Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 4 Issue 6

Cyclic 1 Minute Versus 20 Minutes Hamstrings Stretch for Spastic Cerebral Palsy

Ahmed F Attia1*, Hala R Elhabashy2 and Faten H Abdelaziem3

1Department of Physical Therapy for Pediatrics, Cairo University, Egypt
2Professor of Clinical Neurophysiology, Cairo University, Egypt
3Professor of Physical Therapy for Pediatrics, Cairo University, Egypt

*Corresponding Author: Ahmed F Attia, Department of Physical Therapy for Pediatrics, Cairo University, Giza, Egypt.

Received: April 30, 2021; Published: May 28, 2021

Abstract

Background: Children with cerebral palsy suffer from a wide range of complications which may be neurological, muscular or skeletal. Muscle tightness is a common musculoskeletal complication in cerebral palsy. Stretching exercises are one of the used methods to decrease muscle tightness but there is a lack of agreement on the effective time of single stretching session.

Objectives: To compare between 1-minute and 20-minutes stretching of hamstring.

Patients and Methods: This study was conducted on 20 children with diplegic cerebral palsy classified into 2 equal groups (group A and B). The cyclic 1-minute stretch was applied for group A and 20-minutes positional stretch was applied for group B. Their age ranged from 7 to 10 years, their degree of spasticity ranged from 1 to 2 according to modified Ashworth scale with degree of popliteal angle ranged from 30 to 45 degrees and level II or III according to gross motor function classification system. Nexus 10 by (Mind Media) was used as Surface electromyography device to monitor hamstring activity. Popliteal angle was measured by Digital inclinometer.

Result: Motor unit amplitude during stretch of group A increased significantly more than motor unit amplitude of group B (p < 0.001). No difference between motor unit amplitude of group A and motor unit amplitude of group B post stretch (p > 0.05).

Conclusion: The stretching exercise for hamstrings in children with diplegia has no significant effect on decreasing motor unit amplitude and muscle tension after one session of stretching. If we used stretching exercises on daily basis as a method of controlling hamstrings tightness, it is better to use the 20-minutes positional stretch than the cyclic 1-minute stretch.

Keywords: Stretch Time; Hamstrings Stretch; Spasticity; Cerebral Palsy

References

  1. Schimdt A., et al. “Stability of the gross motor function classification system in children and adolescents with cerebral palsy: a retrospective cohort registry study”. Developmental Medicine and Child Neurology6 (2017): 641-646.
  2. Wu Y., et al. “Chorioaminonitis and cerebral palsy in term and near term infants”. JAMA20 (2003): 2677-2684.
  3. Englander R., et al. “Toward a common taxonomy of competency domains for the health professions and competencies for physicians”. Academic Medicine8 (2013): 1088-1094.
  4. Hirtz D., et al. “How common are the "common" neurologic disorders”. Neurology5 (2007): 326-337.
  5. Hirvonen M., et al. “Cerebral palsy among children born moderately and late preterm”. Pediatrics 6 (2014): 1584-1593.
  6. Braun K., et al. “Birth prevalence of cerebral palsy: a population-based study”. Pediatrics1 (2016): 1-9.
  7. Sellier E., et al. “Decreasing prevalence in cerebral palsy: a multi-site European population based study, 1980 to 2003”. Developmental Medicine and Child Neurology1 (2016): 85-92.
  8. Richards C and Malouin F. “Cerebral palsy: definition, assessment and rehabilitation”. In: O Dulac et al. eds., Handbook of clinical neurology: pediatric neurology, Part I. Quebec, Canada: Elsevier (2013): 183.
  9. Hinden I., et al. “Outcome predictors for multilevel surgery in children with cerebral palsy/spastic diplegia”. Gait and Posture1 (2014): S52-S53.
  10. Katalinic O., et al. “Stretch for the treatment and prevention of contractures”. Cochrane Database of Systematic Reviews9 (2010): CD007455.
  11. Kisner C and Colby L. “Therapeutic exercise: foundations and techniques”. 6th Philadelphia: F.A. Davis Company (2012): 87.
  12. Guyton A and Hall J. “Textbook of medical physiology”. 11th Philadelphia: Elsevier Inc. (2006): 676-680.
  13. Bohannon R and Smith M. “Interrater reliability of a modified Ashworth scale of muscle spasticity”. Physical Therapy2 (1987): 206-207.
  14. Palisano R., et al. “Development and reliability of a system to classify gross motor function in children with cerebral palsy”. Developmental Medicine and Child Neurology4 (1997): 214-223.
  15. Finneran A and O'Sullivan L. “Effect of grip type and wrist posture on forearm EMG activity, endurance, time and movement accuracy”. International Journal of Industrial Ergonomics1 (2013): 91-99.
  16. Burke D., et al. “Autogenic effects of static muscle stretch in spastic man”. Archives of Neurology4 (1971): 367-372.
  17. Odeen I. “Reduction of muscular hypertonus by long-term muscle stretch”. Scandinavian Journal of Rehabilitation Medicine 2-3 (1981): 93-99.
  18. Tremblay F., et al. “Effects of prolonged muscle stretch on reflex and voluntary muscle activations in children with spastic cerebral palsy”. Scandinavian Journal of Rehabilitation Medicine4 (1990): 171-180.
  19. Richards C., et al. “Effects of a single session of prolonged plantarflexor stretch on muscle activations during gait in spastic cerebral palsy”. Scandinavian Journal of Rehabilitation Medicine2 (1991): 103-111.
  20. Kunkel C., et al. “Effect of “standing” on spasticity, contracture, and osteoporosis in paralyzed males”. Archives of Physical Medicine and Rehabilitation1 (1993): 73-78.
  21. Bakheit A., et al. “The effects of isotonic and isokinetic muscle stretch on the excitability of the spinal alpha motor neurones in patients with muscle spasticity”. European Journal of Neurology9 (2005): 719-724.
  22. Pin T., et al. “The effectiveness of passive stretching in children with cerebral palsy”. Developmental Medicine and Child Neurology10 (2006): 855-862.
  23. Harvey A., et al “Stretch for treatment and prevention of contracture”. Journal of Physiotherapy2 (2017): 67-75.
  24. Horsley S., et al. “Four weeks of daily stretch has little or no effect on wrist contracture after stroke: a randomized controlled trial”. The Australian Journal of Physiotherapy4 (2007): 239-245.
  25. Akbayrak T., et al. “Assessment of the short-term effect of antispastic positioning on spasticity”. Pediatrics International 47 (2005): 440-445.
  26. Odeen I and Knutsson E. “Evaluation of the effects of muscle stretch and weight load in patients with spastic paraplegia”. Scandinavian Journal of Rehabilitation Medicine4 (1981): 117-121.
  27. Stuberg A., et al. “Effects of Manual Stretching on Hamstring Flexibility in Children with Spastic Cerebral Palsy”. Pediatric Physical Therapy1(2005): 64-65.
  28. Theis N., et al. “Does acute passive stretching increase muscle length in children with cerebral palsy?” Clinical Biomechanics9-10 (2013):1061-1067.

Citation

Citation: Ahmed F Attia., et al. “Cyclic 1 Minute Versus 20 Minutes Hamstrings Stretch for Spastic Cerebral Palsy".Acta Scientific Orthopaedics 4.6 (2021): 100-107.

Copyright

Copyright: © 2021 Ahmed F Attia., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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