“THE EFFECTS OF RADIAL EXTRACORPOREAL SHOCKWAVE THERAPY AND ANTIGRAVITY TREADMILL TRAINING ON DYNAMIC BALANCE IN INDIVIDUALS WITH SPASTIC CEREBRAL PALSY”

Abstract

BACKGROUND: Spasticity is the most common motor problem in cerebral palsy (CP), and its treatment is difficult, offering a considerable challenge to the rehabilitation team. Radial extracorporeal shock wave therapy (rESWT) has developed in recent years as an effective, non-invasive, and low-risk option for managing spasticity in CP patients, with very mild side effects such as small bruises or soreness during administration. Most of the children with cerebral palsy (CP) are not able to walk or can walk in incorrect pattern and are dependent on assistive devices. Recently an antigravity treadmill has been found to be beneficial as a new therapeutic approach. Thus, the study is done to investigate the effects of antigravity treadmill training (AlterG) along with radial extracorporeal shockwave therapy (rESWT) in improving dynamic balance in spastic cerebral palsy.

OBJECTIVE: The purpose of this study is to determine whether prolonging the duration between rESWT sessions could help patients with CP benefit from therapy for prolonged spasticity. Furthermore, how antigravity treadmill training helps cerebral palsy sufferers with their walking, balance, and fall prevention.

 METHODOLOGY: 30 patients will be included in the study. Enrolment is based upon inclusion/exclusion criteria. Participants will be randomized in 2 groups. GROUP A: (experimental group) Each patient will receive 2000 impulses in the Triceps Sural muscle (distributed by all the plantar flexor muscles: soleus and gastrocnemius), at a 2.2 Bars pressure and a frequency of 8 Hz. There will be a 3-week gap between each session. They also underwent antigravity treadmill training (20 minutes per day, three days per week) in addition to conventional physical treatment throughout the course of three months.    GROUP B: (control group) received only traditional physical therapy such as stretching their spastic lower limb muscles, range of motion exercises, strengthening exercises, constraint-induced movement therapy (CIMT), and gait training on parallel bars and treadmill. Outcomes as Muscle tone and Dynamic balance were measured at baseline and after 6 months and 2 weeks of intervention.

 RESULT: Radial extracorporeal shockwave and antigravity treadmill training improve the dynamic balance of children with spastic cerebral palsy

CONCLUSION: Shock wave therapy could serve as an effective method for diminishing spasticity, enhancing the ability to isolate and manage movement, and thereby, promoting better balance and gross motor skills in children with unilateral cerebral palsy. The clinical significance is that Antigravity treadmill training may be viewed as a therapeutic approach for achieving a lasting enhancement in postural stability for children with spastic cerebral palsy.