Rehabilitation Management of Spastic Diplegic CP child with Ambulation Dysfunction.

Abstract

Rehabilitation management of spastic diplegic cerebral palsy child with ambulation dysfunction.  To determine the role of physical therapy and corrective surgery in improving the functional status of walking in spastic diplegia. Outpatient physical medicine and rehabilitation clinic of the Children’s Hospital, Ferozepure Road, Lahore.  Fifty children with spastic diplegia presenting over a 9 months period.  A prospective descriptive study of spastic diplegic children presenting with delay or difficulty in walking during a 10 months period (from June-2000 to March-2001). They were assessed and categorized from level (I to V) according to the Gross Motor Functional Classification Scale. The children underwent a rehabilitation program comprising of physiotherapy and bracing alone or corrective surgery with pre and postoperative physiotherapy and bracing. The patients were regularly followed up a monthly basis to assess the rehabilitation management and functional improvement in ambulation. Result showed that 36(72%) of the children improved I to II level higher than their presenting ambulatory status. Of these 2(4%) improved from level (V to 111), 9(18%) from level (V to 1V), 19(38%) from level (IV to III) and 6(12%) from level (III to 11, 14(28%) of the total cases showed no improvement in their functional status. These finding suggest that the functional level of ambulation in spastic diplegic cerebral palsy children can be improved with proper rehabilitation management.