Effect Of Appropriate Assistive Device On Rehabilitation Of Children With Cerebral Palsy Under Icf Framework

Objective: To study the role and duration of application of assistive devices in children with cerebral palsy (CP). Methods: We randomly assigned forty-five children with dyskinetic CP: (1) no sitting chair group (DN group, fifteen children); (2) 1-3 hours of daily chair sitting group (DA group, fifteen children); and (3) 4-6 hours of daily chair sitting group (DB group, fifteen children). After six months of regular rehabilitation, both gross motor skills and fine motor skills were evaluated and compared. Additionally, we randomly assigned one hundred and twenty children with spastic CP who received walking training to the following groups: (1) no ankle-foot orthosis (AFO) wearing group (SN group, forty children); (2) 1-3 hours of daily AFO wearing group (SA group, forty children); (3) 4-6 hours of daily AFO wearing group (SB group, forty children). After six months of regular rehabilitation, both gross motor skills and fine motor skills were evaluated and compared. Results: The application of the sitting chair improved the gross motor function of children with dyskinetic CP. In addition, application of the assistive device improved fine motor activities. The ability Gross Motor Function Measure 66 (GMFM-66) Area II score of children from group DB was significantly higher than that of children from group DA (55.70 +/- 2.58 vs. 40.89 +/- 2.64, P < 0.05). Moreover, the ability Fine Motor Function Measure (FMFM) score of children from group DB was significantly higher than that of children from group DA (35.80 +/- 0.73 vs. 32.49 +/- 0.64, P < 0.05). Wearing AFO could improve the walking ability in children with spastic CP. In addition, it improved fine motor activities. The ability GMFM-66 Area II score of children from group SB was 63.45 +/- 2.66, while that of children from group SA was 59.22 +/- 2.71 (P < 0.05). The ability FMFM score of children from group SB was 47.28 +/- 2.31, while that of children from group SA was 44.01 +/- 2.30 (P < 0.05). Conclusion: Appropriate daily use of assistive devices has a great effect on the motor function and fine motor activity of children with CP. It further expands the children's range of movement and improves their social participation, in accordance to the idea of rehabilitation under ICF-CY framework.