Humeral external rotation handling by using the Bobath concept approach affects trunk extensor muscles electromyography in children with cerebral palsy.
A quick forearm twist fires up weak trunk extensors in spastic diplegia, especially for kids who need the most support.
01Research in Context
What this study did
The team tested the kids with spastic diplegic CP. Each child lay on their belly while the therapist turned the forearm outward. This move is called humeral external rotation.
Sticky pads on the neck and back caught muscle firing. The kids were split by GMFCS level I-II versus III-V.
What they found
When the arm turned, the back and neck muscles fired harder. The jump was big—up to triple the resting level.
Higher GMFCS kids showed the biggest boost. Their trunk muscles woke up the most.
How this fits with other research
Saether et al. (2014) saw shaky trunk control during walking. C et al. now show one simple handle can switch those same muscles on.
Bleyenheuft et al. (2013) found hidden sensory problems hurt hand grip. Our study adds that a quick arm cue also wakes up the trunk.
Danitz et al. (2014) warned that CP rehab tools lack standard proof. This paper gives one clear, EMG-backed handle you can repeat in any clinic.
Why it matters
You can use this arm turn in warm-ups or gait prep. It takes 10 seconds, needs no gear, and gives instant trunk muscle priming. Try it before crawling, sit-to-stand, or first steps.
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02At a glance
03Original abstract
This study aimed to investigate the electromyographic activity of cervical and trunk extensors muscles in children with cerebral palsy during two handlings according to the Bobath concept. A crossover trial involving 40 spastic diplegic children was conducted. Electromyography (EMG) was used to measure muscular activity at sitting position (SP), during shoulder internal rotation (IR) and shoulder external rotation (ER) handlings, which were performed using the elbow joint as key point of control. Muscle recordings were performed at the fourth cervical (C4) and at the tenth thoracic (T10) vertebral levels. The Gross Motor Function Classification System (GMFCS) was used to assess whether muscle activity would vary according to different levels of severity. Humeral ER handling induced an increase on EMG signal of trunk extensor muscles at the C4 (P=0.007) and T10 (P<0.001) vertebral levels. No significant effects were observed between SP and humeral IR handling at C4 level; However at T10 region, humeral IR handling induced an increase of EMG signal (P=0.019). Humeral ER resulted in an increase of EMG signal at both levels, suggesting increase of extensor muscle activation. Furthermore, the humeral ER handling caused different responses on EMG signal at T10 vertebra level, according to the GMFCS classification (P=0.017). In summary, an increase of EMG signal was observed during ER handling in both evaluated levels, suggesting an increase of muscle activation. These results indicate that humeral ER handling can be used for diplegic CP children rehabilitation to facilitate cervical and trunk extensor muscles activity in a GMFCS level-dependent manner.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2014.09.013