill SL. Ball catching in children with developmental coordination disorder: control of degrees of freedomJL. Homemade Foot Placement Ladder. Physical therapy. 1976; 56(3): 309-317.
  29. Chruscikowski E, Fry NR, Noble JJ, Gough M, Developmental Medicine & Child Neurology 2007; 49(1): 34-38.
Journal of Paramedical Sciences & Rehabilitation
Volume 10, Issue 4
Winter 2022
Pages 7-19