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Enhancement of Two Motor Functions of the Lower Extremity in a Child With Spastic Quadriplegia

Ms. Laskas completed this study in partial fulfullment for the Master of Science degree, Department of Physical Therapy, Sargent College of Allied Health Professions, Boston University, Boston, MA, and while training at the Developmental Evaluation Clinic, Children's Hospital Medical Center, Boston, MA. She is now Staff Physical Therapist, Kennedy Memorial Hospital for Children, Boston, MA 02135 (USA).
Ms. Mullen is Supervisor of Physical Therapy, North Shore Children's Hospital, Salem, MA.
At the time of this study, Dr. Nelson was Assistant Professor, Occupational Therapy Department, Sargent College of Allied Health Professions, Boston University, Boston, MA. He is now Associate Professor, Occupational Therapy Department, Western Michigan University, Kalamazoo, MI.
At the time of this study, Ms. Willson-Broyles was Supervisor of Physical Therapy, Developmental Evaluation Clinic, Children's Hospital Medical Center, Boston, MA.

This single-subject experimental design examined the immediate effects of four neurodevelopmental treatment (NDT) activities on two dependent variables: dorsiflexor muscle activity during an equilibrium response and frequency of heel contact during movement to a standing position. The subject was a 2.5-year-old boy with spastic quadriplegia. During the seven days of Baseline 1 Phase, the nine days of Treatment Phase, and the seven days of Baseline 2 Phase, dorsiflexor muscle activity was examined using an EMG instrument with surface electrodes. Frequency of heel contact was recorded as the number of times in seven trials that the child came to a standing position with his heel contacting the floor. Conditions were identical across all three phases except that four NDT activities were introduced during the Treatment Phase and were withdrawn during the Baseline 2 Phase. The results demonstrated that these NDT activities increased dorsiflexor muscle activity during a posterior equilibrium reaction and increased the frequency of heel contact when the child came to a standing position. This study contributes to the growing body of literature in NDT.

Key Words: Cerebral palsy • Child development • Neurophysiology • Physical therapy

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