Effects of Neurodevelopmental Therapy on Gross Motor Function and Postural Control in Children with Spastic Cerebral Palsy: A Randomized Controlled Trial

Neurodevelopmental Therapy in Children with Spastic Cerebral Palsy

Authors

  • Abdullah Khalid Khan University Institute of Physical Therapy, University of Lahore, Pakistan
  • Syed Asadullah Arslan University Institute of Physical Therapy, University of Lahore, Pakistan
  • Fahad Tanveer University Institute of Physical Therapy, University of Lahore, Pakistan
  • Saima Jabbar University Institute of Physical Therapy, University of Lahore, Pakistan
  • Iqra Ashraf University Institute of Physical Therapy, University of Lahore, Pakistan
  • Arslan Anwar University Institute of Physical Therapy, University of Lahore, Pakistan
  • Muhammad Sufyan Karamat University Institute of Physical Therapy, University of Lahore, Pakistan
  • Umar Khalid khan University Institute of Physical Therapy, University of Lahore, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v5i5.418

Keywords:

Bobath concept, Gross Motor Function, Neurodevelopmental Therapy Neurorehabilitation., Physical Therapy, Postural Control, Spastic Cerebral Palsy

Abstract

Cerebral palsy (CP) is one of the most prevalent childhood-onset causes of permanent disability affecting gross motor functioning and postural control ability. Objective: To determine the effects of neurodevelopmental treatment on the gross motor function postural control among children with spastic CP. Methods: A single-blinded randomized controlled trial was carried out at Sher e Rabbani Hospital, Department of Pediatric Rehabilitation, Sheikhupura. 66 children fulfilling the inclusion criteria were recruited using the non-probability sampling technique. Participants were divided into two groups, Group A which received beuro developmental techniques along with routine physical therapy while Group B received only routine physical therapy treatment. To collect data, Gross motor function measure scale (GMFM-88) and posture and postural ability scale (PPAS) were employed as outcome measures. Results: Repeated measure ANOVA and an independent t-test were executed for parametric data after assuming normality. Pairwise comparison of both groups demonstrated that gross motor function was significantly improved from baseline to 4th, 8th, and 12th week after applying NDT treatment (p-value≤ 0.05). Pairwise comparison of both groups revealed that postural ability post NDT treatment and significant improvement was observed after 12 weeks in comparison to baseline. While within-group comparison at different follows up for gross motor function measure and postural control also expressed p≤ 0.05 as significant. Conclusions: Children with spastic CP who received Neurodevelopmental Therapy along with conventional physical therapy treatment showed significant improvements in gross motor function and postural control as compared to the control group.

References

Graham HK, Rosenbaum P, Paneth N, Dan B, Lin JP, Damiano DL et al. Cerebral palsy. Nat Rev Dis Primers. 2016 Jan 7;2:15082. doi: 10.1038/nrdp.2015.82.

Van Naarden Braun K, Doernberg N, Schieve L, Christensen D, Goodman A, Yeargin-Allsopp M. Birth Prevalence of Cerebral Palsy: A Population-Based Study. Pediatrics. 2016 Jan;137(1):1–9. doi: 10.1542/peds.2015-2872.

Carvalho A, Brites C, Mochida G, Ventura P, Fernandes A, Lage ML et al. Clinical and neurodevelopmental features in children with cerebral palsy and probable congenital Zika. Brain Dev. 2019 Aug;41(7):587-594. doi: 10.1016/j.braindev.2019.03.005.

Gulati S, Sondhi V. Cerebral Palsy: An Overview. Indian J Pediatr. 2018 Nov;85(11):1006-1016. doi: 10.1007/s12098-017-2475-1.

Morgan C, Darrah J, Gordon AM, Harbourne R, Spittle A, Johnson R et al. Effectiveness of motor interventions in infants with cerebral palsy: a systematic review. Dev Med Child Neurol. 2016 Sep;58(9):900-9. doi: 10.1111/dmcn.13105.

Herskind A, Greisen G, Nielsen JB. Early identification and intervention in cerebral palsy. Dev Med Child Neurol. 2015 Jan;57(1):29-36. doi: 10.1111/dmcn.12531.

Türker D, Korkem D, Özal C, Günel MK, Karahan S. The effects of neurodevelopmental (Bobath) therapy based goal directed therapy on gross motor function and functional status of children with cerebral palsy. International Journal of Therapies and Rehabilitation Research. 2015;4(4):9-20. doi: 10.5455/ijtrr.00000060.

Conway MD. Neurodevelopmental treatment for children with hemiplegic cerebral palsy: clinical guidelines for occupational therapists: Boston University. 2020.

Labaf S, Shamsoddini A, Hollisaz MT, Sobhani V, Shakibaee A. Effects of Neurodevelopmental Therapy on Gross Motor Function in Children with Cerebral Palsy. Iran J Child Neurol. 2015 Spring;9(2):36-41.

Besios T, Nikolaos A, Vassilios G, Giorgos M, Tzioumakis Y, Comoutos N. Effects of the neurodevelopmental treatment (NDT) on the mobility of children with cerebral palsy. Open Journal of Therapy and Rehabilitation. 2018 Nov 30;6(04):95. DOI: 10.4236/ojtr.2018.64009.

Baumann J, Gassmann K, Masjosthusmann S, DeBoer D, Bendt F, Giersiefer S et al. Comparative human and rat neurospheres reveal species differences in chemical effects on neurodevelopmental key events. Arch Toxicol. 2016 Jun;90(6):1415-27. doi: 10.1007/s00204-015-1568-8.

Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options. Neuropsychiatr Dis Treat. 2020 Jun 12;16:1505-1518. doi: 10.2147/NDT.S235165.

Sah AK, Balaji GK, Agrahara S. Effects of Task-oriented Activities Based on Neurodevelopmental Therapy Principles on Trunk Control, Balance, and Gross Motor Function in Children with Spastic Diplegic Cerebral Palsy: A Single-blinded Randomized Clinical Trial. J Pediatr Neurosci. 2019 Jul-Sep;14(3):120-126. doi: 10.4103/jpn.JPN_35_19.

Tekin F, Kavlak E, Cavlak U, Altug F. Effectiveness of Neuro-Developmental Treatment (Bobath Concept) on postural control and balance in Cerebral Palsied children. J Back Musculoskelet Rehabil. 2018;31(2):397-403. doi: 10.3233/BMR-170813.

Salazar Fajardo JC, Kim R, Gao C, Hong J, Yang J, Wang D et al. The Effects of tDCS with NDT on the Improvement of Motor Development in Cerebral Palsy. Journal of Motor Behavior. 2021 Dec 10:1-0. doi.org/10.1080/00222895.2021.2016572.

Dewar R, Love S, Johnston LM. Exercise interventions improve postural control in children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2015 Jun;57(6):504-20. doi: 10.1111/dmcn.12660.

Hadders-Algra M, Boxum AG, Hielkema T, Hamer EG. Effect of early intervention in infants at very high risk of cerebral palsy: a systematic review. Dev Med Child Neurol. 2017 Mar;59(3):246-258. doi: 10.1111/dmcn.13331.

Zanon MA, Porfírio GJM, Riera R, Martimbianco ALC. Neurodevelopmental treatment approaches for children with cerebral palsy. Cochrane Database Syst Rev. 2018 Aug 3;2018(8):CD011937. doi: 10.1002/14651858.CD011937.

Low DC, Walsh GS, Arkesteijn M. Effectiveness of Exercise Interventions to Improve Postural Control in Older Adults: A Systematic Review and Meta-Analyses of Centre of Pressure Measurements. Sports Med. 2017 Jan;47(1):101-112. doi: 10.1007/s40279-016-0559-0.

Rodby-Bousquet E, Persson-Bunke M, Czuba T. Psychometric evaluation of the Posture and Postural Ability Scale for children with cerebral palsy. Clin Rehabil. 2016 Jul;30(7):697-704. doi: 10.1177/0269215515593612.

Lee KH, Park JW, Lee HJ, Nam KY, Park TJ, Kim HJ et al. Efficacy of Intensive Neurodevelopmental Treatment for Children With Developmental Delay, With or Without Cerebral Palsy. Ann Rehabil Med. 2017 Feb;41(1):90-96. doi: 10.5535/arm.2017.41.1.90.

Unger M. The role of the abdominal muscles in pelvic positioning and lower limb function in children with spastic type cerebral palsy. 2011.

Tekin F, Kavlak E, Cavlak U, Altug F. Effectiveness of Neuro-Developmental Treatment (Bobath Concept) on postural control and balance in Cerebral Palsied children. J Back Musculoskelet Rehabil. 2018;31(2):397-403. doi: 10.3233/BMR-170813.

Molenaers G, Calders P, Vanderstraeten G, Himpens E. The evidence-base for conceptual approaches and additional therapies targeting lower limb function in children with cerebral palsy: a systematic review using the international classification of functioning, disability and health as a framework. Journal of rehabilitation medicine. 2012;44(5):396-405.

Kim MR, Lee BH, Park DS. Effects of combined Adeli suit and neurodevelopmental treatment in children with spastic cerebral palsy with gross motor function classification system levels I and II. Hong Kong Physiother J. 2015 Nov 7;34:10-18. doi: 10.1016/j.hkpj.2015.09.036.

Downloads

Published

2022-05-31

How to Cite

Khan, A. K. ., Arslan , S. A., Tanveer, F. ., Jabbar, S., Ashraf, I., Anwar , A. ., Karamat, M. S. ., & khan, U. K. . (2022). Effects of Neurodevelopmental Therapy on Gross Motor Function and Postural Control in Children with Spastic Cerebral Palsy: A Randomized Controlled Trial : Neurodevelopmental Therapy in Children with Spastic Cerebral Palsy. Pakistan BioMedical Journal, 5(5), 298–304. https://doi.org/10.54393/pbmj.v5i5.418

Issue

Section

Original Article

Most read articles by the same author(s)