الفهرس 
CEREBRAL PALSYOnly 14 pages are availabe for public view
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Abstract
C
erebral palsy (CP) is primarily a neuromotor disorder that affects the development of movement, muscle tone and posture. The underlying pathophysiology is an injury to the developing brain in the prenatal through neonatal period. Although the initial neuropathologic lesion is non-progressive, children with CP may develop a range of secondary conditions over time that will variably affect their functional abilities.
Prematurity and low birthweight are important risk factors for CP; however, multiple other factors have been associated with an increased risk for CP, including maternal infections, and multiple gestation.
The range of severity of condition may be from total dependency and immobility to abilities of talking, independent self-care and walking, running and other skills.
Jane ayers in 1972 defined sensory integration as “the neurological process that organizes sensation from one’s own body and from the environment and make it possible to use the body effectively within the environment”. Ayers focused her theory on the vestibular, proprioceptive and tactile systems.
Sensory integration signify to the process by which the brain organizes and interprets external stimuli such as touch, movement, body awareness, sight, sound, and gravity. it takes place in the brain and necessitates a delicate balance between the central and peripheral neural systems, as well as the excitatory and inhibitory neural systems
White matter lesions, which are found in 45 percent of children with CP, are one of the most important drivers of sensory abnormalities. the loss of white matter can have a negative impact on the development of cortical and thalamic areas, which are involved in sensory processing.
Children with adequate sensory integration of afferent impulses display adaptive behavior in daily tasks and meet the demands set by the environment. as a result, sensory integration that is appropriate increases functional performance.
The aim of the current study was to assess the effect of sensory integration therapy on gross motor function in CP children.
The present study included a total number of sixty five CP children with age range 3- 9 years. They were recruited from child psychiatry and rehabilitation clinics at Ain Shams university hospitals and faculty of post-graduate childhood rehabilitation center during the period of months starting from July 2020 to October 2021.
Gross motor function measurement 88 scale, Child sensory profile-2 scale, and modified Ashworth muscle spasticity scale were applied to all CP participants prior the start of the study.
The results showed significant improvement in gross motor function with its five aspects: 1)lying and rolling; 2)sitting; 3)crawling and kneeling; 4)standing; and 5)walking, running, and jumping after sensory integration therapy.
Additionally, Child sensory profile-2 domains have improved significantly after sensory integration therapy in all participants.
Moreover, muscle spasticity significantly decreased in all patients after sensory integration therapy.
The study showed a correlation between gross motor functions and sensory processing in which higher sensory profile scores meet with high scores of gross motor function scores.
In conclusion, the present study emphasized the important role of sensory integration therapy on improving the gross motor function of CP children, thus increases their functional mobility, activity and participation in their daily life.
The current study hoped to contribute an important step in clinical research to provide appropriate care and services to CP children. Moreover, we recommend sensory integration therapy training programs in management of CP children
CONCLUSION
T
he findings of the present study confirm the prior hypothesis of the positive effect of sensory integration therapy on gross motor functions in children with cerebral palsy. Results have showed that sensory integration therapy has significantly improved the five domains of GMFM-88 scale; 1) lying and rolling; 2)sitting; 3)crawling and kneeling; 4)standing; and 5)walking, running, and jumping. The study also emphasized on the sensory integration and processing deficits in those patients and how sensory integration therapy significantly improved the five aspects of child sensory profile.
Muscle spasticity is a cornerstone obstacle in cerebral palsy children that significantly alters functional mobility. According to the current study, sensory integration therapy showed significant decrease in muscle spasticity that aided in improving gross motor functions. Our results are in accordance with previous researches.
In conclusion, the contemporary study and its data integration opens the door for more work on this subject, and offers a promising direction for future clinical research innovations testing collections of sensory integration modalities related to management of cerebral palsy children to cover as many aspects as necessary in clinical and academic domains.
RECOMMENDATIONS
Implementation of sensory integration and processing evaluation and assessment strategies in management of cerebral palsy children.
Adequate professional training to clinicians dealing with children with cerebral palsy and other neurological disorders who may suffer from sensory processing disorders that may affects their gross motor functions and thus their functional mobility.
Evidence-based practices to cerebral palsy individuals with and without comorbid problems to improve their personal outcomes in their daily life activities.
Emphasizing the importance of sensory integration therapy in cerebral palsy children by health education and adequate training to occupational therapists and pediatric neurologists.
Specialized sensory integration therapy clinics and in-patients facilities for children with cerebral palsy under supervision of expert pediatric neurologists and occupational therapists.
Multidisciplinary approach in management of cerebral palsy children to reach the optimum benefits of medical, surgical, occupational, psychological and physical treatment