Improvement in gross motor function and muscle tone in children with cerebral palsy related to neonatal icterus: an open-label, uncontrolled clinical trial

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.

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

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac19.1.12 ◽

2010 ◽

Vol 19 (1) ◽

pp. 12-20 ◽

Cited By ~ 29

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.

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