Effect Of Suspension Exercise Training On Motor And Balance Function In Children With Spastic Cerebral Palsy

Objective:To explore the clinical effect of suspension exercise training on gross motor and balance function in children with spastic cerebral palsy,and to evaluate its effect on the quality of life of children with spastic cerebral palsy.97 children with spastic cerebral palsy were randomly divided into experimental group（n=49）and control group（n=48）according to the random digital table method,both groups were treated with routine rehabilitation,and the experimental group increased the training of suspension exercise on the basis of routine rehabilitation treatment.The scores of the gross motor function test scale-88 D,E area and the Berg balance scale were recorded before,1,3and 6 months after treatment,respectively,at the same time,surface electromyogram（sEMG）examination was performed to observe the the changes of root mean square and integrated electromyography of the adductor muscle,gastrocnemius muscle and tibial anterior muscle and the Chinese version of the PedsQL^TM4.0 universal core scale was used to evaluate the quality of life before treatment and after 6 months of treatment.The effect of treatment between experimental group and control group was analyzed by repeated measurement data analysis of variance.The difference of quality of life between two groups of children with cerebral palsy before and after treatment was compared by covariance analysis.Result:Gross motor function Before treatment,there was no significant difference in GMFM D and E area between the two groups（P>0.05）.For the score of D area,both groups increased with the duration of treatment（F=282.342,P（27）0.001）.There were statistically significant differences between the two groups in the score of D area,and the score of D area of the experimental group was higher than the control group（F=5.094,P=0.026）.Group and time have interaction（F=7.598,P=0.002）.For the score of E area,both groups increased with the duration of treatment（F=420.295,P（27）0.001）.There were statistically significant differences between the two groups in the score of E area,and the score of E area of the experimental group was higher than the control group（F=5.766,P=0.018）,Group and time have interaction（F=76.302,P（27）0.001）.Berg balance scale There was no significant difference in Berg balance scale between the two groups before treatment（P>0.05）.Both groups of training can improve the balance function of the children.After treatment,the scores of Berg balance scale in the two groups have statistical significance,the score of the control group was lower than that of the experimental group（F=5.915,P=0.017）.The time of treatment was also affected,and the scores of the two groups increased gradually after the training（F=298.365,P（27）0.001）.Interaction between group and time（F=8.541,P（27）0.001）.Surface electromyography There was no significant difference in mean RMS and iEMG of the gastrocnemius,adductor and anterior tibial muscle in the passive state between the two groups before treatment（P>0.05）.The mean RMS and iEMG of the adductors were statistically different after treatment.The mean RMS and iEMG of the adductors in the experimental group were lower than those of the control group（RMS:F=5.52,P=0.021;iEMG:F=4.78,P=0.031）,With the increase of treatment time,the mean RMS and iEMG of the adductor muscles in both groups gradually decreased（RMS:F=203.58,P（27）0.001;iEMG:F=262.96,P（27）0.001）.Interaction between group and time（RMS:F=7.506,P=0.001;iEMG:F=16.641,P（27）0.001）.For the mean RMS and iEMG of the gastrocnemius,both groups decreased with the extension of treatment time.（RMS:F=176.89,P（27）0.001;iEMG:F=338.506,P（27）0.001）,The mean RMS and iEMG differences between the two groups in the gastrocnemius muscle were statistically significant after treatment.The mean RMS and iEMG of the gastrocnemius muscle in the experimental group were lower than those in the control group（RMS:F=4.910,P=0.029;iEMG:F=4.410,P=0.039）.Group interaction with time（RMS:F=9.817,P（27）0.001;iEMG:F=17.148,P（27）0.001）.For the mean RMS and iEMG of tibialis anterior muscle,there was no statistically significant difference between the two groups after treatment（RMS:F=0.701,P=0.405;iEMG:F=1.239,P=0.269）.With the extension of treatment time,the mean RMS and iEMG of the two groups of tibialis anterior muscles gradually decreased（RMS:F=31.044,P（27）0.001;iEMG:F=43.038,P（27）0.001）.No interaction between group and time（RMS:F=1.215,P=0.303;iEMG:F=0.355,P=0.697）.Quality of life Adjusted according to each dimension of baseline quality of life,the scores of each dimension of quality of life of children with cerebral palsy in the experimental group were physical functioning 50.22（95%CI:48.36-52.09）,emotional functioning 56.87（95%CI:55.52-58.22）,social functioning 35.76（95%CI:34.19-37.33）,total Score 48.06（95%CI:47.12-49.00）,the scores of each dimension of quality of life in the control group were physical functioning 44.68（95%CI:42.77-46.58）,emotional functioning 57.05（95%CI:55.67-58.43）,social functioning 32.93（95%CI:31.32-34.54）,total Score 44.84（95%CI:43.88-45.81）.The two groups had statistically significant differences in improving physiological function,social function,and overall score.The experimental group was superior to the control group（P<0.05）.There was no statistically significant difference in emotional function between the two groups（P>0.05）.Conclusions:1.Children with spastic cerebral palsy can improve their extensive exercise and balance function by adding suspension exercise training on the basis of regular training.2.Children with spastic cerebral palsy are more likely to improve their quality of life by adding suspension exercise training on the basis of routine training.