Relationship between changes in motor capacity and objectively measured motor performance in ambulatory children with spastic cerebral palsy (original) (raw)
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Edorium J Pediatr, 2017
Introduction: Cerebral palsy (CP) describes a group of disorders the affects movement and posture, causing activity limitations attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication and behaviour by epilepsy and by secondary musculoskeletal problems. Methods: A cross sectional prospective type of study design was used to find out the characteristics of gross motor function among children with spastic cerebral palsy aged between 2-4 years. The study was conducted at pediatric unit of CRP. Results: Total participants were 114 whose mean age was 2.96 years. Sociodemographic results
Egyptian Rheumatology and Rehabilitation, 2015
At baseline, there were no statistically significant differences between the two groups. After 8 weeks, there were significant differences between the two groups as regards the total scores of GMFM-88 and GMPM (P < 0.05). However, highly significant differences for GMFM-88 (P < 0.001) and only significant differences (P < 0.05) for GMPM were observed after 16 weeks. No statistically significant differences were found between the two groups as regards GMFM-66 scores after 8 weeks, and significant differences were found only after 16 weeks (P < 0.05). After 16 weeks, all dimensions of GMFM-88 were significantly increased in both groups (P < 0.001). Only sitting showed no statistically significant difference in group B (P > 0.05). Conclusion Intensive PT regimens were more beneficial than standard therapy in spastic CP, especially in children with a low functional level.
European Journal of Pediatrics, 2009
The aim of this study was to investigate the relationship among functional classification systems, the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy (CP). One hundred and eighty-five children with spastic CP (101 males, 84 females), 65 (35.1%) diparetic, 60 (32.4%) quadriparetic, and 60 (32.4%) hemiparetic children, ranging from 4 to 15 years of age with a median age of 7 years, were included in the study. The children were classified according to the GMFCS for their motor function and according to the MACS for the functioning of their hands when handling objects in daily activities. The functional status and performance were assessed by using the Functional Independence Measure of Children (WeeFIM). A good correlation between the GMFCS and MACS was found in all children (r = 0.735, p < 0.01). There was also a correlation between the GMFCS and WeeFIM s...
Journal of Physical Therapy Science
Cerebral palsy (CP) encompasses a group of disorders of movement and posture with wide ranges of impairments, activity limitations and participation restrictions. Guiding management of children with CP by the ICF model is important to deliver quality services. This study aimed to explore relationship between CP subtypes and the Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) and to examine differences in distribution of impairments and activity limitations across CP subtypes and GMFCS-E&R levels. [Participants and Methods] 70 children with CP (mean age: 6.5 ± 2.9 years) were classified using CP subtypes and GMFCS-E&R. Research assistants examined impairments including: scoliosis, scissoring, and inability to bear weight. Parents described their children's transfers and functional mobility. [Results] CP subtypes and GMFCS-E&R levels were significantly associated. Scissoring and scoliosis were predominant in children in levels IV and V of the GMFCS-E&R. Only scoliosis was predominant in children with quadriplegia. Transfer activities and functional mobility were more limited in children with quadriplegia and in level V of the GMFCS-E&R. [Conclusion] Impairments and activity limitations components of the ICF can be differentiated by CP subtypes and GMFCS-E&R. Clinicians can use the two classification in providing comprehensive and individualized services for children with CP and their families.
Physical & Occupational Therapy In Pediatrics
Aim: To examine associations between interventions and child characteristics; and enhanced gross motor progress in children with cerebral palsy (CP). Methods: Prospective cohort study based on 2048 assessments of 442 children (256 boys, 186 girls) aged 2-12 years registered in the Cerebral Palsy Follow-up Program and the Cerebral Palsy Register of Norway. Gross motor progress estimates were based on repeated measures of reference percentiles for the Gross Motor Function Measure (GMFM-66 percentiles) in a linear mixed model. Results: Intensive training was the only intervention factor associated with enhanced gross motor progress (mean 3.3 percentiles, 95% CI: 1.0, 5.5 per period of ≥ 3 sessions per week and/or participation in an intensive program). GMFM-66 percentiles were on average lower in children with intellectual disability (-24.2 percentiles; 95% CI:-33.2,-15.2) and in children with eating problems (-10.5 percentiles 95% CI:-18.5,-2.4) compared with others. Ankle contractures by age were negatively associated with gross motor progress (-1.9 percentiles 95% CI:-3.6,-0.2). Conclusions: Intensive training was associated with enhanced gross motor progress over an average of 2.9 years in children with CP. Intellectual disability was a strong negative prognostic factor. Preventing ankle contractures appears important for gross motor progress.
Developmental Medicine & Child Neurology, 2014
Objective: To examine if individualised resistance training increases the daily physical activity of adolescents and young adults with bilateral spastic cerebral palsy (CP). Design: A single-blinded randomised controlled trial Setting: Community gymnasiums Participants: Young people with bilateral spastic CP classified as Gross Motor Function Classification System levels II or III were randomly assigned to intervention (mean age: 18.2y, SD: 1.9y) or to usual care (mean age: 18.6y, SD: 2.9y). Interventions: The intervention group completed an individualised lower limb progressive resistance training programme twice a week for 12 weeks. Main outcome measures: The primary outcome was daily physical activity (energy expenditure, number of steps, and time sitting and lying). Secondary outcomes included muscle strength measured with a one-repetition maximum (1RM) leg press and reverse leg press. Outcomes were measured at baseline, 12 weeks, and 24 weeks by examiners blinded to group. Results: From the 36 participants with complete data at 12 weeks there were no between-group differences for any measure of daily physical activity. There was a likely increase in leg press strength in favour of the intervention group (mean difference 11.8 kg; 95%CI:-1.4 to 25.0) but not for reverse leg press strength. No significant adverse events occurred during training. Conclusions: A relatively short-term resistance training programme that may increase leg muscle strength was not effective in increasing daily physical activity. Other 4 strategies are needed to address the low daily physical activity levels of young people with bilateral spastic CP.
Developmental Medicine and Child Neurology, 2007
The relationships between different levels of severity of ambulatory cerebral palsy, defined by the Gross Motor Function Classification System (GMFCS), and several pediatric outcome instruments were examined. Data from the Gross Motor Function Measure (GMFM), Pediatric Orthopaedic Data Collection Instrument (PODCI), temporal-spatial gait parameters, and oxygen cost were collected from six sites. The sample size for each assessment tool ranged from 226 to 1047 participants. There were significant differences among GMFCS levels I, II, and III for many of the outcome tools assessed in this study. Strong correlations were seen between GMFCS level and each of the GMFM sections D and E scores, the PODCI measures of Transfer and Mobility, and Sports and Physical Function, Gait Velocity, and Oxygen Cost. Correlations among tools demonstrated that the GMFM sections D and E scores correlated with the largest number of other tools. Logistic regression showed GMFM section E score to be a significant predictor of GMFCS level. GMFM section E score can be used to predict GMFCS level relatively accurately (76.6%). Study data indicate that the assessed outcome tools can distinguish between children with different GMFCS levels. This study establishes justification for using the GMFCS as a classification system in clinical studies.