Poster 59: Strength Training-Induced Changes in Muscle Size and Motor Improvement in Bilateral Schizencephaly: Experimenter-Blind Case Report 3-Month Follow-Up

Abstract

Objective: To determine the comprehensive hand repetitive intensive strengthening training (CHRIST)−induced morphologic changes in the commonly affected extensor carpi radialis (ECR) and triceps brachii muscle and associated muscle strength and motor performance in a child with spastic quadriplegic cerebral palsy (CP) using standardized clinical tests and ultrasound imaging. Design: A single-case study with pre- and posttest. Setting: Pediatric physical therapy department at a city hospital. Participant: The patient was a 10-year-old girl who was diagnosed with spastic quadriplegic CP. Interventions: The child was trained with CHRIST for 60 minutes a day, 5 times a week, for 5 weeks. The CHRIST was designed to improve motor function and strength of the upper-extremity muscles. Main Outcome Measures: Clinical tests, including the modified Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, and Pediatric Motor Activity Log questionnaire, were used to compare the intervention-related changes in motor performance. Results: Ultrasound imaging data showed that the cross-sectional areas of both the ECR and triceps brachii muscles at relaxation and contraction states were enhanced and the therapy-induced muscle structural changes were associated with enhanced muscle strength and motor performance. Our results suggest that the CHRIST was effective in treating muscle weakness and associated motor dysfunction in a child with spastic quadriplegic CP. Conclusions: As a first step in developing an innovative and effective neurorehabilitation technique, our findings demonstrated the efficacy of CHRIST for improving muscle structure and strength as well as motor performance and skills in a child with quadriplegic CP.