Postural control in children with hemiparetic cerebral palsy: a Bobath Concept approach supplemented by a home-based bimanual activities program

Abstract

Aim: To assess postural control in children with hemiparetic cerebral palsy after a 12-week Physiotherapy intervention program, based on the Bobath Concept and supplemented by a home-based bimanual activities program. Methods: The final sample was composed by 4 children with hemiparesis, and for each one of them two evaluation moments was considered, before and after the application of the intervention program. In both moments, a pressure platform and the Kinovea® software were used in order to analyze kinematic parameters regarding both cervical and trunk’s orientation and the behavior of pressure distribution while performing three functional activities (gait initiation, pick up a box, sit-to-stand) for all four children included in this study. Additionally, the Gross Motor Function Measure, the 30’’ Sit to stand and the Timed Up and Go tests were also applied to the children in question. Results: At the end of the 12-week intervention program, a more suitable scapular and hemi trunks’ orientation was verified, consistent with a decrease of compensatory strategies. In addition, a more symmetric load distribution was verified, as well as a modification of behavior, activity, and function of the contralesional upper limb. Conclusion: The obtained results suggest that a 12-week Physiotherapy intervention program based on the Bobath Concept and supplemented by a home-based bimanual activities program was able to modify not only trunk’s orientation, associated to the reduction of compensatory strategies, but also load distribution, that became more symmetric, suggesting a better pelvis and lower trunk’s stability.