The Treatment Of Continuous Passive Motion On Talipes Valgus In The Older Children With Cerebral Palsy

Objective To observe the treatment of continuous passive motion(CPM) on talipes valgus in the children with cerebral palsy.Methods There were 57 younger children and 65 older children in this research including normal group and valgus group. The children in valgus group were randomly divided into control group, non- CPM group and CPM group. The CPM group received conventional rehabilitation and CPM therapy. The non-CPM group received conventional rehabilitation treatment. The control group didn’t receive any rehabilitation treatment. Evaluate the children in normal group with plantar pressure analysis and Gross motor function measure(only “STAND” item and “RUN WALK JUMP” item). And evaluate each patient before treatment and four months after treatment with plantar pressure analysis and Gross motor function measure(only “STAND” item and “RUN WALK JUMP” item). Two months after treatment, the children in the CPM group and the non-CPM group were also evaluated.Results Compared with the normal group, the percentage of medial midfoot(MMF) pressure, HEEL pressure, initial contact phase(ICP) and forefoot contact phase(FFCP) was obviously higher in valgus groups. On the other hand, the percentage of lateral forefoot(LFF) pressure, lateral midfoot(LMF) pressure and foot flat phase(FFP) was obviously lower in valgus groups(P<0.05). In the younger group, there was an obvious change in control group using GMFM-88 after treatment(P<0.05); The percentage of MMF pressure, and FFP became lower after treatment in both CPM group andnon-CPM group(P<0.05), and the percentage of ICP and FFCP became higher while “STAND” item scores and “RUN WALK JUMP” item scores both increased obviously(P<0.05). Group comparison trend display: In CPM group there was a more obvious change with the change trend of the percentage of MMF pressure and ICP+FFCP compared with non-CPM group(P<0.05); the higher trend of “STAND” item scores is more obvious than non-CPM group(P<0.05). Group comparison display: In CPM group there was a more obvious change with the percentage of MMF pressure, the percentage of ICP+FFCP, the percentage of FFP and “STAND” item scores compared with non-CPM group after 2 months ago(P<0.05) while there was a more obvious change with the percentage of MMF pressure, the percentage of ICP+FFCP, the percentage of FFP, “STAND” item scores and “RUN WALK JUMP” item scores compared with non-CPM group after 4 months ago(P<0.05). In the older group, the numerical change in the control group has no statistical significance before and after treatment(P>0.05). The percentage of MMF pressure, and FFP became lower after treatment in both CPM group and non-CPM group while the percentage of ICP and FFCP became higher(P<0.05). In addition, there was a significant change between therapeutic outcome in the CPM and the non-CPM group using GMFM-88(only “STAND” item and “RUN WALK JUMP” item). Group comparison trend display: In CPM group, the change trend of the percentage of MMF pressure and ICP+FFCP has no statistical significance compared with non-CPM group(P>0.05) while the percentage of FFP has statistically significant difference(P<0.05); and the higher trend of “STAND” item scores is more obvious than non-CPM group(P<0.05). Group comparison display: In CPM group, there was a more obvious change with the percentage of MMF pressure, the percentage of ICP+FFCP, the percentage of FFP, “STAND” item scores and “RUN WALK JUMP” item scores compared with non-CPM group after 4 months ago(P<0.05) while there was a more obvious change with the percentage of ICP+FFCP, the percentage of FFP and “RUN WALK JUMP” item scores after 2 months ago(P<0.05).Conclusion Using CPM can induce the development of the foot bone in the right structure, and alleviate muscle spasms and contracture and further more improve the arch collapse, then improve gait of patients with cerebral palsy; Traditional rehabilitation therapy for the treatment of talipes valgus in the children with cerebral palsy has curative effect, but combined with continuous passive motion therapy can more effectively improve talipes valgus; Early detection and early treatment are the key to treat talipes valgus in the children with cerebral palsy; Preliminary understanding the earlier treatment with CPM, curative effect is more significant for talipes valgus in the children with cerebral palsy, but if we get the real data of group comparison trend between the younger CPM group and the older CPM group(we did’t get it yet), we can more clear this conclusion.