Comparison of emg biofeedback and johnstone pressure splints in children with hemiplegic cerebral palsy

Abstract

Objective: This study was carried out to compare Johnstone pressure splints and electromyographic (EMG) biofeedback in addition to neurodevelopmental therapy on activities of daily living, sensory perception and motor integration functions, functional hand activities, and muscle tone in children with hemiplegic cerebral palsy (CP). Materials and Methods: Thirty-eight children with spastic hemiplegic cerebral palsy, whose motor development levels were similar, were included in this study and were divided into two groups. In addition to Bobath's neurodevelopmental therapy, Group I was treated with pressure splints for the upper extremity and Group II-with EMG biofeedback training, also applied to the upper extremity, three times a week for three months. In the biofeedback group the session length was 20 minutes and in the Johnstone group, it was 50 minutes in total, with and without splinting. Patients were evaluated for muscle tone, activities of daily living, sensory perception and motor integration functions, and functional hand activities before and after therapy, and on the third and sixth months following therapy. Results: At the third and sixth months after treatment, significant improvement was found in muscle tone, activities of daily living, sensory perception and motor integration functions, and functional hand activities (p<0.05). Moreover, the findings in Group I were more significant than those in Group II (p<0.001). Conclusion: These results show that both treatment methods are helpful to Bobath approach in cerebral palsy rehabilitation. However, EMG biofeedback treatment is more effective due to the fact that it encourages the child's active participation. Turk J Phys Med Rehab 2010;56:116-23. © Turkish Journal of Physical Medicine and Rehabilitation.