Cerebral palsy improvement achieved by coordination dynamics therapy.
Low-intensity coordination dynamics therapy, including crawling, treadmill walking, jumping on spring-board and exercising on a special coordination dynamics therapy device, was applied for 3 months (4 hours therapy per week) to 8 cerebral palsy patients (average age 15 years, range 7-27). All patients improved. The organization of the CNS, quantified by the low-load coordination dynamics between arm and leg turning movements, when exercising on the special coordination dynamics therapy device, improved by 46 +/- 17% (range 33-60%) for forward and by 48 +/- 15% (range 22-66%) for backward moving. Also improved the exercised crawling, jumping and walking, although not as much as the CNS organization quantified by coordination dynamics. The motor programs of the tibialis anterior, gastrocnemius, biceps brachii, and triceps brachii muscles, measured by surface electromyography (sEMG), improved only little. Evidence is provided for sEMG being a very suitable tool for optimizing the movement performance and the therapy since sEMG records show under what exercise conditions the recorded motor programs are best. However coordination dynamics, i.e. the integrative parameter for quantifying CNS organization, is better to show the progress in CNS functioning than movement and EMG improvements. When the patients stopped therapy, the value of their coordination dynamics, worsened 24% after 6 months. In one patient the coordination dynamics therapy was continued intensively for further 3 month, including 20 hours exercise per week. The value of the coordination dynamics even improved altogether by 85% and 82% for forward and backward turning movements respectively, and simultaneously movements, vegetative (sleep) and higher mental functions (aggressivity, learning capacity) showed strong improvements. The improvements of coordination dynamics for low-intensity therapy (46%, for forward movements) and additional high-intensity therapy (85%) lie within the recovery range for stroke (70%) and brain injury (69%) after 3 months of intensive coordination dynamics therapy. There is therefore indication that the CNS functioning in cerebral palsy patients can be improved by learning as much as the CNS functioning can be repaired by re-learning in stroke and brain injury. The improvement of the CNS functioning suggests that cerebral palsy can partly be cured if intensive coordination dynamics therapy is administered for 1 to 2 years. It is further suggested that inabilities, including mental inability, are diseases which can partly be cured rather than inabilities.
Schalow
G
G
Institute of Exercise Biology and Physiotherapy, Centre of Bihavioural and Health Sciences, University of Tartu, 5 Jakobi Street, Tartu 51014, Estonia. g_schalow@hotmail.com
Jaigma
P
P
D000293:Adolescent; D000328:Adult; D001132:Arm / Q000503:physiopathology; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000628:therapy*; D002648:Child; D004576:Electromyography; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology