Facilitation handlings induce increase in electromyographic activity of muscles involved in head control of cerebral palsy children.
Side-lying hip holds spark stronger neck muscle firing than belly-lying in kids with CP.
01Research in Context
What this study did
The team worked with children who have cerebral palsy and poor head control.
They used gentle hip holds called facilitation handlings.
Sensors on the neck muscles checked how hard the muscles worked during two lying positions: on the side and on the belly.
What they found
Both holds made the neck muscles fire more.
The side-lying hold lit up the muscles at the C4 neck level the most.
More muscle firing means more practice for head control.
How this fits with other research
Berkovits et al. (2014) also built a new CP tool, but theirs asked parents how hard it feels to move their child.
Perez et al. (2015) used another electric signal, motor-evoked potentials, to map fine-motor skill in hemiparesis.
All three studies show that quick, cheap electric signals—EMG or MEP—can tell us what a child can do before we see big movements.
Why it matters
You can add a 30-second side-lying hip hold to any mat session.
No extra gear beyond your hands.
Watch the child’s head lift higher as the muscles wake up.
It is a simple way to turn passive positioning into active strengthening.
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02At a glance
03Original abstract
This study aimed to investigate the electromyographic (EMG) activation of the main cervical muscles involved in the head control during two postures widely used for the facilitation of head control in children with Cerebral Palsy (CP). A crossover trial involving 31 children with clinical diagnosis of CP and spastic quadriplegia was conducted. Electromyography was used to measure muscular activity in randomized postures. Three positions were at rest: (a) lateral decubitus, (b) ventral decubitus on the floor and (c) ventral decubitus on the wedge. Handlings for facilitating the head control were performed using the hip joint as key point of control in two postures: (a) lateral decubitus and (b) ventral decubitus on wedge. All children underwent standardized handlings, performed by the same researcher with experience in the neurodevelopmental treatment. EMG signal was recorded from muscles involved in the head control (paraspinal and sternocleidomastoid muscles) in sagittal, frontal and transverse planes, at the fourth cervical vertebra (C4), tenth thoracic vertebra (T10) and sternocleidomastoid muscle (SCM) levels. The results showed a significant increase in muscle activation when handling was performed in the lateral decubitus at C4 (P<0.001), T10 (P<0.001) and SCM (P=0.02) levels. A significant higher muscle activation was observed when handling was performed in lateral decubitus when compared to ventral decubitus at C4 level (P<0.001). Handling in ventral decubitus also induced an increase in EMG activation at T10 (P=0.018) and SCM (P=0.004) levels but not at C4 level (P=0.38). In conclusion, handlings performed in both positions may induce the facilitation of head control, as evaluated by the activity of cervical and upper trunk muscles. Handling performed in lateral decubitus may induce a slightly better facilitation of head control. These findings contribute to evidence-based physiotherapy practice for the rehabilitation of severely spastic quadriplegic CP children.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.06.018