Affiliations: [a] Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea | [b] Brain Korea 21 PLUS project for Medical Science, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea | [c] Department of Physical Therapy, Honam University, Gwangju, Republic of Korea | [d] Movement Healing Laboratory, Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea | [e] Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
Correspondence:
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Address for correspondence: Sung (Joshua) Hyun You, PT, PhD, Movement Healing Lab, Department of Physical Therapy, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710, Republic of Korea.
Tel.: +82 33 760 2476; Fax: +82 33 760 2496; E-mail: neurorehab@yonsei.ac.kr
Note: [1] The author contributed to this study as a first co-author.
Abstract: Background:Gait impairments from a neuromuscular imbalance are crucial issues in cerebral palsy. The purpose of our study was to compare the effects of the assistive tubing gait (ATG) and assistive-resistive tubing gait (ARTG) on improving the vasti and hamstring muscle imbalance during the initial contact to mid-stance phases in individuals with spastic diplegic cerebral palsy (CP). Methods:Fourteen age-matched individuals including seven normal individuals (11.7 years) and seven individuals with CP (12.9 years) were recruited. All participants underwent electromyography (EMG) measurement of the unilateral vasti and hamstring muscle activity during the three gait training conditions of no-tubing gait (NTG), ATG, and ARTG. A statistical one-way repeated-measure analysis of variance (ANOVA) was used to determine differences in the vasti and hamstring activity, the vasti/hamstring ratio, and the knee joint angle across the three gait training conditions for each group. Results:The initial vasti and hamstring muscle imbalance in CP was significantly improved by applying the ARTG compared with the ATG. The vasti/hamstring ratio during the ARTG was compatible with the ratio value obtained from the NTG of normal individuals. The knee joint angle in CP was not improved in this short-term intervention. Conclusions:The ARTG proportionately increased the vasti activation and reciprocally inhibited the hamstring activity, subsequently improving the neuromuscular imbalance associated with the flexed-knee gait in individuals with spastic diplegic CP.
