Comparison between combined effect of gluteal activation along with MFR and MFR only on crouch posture in children with spastic diplegia

BACKGROUND

Inspastic diplegia, lower extremities are more involved than the upperextremities. Children have major weakness in trunk. Postural disturbances in CP aremajor difficulty in maintaining body segments aligned on narrow base ofsupport. Such children retain an anterior pelvic tilt, due to the tightness ofthe iliopsoas muscle as well as the weakness in the trunk flexors and hipextensors. Crouch gait is the most common locomotor disability among childrenwith spastic diplegic CP. The activation of gluteus maximus muscle leads toimprove crouched posture and gait in CP.

OBJECTIVE

To determine the combined effect ofgluteal activation along with MFR and MFR only on crouch posture in childrenwith spastic diplegia to improve standing posture and gait.

METHODOLOGY

Natureof the Study

The study will be Randomized Controlled Trial in which the effectof gluteal activation on crouch posture in spastic diplegic CP children will beobserved.

SELECTIONCRITERIA

Inclusioncriteria

Childrenwith Spastic Diplegia, age group 6-12 years, Both males and females, GMFCSlevel 1,2,3.

Exclusioncriteria

 Â·        Those currently on any medication for CP.

·        Who had received botulinum toxin injection.

·        Who had undergone lower limb surgery within 6 months of studyenrolment so as to avoid confounding results secondary to iatrogenic weakness.

·        Children with history of head injury or loss of consciousness, whohas contracture, other co-morbid disorders such as Autism Spectrum disorder.

·        GMFCS level 4,5

 OUTCOMEMEASURES

1. Hamstringflexibility test

2. APECS (A1 PostureEvaluation and Correlation System) app

3. Edinburg VisualGait Score

4.Pediatrics Balance Scale

Procedure

The experimental group will be givenMFR of iliopsoas + tDCS + GlutealActivation exercises i.e. single leg bridging and step up exercises +Conventional Physiotherapy. The control group will be given MFR ofiliopsoas and tDCS with conventional physiotherapy. After the administration ofintervention, scores for Hamstring flexibility, standing posture analysis andgait analysis, Pediatric Balance Score will be recorded.