Comparison of two techniques for transferring adults with cerebral palsy with particular reference to trunk muscles activities

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Comparison of two techniques for transferring adults with cerebral palsy with particular reference to trunk muscles activities

 

Author: Ip, Kam-hing
Title: Comparison of two techniques for transferring adults with cerebral palsy with particular reference to trunk muscles activities
Degree: M.Sc.
Year: 1997
Subject: Cerebral palsied -- Transportation
Lumbar vertebrae
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Pages: xiv, 159 leaves : ill. ; 31 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1405413
URI: http://theses.lib.polyu.edu.hk/handle/200/460
Abstract: Two approaches of scapular-hold transferring technique, namely 'neck-hold' and 'back-hold', have been commonly used in transferring adult clients with cerebral palsy. These two approaches may have different loading on the helpers' lumbar spine and it was known that repeated transfers increase the risk of back injury which may result in accelerating the degeneration process of the lumbar spine. It was therefore, the objective of this study to determine which transferring technique should be preferred. The study was conducted by investigating and comparing electromyographic (EMG) activities of the trunk muscles of the helpers in transferring an adult client with cerebral palsy using the two transferring techniques. An EMG system was used to measure the EMG activities of various trunk muscles including erector spinae, rectus abdominis and external oblique muscles from both sides. During the experiment, each subject performed six transfers: three times with 'back hold' and three times with 'neck hold'. The integrated EMG signals of each muscle were normalized with respect to the EMG signal obtained from a maximum voluntary isometric test of that muscle. Each transferring process was divided into lifting, rotating and lowering phases. The normalized peak EMG signals for three trials in each phase of each transfer were determined and averaged. 2-tailed paired t-test was used to compare the back-hold and the neck-hold transferring techniques. Statistical findings showed that there was significant difference between the two transferring techniques in both left and right erector spinae in all the three phases (P<0.05), except for the right erector spinae in the lowering phase. It was found that the normalized peak EMG values for the neck-hold technique were higher than those for the back-hold technique. No significant difference was found between the two techniques for bilateral rectus abdominis and external oblique muscles in all three phases. The average time taken for the transfers using the two techniques was also found to have significant difference, with the back-hold technique having a longer mean time. Significant differences were also found in EMG-time integrals of bilateral erector spinaes and bilateral external oblique muscles between the two transferring techniques during the lifting phase and the rotating phase respectively. During lifting phase, EMG-time integrals of bilateral erector spinaes were higher in the neck-hold transfers while during the rotating phase, the integrals of bilateral external oblique muscles were higher in the back-hold transfers. Due to the high activation level of erector spinaes in the lifting phase, the effect of higher EMG-time integrals on loading of spine might be larger than that of external oblique muscles. It could be concluded that transferring using the back-hold technique would have a lower demand on the back muscles. However, further studies on kinetics and kinematics, as well as contribution by other body parts during the transfers would be needed in order to provide additional information about the choice of transferring technique specifically for clients with cerebral palsy.

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