Humeral external rotation handling by using the Bobath concept approach affects trunk extensor muscles...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Cerebral palsy (CP) often involves impaired motor control, affecting postural stability.
• The Bobath concept is a common neurodevelopmental therapy approach for CP.
• Understanding muscle activation patterns is crucial for optimizing CP interventions.

Purpose of the Study:

• To investigate electromyographic (EMG) activity of cervical and trunk extensors in children with spastic diplegic CP.
• To compare muscle responses during different handling techniques within the Bobath concept.
• To determine if muscle activity varies with the severity of CP, as classified by the Gross Motor Function Classification System (GMFCS).

Main Methods:

• A crossover trial involving 40 children with spastic diplegic CP.
• Electromyography (EMG) recorded muscle activity at C4 and T10 vertebral levels.
• Handlings included sitting position, shoulder internal rotation (IR), and shoulder external rotation (ER), with the elbow as the key control point.
• Gross Motor Function Classification System (GMFCS) levels were assessed.

Main Results:

• Shoulder external rotation (ER) handling significantly increased EMG signals in trunk extensor muscles at both C4 (P=0.007) and T10 (P<0.001) levels.
• Shoulder internal rotation (IR) handling also increased EMG signal at the T10 level (P=0.019).
• ER handling showed a GMFCS level-dependent response at the T10 vertebra (P=0.017).

Conclusions:

• Humeral ER handling effectively increases electromyographic activity in cervical and trunk extensor muscles in children with diplegic CP.
• These findings suggest that ER handling can be a valuable therapeutic tool for facilitating extensor muscle activation.
• The effectiveness of ER handling is influenced by the child's GMFCS level, indicating a need for tailored rehabilitation strategies.