Neuropediatrics 2006; 37 - PS1_6_2
DOI: 10.1055/s-2006-943591

EFFECT OF FACILITATION TECHNIQUE ON CORTICAL ACTIVITY DURING GAIT IN CHILDREN WITH SPASTIC DIPLEGIA: AN OPTICAL IMAGING STUDY

H Arai 1, M Shima 1, M Suzuki 1, I Miyai 1
  • 1Department of Pediatric Neurology, Bobath Memorial Hospital, Osaka, Japan

Objectives: We investigated changes of regional activation in the frontal cortices of children with cerebral palsy during gait in order to test the hypothesis that a facilitation technique alters the cortical activation.

Methods: Six children with spastic diplegia due to periventricular leukomalacia (CP, 5–11 years) and three healthy children (CON, 9–11 years) were included in the study. Informed consent was obtained from their parents. Each subject performed three tasks of treadmill walking with hands support (0.2–3.0km/hr, depending on each subject's ability), alternated with rest every thirty seconds for three repetitions. Only the second task was performed with facilitation technique that enhanced swinging of the legs. Changes of regional activation were assessed by task-related changes of oxygenated hemoglobin concentration (oxyHb) using a near-infrared spectroscopic imaging technique (OMM-2001, Shimazu). Obtained data was analyzed by two-factorial repeated-measures ANOVA and Fisher's protected least significance posthoc test.

Results: During the first task the regional oxyHb in medial sensori-motor cortex elevated in all subjects, and oxyHb in supplementary motor area elevated in CON. The increase of oxyHb in medial sensori-motor cortex of CP reduced significantly during the second task (1.03±0.43 mMol×cm vs. 0.19±0.41) and remained reduced during the third task. No prominent change of oxyHb was observed in other regions of CP and in any regions of CON. Cadence of each subject did not change throughout the three tasks.

Conclusion: We reported that premotor and pre-supplementary motor activation was enhanced during gait with facilitation technique in adult patients with stroke (Ann Neurol, 2002). Reduction of medial sensori-motor activation observed during and after the technique in CP suggests the difference of locomotion control between CP and adult patients with stroke. We conclude that the facilitation technique provides the chance for CNS to utilize another way of controlling gait in cerebral palsy.