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Therapeutic Effects of Anti-Gravity Treadmill (Alterg) Training on Reflex Hyper-Excitability, Corticospinal Tract Activities, and Muscle Stiffness in Children With Cerebral Palsy Publisher Pubmed



Parvin S1 ; Taghiloo A2 ; Irani A3 ; Mirbagheri MM4, 5
Authors
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Authors Affiliations
  1. 1. Department of Biomedical Engineering and Medical Physics, Faculty of Medicine, Tehran University of Medical Sciences, Neural Engineering Research Center, Noorafshar Hospital, Tehran, Iran
  2. 2. Department of Radiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Occupational Therapy, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences Health Services, Tehran, Iran
  4. 4. Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Neural Engineering Research Center, Noorafshar Hospital, Tehran, Iran
  5. 5. Department of Physical Medicine and Rehabilitation, Northwestern University, United States

Source: IEEE International Conference on Rehabilitation Robotics Published:2017


Abstract

We aimed to study therapeutic effects of antigravity treadmill (AlterG) training on reflex hyper-excitability, muscle stiffness, and corticospinal tract (CST) function in children with spastic hemiplegic cerebral palsy (CP). Three children received AlterG training 3 days per week for 8 weeks as experimental group. Each session lasted 45 minutes. One child as control group received typical occupational therapy for the same amount of time. We evaluated hyper-excitability of lower limb muscles by H-reflex response. We quantified muscle stiffness by sonoelastography images of the affected muscles. We quantified CST activity by transcranial magnetic stimulation (TMS). We performed the evaluations before and after training for both groups. H response latency and maximum M-wave amplitude were improved in experimental group after training compared to control group. Two children of experimental group had TMS response. Major parameters of TMS (i.e. peak-to-peak amplitude of motor evoked potential (MEP), latency of MEP, cortical silent period, and intensity of pulse) improved for both of them. Three parameters of texture analysis of sonoelastography images were improved for experimental group (i.e. contrast, entropy, and shear wave velocity). These findings indicate that AlterG training can improve reflexes, muscle stiffness, and CST activity in children with spastic hemiplegic CP and can be considered as a therapeutic tool to improve neuromuscular abnormalities occurring secondary to CP. © 2017 IEEE.
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