Effects of Combined Postural Correction Exercises on Selected Muscle Activity and Stiffness in Children With Cerebral Spastic Diplegia: Case Study

융합적 자세교정치료가 뇌성경직양측마비 아동의 선택된 근육 활성도와 강직도에 미치는 영향: 사례연구

  • Shim, Jae-Hun (Dept. of Physical Therapy, Division of Health Science, Baekseok University) ;
  • Kang, Min-Soo (Pediatric Therapy Section, Choi's Rehabilitation Hospital)
  • 심재훈 (백석대학교 보건학부 물리치료학과) ;
  • 강민수 (최재활의학과의원 소아치료실)
  • Received : 2017.12.13
  • Accepted : 2018.02.20
  • Published : 2018.02.28


The aim of this study was to investigate the short-term effects of combined postural correction exercises (CPCE) on muscle stiffness and muscle activity in children with cerebral spastic diplegia(CSD). The subjects were 3 children (2 male and 1 female) with CSD from 4 to 7 years old. The measurement sites were upper trapezius muscle(UT), rectus abdominis muscle(RA), and gluteus maximus muscle(Gmax), muscle stiffness and muscle activity were measured using Myoton and surface EMG, and the symmetry of both sides was also examined. As a result, children with severe compensatory action showed decreased muscle stiffness and muscle activity in UT and RA and increase in Gmax after CPCE intervention. Especially, the left and right symmetry of the muscles was decreased. In this study, despite some limitations, CPCE have shown a positive effect in posture correction of children with CSD.


Supported by : Korea Sanhak Foundation


  1. Maruishi M, Mano Y, Sasaki T, Shinmyo, N. , Sato, H. , Ogawa, T. (2001). Cerebral palsy in adults : Independent effects of muscle strength and muscle tone. Archives of Physical Medicine and Rehabilitation, 82(5), 637-641. DOI :
  2. HF Liao, SF Jeny, JS Lai, CK Cheng, MH Hu. (1997). The relation between standing balance and walking function in children with spastic diplegic cerebral palsy. Developmental Medicine & Child Neurology, 39(2), 106-112. DOI : 10.1111/j.1469-8749.1997.tb07392.x
  3. Hagberg B, Hagberg G, Olow I, (1993). The changing panorama of cerebral palsy in sweden. VI. Prevalence and origin during the birth year period 1983-1986, Acta Paediatrica, 82(4), 387-393. DOI : 10.1111/j.1651-2227.1993.tb12704.x
  4. U Marianne, J Jennifer, S Christina. (2013). Effect of a trunk-targeted intervention using vibration on posture and gait in children with spastic type cerebral palsy: A randomized control trial, Developmental Neurorehabilitation, 16(2), 79-88. DOI : 10.3109/17518423.2012.715313
  5. SJ Ilett. (1990). Early diagnosis and therapy in cerebral palsy. Arch Dis Child, 65(10), 1187-1188.
  6. Vera-Garcia F J, Grenier S G, & Mcgill S M, (2000) Abdominal muscle response during curl-ups on both stable and labile surfaces. Physical Therapy, 80(6), 564-569. DOI : 10.1093/ptj/80.6.564
  7. Gillen G, Burkhardt A. (1998). Stroke rehabilitation: A functional-based approach. (2nd Ed.), St.Loui. Mosby.
  8. J. Y Jung, B Song, (2012). The effects of neuromuscular electrical stimulation over trunk muscles on gross motor function and trunk muscle activity in children with cerebral palsy. Rehabilitation welfare, 16(1), 293-314.
  9. Sutherland DH, (1997) The development of mature gait. Gait & Posture, 6(2), 163-170. DOI:
  10. Royeen CB, DeGangi GA, (1992) Use of neurodevelopmental treatment as an intervention : Annotated listing of studies. Perceptual and Motor Skills, 75(1), 175-194.
  11. B. H Song, (2003). The effect of an exercise using elastic thera-band strengthening trunk muscles on the static sitting posture for children with CP. Special Education Studies, 10(1), 301-317.
  12. Jung Y. W. (2006). Effects of McKenzie exercise on the functional recovery and forward head posture of chronic neck pain patients. J Korean Soc Phys Med. 1(1), 93-108.
  13. O'Leary S, Falla D, Jull G. (2011). The relationship between superficial muscle activity during the cranio-cervical flexion test and clinical features in patients with chronic neck pain. Man Ther. 16(5), 452-455. DOI : 10.1016/j.math.2011.02.008
  14. W. M Magrun, (2009). Clinical decision making in treatment of learning disabled children. Occupational Therapy in Health, 5(1), 89-208. DOI : 10.1080/J003v05n01_14
  15. H. J. Seo, T. Y O, M. J Lee, (2012). The effects of neck strengthening exercise on postural control in sitting position during reaching in children with spastic. diplegia. Journal of Korea Society for Neurotherapy, 16(1), 17-24.
  16. H. K Lee, E. H Shin, Y. K Kim, (2015). Converged influencing factors on the stages of change of exercise in middle aged women. Journal of the Korea Convergence Society, 6(5), 187-197. DOI : 10.15207/JKCS.2015.6.5.187
  17. J. K Jeon. (2013). The effects of combination patterns exercise of proprioceptive neuromuscular facilitation on balance in chronic low back pain elderly patients. Journal of Digital Convergence, 11(4), 361-368.
  18. S. H Kim, Y. J Suh, J. B An, D. H Kwon, (2009). The effects of changing the respiratory muscles and acoustic parameters on the children with spastic cerebral palsy. Physical Therapy Korea, 16(2), 16-23.
  19. I. J Yu, K. H Son, (2011). The effects of the lower extremity muscle strengthening exercise on walking and balance of children with cerebral palsy. The Journal of Korean Academy of Physical Therapist, 18(2), 17-28.
  20. J.Y Yoon, (2003). The effects of trunk strengthening exercise using therapeutic ball on the gross functional movements for the cerebral palsy children with spastic type. dankook university, Graduate School of Special Education. Thesis.
  21. SG Baek, HJ Choi, (2015). The effect of 12weeks complexed lower body muscle-strengthening exercise program on fall risk in elderly women.. Journal of Digital Convergence, 13(10), 533-539. DOI : 10.14400/JDC.2015.13.10.533
  22. EJ Lee, (2009). A study on exercise function and balance change of children with cerebral palsy by stabilization movement of swiss ball. Catholic University of Pusan Graduate School of Life Science. Thesis.
  23. JR Oh, (2004). Effect of trunk muscle strength training on sitting balance of children with spastic cerebral palsy. The Journal of Korean Society of Physical Therapy, 16(1), 87-102.
  24. SB Jeon, HS Choi, (2015). Effects of side walking training on balance and gait in stroke patients. Journal of Digital Convergence, 13(10), 541-548. DOI : 10.14400/JDC.2015.13.10.541
  25. JS Kim, JH Lee, YC Choi, (2012). The effects of trunk muscle strengthening exercises on balance performance of sitting posture and muscle tone of children with cerebral palsy. Journal of the Korea Academia-Industrial cooperation Society, 13(9), 4098-4106. DOI : 10.5762/KAIS.2012.13.9.4098