A Comparative Study Of Aarom Exercise With Icing And Aarom Exercise With Prolonged Stretching To Reduce Spasticity In Spastic Cerebral Palsy
Abstract
Introduction-Increased muscular tone and resistance to movement, which restrictsfunctional mobility and independence, are hallmarks of spastic cerebral palsy (CP). The goals of several therapy approaches are to lessen stiffness and enhance motor results in people with spastic cerebral palsy. The effectiveness of Active-Assisted Range of Motion (AAROM) exercises combined with icing versus AAROM exercises paired with extended stretching in reducing spasticity in patients with spastic cerebral palsy is examined in this study.
Objectives of the Study:The objectives of this comparative study is to find out the effectiveness between the two intervention groups (AAROM with icing vs. AAROM with prolonged stretching) on muscle tone, joint flexibility, and spasticity reduction in calf region using the MAS,ROM,VAS.
Method: The research here is purely experimental. According to the study's inclusion and exclusion criteria, a total of 30 individuals were included, with the age range ranging from 5 to 15 years. The participants were split into two groups. One group was given AAROM exercises with ice, while the other group received AAROM activities with extended stretching for plantarflexors. Both groups were given these exercises three times a week for 45 minutes, and the results were measured after six weeks. Pre- and post-treatment assessments were conducted using ROM, MAS, and VAS. Result: We used paired and unpaired t-tests as well as an independent t-test for ROM, MAS, and VAS to examine the results. Both groups experience notable improvements, however the control group (GROUP B) that underwent AAROM exercise with extended stretching showed even more remarkable improvements in the value of the outcome measures (MAS score and VAS score) than the experimental group.
Conclusion: This study concludes that both the protocol reduces reduces pain, discomfort, improve mobility and reduces spasticity.But the results suggest that AAROM exercises with prolonged stretching is a more sustainable approach for managing spasticity and have given better effects than Group A.
References
2. Bottcher L. Children with spastic cerebral palsy, their cognitive functioning, and social participation: a review. Child neuropsychology. 2010 Apr 21;16(3):209-28.
3. Kulak W, Sobaniec W, Smigielska-Kuzia J, Kubas B, Walecki J. A comparison of spastic diplegic and tetraplegic cerebral palsy. Pediatric neurology. 2005 May 1;32(5):311-7.
4. Bovend'Eerdt TJ, Newman M, Barker K, Dawes H, Minelli C, Wade DT. The effects of stretching in spasticity: a systematic review. Archives of physical medicine and rehabilitation. 2008 Jul 1;89(7):1395-406.
5. Burridge JH, Wood DE, Hermens HJ, Voerman GE, Johnson GR, Wijck FV, Platz T, Gregoric M, Hitchcock R, Pandyan AD. Theoretical and methodological considerations in the measurement of spasticity. Disability and rehabilitation. 2005 Jan 1;27(1-2):69-80.
6. Haselkorn JK, Loomis S. Multiple sclerosis and spasticity. Physical Medicine and Rehabilitation Clinics. 2005 May 1;16(2):467-81.
7. Bakheit AM, Maynard V, Shaw S. The effects of isotonic and isokinetic muscle stretch on the excitability of the spinal alpha motor neurones in patients with muscle spasticity. European journal of neurology. 2005 Sep;12(9):719- 24.
8. Al-Zamil ZM, Hassan N, Hassan W. Reduction of elbow flexor and extensor spasticity following muscle stretch. Journal of Neurologic Rehabilitation. 1995 Sep;9(3):161-5
9. Quesada PJ, Lucas-Cuevas AG, Llana-Belloch S, Pérez-Soriano P. Effects of exercise in people with cerebral palsy. A review. Journal of Physical Education and Sport. 2014 Mar 1;14(1):36.
10. Mostafa MS, Al Bagoury M, Agamy AH, Mohamed GI, Hanafy AF. PROLONGED VERSUS BRIEF ICE APPLICATION FORSPASTICITY MODULATION INCHILDREN WITH SPASTIC HEMIPLEGIC CEREBRAL
PALSY (A RANDOMIZED CONTROLLED TRIAL). Turkish Journal of Physiotherapy and Rehabilitation.;32:3. dos Reis AL, de Oliveira LC, de Souza AY, Stabelini Neto A, de Oliveira RG. Effects of stretching on muscle strength, endurance, and power performance: a systematic review and meta-analysis. Isokinetics and Exercise Science. 2024(Preprint):1-7.
11. Pandyan A, Gregoric M, Barnes MP, Wood D, Wijck FV, Burridge J, Hermens H, Johnson GR. Spasticity: clinical perceptions, neurological realities and meaningful measurement. Disability and rehabilitation. 2005 Jan 1;27(1- 2):26.
12. Akanova AA, Issayeva RB, Lokshin VN, Zh SR, Myrzabekov GT. International definitions of cerebral palsies. Вестник Казахского Национального медицинского университета. 2018(2):101-6.
13. De Bruin M, Smeulders MJ, Kreulen M. Why is joint range of motion limited in patients with cerebral palsy?. Journal of Hand Surgery (European Volume). 2013 Jan;38(1):8-13.
14. Mutlu A, Livanelioglu A, Gunel MK. Reliability of Ashworth and Modified Ashworth scales in children with spastic cerebral palsy. BMC musculoskeletal disorders. 2008 Dec;9:1-8.
15. Mutlu A, Livanelioglu A, Gunel MK. Reliability of goniometric measurements in children with spastic cerebral palsy. Medical science monitor. 2007 Jul 1;13(7):CR323-9.
16. Pin T, Dyke P, Chan M. The effectiveness of passive stretching in children with cerebral palsy. Developmental medicine and child neurology. 2006 Oct;48 (10):855-62. 13
