BACKGROUND: While the transdisciplinary-based rehabilitation provided ample evidence on improving impairment (body structure and functions) levels, the therapeutic effects on the international classification of functioning, disability, and health (ICF) domains are unknown in cerebral palsy (CP). OBJECTIVE: To compare the effects of the community-based family-child-centered care (CFC) and conventional pediatric rehabilitation (CPR) on the physical, cognitive, sensory, and social integration domains in children and adolescents with CP. METHODS: Twenty-six participants with CP (mean age = 9.37±5.24, 14 females) were assigned into either CPR or CFC groups. Clinical outcomes included gross motor function measure (GMFM-66), Pediatric Balance Scale (PBS), fine motor area of Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2), Functional Independence Measure (FIM) cognition area, Short Sensory Profile (sSP), COPM, Pediatrics Quality of Life (PedsQL) questionnaire, Short Falls Efficacy Scale (sFES), and Dynamic Postural Instability (DPI). An analysis of variance (ANOVA) and an analysis of covariance (ANCOVA) was conducted at P < 0.05. RESULTS: ANOVA revealed the superior effects of CFC in GMFM-66, PBS, BOT-2, FIM, and PedsQL compared to CPR (P < 0.05). ANCOVA showed the superior effects of CFC in Z-axis of DPI than CPR (P < 0.05). CONCLUSIONS: Our results provide novel, promising clinical evidence that CFC was more effective than CPR at improving impairment, activity, as well as participation levels in participants with CP.
PURPOSE: The purpose of this study was to investigate the immediate effect of Walkbot gait training on knee joint stiffness in an individual with spastic hemiplegia. METHOD: A woman with hemiparetic stroke underwent a 30-minute Walkbot robotic-assisted gait training session. Knee flexion stiffness associated with hamstring spasticity and knee extension torques during the terminal swing phase was determined before and after the intervention using the Walkbot-STIFF measurement system. DESIGN: Descriptive case analysis. RESULTS: Knee joint extension kinematic at the terminal swing phase increased from 2.44 • to −0.28 • . Knee joint torque increased from 0.26 Nm to 0.32 Nm. The knee flexion stiffness decreased from 0.0083 Nm/degree to 0.0022 Nm/degree following the training. CONCLUSIONS: The Walkbot robotic-assisted locomotor training was effective for reducing knee joint stiffness and improving extensor torque during functional gait. Moreover, the Walkbot-STIFF system was useful for assessing and monitoring spasticity during locomotor training.
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