Music Effect on Concentration and Gait in Cerebral Palsy Children During Physical Therapy Sessions

Physical therapy only could be not attractive for child if it done by the traditional way; focus on motor part and no need to involve the sensory part through the rehabilitation.

Sense of hearing could be a unique one to stimulate for a better child attention during physical therapy session, even child with blindness could benefit from this idea.

Using music for attracting attention of the child as a therapeutic way so the child can walk properly regarding time and pace.

Singing as a live form of music could be more sensitive and interactive for child-therapist bond which is important to include the child as an active participant as child is being rehabilitated not just treatment.

Rehabilitation means to involve the child as a whole at this complicated process, not to move a passive limb.

Rehabilitation of CP:

* A "temporal axis": Habilitation/rehabilitation should begin early and continuously - a minimum within the first years of child's life - and intensively - individually designed to meet child's needs.
* A "spatial axis": where individual space, family, school, and social affair places must be all considered.
* An "individual axis": Rehabilitation must observe the child as an active participant, not as a passive person of whom needs care.
* A "relational axis": the standard of taking into consideration the relationship of the child and people who take care of him/her in different contexts of their life (Trabacca et al., 2016).

• Music therapy (Behavioral): Neurologic music therapy (NMT) Listening to music and moving rhythmically.
• physical therapy traditional (Other): program for gait improvement ( Standing, balance and gait training)

Primary outcomes

• concentration as a cognitive function [pre intervention and 3 months post intervention]: ability of child to pay attention during physical therapy sessions and be interactive with the therapist, measured by Moss Attention Rating Scale, score of 22 (minimum score) to less than 110 (maximum score), Higher scores indicate better attention.
• Gait [pre intervention and 3 months post intervention]: improvement measured by Gross motor function measure 88 (gait section), 0 (minimum score) to 100 (maximum score) percentage %
• Kinovea, (Spatial and Temporal Parameters) [pre and 3 months post intervention]: Kinovea, (Spatial and Temporal Parameters); Step length in centimeters (higher score better)
• Kinovea, (Spatial and Temporal Parameters) ; stride length in centimeters (higher score better) [pre and 3 months post intervention]: Kinovea, (Spatial and Temporal Parameters); stride length in centimeters (higher score better)
• Gait (cadence) [pre and 3 months post intervention]: Using Kinovea, cadence measured in steps\\minute (lower score better).

Sex: All, ages: 5 Years to 7 Years

Inclusion Criteria:

* • The children age ranged from 5 to 7 years old (early childhood).

  * Spasticity degree ranges from 1 to 1+ as measured by the Modified Ashworth Scale
  * Children with lack of concentration according to MARS (Moss Attention Rating Scale)
  * Children can stand alone and walk.

Exclusion Criteria:

* • Children with deafness.

• Kamal El-sayed Shoukry, Doctorate, Study chair, Professor of Physical Therapy for Pediatrics Faculty of Physical Therapy Cairo University