Effects Of Family Hip Postural Management On The Hip Development In Children With Spastic Cerebral Palsy

Objective To investigate the effects of family hip postural management on hip development in young children with spastic cerebral palsy.Methods 32 children with spastic bilateral cerebral palsy were selected,who received regular physical treatments in our hospital in December 2013 to October 2014 and were at 2~4 years old,classified at Level ?-? according to the Gross Motor Function Classification System(GMFCS).They were randomly divided into the control group and the experimental group according to a random number table.Both groups were given normal physical rehabilitation treatment,and the experimental group were also given family hip postural management included standing program with hip abduction and nightly sleeping program with hip abduction.Hip radiographs were measured with the migration percentage(MP),the acetabular index(AI)and the head-shaft angle(HSA)method at baseline and average 20 months(18~24 monthes)after the therapy,the MP value,AI value and HSA value in the two groups were compared.The distribution of degree of hip displacement classified by MP value werecompared between two groups at baseline and 18~24 months after the therapy.Results Patients in the experimental group were followed up for(20.06±1.57)months,average physical therapy courses were(13.66±2.22)times,Patients in the control group were followed up for(19.64±2.13)months,average physical therapy courses were(13.42±2.10)times.Before the treatment,there were no significant differences between the two groups in migration percentage value,acetabular index and(P>0.05).At 18~24months after the treatment,The migration percentage value in observation group was(20.96 ±6.35),in comparison to children in control group(29.78±9.38).(P<0.05),The acetabular index in observation group was(18.53±2.54),in comparison to children in control group(21.17±2.73).(P<0.05),The head-shaft angle in treatment group was(165.13 ±9.87),in comparison to children in control group(165.96±10.54)(P>0.05).The values of MP and AI in treatment group are both better than control group,but the value of HSA has no significant difference.The distribution of degree of hip displacement in the two groups has no significant differences at baseline,after therapy,the distribution of degree of hip displacement in experimental group was significantly better than control group.Conclusion Family hip postural management can reduce the degree of displacement and help developing more normal hip in young children with spastic cerebral palsy.