to investigate the effect of the reciprocal neuromuscular electrical stimulation on balance and quality of life in hemiparetic children
Neuromuscular Electrical Stimulation is widely used to reduce spasticity and strengthen weak muscles. Reciprocal electrical stimulation ( RES),which mimic natural agonist-antagonist muscle activation , is a promising too for neuromuscular re-education. RES has been studied for knee stability in diplegic CP and ankle control in adults but its effect on static and dynamic balance in hemiparetic CP remain unexplored . so this study may be a guide in management of balance problems in children with hemiparesis
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
Mode (A) is selected to apply reciprocal neuromuscular electrical stimulation
* neurodevelopmental approach directed toward inhibiting abnormal muscle tone and abnormal reflexes and facilitation of postural control through reflex inhibiting positions using proximal and distal key points of control. * training for active trunk extension to improve posture control and balance . * Balance training from different positions ,from the quadruped position, kneeling ,half kneeling and standing position on mat and tilting board. * facilitation of protective reactions by applying a fast and large amplitude of stimulus to train saving reactions from sitting on roll and also from standing position by pushing the child to encourage the child to take protective steps either forward , backward .or sideways to regain balance. * approximation as a proprioceptive training applied in a slow and rhythmic manner for the upper limbs ,lower limbs , and trunk to control spasticity and stimulate the joint mechanoreceptors from semi reclined and quadruped positions.
balance change measured by humac balance system
the ability to maintain a stable posture and preserve it in counter gravity position
Time frame: 3 monthes
quality of life change xby Egyptian quality of life questionnaire
change in social, psychological and physical domains
Time frame: 3 months
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