Comparative Effects of Functional Task Training Versus Functional Therapy Program on Gross Motor Function, Range of Motion and Balance in Children With Cerebral Palsy
DOI:
https://doi.org/10.61919/jhrr.v4i2.1103Keywords:
Balance, Cerebral Palsy, Gross Motor FunctionAbstract
Background: Cerebral palsy (CP) is a non-progressive neuromotor disorder affecting the developing fetal or newborn brain, leading to impairments in muscle tone, reflexes, posture, coordination, and motor skills. Functional Task Training (FTT) and Functional Therapy Programs (FTP) are rehabilitation techniques aimed at improving the physical capabilities of children with CP.
Objective: To determine the comparative effects of Functional Task Training versus a Functional Therapy Program on gross motor function, range of motion, and balance in children with hemiplegic cerebral palsy.
Methods: This randomized clinical trial was conducted from March 2, 2023, to May 31, 2023, at Rising Sun for Special Children in Lahore. A sample of 18 children, aged 6-12 years, diagnosed with hemiplegic cerebral palsy (GMFCS level I-II), was randomly assigned to two groups: Group A received FTT, and Group B received FTP. Both groups underwent their respective interventions for 50 minutes per day, three times a week, over 12 weeks (36 sessions). Data collection tools included the Goniometer for range of motion (ROM), Pediatric Balance Scale (PBS) for balance, and Gross Motor Function Measure (GMFM-88) for motor function. Baseline and post-intervention assessments were conducted. Statistical analysis was performed using SPSS version 25, with paired and independent t-tests to compare pre- and post-intervention scores within and between groups, respectively. A p-value of less than 0.05 was considered statistically significant.
Results: The mean age of participants was 8.67±2.39 years in Group A and 9.89±1.96 years in Group B. No significant differences were found between the two groups in GMFM domains A, B, C, and E, or in the total GMFM score (p > 0.05). Post-intervention GMFM total scores were 83.11±2.09 in Group A and 84.33±3.42 in Group B (p = 0.375). PBS scores showed no significant differences post-intervention, with mean scores of 36.66±5.02 in Group A and 41.33±7.57 in Group B (p = 0.140). ROM measures indicated significant improvements within Group A in left hip flexion, abduction, and extension (p < 0.05).
Conclusion: Both Functional Task Training and Functional Therapy Programs were equally effective in improving gross motor function, balance, and range of motion in children with hemiplegic cerebral palsy. These findings support the use of both interventions as effective rehabilitation strategies in this population.
Keywords: Cerebral palsy, Functional Task Training, Functional Therapy Program, Gross Motor Function, Pediatric Balance Scale, Range of Motion, Pediatric Rehabilitation, Hemiplegic CP, Randomized Clinical Trial. Management
Downloads
References
McIntyre S, Goldsmith S, Webb A, Ehlinger V, Hollung SJ, McConnell K, et al. Global prevalence of cerebral palsy: A systematic analysis. Developmental Medicine & Child Neurology. 2022;64(12):1494-506.
Janssen-Potten YJ, Roks L, Roijen R, Vermeulen RJ, Group AS, Rameckers EE. Effectiveness of functional intensive therapy on mobility and self-care activities in children and adolescents with cerebral palsy–a prospective clinical study. Disability and rehabilitation. 2022:1-10.
Khan SA, Talat S, Malik MI. Risk factors, types, and neuroimaging findings in Children with Cerebral Palsy. Pakistan Journal of Medical Sciences. 2022;38(7):1738.
Heneidy WE, Eltalawy H, Kassem H, Zaky NA. IMPACT OF VIRTUAL REALITY TRAINING ON BALANCEIN SPASTIC HEMIPLEGIC CEREBRAL PALSIED CHILDREN.
Billen M, Fonteyn L. Functional balance, motor competence and their relationship in children with cerebral palsy compared to typically developing children: A case-control study. 2022.
Souto DO, Cruz TKF, Fontes PLB, Moeller K, Haase VG. Neuromotor examination in unilateral cerebral palsy: Bilateral impairments in different levels of motor integration. Applied Neuropsychology: Child. 2022;11(4):658-68.
Bartlett DJ, Palisano RJ. A multivariate model of determinants of motor change for children with cerebral palsy. Physical Therapy. 2000;80(6):598-614.
Franjoine MR, Darr N, Held SL, Kott K, Young BL. The performance of children developing typically on the pediatric balance scale. Pediatric physical therapy. 2010;22(4):350-9.
Mailleux L, Franki I, Emsell L, Peedima M-L, Fehrenbach A, Feys H, et al. The relationship between neuroimaging and motor outcome in children with cerebral palsy: A systematic review—Part B diffusion imaging and tractography. Research in developmental disabilities. 2020;97:103569.
Huroy M, Behlim T, Andersen J, Buckley D, Fehlings D, Kirton A, et al. Stability of the Gross Motor Function Classification System over time in children with cerebral palsy. Developmental Medicine & Child Neurology. 2022;64(12):1487-93.
Alfuth M, Fichter P, Knicker A. Leg length discrepancy: A systematic review on the validity and reliability of clinical assessments and imaging diagnostics used in clinical practice. Plos one. 2021;16(12):e0261457.
Robert MT, Guberek R, Sveistrup H, Levin MF. Motor learning in children with hemiplegic cerebral palsy and the role of sensation in short‐term motor training of goal‐directed reaching. Developmental Medicine & Child Neurology. 2013;55(12):1121-8.
Patel DR. Therapeutic interventions in cerebral palsy. The Indian Journal of Pediatrics. 2005;72:979-83.
Brogren Carlberg E, Löwing K. Does goal setting in activity‐focused interventions for children with cerebral palsy influence treatment outcome? Developmental Medicine & Child Neurology. 2013;55:47-54.
Stoykov ME, Biller OM, Wax A, King E, Schauer JM, Fogg LF, et al. Bilateral upper extremity motor priming (BUMP) plus task-specific training for severe, chronic upper limb hemiparesis: study protocol for a randomized clinical trial. Trials. 2022;23(1):1-14.
Geijen M, Ketelaar M, Sakzewski L, Palisano R, Rameckers E. Defining functional therapy in research involving children with cerebral palsy: a systematic review. Physical & Occupational Therapy in Pediatrics. 2020;40(2):231-46.
Lee N-Y, Lee E-J, Kwon H-Y. The effects of dual-task training on balance and gross motor function in children with spastic diplegia. Journal of exercise rehabilitation. 2021;17(1):21.
Gonçalves RV, Fonseca ST, de Araújo PA, Souza TR, Resende RA, Mancini MC. Functional task training combined with electrical stimulation improves motor capacity in children with unilateral cerebral palsy: a single-subject design. Pediatric Physical Therapy. 2019;31(2):208-15.
Zai W, Xu N, Wu W, Wang Y, Wang R. Effect of task-oriented training on gross motor function, balance and activities of daily living in children with cerebral palsy: A systematic review and meta-analysis. Medicine. 2022;101(44):e31565.
Azadi H, Hosseini SA, Akbarfahimi N. Effect of task oriented training on functional mobility in children with cerebral Palsy: A systematic review and meta-analysis. Journal of Mazandaran University of Medical Sciences. 2020;30(190):164-77.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Kinza Naeem, Usman Arif, Sahiba Sabber, Sana Kamran, Sarah Sabir
This work is licensed under a Creative Commons Attribution 4.0 International License.
