Effects of Therapeutic Exercise on Muscle Function following Single-Event Multilevel Surgery in Children with Spastic Lower Limb Monoplegic Cerebral Palsy

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doi:2015.24.2.195

Exerc Sci > Volume 24(2); 2015 > Article

Exercise Science 2015;24(2): 195-202. doi: https://doi.org/10.15857/ksep.2015.24.2.195

경직성 뇌성마비로 인한 하지 단마비 환아의 일단계 다수준 수술 후 치료적 운동의 효과

안근옥¹, 김아람², 이호성²

¹국민대학교
²단국대학교

Effects of Therapeutic Exercise on Muscle Function following Single-Event Multilevel Surgery in Children with Spastic Lower Limb Monoplegic Cerebral Palsy

ABSTRACT

PURPOSE:
The purpose of this study was to determine the effect of therapeutic exercise for improving muscle strength and balance ability on muscle function in children with spastic lower limb monoplegic cerebral palsy after single-event multilevel surgery (SEMLS).
METHODS:
A-seven-year-old child with spastic lower limb monoplegic cerebral palsy(CP) after SEMLS of left distal hamstring lengthening, achiles tendon lengthening, and tibialis posterior transfer, the subject showed crouch gait to the left lower limb due to CP. Therapeutic exercise program consisted of ankle joint mobilization, balance exercise, walking up and down stairs, single leg heel raise, and Single leg jump for 40 min/d, 3d/week for 8 weeks. Exercises were performed intensively to an individualized maximum number of repetitions in order to promote motor learning and improve muscle strength and muscle endurance. Calf circumference, ankle joint range of motion (ROM), and one leg standing test (OLS) were measured before and after 8 weeks of therapeutic exercise each affected side and unaffected side.
RESULTS:
Calf circumference of the affected side was increased from 23.80 cm to 24.80 cm, and Ratio of affected side to unaffected side was improved from 94.07% to 95.75%. Ankle dorsiflexion ROM with knee flexion of the affected side was increased from 12.90° to 17.30°, and ratio of affected side to unaffected side was improved from 75.00% to 98.30%. Ankle dorsiflexion ROM with knee extension of the affected side was increased from 12.00° to 17.80°, and ratio of affected side to unaffected side was improved from 70.18% to 93.19%. OLS with eye opened of the affected side was increased from 1.46 sec to 10.66 sec, and ratio of affected side to unaffected side was improved from 7.68% to 57.87%. OLS with eye closed of the affected side was increased from 0.73 sec to 1.60 sec, and ratio of affected side to unaffected side was improved from 8.96% to 18.54%.
CONCLUSIONS:
These results suggest that therapeutic exercise improve muscle function in children with spastic lower limb monoplegic cerebral palsy after SEMLS.

Key words: spastic cerebral palsy, monoplegia, SEMLS, therapeutic exercise