Short Term Effect of Knee-to-Chest Position Plus 90-90 Passive-Hamstring-Stretching Versus 90-90 Passive-Hamstring-Stretching in5-15 Years of Spastic Cerebral Palsy: Non-Randomized Controlled Study

Abhijeet A. Deshmukh¹ , Vidya Krishnaswamy² , Maneesha S. Deshpande³

Section:Research Paper, Product Type: Journal-Paper
Vol.7 , Issue.8 , pp.31-37, Aug-2021

Online published on Aug 31, 2021

Copyright © Abhijeet A. Deshmukh, Vidya Krishnaswamy, Maneesha S. Deshpande . This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
 

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Abstract :
Background: In children with cerebral palsy(spastic diplegia/ quadriplegia), commonly has lower limb hamstring muscle tightness. Hamstrings tightness seen to various degree of tightness in these children. Hamstring tightness is determined by knee extension deficit(KED). The present study evaluated whether both proximal and distal ends of hamstrings stretching will prove better/more effective than alone stretching distal end of hamstring in full range. Hence, knee to chest position component addition to 90-90 hamstring stretch passively may enhances the hamstring flexibility. Methods:Total 19 cerebral palsy children of 5-15 years of both gender with bilateral hamstring tightness(more than 20 degrees) were included. on every participant, application of 90-90 hamstrings passive stretch was applied (60 seconds) to the left leg, whereas knee towards chest position (30 seconds) plus passive 90-90 hamstring-stretching(30 seconds) was performed to the right lower limb. KED angle and angle of spasticity was recorded by using knee extension test(actively) and modified Tardieu scale(MTS) respectively before and after completion of stretching procedure on either side using universal goniometer. Results:Statistically paired t-test was used. The mean hamstring angle of tightness before stretching was 38.95degrees on both sides, with KED to 18.42degrees on right side and on left side (control side) reduced to 11.06degrees. The mean change in spasticity angle on MTS on right side was 30degrees whereas on left side mean was 23.68degrees, suggestive of right side was more significant than left side. Conclusion:The 90-90 passive-hamstring-stretching technique plus knee towards chest position found more effective in hamstring flexibility than passive 90-90 hamstring stretching alone in spastic cerebral palsy children.

Key-Words / Index Term :
Cerebral palsy, Hamstring stretching, Knee extension deficit, Active knee extension test, spasticity, Modified Ashwarth’s scale.

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