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Effect of modified scooter board therapy on trunk control and hip muscle activation in children with cerebral palsy -
Shreekanth D Karnad1, Amitesh Narayan1, Nutan Kamath2
1Department of Physiotherapy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
Insights
Modified Scooter Board Therapy (MSBT) shows promise in reducing hip adductor overactivity in children with cerebral palsy (CP). This engaging, parent-inclusive approach may improve motor control and quality of life.
Area of Science:
- Pediatric rehabilitation
- Neuromuscular disorders
- Biomedical engineering
Background:
- Cerebral palsy (CP) is a leading cause of childhood disability, characterized by muscle overactivity and movement deficits.
- Secondary impairments like hip displacement significantly impact quality of life in children with CP.
- Current treatments, while helpful for function, do not always prevent secondary complications.
Purpose of the Study:
- To develop and evaluate a novel therapy targeting adductor overactivity and trunk control in children with CP.
- To assess the efficacy of Modified Scooter Board Therapy (MSBT) in addressing hip-related deficits.
- To explore parent satisfaction and preference for the new intervention.
Main Methods:
- A specialized scooter board was designed to facilitate prone positioning with hip abduction and neutral rotation.
- Eight children with CP were allocated to either MSBT or a conventional exercise group for an eight-week intervention.
- Electromyographic (EMG) recordings were used to measure muscle activity at rest and during volitional tasks before and after the intervention.
Main Results:
- No statistically significant group differences were observed in overall outcomes after eight weeks.
- The MSBT group demonstrated a significant reduction in mean motor unit potential at rest in volitional hip adductor activity.
- Parents reported a preference for MSBT due to its ease of use and engaging nature.
Conclusions:
- Modified Scooter Board Therapy (MSBT) shows clinical promise for reducing adductor hypertonicity in children with CP.
- The intervention highlights the benefits of prone positioning with active muscle elongation for enhancing motor function.
- MSBT offers a potentially effective, parent-inclusive approach to managing specific motor challenges in cerebral palsy.
Abstract:
Cerebral palsy (CP), with an incidence rate of 2.95, is one of the leading causes of disability in children. The excessive tone in several muscle groups causes significant movement deficits and secondary impairments, such as hip displacement, affecting quality of life. Although age-related functional positioning treatment is effective, it does not prevent secondary deficits. Literature recommends the use of task-based training with an emphasis on the functional elongation of these spastic muscle groups. Thus, a therapy that is engaging, parent-inclusive, and addresses hip-related deficits is needed. Hence, this study aimed to develop and evaluate a therapy targeting adductor overactivity and trunk control. Modified Scooter Board Therapy (MSBT) is an intervention that uses a specially designed scooter board device, allowing children to propel themselves forward while positioned prone with hip abduction and neutral hip rotation. A convenient sample of eight children with CP were assigned to either the MSBT or conventional exercise group. The intervention lasted eight weeks, and electromyographic (EMG) recordings at rest and during volitional activity were obtained at baseline and after eight weeks. Non-parametric statistical analysis, with a significance level of p < 0.05, showed no statistically significant differences between the groups at the end of the eight weeks. However, volitional hip adductor activity significantly changed in the MSBT group, indicated by a reduction in mean motor unit potential at rest. Additionally, parents preferred MSBT for its ease of use. Thus, MSBT appears to be a clinically promising intervention to reduce adductor hypertonicity and improve active control, highlighting the importance of prone positioning with active elongation for better motor function.
