چکیده:
Introduction: Gait impairment is one of the consequences of cerebral palsy (CP) as a permanent neurological disorder. In order to have persistent treatment effect, the therapy-induced neuroplasticity should have accompanied by functional improvement. In this regard, we aimed to determine the correlation between brain functional activity changes and walking capacity improvement following treatments in children with hemiplegic CP (HCP).
Method: Twenty-one spastic HCP children (7-12 years old) were randomly divided into 3 groups. Occupational therapy (OT) was performed for the first group. The second group received repetitive transcranial magnetic stimulation (rTMS) treatment and the third group underwent anti-gravity treadmill (AlterG) training. OT and AlterG training was provided for 45min, and rTMS was applied for 20min per sessions, 3 times per week for 8 weeks.
Brain functional activity while execution of passive tasks involving knee flexion/extension and ankle plantarflexion/dorsiflexion over the range of motion (ROM) was quantified using functional magnetic resonance imaging (fMRI). Walking capacity was indexed by clinical measures. Clinical and fMRI evaluations were performed pre- and post-training.
Result: Our results indicate that intensive OT, rTMS and AlterG training enhanced brain functional activity as well as walking capacity in pediatrics with CP. Also our results revealed a robust correlation between the corpus callosum functional activity changes and walking capacity improvement.
Conclusion: Regardless of the type of treatment, the improvement in gait function in children with CP may reflect as an increase in brain functional activity in callosal neurons which in turn may reveal the increase in interhemispheric coupling.
Method: Twenty-one spastic HCP children (7-12 years old) were randomly divided into 3 groups. Occupational therapy (OT) was performed for the first group. The second group received repetitive transcranial magnetic stimulation (rTMS) treatment and the third group underwent anti-gravity treadmill (AlterG) training. OT and AlterG training was provided for 45min, and rTMS was applied for 20min per sessions, 3 times per week for 8 weeks.
Brain functional activity while execution of passive tasks involving knee flexion/extension and ankle plantarflexion/dorsiflexion over the range of motion (ROM) was quantified using functional magnetic resonance imaging (fMRI). Walking capacity was indexed by clinical measures. Clinical and fMRI evaluations were performed pre- and post-training.
Result: Our results indicate that intensive OT, rTMS and AlterG training enhanced brain functional activity as well as walking capacity in pediatrics with CP. Also our results revealed a robust correlation between the corpus callosum functional activity changes and walking capacity improvement.
Conclusion: Regardless of the type of treatment, the improvement in gait function in children with CP may reflect as an increase in brain functional activity in callosal neurons which in turn may reveal the increase in interhemispheric coupling.
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