Effects of the standing program with hip abduction on hip acetabular development in children with spastic diplegia cerebral palsy

Lourdes Macias-Merlo, Caridad Bagur-Calafat, Montserrat Girabent-Farrés, Wayne Allan Stuberg

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: Early identification and intervention with conservative measures is important to help manage hip dysplasia in children with a high adductor and iliopsoas tone and delay in weight bearing. The effect of a daily standing program with hip abduction on hip acetabular development in ambulatory children with cerebral palsy was studied. Method: The participants were 26 children with spastic diplegia cerebral palsy (CP), classified at Level III according to the Gross Motor Function Classification System (GMFCS). Thirteen children stood with hip abduction at least 1 h daily from 12 to 14 months of age to 5 years with an individually fabricated standing frame with hip abduction. Results: At the age of 5 years, radiologic results of the study group were compared with a comparison group of 13 children with spastic diplegia CP who had not taken part in a standing program. The migration percentage in all children who stood with abduction remained within stable limits (13-23%) at 5 years of age, in comparison to children who did not stand in abduction (12-47%) (p < 0.01). Conclusions: The results indicate that a daily standing program with hip abduction in the first 5 years may enhance acetabular development in ambulatory children with spastic diplegia CP.Implications for RehabilitationAbnormal acetabular development is a problem related to mobility problems and spasticity muscles around the hip.The literature suggests that postural management and standing programs could reduce levels of hip subluxation and increase function in children with cerebral palsy.A standing program with hip abduction can be a beneficial to develop more stable hips in children with spastic diplegic GMFCS level III.

Original languageEnglish (US)
Pages (from-to)1075-1081
Number of pages7
JournalDisability and Rehabilitation
Volume38
Issue number11
DOIs
StatePublished - May 21 2016

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Child Development
Hip
Muscle Spasticity
Cerebral Palsy
Cerebral palsy, spastic, diplegic
Hip Dislocation
Weight-Bearing

Keywords

  • Cerebral palsy
  • Hip dislocation/prevention
  • Postural management
  • Standing program

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Effects of the standing program with hip abduction on hip acetabular development in children with spastic diplegia cerebral palsy. / Macias-Merlo, Lourdes; Bagur-Calafat, Caridad; Girabent-Farrés, Montserrat; Stuberg, Wayne Allan.

In: Disability and Rehabilitation, Vol. 38, No. 11, 21.05.2016, p. 1075-1081.

Research output: Contribution to journalArticle

Macias-Merlo, Lourdes ; Bagur-Calafat, Caridad ; Girabent-Farrés, Montserrat ; Stuberg, Wayne Allan. / Effects of the standing program with hip abduction on hip acetabular development in children with spastic diplegia cerebral palsy. In: Disability and Rehabilitation. 2016 ; Vol. 38, No. 11. pp. 1075-1081.
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abstract = "Purpose: Early identification and intervention with conservative measures is important to help manage hip dysplasia in children with a high adductor and iliopsoas tone and delay in weight bearing. The effect of a daily standing program with hip abduction on hip acetabular development in ambulatory children with cerebral palsy was studied. Method: The participants were 26 children with spastic diplegia cerebral palsy (CP), classified at Level III according to the Gross Motor Function Classification System (GMFCS). Thirteen children stood with hip abduction at least 1 h daily from 12 to 14 months of age to 5 years with an individually fabricated standing frame with hip abduction. Results: At the age of 5 years, radiologic results of the study group were compared with a comparison group of 13 children with spastic diplegia CP who had not taken part in a standing program. The migration percentage in all children who stood with abduction remained within stable limits (13-23{\%}) at 5 years of age, in comparison to children who did not stand in abduction (12-47{\%}) (p < 0.01). Conclusions: The results indicate that a daily standing program with hip abduction in the first 5 years may enhance acetabular development in ambulatory children with spastic diplegia CP.Implications for RehabilitationAbnormal acetabular development is a problem related to mobility problems and spasticity muscles around the hip.The literature suggests that postural management and standing programs could reduce levels of hip subluxation and increase function in children with cerebral palsy.A standing program with hip abduction can be a beneficial to develop more stable hips in children with spastic diplegic GMFCS level III.",
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