EFFECT OF AUDITORY & VISUAL BIOFEEDBACK WITH ELECTRICAL STIMULATION OF THE TIBIALIS ANTERIOR MUSCLE ON ACTIVE ROM & SELECTIVE MOTOR CONTROL OF ANKLE OF CHILDREN WITH SPASTIC CEREBRAL PALSY

Background & Objective: Cerebral palsy (CP) is the most common cause of movement disability in childhood, with an incidence of 1.5?2.5 per 1000 live born children. It is a non-progressive disorder that covers a number of neurological conditions, resulting in an abnormal development of movement and postural control. It is believed that an inability to maximally activate their muscles contributed to this weakness. Visual and auditory feedback cues have been shown to improve ROM & VMC in patients with movement disorders. The aim of this work was to investigate the efficacy of using biofeedback and neuromuscular electrical stimulation applied on tibialis anterior in children with cerebral palsy. The present work was designed to compare the effect of treatment with or without biofeedback applied to children with diplegic CP. Materials and Method: The 30 children with CP were divided in to 2 groups(experimental & control.The control group received NMES on tibialis anterior for 20 min. a day ,6 days in a week for a period of 6 weeks.the experimental group received NMES +biofeedback +conventional treatment.pre and post treatment evaluation included range of motion ,VMC and GMFM scoring. Results: Results showed that there was main effect for time, f(1,28;0.05)=4.37, p<0.046 & a main effect for time, f(1,28;0.05)=1.30, p<0.00,however there main effects were qualified by a group × time interaction, f (1,28;0.05)=219.37, p<0.00.There was main effect for time, f(1,28;0.05)=4.64. p<0.04 & a main effect for group, f(1,28;0.05)=485.96, p<0.00,however there main effects were qualified by a group × time interaction, f (1,28;0.05)=65.96, p <0.00 in right and left ankle joint. Conclusion: A significant improvement in range of motion, VMC & GMFM in experimental group as compare to control group. The study determined that biofeedback have positive clinical effects on the ROM & VMC of ankle of spastic diplegic.