Effects of dynamic neuromuscular stabilization on diaphragm movement, postural control, balance and gait performance in cerebral palsy

NeuroRehabilitation. 2017;41(4):739-746. doi: 10.3233/NRE-172155.

Abstract

Purpose: To determine the effects of a novel dynamic neuromuscular stabilization (DNS) technique on gross motor function, diaphragm movement, and activation of the external oblique (EO) and internal oblique (IO)/transversus abdominal (TrA) muscles in participants with cerebral palsy (CP).

Method: Fifteen participants with CP (7 females) underwent DNS intervention for 30 minutes/day, 3 days a week for 4 weeks. Gross motor function, diaphragm movement, and muscle activation were determined using a gross motor function measure (GMFM-88), ultrasound, and electromyography measurements, respectively, before and after the DNS core stabilization intervention. Paired t-tests were used at p < 0.05.

Design: A single-arm, pretest-posttest clinical trial.

Results: GMFM scores for standing, walking, and jumping domains were significantly improved after the intervention (P < 0.05). Diaphragm descending movement (P = 0.0001) and activation of the internal oblique and transversus abdominals were initially undetectable, but remarkably increased after the intervention (P = 0.012).

Conclusions: DNS is a promising, effective intervention for facilitating deep core muscle activation of the underactive muscle chain comprising the diaphragm, internal oblique, and transversus abdominals, thereby improving age-appropriate standing, walking, and jumping in participants with spastic diplegic CP.

Keywords: Dynamic neuromuscular stabilization; cerebral palsy; diaphragm; ultrasound.

MeSH terms

  • Cerebral Palsy / rehabilitation*
  • Diaphragm / physiology*
  • Exercise Therapy*
  • Female
  • Gait / physiology*
  • Humans
  • Male
  • Postural Balance / physiology*
  • Task Performance and Analysis