Efficacy of intensive versus nonintensive physiotherapy in children with cerebral palsy: a meta-analysis

Arpino, Carla; Vescio, Maria Fenicia; Luca, Angela De; Curatolo, Paolo

doi:10.1097/mrr.0b013e328332f617

Cited by 57 publications

(38 citation statements)

References 17 publications

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“…Previous studies have shown that intensive PT can have an effect in developmentally delayed children, including CP patients (5678913141516). Our results showed a significant change in GMFM-88 score, of 4.67 ± 3.93, after 8 weeks of therapy.…”

Section: Discussionmentioning

confidence: 99%

“…In a meta-analysis, intensive therapy tended to have greater effects on functional motor outcomes (with modest effect sizes) than non‑intensive therapy (5). There is no precise consensus regarding the intensity and duration of intensive therapy, or concerning ‘intensive rehabilitation.’ In addition, the form that intensive rehabilitation treatment takes may vary according to regional facilities, manpower and medical care systems.…”

Section: Introductionmentioning

confidence: 99%

“…There is no precise consensus regarding the intensity and duration of intensive therapy, or concerning ‘intensive rehabilitation.’ In addition, the form that intensive rehabilitation treatment takes may vary according to regional facilities, manpower and medical care systems. Previous studies typically specified a treatment frequency of more than 3 times a week and treatment session durations of 45 minutes to 4 hours a day, completed over several weeks as intensive programs (56789). However, there is no consensus on the optimal frequency and duration of rehabilitative therapy for children with developmental delays, including CP.…”

Section: Introductionmentioning

confidence: 99%

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Factors Influencing the Gross Motor Outcome of Intensive Therapy in Children with Cerebral Palsy and Developmental Delay

Hong

Kim

et al. 2017

J Korean Med Sci

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The study was designed to identify factors influencing the short term effect of intensive therapy on gross motor function in children with cerebral palsy or developmental delay. Retrospectively, total Gross Motor Function Measure-88 (GMFM-88) scores measured during the first and last weeks of intensive therapy were analyzed (n = 103). Good and poor responder groups were defined as those in the top and bottom 25% in terms of score difference, respectively. The GMFM-88 score increased to 4.67 ± 3.93 after 8 weeks of intensive therapy (P < 0.001). Gross Motor Function Classification System (GMFCS) level (I–II vs. IV–V; odds ratio [OR] = 7.763, 95% confidence interval [CI] = 2.177–27.682, P = 0.002) was a significant factor in a good response to therapy. Age (≥ 36 months; OR = 2.737, 95% CI = 1.003–7.471, P = 0.049) and GMFCS level (I–II vs. IV–V; OR = 0.189, 95% CI = 0.057–0.630, P = 0.007; and III vs. IV–V; OR = 0.095, 95% CI = 0.011–0.785, P = 0.029) were significantly associated with a poor response. GMFCS level is the most important prognostic factor for the effect of intensive therapy on gross motor function. In addition, age ≥ 36 months, is associated with a poor outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Influencing the Gross Motor Outcome of Intensive Therapy in Children with Cerebral Palsy and Developmental Delay

Hong

Kim

et al. 2017

J Korean Med Sci

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“…The importance of the current approach is very early detection and referral of a condition which can respond to rehabilitation in early childhood. [32,33]. …”

Section: Discussionmentioning

confidence: 99%

Early prediction of cerebral palsy after neonatal intensive care using motor development trajectories in infancy

Maitre

Slaughter

Aschner

2013

Early Human Development

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Neonatal intensive care unit (NICU) patients are at high-risk for developmental disabilities such as cerebral palsy (CP). Early identification of CP is essential to effective rehabilitation, but diagnosis is often delayed, especially in preterm infants. We hypothesized longitudinal evaluation of motor trajectories in the NICU Follow-up clinic could distinguish in infancy who developed CP by 3 years of age. Study Design and subjects Retrospective study of 606 patients in the NICU Follow-up clinic at Vanderbilt University with birthweight <1500 g or a diagnosis of hypoxic ischemic encephalopathy. Outcomes measures Assessments included neurologic exams, the Developmental Assessment of Young Children (DAYC), the Bayley Scales of Infant Development (BSID) and the Gross Motor Function Classification Scale. Results A decrease in DAYC scores between 6 and 12 months was present in preterm and term infants later diagnosed with CP, but not in children without CP (−23 vs. +1.5, p <0.001). DAYC score decreases in infancy were highly predictive of later CP (p <0.001). BSID scores quantified severe motor delays but did not add to prediction of CP diagnosis. Conclusion Standardized assessments of motor milestones quantitatively predict the risk of CP in former NICU patients by 12 months, allowing for timely diagnosis, counseling and therapy in high-risk infants.

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“…Systematic study reviews on the effectiveness of physical therapy interventions in children with CP show limited evidence of effectiveness with few randomized controlled clinical trials [6]. Nevertheless, it has been demonstrated that high-intensity and task-specific programs have resulted in improved strength and functional performance that were sustained over time [7], [8].…”

Section: Introductionmentioning

confidence: 99%

Feasibility Study of a Wearable Exoskeleton for Children: Is the Gait Altered by Adding Masses on Lower Limbs?

et al. 2013

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We are designing a pediatric exoskeletal ankle robot (pediatric Anklebot) to promote gait habilitation in children with Cerebral Palsy (CP). Few studies have evaluated how much or whether the unilateral loading of a wearable exoskeleton may have the unwanted effect of altering significantly the gait. The purpose of this study was to evaluate whether adding masses up to 2.5 kg, the estimated overall added mass of the mentioned device, at the knee level alters the gait kinematics. Ten healthy children and eight children with CP, with light or mild gait impairment, walked wearing a knee brace with several masses. Gait parameters and lower-limb joint kinematics were analyzed with an optoelectronic system under six conditions: without brace (natural gait) and with masses placed at the knee level (0.5, 1.0, 1.5, 2.0, 2.5 kg). T-tests and repeated measures ANOVA tests were conducted in order to find noteworthy differences among the trial conditions and between loaded and unloaded legs. No statistically significant differences in gait parameters for both healthy children and children with CP were observed in the five “with added mass” conditions. We found significant differences among “natural gait” and “with added masses” conditions in knee flexion and hip extension angles for healthy children and in knee flexion angle for children with CP. This result can be interpreted as an effect of the mechanical constraint induced by the knee brace rather than the effect associated with load increase. The study demonstrates that the mechanical constraint induced by the brace has a measurable effect on the gait of healthy children and children with CP and that the added mass up to 2.5 kg does not alter the lower limb kinematics. This suggests that wearable devices weighing 25 N or less will not noticeably modify the gait patterns of the population examined here.

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Efficacy of intensive versus nonintensive physiotherapy in children with cerebral palsy: a meta-analysis

Cited by 57 publications

References 17 publications

Factors Influencing the Gross Motor Outcome of Intensive Therapy in Children with Cerebral Palsy and Developmental Delay

Factors Influencing the Gross Motor Outcome of Intensive Therapy in Children with Cerebral Palsy and Developmental Delay

Early prediction of cerebral palsy after neonatal intensive care using motor development trajectories in infancy

Feasibility Study of a Wearable Exoskeleton for Children: Is the Gait Altered by Adding Masses on Lower Limbs?

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