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Effects of Johnstone pressure splints combined with neurodevelopmental therapy on spasticity and cutaneous sensory
M Kerem1, A Livanelioglu, M Topcu
1School of Physical Therapy and Rehabilitation, Department of Cerebral Palsy and Paediatric Rehabilitation, Hacettepe University, Ankara, Turkey. mintaze@superonline.com
Insights
Johnstone pressure splints (JPSs) combined with neurodevelopmental therapy (NDT) improved spasticity and sensory function in children with spastic cerebral palsy (CP). This treatment enhanced passive range of motion and somatosensory evoked potentials more than NDT alone.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Spastic cerebral palsy (CP) is a common motor disorder affecting children.
- Spasticity and impaired sensory input are key challenges in managing CP.
- Effective interventions are needed to improve motor function and sensory processing in children with CP.
Purpose of the Study:
- To evaluate the efficacy of Johnstone pressure splints (JPSs) in conjunction with neurodevelopmental therapy (NDT) for children with spastic diplegic CP.
- To assess the impact of JPSs on spasticity and cutaneous sensory inputs.
- To compare outcomes between a treatment group (NDT + JPSs) and a control group (NDT alone).
Main Methods:
- A randomized controlled trial involving 34 children with spastic diplegic CP.
- Participants were divided into a treatment group (NDT + JPSs) and a control group (NDT alone).
- Interventions were administered five days a week for three months, with measurements of passive range of motion (ROM), spasticity (Modified Ashworth Scale - MAS), and somatosensory evoked potentials (SEPs) before and after treatment.
Main Results:
- Both groups showed significant improvements in passive ROM (p<0.01).
- The treatment group demonstrated significantly greater improvements in passive ROM (p<0.05) and MAS scores (p<0.05) compared to the control group.
- Somatosensory evoked potential (SEP) values increased significantly in the treatment group compared to the control group (p<0.05).
Conclusions:
- Johnstone pressure splints (JPSs) combined with neurodevelopmental therapy (NDT) are effective in improving spasticity and sensory function in children with spastic diplegic CP.
- The addition of JPSs to NDT leads to superior outcomes in passive range of motion and spasticity reduction.
- JPSs enhance somatosensory processing, suggesting a beneficial role in the rehabilitation of children with CP.
Abstract:
The purpose of this study was to investigate the effectiveness of Johnstone pressure splints (JPSs) on spasticity and cutaneous sensory inputs in children with spastic cerebral palsy (CP). Thirty-four children with spastic diplegic CP participated in this study. Children whose motor development levels were similar were divided into a treatment and a control group. Each group consisted of 17 participants (six females and 11 males). Mean age of the treatment group was 48.82 months (SEM 4.42), and the control group, 47.52 months (SEM 5.27). The treatment group underwent Bobath's neurodevelopmental therapy (NDT) combined with JPSs. The control group underwent NDT alone five days a week for three months. Before and after treatments, lower-extremity passive range of motion (ROM) by goniometric measurements, spasticity by Modified Ashworth Scale (MAS), and somatosensory evoked potentials (SEPs) were measured. Passive ROM showed significant improvements in both groups (p<0.01). In the treatment group, all MAS scores increased. In the control group, the difference was significant except for values of internal rotator muscles. Improvements in passive ROM in the treatment group were significantly higher than the control group except in hip abduction and external rotation (p<0.05). MAS scores of the treatment group were significantly higher than the control group (p<0.05). SEP values increased in both groups but values of the treatment group were significantly higher than the control group (p<0.05).