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

Abstract

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.

Factors Influencing Motor Outcome of Hippotherapy in Children with Cerebral Palsy

“…20 Similar results were confirmed in another study on factors that affected the response to intensive therapy in children with CP or developmental delay. 21 However, we could not find any additional effects of age on GMFM improvement after hippotherapy, which is not consistent with previous studies. 20,21 This result is thought to be due to the fact that approximately half of the participants were aged 6 years or older who already reached the plateau of the GMFM-66 score.…”

“…21 However, we could not find any additional effects of age on GMFM improvement after hippotherapy, which is not consistent with previous studies. 20,21 This result is thought to be due to the fact that approximately half of the participants were aged 6 years or older who already reached the plateau of the GMFM-66 score. This can be paradoxically interpreted that hippotherapy can be an effective therapy for some school-aged children with little potential of further improvement in GMFM scores.…”

The Effect of a Functional Intensive Intervention Program on Self-Care in Children with Cerebral Palsy: A Case Study

“…Besides, Sorsdahl, et al showed improved basic motor abilities in children with CP after a three-week period of intensive, goal-directed, activity-focused physiotherapy in a group setting [7]. Similar results were observed in the study of Young Hong, et al in which it was shown that Gross Motor Function increased after eight weeks of intensive therapy [8]. This recent evidence points towards short and intensive functional therapies being very promising for CP patients [9].…”

The Role of Regular Physical Therapy on Spasticity in Children With Cerebral Palsy

“…There are no specific guidelines on the duration and frequency of PT have been established for children with CP possibly because of the heterogeneity and wide variation in severity among this pediatric population demographic. In what follows, it is seen that intensive therapy more than three times a week has been shown to have a significant impact on gross motor function in children affected with this condition [22,23]. A previous study found that strength training two to three times a week on non-consecutive days for a minimum of 8 weeks was sufficient to increase strength for these children [24].…”