Integrated effect of treadmill training combined with dynamic ankle foot orthosis on balance in children with hemiplegic cerebral palsy

Background and purpose: Maintaining balance is a necessary requirement for most human actions. Most cerebral palsy children, who constitute a large portion in our country, continue to evidence deficits in balance, co-ordination, and gait throughout childhood. So, the purpose of this study was to determine the combined effects of treadmill and dynamic ankle foot orthosis on balance in spastic hemiplegic children. Subjects and methods: Thirty spastic hemiplegic children from both sexes ranging in age from 7 to 11 years represented the sample of the study. The degree of spasticity ranged from 1 to 1+ according to the Modified Ashworth Scale. They were assigned randomly into two groups of equal number (A and B). Each child in the two groups was evaluated before and after 3 months of treatment for detecting the level of lower limb performance using the Peabody Developmental Test of Motor Proficiency and Stability indices using Biodex instrument system. Both groups received a designed physical therapy program for treatment of hemiplegic cerebral palsy children for 60 min, in addition group B received treadmill training with dynamic ankle foot orthoses for 30 min. Results: Significant improvements were observed in all measuring variables when comparing the pre and post-in the same group. Comparing the post-treatment variables, significant difference is revealed in favor of the group (B). Conclusion: The obtained results strongly support the combined effect of dynamic AFO with treadmill training as an additional procedure to the treatment program of hemiplegic cerebral palsy children