Purpose: To observe the effects of whole-body vibration (WBV) training in conjunction with conventional physical therapy (PT) on joint-position sense (JPS), balance, and gait in children with cerebral palsy (CP). Methods: In this randomized controlled study, 24 children with CP were randomly selected either to continue their conventional PT or to receive WBV in conjunction with their conventional PT programme. Exposure to the intervention was intermittent (3 min WBV, 3 min rest) for 20 minutes, twice weekly for 3 weeks. JPS, balance, and gait were evaluated before and after treatment. Results: Ankle JPS was improved after 3 weeks of WBV training (p=0.014). Participants in the WBV group showed greater improvements in speed (F1,21=5.221, p=0.035) and step width (F1,21=4.487, p=0.039) than participants in the conventional PT group. Conclusion: Three weeks of WBV training was effective in improving ankle JPS and gait variables in children with CP.

Sensorimotor control dysfunction or dyskinesia is a hallmark of neuromuscular impairment in children with cerebral palsy (CP), and is often implicated in reaching and grasping deficiencies due to a neuromuscular imbalance between the triceps and biceps. To mitigate such muscle imbalances, an innovative electromyography (EMG)-virtual reality (VR) biofeedback system were designed to provide accurate information about muscle activation and motivation. However, the clinical efficacy of this approach has not yet been determined in children with CP. The purpose of this study was to investigate the effectiveness of a combined EMG biofeedback and VR (EMG-VR biofeedback) intervention system to improve muscle imbalance between triceps and biceps during reaching movements in children with spastic CP. Raw EMG signals were recorded at a sampling rate of 1,000 Hz, band-pass filtered between 20-450 Hz, and notch-filtered at 60 Hz during elbow flexion and extension movements. EMG data were then processed using MyoResearch Master Edition 1.08 XP software. All participants underwent both interventions consisting of the EMG-VR biofeedback combination and EMG biofeedback alone. EMG analysis resulted in improved muscle activation in the underactive triceps while decreasing overactive or hypertonic biceps in the EMG-VR biofeedback compared with EMG biofeedback. The muscle imbalance ratio between the triceps and biceps was consistently improved. The present study is the first clinical trial to provide evidence for the additive benefits of VR intervention for enhancing the upper limb function of children with spastic CP.

Background/aims Both upper and lower limbs interact through neural coupling. Such interconnection leads to rhythmic interlimb coordination, which affects the central pattern generator for the lower limbs. The aim of this study was to investigate the effects of repetitive intensive arm swing indirect gait training on muscle activity and gait parameters in children with cerebral palsy. Methods A total of 9 children with cerebral palsy were recruited for 20 sessions of repetitive intensive arm swing indirect gait training. They were tested before and after completion of this training using surface electromyography, spatiotemporal gait parameters assessments and clinical tests. A paired t-test was used to investigate differences in participants' vasti and hamstring activity, spatiotemporal gait parameters, and clinical test results before and after the training. Results Participants' vasti muscle activity increased significantly after the repetitive intensive arm swing indirect gait training, but there was no significant change in their hamstring muscles. However, spatiotemporal gait parameters and clinical motor function improved significantly. Conclusions Repetitive intensive arm swing indirect gait training may be suitable as an effective exercise in gait training programmes for children with cerebral palsy.

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