Effects of alternate half kneeling and conductive education on rehabilitation in children with spastic cerebral palsy

Abstract

Objective To explore the effects of alternate half kneeling movement exercise combined with conductive education on the lower extremity function, electromyography and quality of life in children with spastic cerebral palsy (SCP) . Methods By using convenient sampling, and totally 95 SCP children admitted in the Department of Pediatrics, Affiliated Hospital of Ji'ning Medical University from January 2016 to January 2018 were selected. Patients in the control group (n=47) received conventional rehabilitation therapy, while patients in the observation group (n=48) received alternate half kneeling movement exercise combined with conductive education for 6 months. Changes of Gross Motor Function Measure (GMFM) scores, dorsiflexion angle, Modified Ashworth Scale (MAS) scores, integrated electromyography (iEMG) values of tibialis anterior muscle and gastrocnemius muscle, co-contraction ratio (CR) of antagonist muscle, walking parameter, activity of daily living, Barthel index, and Pediatric Quality of Life Inventory TM 3.0 (Peds QLTM 3.0) were compared between the two groups before and after invention. Results The GMFM score was higher while the dorsiflexion angle was lower in the observation group than in the control group, and there was statistically significant difference between the two groups after invention (P<0.05) . The MAS score of gastrocnemius muscle, hamstring muscle and adductor muscle was lower in the observation group than in the control group, and there was statistically significant difference between the two groups (P<0.05) . The iEMG value of tibialis anterior muscle was higher while the iEMG value and CR of gastrocnemius muscle was lower in the observation group than in the control group, and there was statistically significant difference between the two groups (P<0.05) . The observation group showed longer step length, faster pace and smaller stride width than the control group, and there was statistically significant difference between the two groups (P<0.05) . The Barthel index and Peds QLTM 3.0 score of the observation group were higher than those of the control group, and there was statistically significant difference between the two groups (P<0.05) . Conclusions Alternate half kneeling movement exercise combined with conductive education may reduce the lower extremity muscular tension, and improve the lower extremity movement function and walking ability, the quality of daily living and quality of life in SCP children. Key words: Cerebral palsy; Children; Lower extremity function; Movement exercise; Conductive education