Articles

Year 2015, Volume 44, Issue 3

Effectiveness of an intervention program based on vestibular stimulation on the neck muscle response in a population with cerebral palsy

Alí-Morell OJ, Zurita-Ortega F, Fernández-Estévez B, Martínez-Porcel R, Padilla-Obispo B.

Abstract

Introduction: a large number of individuals with cerebral palsy (CP) exhibit alterations of vestibulocollic reflexes (VCR) which are responsible for maintaining the alignment of the head in space depending on vestibular information. Objective: to evaluate, using surface electromyography, the neck muscle response to forward-backward and left-right imbalances following an intervention program based on vestibular stimulation (VS). Material and method: we have carried out a quasi-experimental pretest–posttest study desing. Twelve individuals with cerebral palsy of Fundación Purísima Concepción in Granada participated in the study. Inclusion criteria were diagnosis of cerebral palsy in level V of GMFCS and complementary diagnosis of multiple disabilities. Those individuals who received previous treatment based on VS were excluded. Muscle activity of the neck extensor group with forward-backward and left-right imbalances was recorded using surface electromyography before and after conducting a six-month VS program. Results: statistically significant differences between the means before and after the VS program to forward-backward imbalances for both right neck extensor muscles (p = 0.025) and left (p = 0.014) were obtained. For sideways imbalances, after the implementation of the VS program, percentages of correct contraction were increased by 33.3 % for the right neck extensor muscles (p = 0.10) and 25 % for the left (p = 0.18), although not statistically significant. Conclusions: VS produces measurable improvements at EMG in neck muscle response to imbalances, especially forward and backward, in individuals with CP at GMFCS Level V.

Keywords: Cerebral palsy, vestibulo-ocular reflex, physical therapy modalities, electromyography, neck muscles.