Efektifitas Stretching dan Play Therapy Dalam Menurunkan Tonus Otot Dan Meningkatkan Aktifitas Fungsional Lengan Pada Anak Dengan Cerebral Palsy Spastik Di Yayasan Peduli Kemanusiaan Bali

Abstract

Cerebral palsy (CP) is a group of neuromuscular disorders due to central nerve damage that can occur in the prenatal, perinatal, or postnatal period. The main characteristic is an increase in muscle tone where the muscles will experience stiffness or tightness. Increased muscle tone in children with spastic cerebral palsy results in muscle stiffness in the flexor elbow muscle group and decreased functional activity of the child. The treatment provided is by providing stretching and play therapy with a ring a stack that stimulates the child's propioceptivity and coordination and motor skills. The purpose of this study was to determine the decrease in muscle tone of elbow flexors and functional ability of the arm in children with spastic cerebral palsy at the Bali Humanitarian Care Foundation (YPK). The design of this study was a pre experimental study, with a purposive sampling technique. The study was conducted at YPK Bali for 1 month with a sample of 6 spastic CP children. Measurements using the Modified Asworth Scale (MAS) for muscle tone and The-Manual Ability Classification System (MACS) for legan functional activities. The normality test using the Saphiro Wilk test obtained p value = 0.014 for MAS and p = 0.34 for MACS, which indicates that the data is not normally distributed. Furthermore, the hypothesis test was carried out using the Wilcoxon test, which obtained p value = 0.014 for MAS and p = 0.034 for MACS. This shows that there is a significant effect on decreased muscle tone and increased functional activity of the arm before and after the intervention. The conclusion of this study is that stretching and play therapy can reduce muscle tone of the elbow flexor and increase the functional activities of children with spastic cerebral palsy at YPK Bali.