Effect of different stretching techniques on balance and functionality in children with cerebral palsy

The aim of this study is to investigate the effect of different stretching techniques on balance and function in children with Cerebral Palsy (CP). 16 children who were admitted to diagnosed with CP and had hip flexor contracture between the ages of 8-16 years. Hip flexor shortening (Thomas Test), spasticity severity (Modified Ashworth Scale), balance (Berg Balance Scale) and gait (1-Minute Walk Test), function (Gilette Functional Gait Assessment Questionnaire) were evaluated. GMFCS levels of the children, 4 children were Level I, 2 children were Level II, and 2 children were Level III in the PNF stretching group. In the static stretching group, 6 children were Level I and 2 children were Level III. According to the intragroup comparison results of the groups before and after the treatment, only the dominant side Thomas test results showed a statistically significant improvement in both groups, more in favor of the PNF stretching group (p <0.05). There was no statistically significant difference in other parameters (p> 0.05). When the effect size was calculated, it was seen that the results of 1 Minute Walk Test (in favor of the PNF stretching group) and the Gilette Functional Evaluation Questionnaire (in favor of the static stretching group) between the two groups were found to have a large effect size. Although PNF stretching and static stretching techniques applied to hip flexors are effective in increasing hip range of motion (ROM) in children with CP, it was found that they do not have superiority to each other, and the increase in hip ROM does not cause changes in balance, gait and functional status. For this reason, it was concluded that the effectiveness of the techniques that can create a multifaceted effect on both developmental and motor impairment factors occurring in CP in the treatment of hip flexion contracture should be investigated.