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The effect of upper limb loading with external weights on gait and trunk control in ambulatory children with spastic
A Alkhajeh1, A Arumugam, E Abd ElKafy
1Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates. fhegazy@sharjah.ac.ae.
Insights
Adding external weights to the upper limbs significantly improved gait speed, trunk control, and balance in children with hemiplegic cerebral palsy (CP). This physiotherapy intervention offers a promising, non-invasive approach for CP rehabilitation.
Area of Science:
- Pediatric rehabilitation
- Neuroscience
- Biomechanics
Background:
- Hemiplegic cerebral palsy (CP) often presents with gait asymmetry and increased fall risk in ambulatory children.
- Physiotherapy is a cornerstone of CP management, with limited exploration of upper limb loading interventions.
- Understanding novel therapeutic strategies is crucial for improving functional outcomes in children with CP.
Purpose of the Study:
- To evaluate the efficacy of external upper limb loading on gait speed, trunk control, and balance in ambulatory children with hemiplegic CP.
- To determine if adding weights to the upper limbs can enhance motor function and stability.
- To explore a novel physiotherapy approach for children with hemiplegic CP.
Main Methods:
- Participants included ambulatory children with hemiplegic CP.
- Outcome measures assessed were gait speed (10-Meter Walk Test), trunk control (Trunk Control Measurement Scale), and balance (Pediatric Balance Scale).
- Data were collected at baseline and after a six-week intervention period, analyzed using mixed ANOVA.
Main Results:
- Both intervention and control groups demonstrated significant improvements in gait speed, trunk control, and balance post-intervention (p < 0.001).
- The intervention group, utilizing upper limb loading, exhibited a greater magnitude of improvement across all measured outcomes compared to the control group.
- Specific improvements in the intervention group included: 10 MWT (0.59 m/s), TCMS (10.41), and PBS (9.35).
Conclusions:
- Upper limb loading as a physiotherapy intervention significantly enhanced gait speed, trunk control, and balance in children with hemiplegic CP.
- This method provides a promising, non-invasive adjunct to traditional physiotherapy for improving functional mobility.
- Further research can explore optimal loading parameters and long-term effects of this intervention.
Objective:
Children with hemiplegic cerebral palsy (CP) are typically ambulant with high motor functioning levels but with gait asymmetry and a greater risk of instability and falling. Physiotherapy is considered the core part of CP rehabilitation due to the risk of neurosurgery and the side effects of drug interventions. Although growing evidence has looked at the effect of upper limb loading during walking in many populations, such interventions in children with CP remain unexplored yet. The purpose of this study was to investigate if loading the upper limbs with external weights could improve walking speed, trunk control, and balance in ambulatory children with hemiplegic CP.
Patients And Methods:
The following outcome measures were recorded at baseline and six weeks after the intervention: gait speed [10-Meter Walk Test (10 MWT)], trunk control [Trunk Control Measurement Scale (TCMS)], and balance [Pediatric Balance Scale (PBS)]. Multiple 2 (groups) x 2 (time-points) mixed analysis of variance models (ANOVAs) were used for analysis.
Results:
Both groups showed a significant improvement (p < 0.001) in 10 MWT, TCMS, and PBS scores post-intervention. However, the magnitude of change in the outcome measures was higher in the intervention group (10 MWT = 0.59 m/s, TCMS = 10.41, PBS = 9.35) compared to the control group (10 MWT = 0.37 m/s, TCMS = 6.43, PBS = 4.68).
Conclusions:
This study demonstrated that although both control and intervention groups showed improvements in terms of gait speed, trunk control, and balance, the intervention group that had upper limb loading showed higher significant improvements. Clinicaltrial.gov ID: NCT05444387.
