fahad farooq lasi

Cerebral Palsy (CP) is not a disease, but a non-progressive disorder that occurs in developing brain. CP has become the most common pediatrics problem which needs early medical diagnosis and intervention. CP children have balance difficulties because they are unable to perform their activities of daily living and have high risk of fall. Balance training using vestibular system, gym ball, and assistive devices is one of the main elements in the improvement of balance of CP children. The aim of this study was to identify the impact of gym ball exercise on standing balance in children with CP. 

A quasi-experimental study was conducted on 54 children diagnosed with either spastic, non-spastic, hemiplegic or diplegic CP. Gym ball exercises were regularly given to each participant for 3 weeks. Patient’s standing balance was assessed by using Pediatric Balance Scale (PBS) before and after Gym ball exercises. Data was collected from the department of physiotherapy at (ACELP) Karachi. Paired-t test was used to compare the static balance before and after gym ball exercises. 

 There was no significant difference in standing unsupported between pre-exercise and post exercise (P=0.159). However, for other parameters including standing unsupported with eyes closed (P=0.00), standing unsupported with feet together (P=0.01), standing unsupported one foot in front (P=0.00), and standing on one leg (P=0.01), significant reduction were found after the intervention compared with before the intervention. 

 It was found that the gym ball exercises could significantly improve the standing balance of children with CP.

This study was conducted to assess the attitude and practice of general dental practitioners when dealing with Temporomandibular Disorders (TMDs) and referral to physiotherapy.

This comparative cross-sectional study was conducted with a study population of General Dental Practitioners (GPDs) of Mirpur Khas Sindh. The total study population estimated was about 55 GPDs in this district. A convenient sampling technique was used to recruit the samples. The study questionnaire was adopted from the different articles and modified as per our socio-cultural needs. The reliability and validity of the questionnaire were calculated via chrome back alpha test by doing a pilot study on 25 participants and found its validity as 80% and reliability as 75%. The questionnaire consisted of three sections of general questions regarding referral to physiotherapy, attitude, and practice of general dental practitioners in managing temporomandibular joint dysfunctions (TMD).

The results showed that 57.1% of GPDs believe that 53.1% of patients had neck pain and poor posture. Also, 81.6% of patients were referred to other healthcare providers, and only 22.4% of patients were referred to a physiotherapist. About 28.6% of patients were referred to physiotherapists just because of neck pain, only 22.4% of patients with postural alterations were referred to a physiotherapist. Also, 53.1% of GPDs had little confidence in assessing, therapeutic decision, and treatment outcomes of TMDs. About 69.4% of GPDs provided medical management to the patients suffering from TMD, while 44.9% of GPDs provided pharmacological management.

This study concluded that there is a need for TMD experts to deal with patients suffering from TMDs. General dental practitioners of Mirpur Khas, Sindh know little about the physiotherapeutic benefits for TMD. The majority of GPDs have very little confidence in making a diagnosis and treating patients suffering from temporomandibular dysfunctions