Study protocol of a randomized controlled trial of home-based computerized executive function training for children with cerebral palsy

García-Galant, María; Blasco, Montse; Reid, Lee B.; Pannek, Kerstin; Leiva, David; Laporta-Hoyos, Olga; Ballester‐Plané, Júlia; Miralbell, Júlia; Caldú, Xavier; Alonso, Xenia; Toro-Tamargo, Esther; Meléndez-Plumed, Mar; Gimeno, Francisca; Coronas, Marc; Soro-Camats, Emili; Boyd, Roslyn N.; Pueyo, Roser

doi:10.1186/s12887-019-1904-x

Cited by 8 publications

(6 citation statements)

References 46 publications

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“…[30][31][32][33][34] Even current protocols, such as proposed by García-Galant et al fail to include a proper long-term assessment or follow-up. 35 Even regarding the use of invasive treatments, such as intrathecal Baclofen's or selective dorsal rhizotomy (SDR), that should actually had been better followed-up, the evidence is very scarce and insufficient. 36 Therefore, we are not able to compare our data to other results.…”

Section: Discussionmentioning

confidence: 99%

Effect of Long-Term Repeated Interval Rehabilitation on the Gross Motor Function Measure in Children with Cerebral Palsy

et al. 2020

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Background The efficacy of interventions for cerebral palsy (CP) has been frequently investigated with inconclusive results and motor function measured by the Gross Motor Function Measure (GMFM-66) is common. Objective In this observational analysis, we quantify the GMFM-66 change scores of the second and third year of a multimodal rehabilitation program (interval rehabilitation including home-based, vibration-assisted training) in children with CP. Methods The study was a retrospective analysis of children with CP (2–13 years) participating for a second (n = 262) and third year (n = 86) in the rehabilitation program with GMFM-66 scores at start (M0), after 4 months (M4) of intensive training, and after 8 months of follow-up (M12). A method was previously developed to differentiate between possible treatment effects and expected development under standard of care for GMFM-66 scores using Cohen's d effect size (ES; size of difference). Results After the treatment phase of 4 months (M4) in the second year, 125 of 262 children were responder (ES ≥ 0.2) and 137 children nonresponder (ES < 0.2); mean ES for nonresponder was −0.212 (trivial) and for responder 0.836 (large). After M4 in the third year, 43 children of 86 were responder (ES = 0.881 [large]) and 43 nonresponder (ES = − 0.124 [trivial]). Discussion and Conclusion Repeated rehabilitation shows a large additional treatment effect to standard of care in 50% of children which is likely due to the intervention, because in the follow-up period (standard of care), no additional treatment effect was observed and the children followed their expected development.

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Section: Discussionmentioning

confidence: 99%

Effect of Long-Term Repeated Interval Rehabilitation on the Gross Motor Function Measure in Children with Cerebral Palsy

et al. 2020

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“…Given that the quality of evidence for the effectiveness of many of the included motor rehabilitation interventions varied from low to moderate, new study protocols based on rigorous methodologies might modify the recommendations formulated. [37][38][39][40][41][42][43][44]…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Evidence-Based, Implementable Motor Rehabilitation Guidelines for Individuals With Cerebral Palsy

et al. 2022

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Background:Cerebral palsy is a life-long condition that causes heterogeneous motor disorders. Motor rehabilitation interventions must be adapted to the topography of the symptoms, ambulatory capacity and age of the individual. Current guidelines do not differentiate between the different profiles of individuals with cerebral palsy, which limits their implementation.Objectives:To develop evidence-based, implementable guidelines for motor rehabilitation interventions for individuals with cerebral palsy according to the age, topography of the cerebral palsy and ambulatory capacity of the individual, and to determine a level of priority for each intervention.Methods:We used a mixed methods design that combined a systematic review of the literature on available motor rehabilitation interventions with expert opinions. Based on the French National Authority for Health methodology, recommendations were graded as strong, conditional or weak. Interventions were then prioritized by the experts according to both the evidence and their own opinions on relevance and implementability to provide a guide for clinicians. All recommendations were approved by experts who were independent from the working group.Results:Strong recommendations as first-line treatments were made for gait training, physical activities and hand-arm bimanual intensive therapy for all children and adolescents with cerebral palsy. Moderate recommendations were made against passive joint mobilizations, muscle stretching, prolonged stretching with the limb fixed, and neurodevelopmental therapies for all children and adolescents with cerebral palsy. Strong recommendations as first-line treatments were made for gait training for all adults with cerebral palsy and moderate recommendations as moderate importance interventions for strengthening exercises and ankle-foot orthoses for motor impairment of the feet and the ankles.Discussion:These guidelines, which combine research evidence and expert opinion, could help individuals with cerebral palsy and their families to co-determine rehabilitation goals with health professionals, according to their preferences.

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“…Images were acquired as part of a clinical trial involving temporal lobe resection for epilepsy (n = 3 before surgery, n = 6 after surgery), glioma resection (n = 2 before surgery), or removal of arteriovenous malformations (n = 1 before surgery). This study included acquisition of a T1w MPRAGE scan (1mm isotropic, α = 9˚; TE = 2.9 ms; TI = 900 ms; TR = 1900 ms; acquisition time 4m 18s) and a modern multishell diffusion acquisition (12 @ b = 0s/mm 2 ; 20 directions @ b = 2000s/mm 2 ; 30 directions @ b = 1000s/mm 2 ; 60 directions @ b = 3000s/mm 2 ; 2mm isotropic; acquisition time 11m 30s) that is in use in a variety of studies [36][37][38]. Written informed consent was provided by all patients and the study approved by the Royal Brisbane and Women's Hospital (RBWH) Human Research Ethics Committee.…”

Section: In-vivo Experimentsmentioning

confidence: 99%

Avoiding data loss: Synthetic MRIs generated from diffusion imaging can replace corrupted structural acquisitions for freesurfer-seeded tractography

et al. 2022

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Magnetic Resonance Imaging (MRI) motion artefacts frequently complicate structural and diffusion MRI analyses. While diffusion imaging is easily ‘scrubbed’ of motion affected volumes, the same is not true for T1w or T2w ‘structural’ images. Structural images are critical to most diffusion-imaging pipelines thus their corruption can lead to disproportionate data loss. To enable diffusion-image processing when structural images are missing or have been corrupted, we propose a means by which synthetic structural images can be generated from diffusion MRI. This technique combines multi-tissue constrained spherical deconvolution, which is central to many existing diffusion analyses, with the Bloch equations that allow simulation of MRI intensities for given scanner parameters and magnetic resonance (MR) tissue properties. We applied this technique to 32 scans, including those acquired on different scanners, with different protocols and with pathology present. The resulting synthetic T1w and T2w images were visually convincing and exhibited similar tissue contrast to acquired structural images. These were also of sufficient quality to drive a Freesurfer-based tractographic analysis. In this analysis, probabilistic tractography connecting the thalamus to the primary sensorimotor cortex was delineated with Freesurfer, using either real or synthetic structural images. Tractography for real and synthetic conditions was largely identical in terms of both voxels encountered (Dice 0.88–0.95) and mean fractional anisotropy (intrasubject absolute difference 0.00–0.02). We provide executables for the proposed technique in the hope that these may aid the community in analysing datasets where structural image corruption is common, such as studies of children or cognitively impaired persons.

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Study protocol of a randomized controlled trial of home-based computerized executive function training for children with cerebral palsy

Cited by 8 publications

References 46 publications

Effect of Long-Term Repeated Interval Rehabilitation on the Gross Motor Function Measure in Children with Cerebral Palsy

Effect of Long-Term Repeated Interval Rehabilitation on the Gross Motor Function Measure in Children with Cerebral Palsy

Evidence-Based, Implementable Motor Rehabilitation Guidelines for Individuals With Cerebral Palsy

Avoiding data loss: Synthetic MRIs generated from diffusion imaging can replace corrupted structural acquisitions for freesurfer-seeded tractography

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