Immediate effects of short period lower limb ergometer exercise in adolescent and young adult patients with cerebral palsy and spastic diplegia
Junpei Fujimoto, Yasunori Umemoto, Yumi Koike, Kazuya Isida, Keiko Sakamoto, Fumihiro Tajima, Junpei Fujimoto, Yasunori Umemoto, Yumi Koike, Kazuya Isida, Keiko Sakamoto, Fumihiro Tajima
Abstract
[Purpose] To determine the effects of lower limb ergometer exercise on the spasticity and joint range of motion of the lower extremity and gait function in patients with cerebral palsy and spastic paralysis. [Participants and Methods] This study included 8 participants with cerebral palsy and spastic paralysis (GMFCS levels I to IV) who received care at the outpatient clinic. After a 5-min rest, the lower limb ergometer exercises were performed for 10 min. We measured the participants' arterial blood pressure, pulse rate, passive range of knee joint extension, muscle tone using the Modified Ashworth scale (MAS) and Modified Tardieu scale (MTS), and 10-m walk test (10MWT). Measurements were collected three times (at baseline before exercise, immediately at the end of exercise, and 5 min after exercise during recovery). [Results] The 10-min lower limb ergometer exercise significantly improved the knee joint extension, MAS and MTS scores, and reduced lower extremity spasticity. Furthermore, it significantly increased the range of knee joint extension and decreased the 10MWT score. [Conclusion] The results showed that the 10-minute lower limb ergometer exercise is beneficial in reducing the spasticity of the lower limb muscles and in increasing the range of motion of knee extension in paraplegic patients with cerebral palsy, suggesting that its implementation in young children could prevent spasticity and enhance motor function.
Keywords: Muscle tone; Rehabilitation; Spasticity.
Conflict of interest statement
There is no conflict of interest to be disclosed in this research.
2021©by the Society of Physical Therapy Science. Published by IPEC Inc.
References
- Khamis S, Martikaro R, Wientroub S, et al. : A functional electrical stimulation system improves knee control in crouch gait. J Child Orthop, 2015, 9: 137–143.
- Kahraman A, Seyhan K, Değer Ü, et al. : Should botulinum toxin A injections be repeated in children with cerebral palsy? A systematic review. Dev Med Child Neurol, 2016, 58: 910–917.
- Shamsoddini A, Amirsalari S, Hollisaz MT, et al. : Management of spasticity in children with cerebral palsy. Iran J Pediatr, 2014, 24: 345–351.
- Kim JH, Seo HJ: Effects of trunk-hip strengthening on standing in children with spastic diplegia: a comparative pilot study. J Phys Ther Sci, 2015, 27: 1337–1340.
- Lorentzen J, Kirk H, Fernandez-Lago H, et al. : Treadmill training with an incline reduces ankle joint stiffness and improves active range of movement during gait in adults with cerebral palsy. Disabil Rehabil, 2017, 39: 987–993.
- Williams H, Pountney T: Effects of a static bicycling programme on the functional ability of young people with cerebral palsy who are non-ambulant. Dev Med Child Neurol, 2007, 49: 522–527.
- Sakamoto K, Nakamura T, Uenishi H, et al. : Immediate effects of unaffected arm exercise in poststroke patients with spastic upper limb hemiparesis. Cerebrovasc Dis, 2014, 37: 123–127.
- Li S, Francisco GE: New insights into the pathophysiology of post-stroke spasticity. Front Hum Neurosci, 2015, 9: 192.
- Pyndt HS, Laursen M, Nielsen JB: Changes in reciprocal inhibition across the ankle joint with changes in external load and pedaling rate during bicycling. J Neurophysiol, 2003, 90: 3168–3177.
- Theis N, Korff T, Kairon H, et al. : Does acute passive stretching increase muscle length in children with cerebral palsy? Clin Biomech (Bristol, Avon), 2013, 28: 1061–1067.
- Yun CK, Kim WH, Kim SG: Partial correlation between lower muscle thickness, 10-meter walk test, and the timed up & go test in children with spastic cerebral palsy. J Phys Ther Sci, 2016, 28: 1611–1613.
- Chruscikowski E, Fry NR, Noble JJ, et al. : Selective motor control correlates with gait abnormality in children with cerebral palsy. Gait Posture, 2017, 52: 107–109.
- Cheng HY, Ju YY, Chen CL, et al. : Managing spastic hypertonia in children with cerebral palsy via repetitive passive knee movements. J Rehabil Med, 2012, 44: 235–240.
Source: PubMed