Upper limb weight-bearing effect on the body alignment of individuals with cerebral palsy who have spastic hemiparesis: a randomized clinical trial

Efeitos da descarga de peso em membros superiores sobre o alinhamento corporal de indivíduos com paralisia cerebral do tipo hemiparesia espástica: ensaio clínico randomizado

Efectos de la descarga de peso en los miembros superiores sobre la alineación corporal de individuos con parálisis cerebral de tipo hemiparesia espástica: un ensayo clínico aleatorizado

Abstract

Introduction:  Cerebral Palsy (CP) patients who have spastic hemiparesis usually present asymmetrical weight shift between the affected and non-affected side.

Objective:  To assess the effects of upper limb (UL) weight-bearing exercises on trunk symmetry, weight shift to the affected side and possible secondary effects on gait (speed and quality).

Method:  eleven participants with CP were randomized into two groups: Intervention Group (IG) and Control Group (CG); IG (n = 6) performed stretching exercises of the major muscle groups of UL and lower limbs (LL) and UL weight-bearing exercises in prone and seated position for 12 weeks. The CG (n = 5) did not undergo any kind of motor therapy during the study period but received the same exercises that IG after the study. The variables analyzed were: Gross Motor Function Measure (GMFM-88); Pediatric Berg Scale; Trunk Impairment Scale (TIS); Six-minute walking test (6MWT); Ten meters walking test (10MWT); Timed Up & Go (TUG); Edinburgh Visual Gait Scale (EVGS); and ground reaction force.

Results:   The IG showed improvement on 6MWT, TUG, TIS and Pediatric Berg Scale (p < 0.01), and CG showed improvement on GMFM-88 (p < 0.04) only for the intragroup analysis.

Conclusion:  The exercises were effective to improve static and dynamic balance, increasing gait speed and identifying a trend of improvement on body alignment and weight shift to the affected side.

Keywords: Cerebral Palsy; Paresis; Upper Extremity