Universität zu Köln

Krause, Anne, Schoenau, Eckhard, Gollhofer, Albert, Duran, Ibrahim ORCID: 0000-0003-4044-8822, Ferrari-Malik, Anja, Freyler, Kathrin and Ritzmann, Ramona (2017). Alleviation of Motor Impairments in Patients with Cerebral Palsy: Acute Effects of Whole-body Vibration on Stretch Reflex Response, Voluntary Muscle Activation and Mobility. Front. Neurol., 8. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-2295

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Abstract

Introduction: Individuals suffering from cerebral palsy (CP) often have involuntary, reflex-evoked muscle activity resulting in spastic hyperreflexia. Whole-body vibration (WBV) has been demonstrated to reduce reflex activity in healthy subjects, but evidence in CP patients is still limited. Therefore, this study aimed to establish the acute neuromuscular and kinematic effects of WBV in subjects with spastic CP. Methods: 44 children with spastic CP were tested on neuromuscular activation and kinematics before and immediately after a 1-min bout of WBV (16-25 Hz, 1.5-3 mm). Assessment included (1) recordings of stretch reflex (SR) activity of the triceps surae, (2) electromyography (EMG) measurements of maximal voluntary muscle activation of lower limb muscles, and (3) neuromuscular activation during active range of motion (aROM). We recorded EMG of m. soleus (SOL), m. gastrocnemius medialis (GM), m. tibialis anterior, m. vastus medialis, m. rectus femoris, and m. biceps femoris. Angular excursion was recorded by goniometry of the ankle and knee joint. Results: After WBV, (1) SOL SRs were decreased (p < 0.01) while (2) maximal voluntary activation (p < 0.05) and (3) angular excursion in the knee joint (p < 0.01) were significantly increased. No changes could be observed for GM SR amplitudes or ankle joint excursion. Neuromuscular coordination expressed by greater agonistantagonist ratios during aROM was significantly enhanced (p < 0.05). Discussion: The findings point toward acute neuromuscular and kinematic effects following one bout of WBV. Protocols demonstrate that pathological reflex responses are reduced (spinal level), while the execution of voluntary movement (supraspinal level) is improved in regards to kinematic and neuromuscular control. This facilitation of muscle and joint control is probably due to a reduction of spasticity-associated spinal excitability in favor of giving access for greater supraspinal input during voluntary motor control.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Krause, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoenau, Eckhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Gollhofer, Albert UNSPECIFIED UNSPECIFIED UNSPECIFIED Duran, Ibrahim UNSPECIFIED orcid.org/0000-0003-4044-8822 UNSPECIFIED Ferrari-Malik, Anja UNSPECIFIED UNSPECIFIED UNSPECIFIED Freyler, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ritzmann, Ramona UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-221729
DOI:	10.3389/fneur.2017.00416
Journal or Publication Title:	Front. Neurol.
Volume:	8
Date:	2017
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-2295
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MODIFIED ASHWORTH SCALE; SPINAL-CORD-INJURY; SOLEUS H-REFLEX; RECIPROCAL INHIBITION; INTERRATER RELIABILITY; TENDON VIBRATION; CHILDREN; SPASTICITY; BALANCE; GAIT Multiple languages Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22172