EFFECT OF PILATES ON MOVEMENT PATTERNS, BALANCE AND FATIGUE LEVEL IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY

Abstract

Purpose: Children with cerebral palsy (CP) exhibit varying degrees of impairments that affect the patient’s mobility and ability to perform activities of daily living. It restricts the patient’s capacity to stay balanced and increase energy expenditure. Although the benefits of regular exercise for patients with CP are known, there is a need for more studies, which deal with the effects of different exercise approaches in them. Therefore, the aim of the present study is to investigate the effects of Pilates on sit-to-stand (STS) movement patterns, balance and fatigue in ambulatory children with CP. Methods: Present study was a randomised controlled trial which was conducted at the Ved Special School, Sampoorna Special School, Abhyaas Special School in Delhi and the SGT Medical College Hospital and Research Institute in Gurugram, Haryana from October 2022 to March 2023. Thirty-two children (7-12 years) with spastic diplegic CP and Gross Motor Function Classification System I and II were randomly assigned into two groups. The study group underwent pilates and conventional treatment and the control group received conventional treatment alone. Images of the subjects’ STS movement pattern were shot from the side through a camera, and 15 items were used to assess the condition of the subjects’ extremities. Balance and fatigue were measured with Pediatric Balance Scale and Modified Borg Scale respectively at baseline, 4th week and 8th week. Results: Significant improvements were observed in STS movement pattern in the pilates group. Significantly, greater improvements were also observed for other variables such as balance and fatigue (p<0.001) in response to adding pilates exercise program to conventional treatment versus conventional treatment alone. Conclusion: Children with diplegic CP benefit more from pilates exercises in addition to conventional therapy when it comes to improving their functional movements and fatigue than from conventional therapy alone.

Keywords

• Balance
• Cerebral palsy
• Fatigue
• Pilates
• Spasticity

PİLATES’İN SPASTİK DİPLEJİK SEREBRAL PALSİLİ ÇOCUKLARDA HAREKET DÜZENLERİ, DENGE VE YORGUNLUK DÜZEYİ ÜZERİNE ETKİSİ

Öz

Amaç: Serebral palsili (SP) çocuklarda, hareket kabiliyetini ve günlük yaşam aktivitelerini yerine getirme becerisini etkileyen farklı derecelerde bozukluklar görülmektedir. Bu durum, hastanın dengede kalma kapasitesini kısıtlamakta ve enerji harcamasını artırmaktadır. SP’li bireylerde düzenli egzersizin faydaları bilinmesine rağmen, farklı egzersiz yaklaşımlarının etkilerini ele alan daha fazla çalışmaya ihtiyaç vardır. Bu nedenle, bu çalışmanın amacı, ayaktan tedavi gören SP’li çocuklarda Pilates’in otur-kalk (STS) hareket paternleri, denge ve yorgunluk üzerindeki etkilerini araştırmaktır. Yöntem: Bu çalışma, Ekim 2022’den Mart 2023’e kadar Delhi’deki Ved Özel Okulu, Sampoorna Özel Okulu, Abhyaas Özel Okulu ve Gurugram, Haryana’daki SGT Tıp Koleji Hastanesi ve Araştırma Enstitüsü’nde gerçekleştirilen randomize kontrollü bir araştırmadır. Spastik diplejik SP’li ve Kaba Motor Fonksiyon Sınıflandırma Sistemi I ve II düzeyinde olan otuz iki çocuk (7–12 yaş) rastgele iki gruba ayrılmıştır. Çalışma grubuna pilates egzersizleri ve konvansiyonel tedavi, kontrol grubuna ise yalnızca konvansiyonel tedavi uygulanmıştır. Deneklerin STS hareket paternleri bir kamera aracılığıyla yandan kaydedilmiş ve ekstremitelerin durumunu değerlendirmek için 15 madde kullanılmıştır. Denge ve yorgunluk, sırasıyla başlangıçta, 4. haftada ve 8. haftada Pediatrik Denge Ölçeği ve Modifiye Borg Ölçeği ile ölçülmüştür. Bulgular: Pilates grubunda STS hareket paterninde anlamlı iyileşmeler gözlenmiştir. Ayrıca, konvansiyonel tedaviye pilates egzersiz programının eklenmesiyle, yalnızca konvansiyonel tedaviye kıyasla denge ve yorgunluk gibi diğer değişkenlerde de daha belirgin iyileşmeler elde edilmiştir (p<0,001). Sonuç: Diplejik SP’li çocuklar, fonksiyonel hareketlerini geliştirme ve yorgunluğu azaltma açısından yalnızca konvansiyonel terapiye göre, pilates egzersizlerinin de dahil edildiği tedavilerden daha fazla yarar sağlamaktadır.

Anahtar Kelimeler

• Denge
• Serebral palsi
• Yorgunluk
• Pilates
• Spastisite

Kaynakça

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