Correction of muscle imbalance in spasticity

A summary is presented of observations made and results obtained during evaluation and preliminary treatment of twenty-one predominantly spastic cerebral palsied subjects, whose neuromuscular function was studied in each of four positions (supine, prone, kneeling and sitting on the floor) and in three dynamic situations (rising to standing, maintaining standing balance, and ambulating). A description is given of the procedures utilized to; (i) correct the imbalance of muscle tone imposing abnormal "resting" joint positions and limiting the range of their voluntary movements, and (ii) assist them in developing the sensorimotor function requisite for postural stability and voluntary motor control, involving exercises performed in each of the four positions and in transitions between them. Resistance exercises performed with the investigator and independent exercises both were included in the program. Case studies of a six-year-old spastic with "pre-athetoid" tendencies, an 11-year old spastic and a 32-year-old spastic are provided to illustrate typical initial evaluations, therapeutic activities subsequently utilized to improve neuromuscular function, and results thereby obtained.