The effect of proprioceptive neuromuscular facilitation on functional skills, muscle strength, and trunk control in children with cerebral palsy: A randomized controlled trial

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY Early human development Pub Date : 2024-04-15 DOI:10.1016/j.earlhumdev.2024.106010

Hatice Adiguzel , Zekiye Ipek Katirci Kirmaci , Mehmet Gogremis , Yusuf Sinasi Kirmaci , Cengiz Dilber , Deniz Tuncel Berktas

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Abstract

Background

Proprioceptive neuromuscular facilitation (PNF) is generally used for the lower limbs in children with Cerebral Palsy (CP). This study aimed to determine the effect of PNF and Neurodevelopmental Therapy (NDT) on functional abilities, muscle strength, and trunk control in children with CP.

Methods

Thirty spastic CP children classified as either level I–II in the Gross Motor Function Classification System (GMFCS) or level I–II in the Manual Ability Classification System (MACS) were included. The PNF (n = 15) and the NDT group (n = 15) had physiotherapy for six weeks. The ABILHAND-Kids scale, the Purdue Pegboard Test (PBPT), the Nine-Hole Peg Test (9-HPT), and the Jebson-Taylor Hand Function Test (JTHFT) were employed. Pinch meters, Jamar handheld dynamometers, and digital muscular strength assessments were used.

Results

The PNF group increased shoulder flexion (p < 0.05), adduction (p < 0.05), elevation (p < 0.05), scapular abduction (p < 0.05), elbow extension (right) (p < 0.05), grip (p < 0.05), and pinch strengths (left p < 0.05, right p < 0.05). The PNF group had significantly lower 9-HPT (p < 0.05), JTHFT (card turning), JTHFT (simulated feeding), JTHFT (lifting light cans), and JTHFT (lifting weight cans) durations (p < 0.05), and significantly higher PBPT (right-left) PBPT (bimanual), PBPT (assembly).

(p < 0.05), ABILHAND (p < 0.05), and TCMS total scores (p < 0.001). While JTHFT (simulated feeding-left), JTHFT (stacking checkers-left), JTHFT (lifting light cans-left), and JTHFT (lifting weight cans-right/left) (p < 0.05) durations decreased in the NDT group, PBPT (right) (p < 0.05) had an increase in duration.

Conclusion

PNF improves trunk control, upper extremity functional skills, selective proximal muscle strength, and distal upper extremity muscle and grip strength.

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本体感觉神经肌肉促进对脑瘫儿童功能技能、肌肉力量和躯干控制的影响：随机对照试验

背景感觉神经肌肉促进（PNF）通常用于脑瘫（CP）儿童的下肢。本研究旨在确定 PNF 和神经发育疗法（NDT）对 CP 儿童的功能能力、肌肉力量和躯干控制能力的影响。方法纳入 30 名痉挛型 CP 儿童，他们在粗大运动功能分类系统（GMFCS）中被划分为 I-II 级，或在徒手能力分类系统（MACS）中被划分为 I-II 级。PNF组（15人）和NDT组（15人）接受了为期六周的物理治疗。研究人员采用了儿童手部功能量表（ABILHAND-Kids scale）、普渡钉板测试（Purdue Pegboard Test，PBPT）、九孔钉测试（Nine-Hole Peg Test，9-HPT）和捷布森-泰勒手部功能测试（Jebson-Taylor Hand Function Test，JTHFT）。结果PNF组增加了肩关节屈曲（p < 0.05）、内收（p < 0.PNF组增加了肩关节屈伸（p <0.05）、内收（p <0.05）、上举（p <0.05）、肩胛骨外展（p <0.05）、肘关节伸展（右）（p <0.05）、握力（p <0.05）和捏力（左p <0.05，右p <0.05）。PNF 组的 9-HPT（p < 0.05）、JTHFT（翻卡片）、JTHFT（模拟喂食）、JTHFT（提轻罐）和 JTHFT（提重罐）持续时间明显较低（p < 0.05），PBPT（右-左）、PBPT（双臂）、PBPT（装配）、ABILHAND（p < 0.05）和 TCMS 总分（p < 0.001）明显更高。虽然无损检测组的 JTHFT（模拟喂食-左）、JTHFT（堆叠检查器-左）、JTHFT（提轻罐-左）和 JTHFT（提重罐-右/左）（p < 0.05）持续时间减少，但 PBPT（右）（p < 0.05）持续时间增加。

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来源期刊

Early human development 医学-妇产科学

CiteScore

4.40

自引率

4.00%

发文量

100

审稿时长

46 days

期刊介绍： Established as an authoritative, highly cited voice on early human development, Early Human Development provides a unique opportunity for researchers and clinicians to bridge the communication gap between disciplines. Creating a forum for the productive exchange of ideas concerning early human growth and development, the journal publishes original research and clinical papers with particular emphasis on the continuum between fetal life and the perinatal period; aspects of postnatal growth influenced by early events; and the safeguarding of the quality of human survival. The first comprehensive and interdisciplinary journal in this area of growing importance, Early Human Development offers pertinent contributions to the following subject areas: Fetology; perinatology; pediatrics; growth and development; obstetrics; reproduction and fertility; epidemiology; behavioural sciences; nutrition and metabolism; teratology; neurology; brain biology; developmental psychology and screening.