1. Improved trunk and neck control after selective dorsal rhizotomy in children with spastic cerebral palsy (original) (raw)
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Journal of Electromyography and Kinesiology, 2001
Cerebral palsy is a condition that results in varying degrees of functional deficits. The goal of this study was to develop an objective measure of muscle activity during a prescribed voluntary motor task in non-ambulatory children with spastic cerebral palsy. While performing a simultaneous hip/knee flexion task from the supine position, followed by return to the starting position, electromyographic and kinematic data were obtained from the right leg of eight children before and after selective dorsal rhizotomy and compared with eight age-matched controls. The electromyographic and kinematic data were combined to determine for each muscle of interest (tibialis anterior, soleus, vastus lateralis, biceps femoris) the percentage of the movement cycle for which the muscle was acting concentrically, eccentrically, isometrically or was considered inactive. Averaged over the four muscles, isometric activity decreased by 38% post-op and the time the muscles were inactive increased by 37% following surgery. The percentages of concentric and eccentric activity did not differ significantly between pre-and post-op conditions. Post-operatively, the percentage muscle activity patterns of the children with cerebral palsy more closely resembled that of the control children: averaged across all muscles and contraction types, the difference between the control children and the children with cerebral palsy was reduced by 50% following surgery. This measurement technique indicates promise as a method for quantifying muscle activity during voluntary motor tasks in non-ambulatory children with cerebral palsy.
International journal of health sciences
Background: Children with bilateral spastic cerebral palsy (BSCP) have insufficient trunk control and upper limbs (ULs) dysfunction. Purpose: to investigate the effect of segmental trunk stability training at different levels on sitting and ULs functions in children with BSCP. Subjects & Methods: Thirty-nine children with BSCP, with ages ranged from 2 to 4 years, , their spasticity grade ranged from 1 to 1+ according to the Modified Ashworth Scale, their motor function was at level IV according to the Gross Motor Function Classification System – Expanded and Revised, their self-initiated ability to handle objects in daily activities with their hands was at level V according to the Mini-Manual Ability Classification System, all children’s level of segmental trunk control score ranged from 3 to 5 according to the Segmental Assessment of Trunk Control were assigned randomly to 3 groups of equal numbers, 13 children for each group. Group (A) received a specially designed physical therap...
Developmental Medicine & Child Neurology, 2007
Hip adductor spasticity and strength in participants with cerebral palsy (CP) were quantified before and after selective dorsal rhizotomy (SDR) and intensive physical therapy. Twenty-four participants with cerebral palsy (CP group) and 35 non-disabled participants (ND controls) were tested with a dynamometer (CP group: mean age 8 years 5 months, 13 males, 11 females; ND group: mean age 8 years 6 months, 19 males, 16 females). According to the Gross Motor Function Classification System (GMFCS), of the 24 participants with CP, eight were at level I, six were at level II, and 10 participants were at level III. For the spasticity measure, the dynamometer quantified the resistive torque of the hip adductors during passive abduction at 4 speeds. The adductor strength test recorded a maximum concentric contraction. CP group spasticity was significantly reduced following SDR and adductor strength was significantly increased after surgery. Both pre-and postoperative values remained significantly less than the ND controls. Spasticity results agreed with previous studies indicating a reduction. Strength results conflicted with previous literature subjectively reporting a decrease following SDR. However, results agreed with previous objective investigations examining knee and ankle strength, suggesting strength did not decrease following SDR.
Proceedings of the International Conference on Health Informatics and Medical Application Technology, 2019
Spastic cerebral palsy is a type of brain damage that occurs in the extreme part of the pyramids that results in an increase in reflexes that make muscle tone higher than normal. This study aims to look at the effect of a combination of Trunk Mobilization and Neuro Development Treatment on reducing spasticity in spastic type cerebral palsy children. The research design used was one group pre and post test design. Test Results for the results of reducing spasticity in cerebral palsy children before and after the intervention of Trunk Mobilization and Neuro Development Treatment, it can be seen that the value of p = 0.157 which means greater than 0.05 (p> 0.05) so that the null hypothesis (Ho) accepted and the alternative hypothesis (Ha) was rejected. So the conclusion with the acceptance of Ho means there is no effect of a combination of Trunk Mobilization and Neuro Development Treatment to reduce spasticity in children with cerebral palsy after intervention.
Developmental Neurorehabilitation, 2013
Aim: This study aimed to determine whether strengthening trunk muscles using vibration can improve posture and gait in children with spastic-type cerebral palsy (STCP). Methods: A total of 27 children (6-13 years) participated in a single-blinded pre-post crossover experimental trial. The 1-Minute Walk Test, 2D-posturography, ultrasound imaging and sit-ups in one minute were used to assess effect on gait, posture, resting abdominal muscle thickness and functional strength. Results: Significant increase in distance walked (p 5 0.001), more upright posture, an increase in sit-ups executed (p 5 0.001) and an increase in resting thicknesses of all the four abdominal muscles -transversus abdominis (p ¼ 0.047), obliquus internus (p ¼ 0.003), obliquus externus (p ¼ 0.023) and the rectus abdominis (p ¼ 0.001) was recorded. Strength and posture were maintained at 4-weeks post-intervention. Conclusion: A trunk-targeted intervention using vibration can improve posture and gait in children with STCP without any known side effects. It is recommended that vibration and specific trunk strengthening is included in training or rehabilitation programmes. Effects of vibration on force generation and spasticity need further investigation.
Research Square (Research Square), 2022
To determine in uence of lower extremity impairment and trunk control on postural control and functional mobility in children with spastic Cerebral Palsy (CP). Methods children with between the ages of 6-17 were evaluated. Gross Motor Function Measure (GMFM) E Section, Modi ed Timed Up and Go Test (TUG), Trunk Impairment Scale (TIS), Computerized Dynamic Posturography, Sensory Organization Test (SOT) were applied; lower limb's range of movement (ROM) of joints were evaluated passively to all participants. Spasticity levels of lower limbs were evaluated. Results In children with CP, there were signi cant relationship between spasticity, ROM and trunk control and motor function capacity and composite balance score (p < 0,05). Impairments of the lower extremity in children with CP were related with balance responses (p < 0,05). (p < 0,05). TUG, and composite balance score tests were correlated with all sub-dimensions of TIS (p < 0,05). the results of univariate and multivariate regression analyses and TIS total were found to be independent risk factor of TUG and GMFM-E according to the univariate analyses (ß=-0.77, B:0.353 standard error: 0.061, p < 0.01; ß=0.809, B:3.806 standard error: 0.578 p < 0.045 respectively). According to the multivariate regression analyses, TIS dynamic, SOM and VEST were found predictors of mTUG, and ROM, TIS dynamic and coordination, VIS were found predictors of GMFM-E (p < 0.05). Conclusion Lower limb impairment and trunk control plays important role on postural control and functional mobility, therefore it is important including these parameters into the physiotherapy and rehabilitation aiming to improve functional mobility.
Postural Control Alterations in Children with Mild Forms of Spastic Cerebral Palsy
Pediatric Health, Medicine and Therapeutics, 2022
To determine the postural control responses' differences between children with mild spastic Cerebral Palsy (CP) and children who are typically developing (TD). Patients and Methods: Children with spastic CP, Level I-II (n=20, mean age=9.42±4.59 years, 50% girls, 50% boys) and children with TD (N=20, mean age=9.65±3.03, 55% girls, 45% boys) were included in the study. All participants were evaluated with Computerized Dynamic Posturography, Sensory Organization Test (SOT). Results: There were differences between children with spastic CP and children with TD in visual and composite balance score of SOT significantly (p<0.05); there were no differences at vestibular and somatosensory scores of SOT. Children with CP had more postural sway than children with TD (p<0.05). Conclusion: There were differences between children with mild CP and TD in terms of postural control responses.
International Journal of Clinical Medicine, 2017
Purpose: The aim of this study was to investigate the effects of trunk control on motor function, which plays an important role in the daily activities of children with Cerebral Palsy (CP) and is often observed as a deficiency in children with CP. Material and Methods: Forty children with spastic bilateral CP, ages between 3 to 10 years and with Gross Motor Function Classification System (GMFCS) level I, II, and III were included in this study. Children were divided into two groups using randomization and in training group; Bobath Therapy for trunk control in addition to classical physiotherapy programs was performed for 45 minutes, for two days a week, for 6 weeks. In control group, existing physiotherapy program, 45 minutes for two days a week, continued. Any addition was not made into the existing program of the control group. Modified Ashworth Scale (MAS), Pediatric Berg Balance Scale (PBBS), Trunk Control Measurement Scale (TCMS), 1 Minute Walking Test (1MWT), Timed Up and Go Test (TUG) were applied to both groups before and after 6 weeks. Moreover, trunk muscle strength of children was evaluated. Results: After therapy, differences were found in results of MAS and PBBS, and trunk extensor strength between the training group and the control group in favor of the training group (p < 0.05). In addition, TCMS, 1MWT, TUG test and showed significant improvement compared to the average of the pre-treatment of the trunk muscle strength (p < 0.05). In addition, after treatment, training group's averages of TCMS, PBBS, 1MWT, YUG test and all trunk muscle strength were higher compared to the ones before treatment (p < 0.05). Conclusion: This study shows that adding exercises which aim trunk to conventional physiotherapy and exercise programs of children with CP, affects motor function positively. How to cite this paper: Arı, G. and Günel, M.K. (2017) A Randomised Controlled Study to Investigate Effects of Bobath Based Trunk Control Training on Motor Function of Children with Spastic Bilater