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Meghdad Ashtiyani1 
, Parmida Moradi Birgani2 , Maryam Soleimani3 , Seyed Behnamedin Jameie4 , Amin Shahrokhi3 , Mohammad Reze Deevband * 1, Mohammad Mehdi Mirbagheri2
, Parmida Moradi Birgani2 , Maryam Soleimani3 , Seyed Behnamedin Jameie4 , Amin Shahrokhi3 , Mohammad Reze Deevband * 1, Mohammad Mehdi Mirbagheri2
1- Biomedical Engineering and Medical Physics Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Basic Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
4- Neuroscience Research Centre (NRC), Iran University of Medical Sciences, Tehran, Iran.
2- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Basic Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
4- Neuroscience Research Centre (NRC), Iran University of Medical Sciences, Tehran, Iran.
Abstract:
Introduction: Cerebral Palsy (CP) is one of the most common causes of motor disability in childhood. Since CP is a corollary to brain damage, persistent treatment should accompany an alteration in brain functional activity in line with clinical improvements.
Methods: Fourteen children with spastic hemiplegia CP were randomly divided into 2 groups. The study group (8yrs-5mos) underwent 45min AlterG training sessions 3 times/week for 8 weeks, while the control group (8yrs-2mos) received the same amount of occupational therapy (OT). Functional magnetic resonance imaging (fMRI) was conducted to quantify brain activation during the performance of passive tasks including ankle plantarflexion to dorsiflexion and knee flexion to extension over the range of motion. Walking capacity was assessed using the Timed-Up-and-Go, 10-meter, and 6-minute walk tests. All evaluations were performed before and after training and compared between the two groups.
Results: We were able to detect the signatures of ankle and knee passive movement tasks in the fMRI and characterize them in terms of activated voxels. The pre-post activation changes following the completion of training course showed that the elicited motor cortex activation was greater for the ankle than the knee tasks. For the ankle, primary motor cortex, precentral gyrus and corpus callosum showed significant enhancement in most study participants. The results indicated 16.1% more active voxels in the study than control groups. Similarly, clinical outcome measures improved over twice as much in this group.
Conclusions: AlterG training could be a potentially effective therapeutic intervention for improving gait and balance impairments in children with CP.
Methods: Fourteen children with spastic hemiplegia CP were randomly divided into 2 groups. The study group (8yrs-5mos) underwent 45min AlterG training sessions 3 times/week for 8 weeks, while the control group (8yrs-2mos) received the same amount of occupational therapy (OT). Functional magnetic resonance imaging (fMRI) was conducted to quantify brain activation during the performance of passive tasks including ankle plantarflexion to dorsiflexion and knee flexion to extension over the range of motion. Walking capacity was assessed using the Timed-Up-and-Go, 10-meter, and 6-minute walk tests. All evaluations were performed before and after training and compared between the two groups.
Results: We were able to detect the signatures of ankle and knee passive movement tasks in the fMRI and characterize them in terms of activated voxels. The pre-post activation changes following the completion of training course showed that the elicited motor cortex activation was greater for the ankle than the knee tasks. For the ankle, primary motor cortex, precentral gyrus and corpus callosum showed significant enhancement in most study participants. The results indicated 16.1% more active voxels in the study than control groups. Similarly, clinical outcome measures improved over twice as much in this group.
Conclusions: AlterG training could be a potentially effective therapeutic intervention for improving gait and balance impairments in children with CP.
Keywords: Cerebral Palsy (CP), functional Magnetic Resonance Imaging (fMRI), Anti-Gravity Treadmill, Gait
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