Original Research Article
Year: 2022 | Month: June | Volume: 12 | Issue: 6 | Pages: 36-49
DOI: https://doi.org/10.52403/ijhsr.20220606
The Effect of Selective Voluntary Motor Control Training of Lower Limb on Gait and Activities of Daily Living of Children with Spastic Cerebral Palsy: Randomized Controlled Trial
Sonal Mahendra Kumar Sharma1, Usha Udhay Kasar2
1Master of Occupational Therapy, Occupational Therapy School & Centre, Seth G.S. Medical College & KEMH, Mumbai, Maharashtra, India.
2Assistant Professor, Occupational Therapy School & Centre, Seth G.S. Medical College & KEMH,
Mumbai, Maharashtra, India.
Corresponding Author: Dr. Sonal Mahendra Kumar Sharma
ABSTRACT
Context: Voluntary movement is produced by the corticospinal tracts. Injury to CST (periventricular white matter) leads to motor disability in Cerebral Palsy (CP). Selective Voluntary Motor Control is vital for efficient locomotion & functional activities.
Aims: To find the efficacy of improving Selective Voluntary Motor Control of the Lower limb on Gait and Activities of Daily Living children (ADL) with spastic Cerebral Palsy.
Settings and Design: Occupational Therapy Department of Tertiary Health Care Centre, Prospective, Interventional, Comparative, Single-blinded, Randomized Control Trial.
Methods and Material: 32 CP children were ethically recruited and using a simple random sampling method were divided into 2 groups. Each subject was assessed using standardized tools: Modified Ashworth scale (MAS), Selective Control Assessment of Lower Extremity (SCALE), Observational Gait Scale (OGS), Wee-Functional independence measure (Wee-fim), Case-Record Form on day 1, 30th, and 60th.
Statistical analysis used: Data were entered using MS-EXCEL Office 365, SPSS Statistical Software version 23.0 was used for data analysis and non-parametric tests of significance were used. Results: 28 Subjects completed the study. Post-intervention SCALE and OGS scores showed a positive correlation in the Control group(r2=0.104) and the Experimental group(r2=0.244). From baseline-day 60 SCALE and Wee-fim showed a correlation r2=0.463-0.022 in the Experimental group and r2=0.426-0.051 in the Control group. Overall, the experimental group showed better improvement in gait and ADL than the control group.
Conclusions: SVMC training of the lower limb was effective & has a positive impact on the performance of Gait. Thus, it improves functional independence.
Key Messages: Understanding the influence of impaired Selective Voluntary Motor Control helps Occupational Therapists in being an important part of decision-making regarding therapeutic problem solving, splint prescription, muscle selection for Botox, muscle transfers, and surgery in a multidisciplinary team of rehabilitation.
Key words: Activities of Daily Living, Cerebral palsy, Gait, Selective motor control.