The Journal of Pediatrics of Korean Medicine (대한한방소아과학회지)

The Association of Korean Oriental Pediatrics (대한한방소아과학회)
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Integrative medicine rehabilitation of simultaneous intra-dermal acupuncture (IDA) and neurodevelopmental treatment (NDT) for children with cerebral palsy: Pilot Study of Functional Near-Infrared Spectroscopy

뇌성마비 소아에 대한 중추신경계재활치료 및 피내침 병용치료에 관한 연구 - 기능성 적외선 분광법(fNIRS)를 이용한 예비 연구 -

  • Chang, Seok Joo (Department of Pediatrics, College of Korean Medicine, Dongguk University) ;
  • Nam, Yeon Gyo (Dongguk University Posture Science Institute, Dongguk University) ;
  • Kim, Ji Hyun (Department of Medical Device Industry Graduate School of Dongguk University) ;
  • Ko, Mun Jung (Department of Biostatistics, School of Medicine, Dongguk University) ;
  • Kwon, Bum Sun (Dongguk University Posture Science Institute, Dongguk University) ;
  • Lim, Chi-Yeon (Department of Biostatistics, School of Medicine, Dongguk University) ;
  • Min, Sang Yeon (Department of Pediatrics, College of Korean Medicine, Dongguk University)
  • 장석주 (동국대학교 한의과대학 소아과교실) ;
  • 남연교 (동국대학교 자세과학연구소) ;
  • 김지현 (동국대학교 의료기기산업학과) ;
  • 고문정 (동국대학교 의과대학 의학통계학교실) ;
  • 권범선 (동국대학교 자세과학연구소) ;
  • 임지연 (동국대학교 의과대학 의학통계학교실) ;
  • 민상연 (동국대학교 한의과대학 소아과교실)
  • Received : 2021.01.15
  • Accepted : 2021.02.22
  • Published : 2021.02.28
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Abstract

Objectives The purpose of this study is to investigate differences in brain activities when Neurodevelopmental treatment (NDT) is used alone compare to NDT is combined with intradermal acupuncture (IDA) treatment, using functional infrared spectroscopy (fNIRS) Methods Three children less than 7 year-old with cerebral palsy were participated. On their first visit, only NDT was used. After a week, they were treated with both NDT and IDA. During the treatment, fNIRS was used to measure any changes in their brain activities. Results In first patient with NDT, oxyhemoglobin level was increased during Standing exercise and Gait training compared to resting state. When the patient was treated with NDT and IDA, oxyhemoglobin level was decreased during Standing exercise and Gait training compared to resting state, and the result was significant (p<0.05). In second patient, oxyhemoglobin level was decreased in Gait training compared to resting state when NDT was used, but the level was increased when NDT and IDA were used in Gait training compared to resting state (p<0.05). In third patient, the difference in oxyhemoglobin levels between Gait training and resting state was significant (p<0.05). Conclusions Treatment involving both NDT and IDA has more potential to improve brain activities compared to that of NDT alone, and no adverse effect was reported. In order to confirm the finding, larger scale randomized controlled trials are needed.

Keywords

References

  1. Vitrikas K, Dalton H, Breish D. Cerebral Palsy: An Overview. Am Fam Physician. 2020;101(4):213-220. PMID: 32053326.
  2. Kim KB, Kim DG, Kim YH, Kim JH, Min SY, Park EJ, Baek JH, Sungs HK, Yu SA, Lee SY, Lee JY, Lee HJ, Chang GT, Jeong MJ, Chai JW, Cheon JH, Han YJ, Han JK. Hanbangsoacheongsonyeonuihak (sang). Seoul: Ui Sung Dang Publishing Co. 2015;2:486-9.
  3. Tak S, Ye JC. Statistical analysis of fNIRS data: a comprehensive review. Neuroimage. 2014;85(1):72-91. doi: 10.1016/j.neuroimage.2013.06.016.Epub 2013 Jun 15. PMID: 23774396.
  4. Chang SJ, Seong EH, Kim JH, Min SY. The Effect of Acupuncture combined with Conventional Rehabilitation Treatment for Cerebral palsy: A Systematic review of Randomized Controlled Trials (RCTs). J Korean Orient Pediatr, 2020;34(3):81-96.
  5. Qi T, Wang C. Effects of intradermal needling on core muscle stability in children with cerebral palsy: a clinical comparative study. Zhongguo Zhen Jiu. 2018;38(6):597-601. Chinese. doi: 10.13703/j.0255-2930.2018.06.007. PMID: 29972001.
  6. Li LX, Zhang MM, Zhang Y, He J. Acupuncture for cerebral palsy: A meta-analysis of randomized controlled trials. Neural Regen Res. 2018;13(6):1107-1117. doi: 10.4103/1673-5374.233455. PMID: 29926839; PMCID: PMC6022466.
  7. Johnston MV. Plasticity in the developing brain: implications for rehabilitation. Dev Disabil Res Rev. 2009;15(2):94-101. doi: 10.1002/ddrr.64. PMID: 19489084.
  8. Sukal-Moulton T, de Campos AC, Alter KE, Huppert TJ, Damiano DL. Relationship between sensorimotor cortical activation as assessed by functional near infrared spectroscopy and lower extremity motor coordination in bilateral cerebral palsy. Neuroimage Clin. 2018;20:275-285. doi: 10.1016/j.nicl.2018.07.023. PMID: 30101059; PMCID: PMC6083901.
  9. de Campos AC, Sukal-Moulton T, Huppert T, Alter K, Damiano DL. Brain activation patterns underlying upper limb bilateral motor coordination in unilateral cerebral palsy: an fNIRS study. Dev Med Child Neurol. 2020;62(5):625-632. doi: 10.1111/dmcn.14458. Epub 2020 Feb 7. PMID: 32034770.
  10. Sukal-Moulton T, de Campos AC, Alter KE, Damiano DL. Functional near-infrared spectroscopy to assess sensorimotor cortical activity during hand squeezing and ankle dorsiflexion in individuals with and without bilateral and unilateral cerebral palsy. Neurophotonics. 2020;7(4):045001. doi: 10.1117/1.NPh.7.4.045001. Epub 2020 Oct 6. PMID: 33062800; PMCID: PMC7536541.
  11. Peng C, Hou X. Applications of functional near-infrared spectroscopy (fNIRS) in neonates. Neurosci Res. 2020: S0168-0102(20)30482-X. doi: 10.1016/j.neures.2020.11.003. Epub ahead of print. PMID: 33347910.
  12. Michael-Asalu A, Taylor G, Campbell H, Lelea LL, Kirby RS. Cerebral Palsy: Diagnosis, Epidemiology, Genetics, and Clinical Update. Adv Pediatr. 2019;66:189-208. doi: 10.1016/j.yapd.2019.04.002. Epub 2019 May 15. PMID:31230694.
  13. You HS, Oh MS, Song TW. The literature study on the cerebral palsy. Journal of Oriental Medicine, Daejeon University. 2000;9(1):469-501.
  14. Gok SY, Lee SY, Lyu SA. A Literary Review on Early Treatment of Cerebral Palsy - Centered on the Chinese Medical Journal -. J Korean Orient Pediatr. 2008;22(3):35-62.
  15. Moreau NG, Bodkin AW, Bjornson K, Hobbs A, Soileau M, Lahasky K.Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis. Phys Ther. 2016;96(12):1938-1954. doi: 10.2522/ptj.20150401. Epub 2016 Jun 16. PMID: 27313240; PMCID: PMC5131187.
  16. Booth ATC, Buizer AI, Meyns P, Oude Lansink ILB, Steenbrink F, van der Krogt MM. The efficacy of functional gait training in children and young adults with cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2018;60(9):866-883. doi: 10.1111/dmcn.13708. Epub 2018 Mar 7. PMID: 29512110.
  17. Moreau NG, Bodkin AW, Bjornson K, Hobbs A, Soileau M, Lahasky K. Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis. Phys Ther. 2016;96(12):1938-1954. doi: 10.2522/ptj.20150401.Epub 2016 Jun 16. PMID: 27313240; PMCID: PMC5131187.
  18. Goodwin J, Lecouturier J, Basu A, Colver A, Crombie S, Smith J, Howel D, McColl E, Parr JR, Kolehmainen N, Roberts A, Miller K, Cadwgan J. Standing frames for children with cerebral palsy: a mixed-methods feasibility study. Health Technol Assess. 2018;22(50):1-232. doi: 10.3310/hta22500. PMID: 30234480; PMCID: PMC6174326.
  19. Perez Ramirez N, Rozbaczylo Fuster C, Nahuelhual Cares P. Efectividad del uso de bipedestadores en la prevencion de la luxacion de cadera en ninos y adolescentes con paralisis cerebral espastica, GMFCS III, IV y V. Revision sistematica [Effectiveness of the use of standing devices in the prevention of hip dislocation in children and adolescents with spastic cerebral palsy, GMFCS III, IV and V. A systematic review]. Rehabilitacion (Madr). 2019;53(3):169-180. Spanish. doi: 10.1016/j.rh.2019.05.001. Epub 2019 Jul 9.PMID: 31370944.
  20. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J, Cioni G, Damiano D, Darrah J, Eliasson AC, de Vries LS, Einspieler C, Fahey M, Fehlings D, Ferriero DM, Fetters L, Fiori S, Forssberg H, Gordon AM, Greaves S, Guzzetta A, Hadders-Algra M, Harbourne R, Kakooza-Mwesige A, Karlsson P, Krumlinde-Sundholm L, Latal B, Loughran-Fowlds A, Maitre N, McIntyre S, Noritz G, Pennington L, Romeo DM, Shepherd R, Spittle AJ, Thornton M, Valentine J, Walker K, White R, Badawi N. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA Pediatr. 2017;171(9):897-907. doi: 10.1001/jamapediatrics.2017.1689. Erratum in: JAMA Pediatr. 2017 Sep 1;171(9):919. PMID: 28715518.