Intra-Rater Reliability Analysis of Trunk Muscle Tone and Activity across Different Postures Before and After Vojta Therapy in Children with Developmental Disabilities and Healthy Individuals

다국어 초록 (Multilingual Abstract)

The participants in this study consisted of four adults without disabilities and five children with disabilities, including one diagnosed with ADHD (attention deficit hyperactivity disorder), one with asymmetric developmental delay, and three with cerebral palsy. In adults without disabilities, maximal voluntary isometric contraction (MVIC) of the rectus abdominis (RA), external oblique (EO), and multifidus (MF) muscles was assessed using a myotonometer and electromyography (EMG) in supine and sitting positions. In children with disabilities, muscle tone was assessed using a myotonometer in both supine and sitting positions before and after Vojta therapy. In the assessment of intra-rater reliability among adults without disabilities, the RA muscle showed low to moderate reliability, with r = .689 during MVIC, r = .268 before therapy in the sitting position, r = .633 after therapy, and very high reliability in the supine position. The MF muscle showed a moderate correlation (r = .593) before treatment during MVIC, and a high correlation (r = .710) in the prone position, while correlations in the remaining conditions ranged from high to very high. The RA muscle in children with disabilities demonstrated moderate reliability, with correlation coefficients of r = .990 before treatment in the supine position, r = .728 before treatment (trial 1), r = .968 before treatment (trial 2), r = .867 after treatment, and r = .842 in the sitting position. The MF muscle demonstrated very high correlation, with r = .979 before treatment and r = .944 after assuming the prone position. Except for the RA muscle, correlations showed high to very high levels before therapy. In the assessment of intra-rater reliability of EMG signals across postures in non-disabled adults, the MVIC values for the three muscles varied by posture, ranging from .594 (moderate) to .941 (very high) in the RA muscle, while values were high in the remaining conditions. However, in the supine post-RA condition, the value was .112 (poor), whereas in the prone pre-condition, the MF muscle showed .372 (low). The intra-rater reliability of the EMG measurements for each muscle in the remaining postures ranged from high to very high. The intra-rater reliability of myotonometer measurements for trunk muscles was found to be high in both disabled and non-disabled participants. In this study, EMG demonstrated appropriate %MVIC values in both supine and sitting positions, indicating high reliability and validity across postures, and confirming its effectiveness as an evaluation tool for comparing pre- and post-Vojta therapy outcomes. To effectively utilize a myotonometer for assessing trunk muscle stability, it is essential to develop a standardized protocol applicable to diverse patient populations.

목차 (Table of Contents)

• Abstract
• Ⅰ. Introduction
• Ⅱ. Methods
• 1. Participants
• 2. Equipment for measuring muscle tension and electromyography
• 3. Methods for measuring muscle tone and conducting electromyography
• 4. Statistical analysis
• Ⅲ. Results
• 1. General characteristics of the study participants
• 2. Comparison of the reliability of trunk muscle tone across different postures before and after Vojta therapy in non-disabled adults
• 3. Comparison of the reliability of trunk muscle tone across different postures before and after Vojta therapy in children with disabilities
• 4. Comparison of the reliability of postural electromyography signals of trunk muscles before and after Vojta therapy in non-disabled adults
• Ⅳ. Discussion
• Ⅴ. Conclusion
• References