Innovative strength training-induced neuroplasticity and increased muscle size and strength in children with spastic cerebral palsy: An experimenter-blind case study – three-month follow-up
Affiliations: [a] Department of Physical Therapy, Honam University, Gwangju, Republic of Korea | [b] Movement Healing Lab, Department of Physical Therapy Program, Yonsei University, Wonju, Republic of Korea | [c] Department of Physical Medicine and Rehabilitation, Stroke and Cerebrovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea | [d] Korea National Rehabilitation Center, Seoul, Republic of Korea | [e] Department of Motor & Cognitive Rehabilitation, National Rehabilitation Research Institution, Seoul, Republic of Korea | [f] Department of Rehabilitation Standard and Policy, National Rehabilitation Center Research Institute, Seoul, Republic of Korea
Correspondence:
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Address for correspondence: Sung (Joshua) H. You, PT, PhD, Department of Physical Therapy, Director of Movement Healing Lab, Yonsei University, 1 Yonseidae Kil, Wonju City, 220-710 Kangwon-do, Republic of South Korea. Tel.: +82 033 760 2476; Fax: +82 033 760 2496; E-mail: neurorehab@yonsei.ac.kr
Abstract: Background:In children with cerebral palsy (CP), the never-learned-to-use (NLTU) effect and underutilization suppress the normal development of cortical plasticity in the paretic limb, which further inhibits its functional use and increases associated muscle weakness. Objective:To highlight the effects of a novel comprehensive hand repetitive intensive strengthening training system on neuroplastic changes associated with upper extremity (UE) muscle strength and motor performance in children with spastic hemiplegic CP. Method:Two children with spastic hemiplegic CP were recruited. Intervention with the comprehensive hand repetitive intensive strengthening training system was provided for 60 min a day, three times a week, for 10 weeks. Neuroplastic changes, muscle size, strength, and associated motor function were measured using functional magnetic resonance imaging (MRI), ultrasound imaging, and standardized motor tests, respectively. Results:The functional MRI data showed that the comprehensive hand repetitive intensive strengthening training intervention produced measurable neuroplastic changes in the neural substrates associated with motor control and learning. These neuroplastic changes were associated with increased muscle size, strength and motor function. Conclusions:These results provide compelling evidence of neuroplastic changes and associated improvements in muscle size and motor function following innovative upper extremity strengthening exercise.
