Strengthening exercises versus neuro-muscular electrical Stimulation of gluteus maximus on pelvic obliquity in children with spastic diplegic cerebral palsy: A comparative study

Abstract

INTRODUCTION: In spastic diplegic Cerebral Palsy, there is weakness of lower limbs especially in Gluteus Maximus. Biomechanically gluteus maximus tilts the pelvic posteriorly. So in spastic diplegic cerebral palsy there is anterior pelvic tilt which cause postural abnormality and difficulty in walking. AIM OF THE STUDY: To evaluate the effect of Neuro-muscular electrical stimulation (NMES) and functional strengthening exercises on gluteus maximus strength and pelvic obliquity. METHODOLOGY: 30 children with spastic diplegic cerebral palsy were fulfilling the inclusion criteria were taken into the study and assigned into 2 groups with 15 subjects in each group ranged from 3-12 years. Group 1: (3 girls and 12 boys) received NMES with conventional exercises. Group 2: (1 girl and 14 boys). received only conventional strengthening exercises. All the subjects underwent an initial baseline assessment of gluteus maximus isometric strength by modified sphygmomanometer and pelvic tilt by modified pelvic inclinometer. Total duration of treatment was 5 days per week for 6 weeks. DATA ANALYSIS: The data was analysed using SPSS version 16, between groups difference for gluteus maximus strength and pelvic inclination was done by using 2X2 ANOVA and within group difference analysis was done using Multivariate test and Mauchly's sphericity test. RESULTS: Results of the study suggested that both the control group and experimental group had a significant improvement after treatment for 6 weeks. However, the experimental group showed greater change as compared to control group. CONCLUSION: The NMES with conventional exercises are more effective than conventional strengthening exercises alone to improve gluteus maximus strength and pelvic obliquity.