Effect of elbow crutch on whole body kinematics and back muscle activities in patients with cerebral palsy

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Effect of elbow crutch on whole body kinematics and back muscle activities in patients with cerebral palsy

 

Author: Yeung, Hiu-kwong Eric
Title: Effect of elbow crutch on whole body kinematics and back muscle activities in patients with cerebral palsy
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Cerebral palsied -- Rehabilitation.
Crutches -- Physiological aspects.
Kinematics.
Department: Dept. of Health Technology and Informatics
Pages: xvi, 99 leaves : ill. (some col.) ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2265920
URI: http://theses.lib.polyu.edu.hk/handle/200/4886
Abstract: The effect of using crutches on back muscle activities and body alignment were studied on diplegic cerebral palsy patients. Erector spinae and multifidus muscle activities and kinematics of head, upper trunk, lower trunk, pelvis, hip, knee and ankle were investigated with the subjects tested under three walking conditions: no crutch, one crutch and two crutches. Ten patients who were classified as level II or III according to the Gross Motor Function Classification System (GMFCS) were recruited. A motion analysis system (VICON 370 system, Oxford Metrics, UK) with six infra-red cameras and a telemetric electromyography (Telemyo 2400R, 16-channel portable wireless recording device, Naroxon U.S.A., Inc) were used to monitor the subjects' whole body kinematics and back muscle activities in the three walking conditions. The sequence of testing of the three walking conditions was randomized. Five successful trials were acquired for each participant, for each walking condition, and averaged for statistical analysis. The data were analyzed using repeated measures analysis of variance (ANOVA). Results showed that walking speed and cadence were significantly lowered when crutches were used (p < 0.05). Erector spinae and multifidus muscle activities were significantly lowered when crutches were used (p < 0.05). Kinematic results showed that there was approximately 6o reduction in lumbar lordosis when crutches were used (p < 0.05). The pelvis was found to tilt more anteriorly (p < 0.05) and the knee was more extended at stance phase (p=0.038) when crutches were used. This phenomenon was found to be caused by a partial shift of load to the crutches; and the knees had lesser tendency to collapse into flexion. The vertical motion of trunk measured at C7 level was studied and significant reduction was observed when crutches were used. This indicates less mechanical energy is required for locomotion. In conclusion, this was the first study on the effect of elbow crutch on whole body kinematics and back muscle activities on patients with cerebral palsy. The reduction in vertical motion of body and back muscle activities might alleviate the demand on the subjects and this might help reduce the risk of back problem in patients with CP. However, further longitudinal study of back pain in cerebral palsy patients is recommended to confirm its significance.

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