Influence of biofeedback training time on muscle torque and knee excursion following semitendinosus release in spastic quadriplegic children with cerebral palsy: A randomized controlled trial

Abstract

Background. Medial hamstring shortening represents a serious common complication in children suffering from spastic quadriplegic cerebral palsy. Objective. The purpose of the study was to examine the efficacy of biofeedback training timing following tendon release in spastic quadriplegic cerebral palsied children. Design. a prospective, single-blind, randomized controlled trial. Setting: several hospitals across Giza and Cairo, where children were operated. Methods. Thirty spastic quadriplegic cerebral palsied children of both genders, with their ages ranged from 7 to 9 years (x ̅  = 8.2 ± 0.86 yr.) were randomly assigned into two equal groups (A and B). The control group (A) was trained using electromyographic biofeedback daily for two weeks after removal of plaster cast, in addition to an hour/ day of a designed physical therapy program, while the study group (B) was trained by electromyographic biofeedback during the immobilization period and for two weeks after removal of the cast along with the same physical therapy program as the group (A). The knee extensors’ peak torque and knee excursion angle were measured immediately and two weeks following cast removal by MERAC isokinetic system and electro-goniometer, respectively. Results. The findings exhibited a significant increase (P < 0.05) in the peak torque of knee extensors and an increase in knee excursion in the group (B) immediately and after two weeks of the cast removal when compared with the results of the group (A) after the same period. Conclusion. Applying electromyographic biofeedback training at the two-week immobilization period resulted in a strengthening of the quadriceps and maintaining the obtained range of knee extension following semitendinosus muscle release in spastic quadriplegic children with cerebral palsy.