comparison between Rood inhibitory approach and Bobath Reflex inhibiting pattern to improve Gross motor function and reduce spasticity in hemiplegic children of encephalitis
This study will be conducted with an aim of comparing the effects of Rood (Inhibitory) approach and Bobath (Reflex Inhibiting pattern) to reduce spasticity and improve Gross motor Functional Movements in Hemiplegic Children of Encephalitis.
Design
Randomized clinical design
Settings and conduct
1)children hospital faisalabad
2)Gernal hospital Ghulam Muhammada bad faisalbad
Participants/Inclusion and exclusion criteria
N=22 (through epitool, sample size to estimate a simple proportion, apparent prevalence)
Patients who agree to give consent will be screened according to set inclusion and exclusion criteria. Patients who meet the eligibility criteria will be enrolled in the study. Patients recruited in the study will be randomly allocated into treatment A (n=11) and treatment B (n=11) groups.
Inclusion Criteria:
1. Both gender
2. Hemiplegic Spastic Encephalitis Children
3. Age should be between 2 year to 15 years
4. Spasticity of grade 1 to 3 through Modified Ashworth Scale
5. Chronic Encephalitis children
6. Written Informed Consent.
Exclusion Criteria:
1. Spasticity because of any other disease e.g. CP and stroke etc
2. Children having fits and tremors and any red flag sign
3. Children taking any other physical therapy treatment during this study
4. Severe Mental Retardation, Contractures, Decrease Tone
5. Tumor, fractures and any other severe infections
6. Red flag signs that may indicate cauda equina syndrome, such as bladder and bowel Dysfunction and
saddle anesthesia
7. History of spinal surgery
Intervention groups
Group 1:Rood inhibitory approach
Group 2:Bobath reflex inhibiting pattern
comparison between Rood inhibitory approach and Bobath Reflex inhibiting pattern to improve Gross motor function and reduce spasticity in hemiplegic children of encephalitis
Public title
comparison between Rood inhibitory approach and Bobath Reflex inhibiting pattern to improve Gross motor function and reduce spasticity in hemiplegic children of encephalitis
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Both gender
Hemiplegic Spastic Encephalitis Children
Age should be between 2 year to 15 years
Spasticity of grade 1 to 3 through Modified Ashworth Scale
Written Informed Consent.
Chronic Encephalitis children
Exclusion criteria:
Spasticity because of any other disease e.g. CP and stroke etc
Children having fits and tremors and any red flag sign
Children taking any other physical therapy treatment during this study
Severe Mental Retardation, Contractures, Decrease Tone
Tumor, fractures and any other severe infections
Red flag signs that may indicate cauda equina syndrome, such as bladder and bowel Dysfunction and saddle anesthesia
History of spinal surgery
Age
From 5 years old to 15 years old
Gender
Both
Phase
3
Groups that have been masked
Participant
Sample size
Target sample size:
30
More than 1 sample in each individual
Number of samples in each individual:
15
In this study have two groups so total sample size is 30 and in each group have 15 sample size
Randomization (investigator's opinion)
Randomized
Randomization description
Non-probability purposive sampling technique will be utilized to collect sample and the sample will be allocated to treatment group 1 and 2 by using lottery method.Screening of population will be done by using, selected inclusion and exclusion criteria.Lottery method basically is a chit and draw method during allocation make the chits and than said the patients that please collect any one chit than enrolled the patient in respective group.In a chit-pull system, a number of chits is first placed in a container (often a bag or cup). ... In the course of the game, chits are drawn randomly out of this container, triggering certain game effects. This is essentially just another way of producing random results.Patients who met the eligibility criteria will be enrolled in the study.During randomization patients fully blinded than allocate the patients into treatment group 1(Rood inhibitory approach) and treatment group
2(Bobath reflex inhibiting pattern).
Blinding (investigator's opinion)
Single blinded
Blinding description
Patients will be kept blind through allocation concealment to treatment groups.Patients will be unaware of their respective group treatment plans.Patients who met the eligibility criteria will be enrolled in the study.During randomization patients fully blinded than allocate the patients into treatment group 1(Rood inhibitory approach) and treatment group 2(Bobath reflex inhibiting pattern).Basically blinding in research prevent biasness in the study.Patients will be fully unknown about the allocation procedure because used lottery method for allocation of the patients.
Encephalitis is defined as inflamation of brain caused by any viral and bacterial infection but in different researches cause of encephalitis is unknown due to encephalitis patients present with the symptoms of fever,vomiting,headach,spasticity,muscle weakness etc.
ICD-10 code
G04.90
ICD-10 code description
Encephalitis and encephalomyelitis, unspecified
Primary outcomes
1
Description
Gross motor functional scale will use to measure the Gross motor functions and it is a primary outcome measure scale
Timepoint
two times reading will be measure before treatment and after the treatment session in last follow up
Method of measurement
Gross motor functional scale will be utilized to asses the gross motor functional movements
Secondary outcomes
1
Description
Secondary outcome measure of this study will be Modified Ashworth scale.Modified ashworth scale will be used to measure the spasticity
Timepoint
Reading will be measure before treatment session and after 1st follow up,2nd follow up,3rd follow up,4th follow up and in last follow up each reading will be taken after 15 days of treatment in alternative days
Method of measurement
Modified Ashworth scale will be used to measure the spasticity
Intervention groups
1
Description
Intervention group 1:Rood Inhibitory Approach will be receive of group 1 in alternatives days for 4 month duration after the approval of synopsis.•After allocation to treatment Group A and B, level of spasticity will be recorded using modified Ashworth Scale.•GMFM-88 and GMFM-66 scale will also be used to record the improvement of Gross Motor Functional Movements.•Measurement will also be recorded pretreatment.•First reading will be taken on baseline before treatment session•Each reading was taken after the treatment session of 15 days •Data will be collected before treatment and after 2, 4 and 6 weeks of intervention.•Infrared: On baseline for 15 min.•Rood (Inhibitory): Group 1 will be receiving Rolling, Shaking, Slow joint compression, Maintain stretch for 30 mints in alternative days. .Rood inhibitory approach basically is generally accepted.This approach is used to homogenize the muscle tone,correcting the body postures,positioning and improve gross motor functions. Basically its a stretching and specialized method of handling.
Category
Rehabilitation
2
Description
Intervention group 2: Bobath reflex inhibiting patterns technique will be apply in group 2 patients in alternatives days for 4 month duration after the approval of synopsis.•After allocation to treatment Group A and B, level of spasticity will recorded using modified Ashworth Scale.•GMFM-88 and GMFM-66 scale will also be used to record the improvement of Gross Motor Functional Movements.•Measurement will also be recorded pretreatment.•First reading will taken on baseline before treatment session•Each reading will taken after the treatment session of 15 days• Data will be collected before treatment and after 2, 4 and 6 weeks of intervention.Group 2 will be received infrared on baseline for 15 minutes and bobath reflex inhibiting pattern in which traction and light joint compression will be receive for 30 minutes in alternative days. Bobath reflex inhibiting pattern and posture also called tone influencing pattern and postures includes spasticity inhibiting position and postures so the person can move his body parts by his/her on wil. This make the person independent in his daily activities.When the stimulation is given in inhibitory postures than the chance in increase spasticity decrease rapidly.