scholarly journals Factors Influencing Motor Outcome of Hippotherapy in Children with Cerebral Palsy

2019 ◽  
Vol 50 (03) ◽  
pp. 170-177 ◽  
Author(s):  
Yeo Seung Mi ◽  
Lee Ji Young ◽  
Shin Hye Yeon ◽  
Seo Yun Sik ◽  
Kwon Jeong Yi
Keyword(s):  
Cerebral Palsy ◽  
Postural Control ◽  
Motor Function ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Factors Influencing ◽  
Children With Cerebral Palsy ◽  
Motor Outcome ◽  
Level I ◽  
Gmfcs Level

Objective This study was aimed to identify individual factors influencing the gross motor outcome of hippotherapy in children with cerebral palsy (CP). Methods One hundred and forty-six children with CP (mean age: 5.78 ± 1.72 years, male: 56.2%) presenting variable function (gross motor function classification system [GMFCS], levels I–IV) participated in this study. Participants received 30 minutes of hippotherapy twice a week for 8 weeks. Clinical information including GMFCS level, age, sex, CP distribution, CP type, gross motor function measure-88 (GMFM-88), GMFM-66, and pediatric balance scale (PBS) score were collected retrospectively. We regarded the children with GMFM-66 score increased by 2.0 points as good responders to hippotherapy. Further we analyzed factors affecting good responders. Results GMFCS level I and II compared with IV (odds ratio [OR] = 6.83) and III compared with IV (OR = 4.45) were significantly associated with a good response to hippotherapy. Higher baseline GMFM E (OR = 1.05) and lower baseline GMFM B (OR = 0.93) were also significantly associated with a good response to hippotherapy. Sex, age, CP type, and distribution were not factors influencing gross motor outcome of hippotherapy. Conclusions The children with CP, GMFCS level I–III, with relatively poor postural control in sitting might have a greater chance to improve their GMFM-66 scores through hippotherapy. This supports the hypothesis that hippotherapy is a context-focused therapy to improve postural control in sitting.

scholarly journals Validation of a Model of Gross Motor Function for Children With Cerebral Palsy

2000 ◽  
Vol 80 (10) ◽  
pp. 974-985 ◽  
Author(s):  
Robert J Palisano ◽  
Steven E Hanna ◽  
Peter L Rosenbaum ◽  
Dianne J Russell ◽  
Stephen D Walter ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Rehabilitation Centers ◽  
Level Ii ◽  
Children With Cerebral Palsy ◽  
Stratified Sample ◽  
Level I ◽  
Gmfcs Level

Abstract Background and Purpose. Development of gross motor function in children with cerebral palsy (CP) has not been documented. The purposes of this study were to examine a model of gross motor function in children with CP and to apply the model to construct gross motor function curves for each of the 5 levels of the Gross Motor Function Classification System (GMFCS). Subjects. A stratified sample of 586 children with CP, 1 to 12 years of age, who reside in Ontario, Canada, and are known to rehabilitation centers participated. Methods. Subjects were classified using the GMFCS, and gross motor function was measured with the Gross Motor Function Measure (GMFM). Four models were examined to construct curves that described the nonlinear relationship between age and gross motor function. Results. The model in which both the limit parameter (maximum GMFM score) and the rate parameter (rate at which the maximum GMFM score is approached) vary for each GMFCS level explained 83% of the variation in GMFM scores. The predicted maximum GMFM scores differed among the 5 curves (level I=96.8, level II=89.3, level III=61.3, level IV=36.1, and level V=12.9). The rate at which children at level II approached their maximum GMFM score was slower than the rates for levels I and III. The correlation between GMFCS levels and GMFM scores was −.91. Logistic regression, used to estimate the probability that children with CP are able to achieve gross motor milestones based on their GMFM total scores, suggests that distinctions between GMFCS levels are clinically meaningful. Conclusion and Discussion. Classification of children with CP based on functional abilities and limitations is predictive of gross motor function, whereas age alone is a poor predictor. Evaluation of gross motor function of children with CP by comparison with children of the same age and GMFCS level has implications for decision making and interpretation of intervention outcomes.

scholarly journals Changes in children with cerebral palsy after six months of hippotherapy: A clinical trial applying rehabilitation treatment taxonomy

2019 ◽  
Author(s):  
Juliana MP Starling ◽  
Ana Paula B Gontijo ◽  
Rosana F Sampaio ◽  
Juliana V Mambrini ◽  
Sergio T Fonseca ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Cerebral Palsy ◽  
Postural Control ◽  
Outcome Measures ◽  
Motor Function ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Children With Cerebral Palsy

Abstract Background Hippotherapy is a complementary therapeutic modality that seeks to promote functional changes in children with cerebral palsy (CP). Knowledge of the direct and indirect changes resulting from this therapy will help identify which groups of children with cerebral palsy can benefit from this type of therapy. The present study aimed to analyze the effects of hippotherapy for children with cerebral palsy with regard to age, topography, and severity using the rehabilitation treatment taxonomy. Methods We conducted a before-after clinical trial. Thirty-one children with CP, stratified by age (4-7 years; 8-12 years), severity (mild, moderate, severe), topography (hemiplegia, diplegia, quadriplegia) and previous time in hippotherapy (3-6 months, over 6 months) underwent individual weekly 30-minute hippotherapy sessions for 6 months in addition to regular rehabilitation. Postural control and balance were evaluated by the Early Clinical Assessment of Balance (ECAB). Secondary outcome measures included the Gross Motor Function Measure (GMFM) and the Cerebral Palsy Quality of Life for Children self-report of the primary caregiver questionnaire. Blinding was used for scoring the outcome measures. Results Postural control and balance and gross motor function showed small improvements after 6 months of intervention, with larger effects in dimensions D and E of the children’s gross motor function. These changes were influenced by the severity and topography of the CP. The taxonomy of rehabilitation treatments structured the interpretation of the hippotherapy effects, identifying the possible mechanism of action (horse’s step and movement demands), active ingredients (activation of muscles involved in postural correction, vestibular and visual stimuli), target outcomes (postural control and balance) and indirect outcomes (gross motor function and quality of life). Conclusion Hippotherapy sessions, in addition to rehabilitation, produced small, but positive changes in motor and psychosocial outcomes in children with CP. The benefits varied from 3 to 7 points in postural control and balance (ECAB) and in all dimensions of the GMFM. The changes in gross motor function were influenced by the type and severity of CP.

Social and Community Participation of Children and Youth With Cerebral Palsy Is Associated With Age and Gross Motor Function Classification

2009 ◽  
Vol 89 (12) ◽  
pp. 1304-1314 ◽  
Author(s):  
Robert J. Palisano ◽  
Lin-Ju Kang ◽  
Lisa A. Chiarello ◽  
Margo Orlin ◽  
Donna Oeffinger ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Community Participation ◽  
Motor Function ◽  
Structured Interview ◽  
Children And Youth ◽  
Cross Sectional ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Level I ◽  
Gmfcs Level

Background Through social and community participation, children and youth with cerebral palsy (CP) form friendships, gain knowledge, learn skills, express creativity, and determine meaning and purpose in life. Objective The purposes of this study were: (1) to determine whether social and community participation of children and youth with CP differ based on age, sex, and gross motor function, and (2) to identify the types of activities in which social and community participation are highest. Design and Methods A prospective cross-sectional analytic design was used. The participants were a sample of convenience of 291 children (6–12 years of age) and 209 youth (13–21 years of age) with CP (55.4% males, 44.6% females) receiving services from 7 children's hospitals. Participants completed the Children's Assessment of Participation and Enjoyment (CAPE) by structured interview. Gross Motor Function Classification System (GMFCS) level was determined by the researchers. Results Youth did a higher percentage of activities with friends and others and outside the home than children. Children and youth in level I did a higher percentage of activities with friends and others compared with children and youth in levels II and III and in levels IV and V. Children and youth in level I and in levels IV and V did a higher percentage of activities outside the home than children and youth in levels II and III. Differences were not found between females and males. The percentage of activities done with friends and others and outside the home was highest for physical and skill-based activities. Limitations Findings cannot be attributed only to GMFCS level. Conclusions The ability to walk without restrictions is desirable for social and community participation. For children and youth with CP who have limitations in mobility, physical therapists have roles as consultants for accessibility, activity accommodations, and assistive technology and as advocates for inclusive environments.

scholarly journals Association between Gait Deviation Index and Physical Function in Children with Bilateral Spastic Cerebral Palsy: A Cross-Sectional Study

2019 ◽  
Vol 9 (1) ◽  
pp. 28 ◽  
Author(s):  
Tadashi Ito ◽  
Koji Noritake ◽  
Hiroshi Sugiura ◽  
Yasunari Kamiya ◽  
Hidehito Tomita ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gait Speed ◽  
Spastic Cerebral Palsy ◽  
Cross Sectional ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Gait Deviation Index ◽  
Level I ◽  
Gmfcs Level

This study examined the association between Gait Deviation Index (GDI) and the five-times-sit-to-stand test (FTSST) or gait speed results, which represent mobility and muscle strength of the lower extremities in ambulatory children with Gross Motor Function Classification System (GMFCS) level I and II spastic cerebral palsy. In this cross-sectional, observational study, three-dimensional gait analysis data were obtained during gait trials to evaluate the GDI in 35 children (age 5–16 years) with spastic palsy. Motor function was evaluated using FTSST and gait speed. Gross motor function was evaluated using GMFCS. Children with GMFCS level II spastic cerebral palsy demonstrated lower GDI (p < 0.001) and poorer FTSST (p = 0.031) than those with GMFCS level I spastic cerebral palsy. Correlation analysis showed that FTSST results were significantly correlated with GDI (r = −0.624; p < 0.001). Motor function may be important for the maintenance of gait quality in patients with GMFCS level I and II spastic cerebral palsy and should not be ignored. In conclusion, reduction in gait impairment may affect the values of FTSST and GDI in patients with spastic cerebral palsy who can ambulate without an assistive device.

scholarly journals Therapist-Designed Adaptive Riding in Children With Cerebral Palsy: Results of a Feasibility Study

2015 ◽  
Vol 95 (8) ◽  
pp. 1151-1162 ◽  
Author(s):  
Mattana Angsupaisal ◽  
Baudina Visser ◽  
Anne Alkema ◽  
Marja Meinsma-van der Tuin ◽  
Carel G.B. Maathuis ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cerebral Palsy ◽  
Postural Control ◽  
Motor Function ◽  
Controlled Trial ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Randomized Controlled ◽  
Children With Cerebral Palsy ◽  
T1 And T2

Background It is debatable whether adaptive riding (AR) in children with cerebral palsy (CP) improves postural control and gross motor development. Objective The study aim was to explore the feasibility of an extensive assessment protocol for a randomized controlled trial of therapist-designed adaptive riding (TDAR) in children with CP, with the goals of assessing the effect on child outcomes and evaluating working mechanisms of sitting postural control. Design A pretest-posttest group design with 2 baseline measurements was used. Methods Six children (1 girl, 5 boys; age range=6–12 years, median age=8 years 9 months) with bilateral spastic CP (Gross Motor Function Classification System level III) participated. Outcomes were evaluated 3 times (T0, T1, and T2) at 6-week intervals. T0 and T1 were baseline measurements; between T1 and T2, a TDAR intervention including an integrated program of postural challenge exercises (2 times per week for 1 hour) was applied. The complex protocol included the 88-item Gross Motor Function Measure (GMFM-88) and electromyographic (EMG) recording of postural muscle activity during reaching while sitting (EMG recording at T1 and T2 only). Results The protocol was feasible. Median GMFM-88 scores changed from 64.4 at T0 to 66.7 at T1 and from 66.7 at T1 to 73.2 at T2. The change scores for all children exceeded the minimal clinically important difference of the GMFM-88. Five of 6 children showed a decrease in stereotyped top-down recruitment between T1 and T2. Limitations Study limitations included the lack of a control group, small sample size, and potential assessor bias for all but the EMG parameters. Conclusions The feasibility of the complex protocol was established. The data suggested that a 6-week TDAR intervention may improve gross motor function and may reduce stereotyped postural adjustments in children with CP. The limited results warrant replication in a well-powered randomized controlled trial.

Prevalence of Speech Problems and the Use of Augmentative and Alternative Communication in Children With Cerebral Palsy: A Registry-Based Study in Norway

2010 ◽  
Vol 19 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Guro Andersen ◽  
Tone R. Mjøen ◽  
Torstein Vik
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gestational Age ◽  
Augmentative And Alternative Communication ◽  
Alternative Communication ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Children With Cerebral Palsy ◽  
Communicative Abilities ◽  
Normal Speech

Abstract This study describes the prevalence of speech problems and the use of augmentative and alternative communication (AAC) in children with cerebral palsy (CP) in Norway. Information on the communicative abilities of 564 children with CP born 1996–2003, recorded in the Norwegian CP Registry, was collected. A total of 270 children (48%) had normal speech, 90 (16%) had slightly indistinct speech, 52 (9%) had indistinct speech, 35 (6%) had very indistinct speech, 110 children (19%) had no speech, and 7 (1%) were unknown. Speech problems were most common in children with dyskinetic CP (92 %), in children with the most severe gross motor function impairments and among children being totally dependent on assistance in feeding or tube-fed children. A higher proportion of children born at term had speech problems when compared with children born before 32 weeks of gestational age 32 (p > 0.001). Among the 197 children with speech problems only, 106 (54%) used AAC in some form. Approximately 20% of children had no verbal speech, whereas ~15% had significant speech problems. Among children with either significant speech problems or no speech, only 54% used AAC in any form.

Ankle contractures are frequent among children with cerebral palsy and associated with lower gross motor function and degree of spasticity

2021 ◽  
Author(s):  
Lærke Hartvig Krarup ◽  
Pia Kjær Kristensen ◽  
Louise Strand ◽  
Sofie Langbo Bredtoft ◽  
Inger Mechlenburg ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Children With Cerebral Palsy
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