Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
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Effect of Sensorimotor Training Using a Flexi-bar on Postural Balance and Gait Performance for Children With Cerebral Palsy: A Preliminary Study

  • Ga, Hyun-you (Dept. of Rehabilitation Medicine, Samsung Medical Center) ;
  • Sim, Yon-ju (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Moon, Il-young (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Yun, Sung-joon (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Yi, Chung-hwi (Dept. of Physical Therapy, College of Health Science, Yonsei University)
  • Received : 2016.11.02
  • Accepted : 2017.02.07
  • Published : 2017.05.21
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Abstract

Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.

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References

  1. Chung JS, Park S, Kim J, et al. Effects of flexi-bar and non-flexi-bar exercises on trunk muscles activity in different postures in healthy adults. J Phys Ther Sci. 2015;27(7):2275-2278. https://doi.org/10.1589/jpts.27.2275
  2. Correa JC, Correa FI, Franco RC, et al. Corporal oscillation during static biped posture in children with cerebral palsy. Electromyogr Clin Neurophysiol. 2007;47(3):131-136.
  3. Damiano DL, Kelly LE, Vaughn CL. Effects of quadriceps femoris muscle strengthening on crouch gait in children with spastic diplegia. Phys Ther. 1995;75(8):658-667. https://doi.org/10.1093/ptj/75.8.658
  4. de Graaf-Peters VB, Blauw-Hospers CH, Dirks T, et al. Development of postural control in typically developing children and children with cerebral palsy: Possibilities for intervention? Neurosci Biobehav Rev. 2007;31(8):1191-1200. https://doi.org/10.1016/j.neubiorev.2007.04.008
  5. Duarte M, Freitas SM. Revision of posturography based on force plate for balance evaluation. Rev Bras Fisioter. 2010;14(3):183-192. https://doi.org/10.1590/S1413-35552010000300003
  6. Eagleton M, Iams A, McDowell J, et al. The effects of strength training on gait in adolescents with cerebral palsy. Pediatr Phys Ther. 2004;16(1):22-30. https://doi.org/10.1097/01.PEP.0000116781.00415.8E
  7. El-Shamy SM, Abd El Kafy EM. Effect of balance training on postural balance control and risk of fall in children with diplegic cerebral palsy. Disabil Rehabil. 2014;36(14):1176-1183. https://doi.org/10.3109/09638288.2013.833312
  8. Heyrman L, Desloovere K, Molenaers G, et al. Clinical characteristics of impaired trunk control in children with spastic cerebral palsy. Res Dev Disabil. 2013;34(1):327-334. https://doi.org/10.1016/j.ridd.2012.08.015
  9. Hrysomallis C1. Relationship between balance ability, training and sports injury risk. Sports Med. 2007;37(6):547-56. https://doi.org/10.2165/00007256-200737060-00007
  10. Janssen WG, Bussmann JB, Horemans HL, et al. Validity of accelerometry in assessing the duration of the sit-to-stand movement. Med Biol Eng Comput. 2008 Sep;46(9):879-87. https://doi.org/10.1007/s11517-008-0366-3
  11. Ju YH, You JY, Cherng RJ. Effect of task constraint on reaching performance in children with spastic diplegic cerebral palsy. Res Dev Disabil. 2010;31(5):1076-1082. https://doi.org/10.1016/j.ridd.2010.04.001
  12. Karabay I, Dogan A, Arslan MD, et al. Effects of functional electrical stimulation on trunk control in children with diplegic cerebral palsy. Disabil Rehabil. 2012;34(11):965-970. https://doi.org/10.3109/09638288.2011.628741
  13. Katz-Leurer M, Rotem H, Keren O, et al. The effects of a 'home-based' task-oriented exercise programme on motor and balance performance in children with spastic cerebral palsy and severe traumatic brain injury. Clin Rehabil. 2009;23(8):714-724. https://doi.org/10.1177/0269215509335293
  14. Kim EK, Kim SG. The effect of an active vibration stimulus according to different shoulder joint angles on functional reach and stability of the shoulder joint. J Phys Ther Sci. 2016;28(3):747-751. https://doi.org/10.1589/jpts.28.747
  15. Maki BE, Perry SD, Norrie RG, et al. Effect of facilitation of sensation from plantar foot-surface boundaries on postural stabilization in young and older adults. J Gerontol A Biol Sci Med Sci. 1999;54(6):M281-M287. https://doi.org/10.1093/gerona/54.6.M281
  16. Michaelsen SM, Gomes RP, Marques AP, et al. Using an accelerometer for analyzing a reach-to-grasp movement after stroke. Motriz, Rio Claro. 2013;19(4):746-752.
  17. Mileva KN, Kadr M, Amin N, et al. Acute effects of Flexi-bar vs. Sham-bar exercise on muscle electromyography activity and performance. J Strength Cond Res. 2010;24(3):737-748. https://doi.org/10.1519/JSC.0b013e3181c7c2d8
  18. Moreside JM, Vera-Garcia FJ, McGill SM. Trunk muscle activation patterns, lumbar compressive forces, and spine stability when using the bodyblade. Phys Ther. 2007;87(2):153-163. https://doi.org/10.2522/ptj.20060019
  19. Prosser LA, Lee SC, VanSant AF, et al. Trunk and hip muscle activation patterns are different during walking in young children with and without cerebral palsy. Phys Ther. 2010;90(7):986-997. https://doi.org/10.2522/ptj.20090161
  20. Saether R, Helbostad JL, Adde L, et al. Gait characteristics in children and adolescents with cerebral palsy assessed with a trunk-worn accelerometer. Res Dev Disabil. 2014;35(7): 1773-1781. https://doi.org/10.1016/j.ridd.2014.02.011
  21. Saavedra S, Joshi A, Woollacott M, et al. Eye hand coordination in children with cerebral palsy. Exp Brain Res. 2009;192(2):155-165. https://doi.org/10.1007/s00221-008-1549-8
  22. Unger M, Jelsma J, Stark C. Effect of a trunk-targeted intervention using vibration on posture and gait in children with spastic type cerebral palsy: A randomized control trial. Dev Neurorehabil. 2013;16(2):79-88. https://doi.org/10.3109/17518423.2012.715313
  23. Umphred DA, Byl N, Lazaro RT, et al. Interventions for neurological disabilities. In: Umphred DA ed. Neurological Rehabilitation. 4th ed. St Louis, Mosby. 2001.
  24. Woollacott M, Shumway-Cook A, Hutchinson S, et al. Effect of balance training on muscle activity used in recovery of stability in children with cerebral palsy: A pilot study. Dev Med Child Neurol. 2005;47(7):455-461. https://doi.org/10.1017/S0012162205000885
  25. Yang YR, Tsai MP, Chuang TY, et al. Virtual reality-based training improves community ambulation in individuals with stroke: A randomized controlled trial. Gait Posture. 2008;28(2):201-206. https://doi.org/10.1016/j.gaitpost.2007.11.007
  26. Yoo JW. Augmented effects of EMG biofeedback interfaced with virtual reality on neuromuscular control and movement coordination during reaching in children with cerebral palsy. Seoul, Yonsei University, Master Thesis. 2015.
  27. Zadnikar M, Kastrin A. Effects of hippotherapy and therapeutic horseback riding on postural control or balance in children with cerebral palsy: A meta-analysis. Dev Med Child Neurol. 2011;53(8):684-691. https://doi.org/10.1111/j.1469-8749.2011.03951.x