scholarly journals Goal-Directed Therapy to Improve Gross Motor Function and the Quality of Life of Children with Cerebral Palsy: A Randomized Controlled Trial

2022 ◽  
Vol 74 (1) ◽  
pp. 1-10
Author(s):  
Suwannika Palee ◽  
Teerada Ploypetch ◽  
Kingkaew Pajareya ◽  
Suttirat Timdang
Keyword(s):  
Motor Function ◽  
Caregiver Burden ◽  
Controlled Trial ◽  
Gross Motor ◽  
Goal Directed Therapy ◽  
Home Program ◽  
Gross Motor Function ◽  
Randomized Controlled ◽  
Program Compliance

Background: The multiplicity of interventions for the treatment of cerebral palsy (CP) can cause confusion about which are most suited to certain individuals. Hypothesis is that goal-directed therapy (GDT) can guide integrating therapies to improve clinical outcomes compared with conventional therapy (CT). Method: A prospective, assessor-blinded, randomized controlled trial was done with 23 children with CP (mean age, 4 years 4 months old; SD 1y4mo), who were divided into groups according to their level of gross motor function: GDT and CT. Both groups received 12 physiotherapy (PT) sessions and advice on daily home programs. The GDT group additionally had a team meeting to set a specific goal, and PT programs were shaped toward that goal. Assessments were done at baseline and after treatments, using the Thai-version Gross Motor Function Measure (GMFM-66), CP-Quality of Life (CP-QOL), caregiver burden, and home program compliance. Results: After the treatments, the GDT group showed significant improvements in GMFM-66, CP-QOL, and caregiver burden, while the CT group revealed improvements in caregiver burden and some domains of the GMFM, including sitting and crawling & kneeling. Comparisons between groups found GDT was more effective than CT in improving GMFM-66 and CP-QOL. Home program compliance was higher in the GDT (69%) than the CT group (42%). Conclusion: GDT demonstrated clear gains for children with CP regarding gross motor function and QOL improvements. Team communication toward a customized goal was crucial, empowering the children and their caregivers to comply with home programs to achieve the set goal.

scholarly journals Preschool HABIT-ILE: study protocol for a randomised controlled trial to determine efficacy of intensive rehabilitation compared with usual care to improve motor skills of children, aged 2–5 years, with bilateral cerebral palsy

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041542
Author(s):  
Leanne Sakzewski ◽  
Sarah Reedman ◽  
Kate McLeod ◽  
Megan Thorley ◽  
Andrea Burgess ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Motor Function ◽  
Motor Skills ◽  
Controlled Trial ◽  
Ethics Committee ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Randomised Controlled

IntroductionYoung children with bilateral cerebral palsy (BCP) often experience difficulties with gross motor function, manual ability and posture, impacting developing independence in daily life activities, participation and quality of life. Hand Arm Bimanual Intensive Training Including Lower Extremity (HABIT-ILE) is a novel intensive motor intervention integrating upper and lower extremity training that has been developed and tested in older school-aged children with unilateral and BCP. This study aims to compare an adapted preschool version of HABIT-ILE to usual care in a randomised controlled trial.Methods and analysis60 children with BCP aged 2–5 years, Gross Motor Function Classification System (GMFCS) II–IV will be recruited. Children will be stratified by GMFCS and randomised using concealed allocation to either receive Preschool HABIT-ILE or usual care. Preschool HABIT-ILE will be delivered in groups of four to six children, for 3 hours/day for 10 days (total 30 hours). Children receiving Preschool HABIT-ILE be provided a written home programme with the aim of achieving an additional 10 hours of home practice (total dose 40 hours). Outcomes will be assessed at baseline, immediately following intervention and then retention of effects will be tested at 26 weeks. The primary outcome will be the Peabody Developmental Motors Scales–Second Edition to evaluate gross and fine motor skills. Secondary outcomes will be gross motor function (Gross Motor Function Measure-66), bimanual hand performance (Both Hands Assessment), self-care and mobility (Pediatric Evaluation of Disability Inventory-Computer Adapted Test), goal attainment (Canadian Occupational Performance Measure), global performance of daily activities (ACTIVLIM-CP), cognition and adaptive function (Behavior Rating Inventory of Executive Function—Preschool Version), habitual physical activity (ActiGraph GT3X+) and quality of life (Infant Toddler Quality of Life Questionnaire and Child Health Utility Index-9). Analyses will follow standard principles for RCTs using two-group comparisons on all participants on an intention-to-treat basis. Comparisons between groups for primary and secondary outcomes will be conducted using regression models.Ethics and disseminationEthics approval has been granted by the Medical Research Ethics Committee Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/19/QCHQ/59444) and The University of Queensland (2020000336/HREC/19/QCHQ/59444).Trial registration numberACTRN126200000719.

scholarly journals Early, intensive rehabilitation improves gross motor function after perinatal stroke: results of a randomized controlled trial

2021 ◽  
Author(s):  
Caitlin Hurd ◽  
Donna Livingstone ◽  
Kelly Brunton ◽  
Allison T Smith ◽  
Monica A Gorassini ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Lower Extremity ◽  
Motor Function ◽  
Controlled Trial ◽  
Weight Bearing ◽  
Delay Group ◽  
Gross Motor ◽  
Perinatal Stroke ◽  
Gross Motor Function ◽  
Randomized Controlled

Background: Perinatal stroke injures motor regions of the brain, compromising movement for life. Early, intensive, active interventions for the upper extremity are efficacious, but interventions for the lower extremity (LE) remain infrequent and understudied. Objective: To determine the efficacy of ELEVATE – Engaging the Lower Extremity Via Active Therapy Early – on gross motor function, as compared to usual care. Methods: We conducted a single–blind, two–arm, randomized controlled trial (RCT), with the Immediate Group receiving the intervention while the Delay Group served as a three–month waitlist-control. A separate cohort living beyond commuting distance was trained by their parents with guidance from physical therapists. Participants were 8 months to 3 years old, with MRI–confirmed perinatal ischemic stroke and early signs of hemiparesis. The intervention was play–based, focused on weight–bearing, balance and walking for 1 hour/day, 4 days/week for 12 weeks. The primary outcome was the Gross Motor Function Measure–66 (GMFM–66). Secondary outcomes included steps and gait analyses. Final follow–up occurred at age four. Results: Thirty–four children participated (25 RCT, 9 Parent-trained). The improvement in GMFM–66 over 12 weeks was greater for the Immediate than the Delay Group (average change 3.4 units higher) and greater in younger children. Average step counts reached 1370–3750 steps/session in the last week of training for all children. Parent–trained children also improved but with greater variability. Conclusions: Early, activity–intensive LE therapy for young children with perinatal stroke is feasible and improves gross motor function in the short term. Longer term improvement may require additional bouts of intervention.

scholarly journals Potential effects of traditional massage on spasticity and gross motor function in children with spastic cerebral palsy: A randomized controlled trial

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Qamar Mahmood ◽  
Dr. Shaista Habibullah ◽  
Prof. Dr. Muhammad Naveed Babur
Keyword(s):  
Randomized Controlled Trial ◽  
Cerebral Palsy ◽  
Motor Function ◽  
Controlled Trial ◽  
Intervention Group ◽  
Spastic Cerebral Palsy ◽  
Control Group ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Randomized Controlled

Objective: To evaluate the effects of traditional massage (TM) on spasticity and gross motor function in children with cerebral palsy (CP). Methods: This randomized control trial (RCT) was conducted with recruitment of 86 children (Dropped out= 11; Analyzed= 75) with spastic CP (diplegia) allocated randomly through sealed envelope method to intervention and control group with ages between 2-10 years from September 2016 to August 2018. Both groups received conventional physical therapy (CPT) once daily, five times a week for a period of three months. However, intervention group received TM additionally. Modified Ashworth Scale (MAS), Gross Motor Function Measure (GMFM-88) and Gross Motor Function Classification System (GMFCS) were used to evaluate spasticity and gross motor function at the beginning, after six and 12 weeks of intervention. Data were compared and analyzed through SPSS-20. Results: Mean age in control and intervention group was 6.81±2.31 and 7.05±2.47 years respectively. No statistically significant differences in MAS, GMFM and GMFCS scores were found at base line. The children in intervention group showed statistically significant reduction in MAS scores in all four limbs after six and 12 weeks of intervention (p < 0.05) in comparison with the control group. However, GMFM scores and GMFCS levels did not change significantly in intervention group as compared to control group. Conclusion: It is concluded that TM can effectively reduce the spasticity, does not have harmful effects, so can be administered safely by mothers at home and making it suitable for the management of spastic CP. However, in order to achieve better gross motor function, it should be practiced in conjunction with CPT, functional skills and task oriented approaches. doi: https://doi.org/10.12669/pjms.35.5.478 How to cite this:Mahmood Q, Habibullah S, Babur MN. Potential effects of traditional massage on spasticity and gross motor function in children with spastic cerebral palsy: A randomized controlled trial. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.478 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Pediatric Endurance and Limb Strengthening (PEDALS) for Children With Cerebral Palsy Using Stationary Cycling: A Randomized Controlled Trial

2010 ◽  
Vol 90 (3) ◽  
pp. 367-381 ◽  
Author(s):  
Eileen G. Fowler ◽  
Loretta M. Knutson ◽  
Sharon K. DeMuth ◽  
Kara L. Siebert ◽  
Victoria D. Simms ◽  
...  
Keyword(s):  
Motor Function ◽  
Controlled Trial ◽  
Knee Extensor ◽  
Control Group ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Randomized Controlled ◽  
Peak Knee ◽  
Children With Cerebral Palsy ◽  
Run Test

Background Effective interventions to improve and maintain strength (force-generating capacity) and endurance are needed for children with cerebral palsy (CP). Objective This study was performed to examine the effects of a stationary cycling intervention on muscle strength, locomotor endurance, preferred walking speed, and gross motor function in children with spastic diplegic CP. Design This was a phase I randomized controlled trial with single blinding. Setting The interventions were performed in community-based outpatient physical therapy clinics. Outcome assessments were performed in university laboratories. Participants Sixty-two ambulatory children aged 7 to 18 years with spastic diplegic CP and Gross Motor Function Classification System levels I to III participated in this study. Intervention and Measurements Participants were randomly assigned to cycling or control (no-intervention) groups. Thirty intervention sessions occurred over 12 weeks. Primary outcomes were peak knee extensor and flexor moments, the 600-Yard Walk-Run Test, the Thirty-Second Walk Test, and the Gross Motor Function Measure sections D and E (GMFM-66). Results Significant baseline-postintervention improvements were found for the 600-Yard Walk-Run Test, the GMFM-66, peak knee extensor moments at 120°/s, and peak knee flexor moments at 30°/s for the cycling group. Improved peak knee flexor moments at 120°/s were found for the control group only, although not all participants could complete this speed of testing. Significant differences between the cycling and control groups based on change scores were not found for any outcomes. Limitations Heterogeneity of the patient population and intrasubject variability were limitations of the study. Conclusions Significant improvements in locomotor endurance, gross motor function, and some measures of strength were found for the cycling group but not the control group, providing preliminary support for this intervention. As statistical differences were not found in baseline-postintervention change scores between the 2 groups; the results did not demonstrate that stationary cycling was more effective than no intervention. The results of this phase I study provide guidance for future research.

Can a six-week exercise intervention improve gross motor function for non-ambulant children with cerebral palsy? A pilot randomized controlled trial

2012 ◽  
Vol 27 (2) ◽  
pp. 150-159 ◽  
Author(s):  
Elizabeth Bryant ◽  
Terry Pountney ◽  
Heather Williams ◽  
Natalie Edelman
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Control Group ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Randomized Controlled ◽  
Children With Cerebral Palsy ◽  
And Control

Objective: To determine the effect of a six-week exercise intervention on gross motor function for non-ambulant children with cerebral palsy. Design: A parallel arm randomized controlled trial. Setting: Four special schools. Participants: Thirty-five children aged 8–17 with bilateral cerebral palsy; Gross Motor Function Classification System levels IV–V. Method: Participants were randomly allocated to a static bike group, a treadmill group or control group. Participants in the bike and treadmill groups received exercise training sessions, three times weekly for six weeks. The control group received their usual care. Blinded assessments were performed at baseline and six weeks and followed up at 12 and 18 weeks. Outcome measures: Gross Motor Function Measures GMFM-66, GMFM-88D and GMFM-88E. Results: At six weeks significant differences were found in GMFM-88D scores between the bike group and the control group, and the treadmill group and the control group ( P < 0.05). The mean change (SD) in GMFM-88D score was 5.9 (6.8) for the bike group; 3.7 (4.4) for the treadmill group and 0.5 (1.9) for the control group. No significant differences were found for GMFM-66 or GMFM-88E scores between the bike group and control group, or the treadmill group and control group, although trends of improvement were observed for both exercise groups. The improvements observed declined during the follow-up period. Conclusion: This study provides preliminary evidence that exercising on a bike or treadmill may provide short-term improvements in gross motor function for non-ambulant children with cerebral palsy. This needs to be tested in a large-scale randomized trial.

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.

Gross Motor Function and Health Quality of Life Among Children with Autism Spectrum Disorder Participating in a Gymnastics Program: A Pilot Study

2020 ◽  
Vol 31 (1) ◽  
Author(s):  
M. Dannielle Ayers ◽  
E. Laurette Taylor ◽  
Paul Branscum ◽  
Craig Hofford
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Motor Function ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Health Quality ◽  
Health Quality Of Life

The current study assessed impact of a gymnastics program on gross motor function and health quality of life in children with autism spectrum disorder (ASD). Eleven children participating in gymnastics were compared to ten children in a comparison group. Measurement tools were the Test of Gross Motor Development-second edition (TGMD-2) and Pediatric Quality of Life- fourth edition (PedsQL-4.0). Results showed no between group differences for overall gross motor function and health quality of life. Statistically significant differences were found for two individual skills on the TGMD-2: run (p=.026) and gallop (p=.041). Potential confounding factors were observed (i.e. rater bias, dose response, and “toe-walking”).

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