Neurologic music therapy in upper-limb rehabilitation in children with severe bilateral cerebral palsy: a randomized controlled trial.

BACKGROUND: After receiving neurologic music therapy, functional improvements in children with severe bilateral cerebral palsy have not been found in the literature. Musical training with instruments allows interrelationships between movement, emotions and cognition for task-based learning, in order to improve motor control. AIM: To understand whether neurologic music therapy has an impact on the functionality of children with severe cerebral palsy. DESIGN: A randomized controlled assessor-blind trial was carried out. SETTING: Children were recruited and treated in their own community center. POPULATION: Eighteen children with severe bilateral cerebral palsy between 4 and 16 years old were studied. METHODS: The intervention group (N.=18) received music therapy for 16 weeks, in addition to its usual physiotherapy input. Two music therapists implemented a neurologic music therapy program of therapeutic instrumental music performance. The control group (N.=9) received its usual therapeutic input, similar to the intervention group, but not neurologic music therapy. Overall and specific "Chailey levels of Ability" were quantified, as well as the locomotor stages. RESULTS: Significant improvements in the overall and specific "arm and hand position" as well as "activities" from the Chailey Levels of Ability and the locomotor stages were observed (P<0.05) in the group which received the music therapy. All these improvements persisted after 4 months. The control group showed no improvements after a four-month follow-up. CONCLUSIONS: Optimized intervention of neurologic music therapy can improve the functionality of children with severe bilateral cerebral palsy. CLINICAL REHABILITATION IMPACT: Music therapy is a useful tool in rehabilitation and its positive effects remain four months after completing the treatment.

Training intensity and sagittal curvature of the spine in male and female artistic gymnasts.

BACKGROUND: Specific adaptations of the spine in the sagittal plane have been described according to different sports disciplines. The goal of this study was to describe the integrative diagnosis of the sagittal morphotype of the spine in male and female artistic gymnasts. METHODS: Forty-eight gymnasts were measured with an inclinometer. Thoracic and lumbar curves were quantified in standing position, in Sit and Reach and Slump Sitting in order to assess the sagittal spine posture and analyze if adaptations were related to training intensity. RESULTS: Correlation values of the sagittal plane spine measurements showed significantly increased thoracic kyphosis in men (-0.445, P<0.001). No significant correlations have been found between training hours per year or training volume and any measurements of the spine on the sagittal plane. When data from the two sitting tests were integrated, 62.5% of gymnasts had a functional thoracic kyphosis and 39.6% had lumbar kyphotic attitude. CONCLUSIONS: Our hypothesis has only been partially confirmed, because training intensity did not influence the sagittal curvatures in artistic gymnastics; however, this sport seems to cause specific adaptations in postural hypolordosis, functional thoracic kyphosis and lumbar kyphotic attitude during sitting and trunk flexion. The implications of the functional adaptations observed in our results may require a preventive intervention in male and female artistic gymnasts can be assessed with the integrative diagnosis of the sagittal morphotype of the spine.