Journal of Korean Physical Therapy Science (대한물리치료과학회지)

Korean Physical Therapy Science (대한물리치료과학회)
권호 표지
DOI QR코드

DOI QR Code

The Effects of Cranio-Cervical Flexion based Trunk Stabilization Exercise on Gross Motor Function and Posture Alignment Change in Children with Spastic Cerebral Palsy

머리-목 굽힘 기반 몸통 안정화 운동이 경직성 뇌성마비 아동의 대동작기능과 앉은 자세정렬에 미치는 효과

  • 정은정 (안동과학대학교 물리치료과) ;
  • 한상진 (건국대학병원 물리치료실) ;
  • 이병희 (삼육대학교 물리치료학과)
  • Received : 2019.08.14
  • Accepted : 2019.09.23
  • Published : 2019.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was to evaluate the effect of cranio-cervical flexion based trunk stabilization exercise on gross motor function and posture alignment change in children with spastic cerebral palsy. Design: Randomized Controlled Trial. Methods: Twenty-six children participated in this study. All subjects were randomly assigned to either the Cranio-Cervical Flexion Based Trunk Stabilization Exercise (CCFTS) group (n=13) or the Trunk Stabilization Exercise (TS) group (n=13). In both groups were trained general physical therapy for 10 minutes, in the CCFTS group was trained cranio-cervical flexion based trunk stabilization exercise for 20 minutes and in the TS group was trained trunk stabilization exercise for 20 minutes. The training was provided 2 times a week during 8 weeks. All subjects were measured with the Gross Motor Function Measure (GMFM) and Cranio-Vertebral Angle (CVA) before and after intervention. Results: The results showed that the CCFTS have increased significantly in GMFM (B, C, D and E-dimension) and CVA, and the TS group have increased significantly in GMFM (B, C D and E-dimension). In particular, the CCFTS group improved significantly than TS group in GMFM (B, C and D-dimension) and CVA. Therefore, the cranio-cervical flexion based trunk stabilization exercise improved gross motor function and posture alignment in children with spastic cerebral palsy. Conclusion: These results suggest that cranio-cervical flexion based trunk stabilization exercise is feasible and suitable for individuals with a spastic cerebral palsy and can be used in addition to conventional physical therapy.

Keywords

References

  1. Ahmed, M. A. E. M., El Azeim, F. H. A., Ragaa, E., & El Raouf, A. The Problem Solving Strategy of Poor Core Stability in Children with Cerebral Palsy: A Clinical Trial. Journal of Pediatrics & Neonatal Care. 2014;1(2):2-6.
  2. Akuthota, V., & Nadler, S. F. Core strengthening. Archives of physical medicine and rehabilitation. 2004;85(3):86-92. https://doi.org/10.1053/j.apmr.2003.12.005
  3. Bly, L. Motor skills acquisition in the first year: an illustrated guide to normal developmen. Psychological Corp; 1994.
  4. Bobath, K. A neurophysiological basis for the treatment of cerebral palsy. Cambridge University Press; 1991.
  5. Boyd-Clark, L., Briggs, C., & Galea, M. Muscle spindle distribution, morphology, and density in longus colli and multifidus muscles of the cervical spine. Spine. 2002;27(7):694-701. https://doi.org/10.1097/00007632-200204010-00005
  6. Brogren, E., Forssberg, H., & Hadders-Algra, M. Influence of two different sitting positions on postural adjustments in children with spastic diplegia. Developmental Medicine & Child Neurology. 2001;43(8):534-546. https://doi.org/10.1017/S0012162201000974
  7. Chae, Y. W. The effect of forward head posture and cervical ROM on chronic and episodic tension- type headache in university student. The Journal of Korean Society of Physical Therapy. 2009;21(2):71-77.
  8. Chiu, T. T., Lam, T.-H., & Hedley, A. J. A randomized controlled trial on the efficacy of exercise for patients with chronic neck pain. Spine. 2005;30(1):E1-E7. https://doi.org/10.1097/01.brs.0000149082.68262.b1
  9. Chung, S. H., Her, J. G., Ko, T., You, Y. Y., & Lee, J. S. Effects of exercise on deep cervical flexors in patients with chronic neck pain. Journal of Physical Therapy Science. 2012;24(7):629-632. https://doi.org/10.1589/jpts.24.629
  10. Damiano, D. L., & Abel, M. F. Functional outcomes of strength training in spastic cerebral palsy. Archives of physical medicine and rehabilitation. 1998;79(2):119-125. https://doi.org/10.1016/S0003-9993(98)90287-8
  11. Dan, B., Bouillot, E., Bengoetxea, A., Noel, P., Kahn, A., & Cheron, G. Head stability during whole body movements in spastic diplegia. Brain and Development. 2000;22(2):99-101. https://doi.org/10.1016/S0387-7604(99)00123-0
  12. Dewar, R., Love, S., & Johnston, L. M. Exercise interventions improve postural control in children with cerebral palsy: a systematic review. Developmental medicine and child neurology. 2015;57(6):504-520. https://doi.org/10.1111/dmcn.12660
  13. Falla, D., Jull, G., Hodges, P., & Vicenzino, B. An endurance-strength training regime is effective in reducing myoelectric manifestations of cervical flexor muscle fatigue in females with chronic neck pain. Clinical Neurophysiology. 2006;117(4):828-837. https://doi.org/10.1016/j.clinph.2005.12.025
  14. Frank, C., Kobesova, A., & Kolar, P. Dynamic neuromuscular stabilization & sports rehabilitation. International journal of sports physical therapy. 2013;8(1):62.
  15. Girish, V., & Vijayalakshmi, A. Affordable image analysis using NIH Image/ImageJ. Indian journal of cancer. 2004;41(1):47.
  16. Hanten, W. P., Lucio, R. M., Russell, J. L., & Brunt, D. Assessment of total head excursion and resting head posture. Archives of physical medicine and rehabilitation. 1991;72(11):877-880. https://doi.org/10.1016/0003-9993(91)90003-2
  17. Hong, J. S. Cerebral palsy treatment ideas. Seoul: Gunja; 2011.
  18. Iqbal, Z. A., Rajan, R., Khan, S. A., & Alghadir, A. H. Effect of deep cervical flexor muscles training using pressure biofeedback on pain and disability of school teachers with neck pain. Journal of physical therapy science. 2013;25(6):657-661. https://doi.org/10.1589/jpts.25.657
  19. Jung, J. W., & Song, B. The effects of neuromuscular electrical stimulation over trunk muscles on gross motor function and trunk muscle activity in children with cerebral palsy. Journal of Rehabilitation Research. 2013;16(1):293-314.
  20. Kapreli, E., Vourazanis, E., Billis, E., Oldham, J., & Strimpakos, N. Respiratory dysfunction in chronic neck pain patients. A pilot study. Cephalalgia. 2009;29(7):701-710. https://doi.org/10.1111/j.1468-2982.2008.01787.x
  21. Karim, L., Marotta, M., Rands, J., Thrush, A., & Reiman, M. P. Trunk stability with abdominal draw-in (hollowing) exercise versus abdominal bracing exercise. 5th Annual Symposium: Graduate Research and Scholarly Projects. Wichita, KS: Wichita State University; 2009. p.118-119.
  22. Katherine, H. Effectiveness of an exercise program to improve forward head posture in normal adult: a randomized, controlled 10-week trial. The Journal of Manual & Manipulative Therapy; 2015;13(3):163-176. https://doi.org/10.1179/106698105790824888
  23. Kim, C. J. Comparison of the impact of balance training, trunk stability exercise, and horse-riding simulator exercise on the sitting position balance, posture control, and upper limb function of children with spastic cerebral palsy. [Doctoral dissertation]. Daegu Univ.;2015.
  24. Kim, J. G., & Kim, T. Y. The correlation between motor capacity, capability, and performance in children with cerebral palsy. Journal of Rehabilitation Research. 2016;20(3):125-139. https://doi.org/10.16884/JRR.2016.20.3.125
  25. Kim, S. E. Effects of the deep neck flexor strength training and bridge exercise on sitting balance of children with spastic cerebral palsy. [Master thesis]. Daegu Univ.;2013.
  26. Ko, J., & Kim, M. Reliability and responsiveness of the gross motor function measure-88 in children with cerebral palsy. Physical therapy. 2013;93(3):393-400. https://doi.org/10.2522/ptj.20110374
  27. Krigger, K. W. Cerebral palsy: an overview. American Family Physician. 2006;73(1):91-100.
  28. Lee, H. J. Effects of cranio-cervical flexion exercise on muscle activity of sternocleidomastoid and upper trapezius in children with spastic diplegia. [Master thesis]. Daegu Univ.;2015.
  29. Lee, J. M., Lee H. A.., Yu, J. S., Lim, J. E., Moon, S. G., & Jang, H. J. The correlation between forward head position and neck flexor thickness during cranio-cervical flexion exercise. Journal of Korean Academy of Orthopaedic Manual Therapy. 2014;20(1):1-7.
  30. Lee, M. H., Song, J. M., & Kim, J. S. The effect of neck exercises on neck and shoulder posture and pain in high school students. The Journal of Korean Society of Physical Therapy. 2011;23(1):29-35.
  31. Papavasiliou, A. S. Management of motor problems in cerebral palsy: a critical update for the clinician. European Journal of Paediatric Neurology. 2009;13(5):387-396. https://doi.org/10.1016/j.ejpn.2008.07.009
  32. Plisky, P. J., Rauh, M. J., Kaminski, T. W., & Underwood, F. B. Star excursion balance test as a predictor of lower extremity injury in high school basketball players. The Journal of Orthopaedic and Sports Physical Therapy. 2006);36(12):911-919. https://doi.org/10.2519/jospt.2006.2244
  33. Porterfield, J. A. Mechanical low back pain: perspectives in functional anatomy. WB Saunders company; 1998.
  34. Raine, S., & Twomey, L. T. Head and shoulder posture variations in 160 asymptomatic women and men. Archives of physical medicine and rehabilitation. 1997;78(11):1215-1223. https://doi.org/10.1016/S0003-9993(97)90335-X
  35. Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, D. L., Dan, B., & Jacobsson, B. A report: the definition and classification of cerebral palsy April 2006. Developmental Medicine and Child Neuroogyl. 2007;49(Suppl 109):8-14.
  36. Ryu, H. J. Effects of core exercise and neck stabilizing exercise on proprioception and balance in children with cerebral palsy due to premature birth. [Doctoral dissertation]. Daegu Univ.;2015.
  37. Ryu, H. J., & Song, G.-b. Differences in proprioceptive senses between children with diplegic and children with hemiplegic cerebral palsy. Journal of physical therapy science. 2016;28(2):658-660. https://doi.org/10.1589/jpts.28.658
  38. Saavedra, S., Joshi, A., Woollacott, M., & van Donkelaar, P. Eye hand coordination in children with cerebral palsy. Experimental brain research. 2009;192(2):155-165. https://doi.org/10.1007/s00221-008-1549-8
  39. Saavedra, S., Woollacott, M., & van Donkelaar, P. Head stability during quiet sitting in children with cerebral palsy: effect of vision and trunk support. Experimental brain research. 2010;201(1):13-23. https://doi.org/10.1007/s00221-009-2001-4
  40. Seo, H. J., Lee, M. J., & Oh, T. Y. The effects of neck strengthening exercise on postural control in sitting position during reaching in children with spastic diplegia. The Journal of Korean Society for Neurotherapy. 2012;16(1):17-24.
  41. Shin, J. W. The Effects of neck and trunk stabilization exercise on motor skill and balance and visual perception of children with cerebral palsy. [Doctoral dissertation]. Daegu Univ.;2016.
  42. Song, B. H., & Yoon, J. Y. The effect of trunk strengthening exercise using therapeutic ball on the gross functional movements for the cerebral palsy children with spastic type. Special Education Research. 2003;2(2):125-146. https://doi.org/10.18541/ser.2003.10.2.2.125
  43. Yun, K. H., & Kim, K. Effect of cranio cervical felxion exercise using sling on thickness of sternocleidomastoid muscle and deep cervical flexor muscle. Journal of the Korean Society of Physical Medicine. 2013;8(2):253-651. https://doi.org/10.13066/kspm.2013.8.2.253
  44. Wallard, L., Bril, B., Dietrich, G., Kerlirzin, Y., & Bredin, J. The role of head stabilization in locomotion in children with cerebral palsy. Annals of physical and rehabilitation medicine. 2012;55(9-10):590-600. https://doi.org/10.1016/j.rehab.2012.10.004

Cited by

  1. 대체입력기기를 이용한 목적 있는 컴퓨터 작업 활동이 뇌성마비 환자의 수행도 만족도에 미치는 영향 vol.27, pp.2, 2019, https://doi.org/10.26862/jkpts.2020.09.27.2.80