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Published on: August 9, 2024
Managing lower extremity muscle tone and function in children with cerebral palsy via eight-week repetitive passive
Hsin-Yi Kathy Cheng1, Yan-Ying Ju, Chia-Ling Chen
1Graduate Institute of Early Intervention, Chang Gung University, Tao-Yuan, Taiwan. kcheng@mail.cgu.edu.tw
Insights
Repetitive passive movement (RPM) therapy effectively reduced lower extremity spasticity and improved walking in children with cerebral palsy (CP). These benefits, including enhanced ambulatory function, were observed for up to three days post-intervention.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting movement and posture.
- Spastic hypertonia and impaired ambulatory function are significant challenges for children with CP.
Purpose of the Study:
- To evaluate the efficacy of an eight-week repetitive passive movement (RPM) intervention on lower extremity muscle tone and function in children with spastic CP.
- To determine the duration of the effects of RPM on spasticity and ambulation.
Main Methods:
- A repeated measures crossover design was employed with 18 children with spastic CP.
- Participants received either an 8-week knee RPM intervention or a control condition, followed by a 4-week washout and crossover.
- Intervention involved a continuous passive motion device for 20 minutes, 3 times weekly.
Main Results:
- Significant improvements were noted in active range-of-motion, relaxation index, Modified Ashworth Scale scores, Timed Up-and-Go test, and 6-minute walk test.
- No significant changes were observed in passive range-of-motion.
- Positive effects on ambulation persisted for up to 3 days after the intervention.
Conclusions:
- Repetitive passive movement (RPM) is an effective strategy for reducing lower extremity spastic hypertonia in children with cerebral palsy.
- RPM improves ambulatory function, specifically walking speed, offering a valuable therapeutic option.
Abstract:
This study used a repeated measures design to assess the effect of an eight-week repetitive passive movement (RPM) intervention on lower extremity muscle tone and function in children with cerebral palsy (CP). Eighteen children (aged 9.5 ± 2.1 years) with spastic CP were randomly assigned to a knee RPM intervention condition of 3 times a week for 8 weeks or a control condition. The 8 weeks were followed by 4 weeks of washout period, after which the participants were crossed over to the other group. In the RPM condition, each subject's knees were intervened with continuous passive motion device (at a velocity of 15°/s) for 20 min. The subjects were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, after, 1 day after, and 3 days after each intervention. Repeated-measures statistical analyses found significant differences between condition variable on active range-of-motion of the knee (AROM, increased), relaxation index (RI, increased), Modified Ashworth Scale (MAS, decreased), timed up-and-go (TUG, decreased), 6-min walk test (6 MWT, increased); and significant differences among time variable including RI, MAS, and 6 MWT. No difference was found in passive range-of-motion measurements. Repetitive passive movement reduced lower extremity spastic hypertonia in children with cerebral palsy, and it also improved ambulatory function in terms of walking speed. Effects of this treatment protocol on ambulation lasted up to 3 days post intervention. Findings of this study provide clinicians and patients an alternative, effective and efficient strategy for spastic control and ambulatory improvement.
