Wednesday, May 26, 2010

Effects of Standing Programs on Walking in Children with CP

Physical and Occupational Therapy in Pediatrics published research on the effects of prolonged standing on the walking patterns of children with cerebral palsy. Six children with spastic cerebral palsy (Gross Motor Function Classification Levels II and III) participated in this study over a period of 9 weeks. The first three weeks the children received physical therapy. The second three weeks the children received physical therapy and prolonged periods of standing, 3x per week. The last three weeks the children received only physical therapy again. Before and after each 3 week phase, gait analysis and spasticity assessment was performed. The results indicated that after the middle three week period with prolonged standing, testing showed a significant difference in improvements noted in the following areas: stride length, gait speed, stride time, stance phase time, double support time, muscle tone, and peak dorsiflexion angle during midstance. These results were not sustained when tested again 3 weeks later. The researchers recommend additional research with larger sample size and to establish specific duration and frequency of the standing program.

Reference: Yasser Salem‌ Venita Lovelace-Chandler‌ Reta J. Zabel‌ Amy Gross McMillan‌ Effects of Prolonged Standing on Gait in Children with Spastic Cerebral Palsy Physical & Occupational Therapy in Pediatrics February 2010, Vol. 30, No. 1, Pages 54-65

2 comments:

TherExtras said...

Thanks for bringing this to the fore, Margaret. I cannot help but own-up to believing (one of) the authors and journal credible. This is why I write (repeatedly) trust who you believe (i.e. if you believe it you are trusting who told you). Venita is a trusted therapist-researcher.

This study affirms what I believe also regarding the benefits of standing for mitigating the orthopedic consequences of neural impairment through stretching and exercise. Standing is exercise in small ROMs.

Yet, small n precludes extrapolating the results. I can't help but wonder...if standing was shown (statistically in research) to increase the length and strength of muscles in children w/ CP - standing would be recognized as exercise and gain all the credibility of the effects of exercise already verified by research. No? Must also point-out how incredibly labor intensive it is to take data on gait.

As much as I LOVE our dialogues here, where is everyone else?! I would sure like to see more comments on this excellent blog!

Barbara

Your Therapy Source Inc said...

Good question to ponder about standing as exercise. I would agree that children are definitly working in small ranges while standing, no doubt about it. Contracting and relaxing many different muscles at different times. I have never seen standing to be a totally static posture. Just like I must work my muscles in standing to have good posture (which I don't but wish I did).

I wish more therapists would comment. Not sure why they don't. Thousands of people read the blog based on web statistics. I have had this discussion before with other therapists who blog. It is my opinion, that some therapists are not very verbose when it comes to offering an opinion on treatment techniques unless they are very well versed in the topic. Just my personal opinion.