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Grajales López V, Hernández Suárez OI, Pinzón Bernal MY, Salamanca Duque LM. [Effectiveness of early motor interventions in children with cerebral palsy between 3 to 5years of age: Systematic review]. Rehabilitacion (Madr) 2024; 58:100832. [PMID: 38141422 DOI: 10.1016/j.rh.2023.100832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 12/25/2023]
Abstract
Early motor intervention is essential in children with cerebral palsy; however, it is unknown its effectiveness between 3 to 5years. The objective was to determinate the effectiveness of early motor intervention in the motor development of this population. A systematic literature search was performed in Pubmed/Medline, PEDro, OTSeeker, Embase, and LILACS. Finally, 18 articles were selected, of which 4 showed favorable changes in the experimental group in the outcomes of overall motor development and manual motor function, with sensory integration therapy and movement-induced restriction therapy, respectively; however, the results were not statistically significant, and the level of evidence was low. Early motor intervention could be cautiously considered for improving overall motor development and manual function. Higher-quality methodological studies are necessary.
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Khanna S, Arunmozhi R, Goyal C. Neurodevelopmental Treatment in Children With Cerebral Palsy: A Review of the Literature. Cureus 2023; 15:e50389. [PMID: 38213384 PMCID: PMC10783202 DOI: 10.7759/cureus.50389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
This review aimed to explore the current literature on neurodevelopmental treatment (NDT) in children with cerebral palsy (CP). It also sought to determine what outcome measures are used to analyze the effect of NDT and whether these parameters are in line with the components of the International Classification of Functioning, Disability and Health (ICF). The studies published in the English language between 2000 and 2023 were included based on a search of the databases PEDro, PubMed, and Google Scholar. Studies that examined the effect of NDT on children with CP were included. We found a total of 54 studies describing the effect of NDT in children with CP and these were included in this literature review. NDT in children with CP was found to have positive outcomes in 41 studies, while 13 studies had contradictory conclusions. Based on our findings, NDT is widely used for the rehabilitation of children with CP globally. The parameters used to assess the improvement mostly included gross motor function, balance, and postural control. The outcome measures used in studies are usually linked to body structure and function or activities domain of the ICF model by the World Health Organization (WHO). However, there is a scarcity of studies on the effect of NDT on participation, which should be the outcome of any rehabilitation program. There is scope for future research to demonstrate the effect of NDT on the participation of children with CP. Further studies with larger sample sizes and homogenous groups are recommended.
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Affiliation(s)
- Sandeep Khanna
- Physiotherapy, PhD Program, Sardar Bhagwan Singh University, Dehradun, IND
- Physiotherapy, Latika Roy Memorial Foundation, Dehradun, IND
| | | | - Chanan Goyal
- Physiotherapy, Government Physiotherapy College, Raipur, IND
- Neuro Physiotherapy, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Kim M, Park C, Jeon H, Choi WJ, You SJH. Comparative effects of community-based family-child-centered care and conventional pediatric rehabilitation for cerebral palsy. NeuroRehabilitation 2021; 49:533-546. [PMID: 34776430 DOI: 10.3233/nre-210219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
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.
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Affiliation(s)
- Mikyoung Kim
- Sports Movement Artificial Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea.,Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
| | - Chanhee Park
- Sports Movement Artificial Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea.,Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
| | - Hyeseon Jeon
- Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
| | | | - Sung Joshua Hyun You
- Sports Movement Artificial Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea.,Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
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Belizón-Bravo N, Romero-Galisteo RP, Cano-Bravo F, Gonzalez-Medina G, Pinero-Pinto E, Luque-Moreno C. Effects of Dynamic Suit Orthoses on the Spatio-Temporal Gait Parameters in Children with Cerebral Palsy: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111016. [PMID: 34828729 PMCID: PMC8621824 DOI: 10.3390/children8111016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022]
Abstract
Dynamic suit orthoses (DSO) are currently used as a complementary treatment method in children with Cerebral Palsy (cwCP). The aim of this review was to assess the effects of interventions with DSO on the altered spatio-temporal gait parameters (STGPs) in cwCP. An electronic search was conducted in the Web of Science, Scopus, PEDro, Cochrane Library, MEDLINE/PubMed, and CINAHL databases up to July 2021. We included a total of 12 studies, which showed great heterogeneity in terms of design type, sample size, and intervention performed (two employed a Therasuit, three employed the Adeli suit, three employed Theratogs, one employed elastomeric tissue dynamic orthosis, one employed a full-body suit, one employed external belt orthosis, and one employed dynamic orthosis composed of trousers and T-shirt). The Cochrane collaboration’s tool and the Checklist for Measuring Study Quality were used to assess the risk of bias and the methodological quality of the studies. It was variable according to the Checklist for Measuring Study Quality, and it oscillated between eight and 23. The studies of higher methodological quality showed significant post-intervention changes in walking speed (which is the most widely evaluated parameter), cadence, stride length, and step length symmetry. Although the evidence is limited, the intervention with DSO combined with a programme of training/physical therapy seems to have positive effects on the STGPs in cwCP, with the functional improvements that it entails. Despite the immediate effect after one session, a number of sessions between 18 and 60 is recommended to obtain optimum results. Future studies should measure all STGPs, and not only the main ones, such as gait speed, in order to draw more accurate conclusions on the functional improvement of gait after the use of this type of intervention.
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Affiliation(s)
- Natalia Belizón-Bravo
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (N.B.-B.); (G.G.-M.); (C.L.-M.)
| | - Rita Pilar Romero-Galisteo
- Department of Physiotherapy, Biomedical Research Institute of Malaga (IBIMA), University of Málaga, 29071 Málaga, Spain
- Correspondence: ; Tel.: +0034-951-052-862
| | - Fatima Cano-Bravo
- Pediatric Rehabilitation Unit, Virgen del Rocío Hospital, 41013 Sevilla, Spain;
| | - Gloria Gonzalez-Medina
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (N.B.-B.); (G.G.-M.); (C.L.-M.)
| | - Elena Pinero-Pinto
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41004 Sevilla, Spain;
| | - Carlos Luque-Moreno
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (N.B.-B.); (G.G.-M.); (C.L.-M.)
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41004 Sevilla, Spain;
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Karadağ-Saygı E, Giray E. The clinical aspects and effectiveness of suit therapies for cerebral palsy: A systematic review. Turk J Phys Med Rehabil 2019; 65:93-110. [PMID: 31453550 PMCID: PMC6648185 DOI: 10.5606/tftrd.2019.3431] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 12/18/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The aim of this review to evaluate the clinical aspects and effectiveness of suit therapy for patients with cerebral palsy (CP). MATERIALS AND METHODS A literature search was performed in the PubMed, SCOPUS, Web of Science, and PEDro databases within the period from the establishment of the relevant database to July 2018. The articles were categorized according to their study design. We included studies published in peer-review journals focusing on the efficacy of suit therapies for CP and excluded review articles, duplications, non-related articles. A narrative synthesis approach was used, as it was not possible to classify extracted and analyzed data, and the overall effect size was unable to be calculated. Data regarding study subjects (number, age, CP type, Gross Motor Function Classification System [GMFCS] level), suit type, intervention including dose of suit therapy, outcome measurements, outcomes, adverse effects, and funding were extracted. The method introduced by Furlan, Pennick, Bombardier, and van Tulder was used to evaluate the risk of bias for the assessment of methodological quality of randomized-controlled trials (RCTs). RESULTS A total of 29 studies were included of which 10 were Class I, eight were Class II-III, and 11 were Class IV studies. Studies were heterogenous in design, sample size, study population, and outcomes measured. The methodological quality score of RCTs varied between 4 and 10. The results of the high-quality RCTs showed that wearing the suit along with conventional therapy improved proximal stability, gross motor function, and gait. The Class II-III and IV studies supported the findings of the Class I studies. CONCLUSION The major improvements from the RCTs were seen in proximal stability, gross motor function and gait, although grading was unable to be done due to the heterogeneity of included studies. In order to obtain gains in the function, it is important to carefully consider intended use, patient selection criteria, and suit type.
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Affiliation(s)
- Evrim Karadağ-Saygı
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, İstanbul, Turkey
| | - Esra Giray
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, İstanbul, Turkey
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Fragkou D, Gkrimas G, Pyrgeli M. Therapeutic interventions for trunk and improvement of posture in children with cerebral palsy: a review of the literature. ACTA ACUST UNITED AC 2018. [DOI: 10.15406/mojor.2018.10.00434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Lee BH. Clinical usefulness of Adeli suit therapy for improving gait function in children with spastic cerebral palsy: a case study. J Phys Ther Sci 2016; 28:1949-52. [PMID: 27390453 PMCID: PMC4932094 DOI: 10.1589/jpts.28.1949] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 03/12/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to determine the effects of Adeli suit therapy (AST) on gross motor function and gait function in children with cerebral palsy. [Subjects and Methods] Two participants with spastic cerebral palsy were recruited to undergo AST. AST was applied in 60-minute sessions, five times per week, with 20 sessions total over 4 weeks. Assessments of gross motor function, spatiotemporal parameters, and functional ambulation performance for gait were conducted. [Results] Gross motor function, cadence, and functional ambulation performance improved after the intervention in both cases. [Conclusion] Although additional follow-up studies are required, the results demonstrated improved gross motor function and functional ambulation performance in the children with cerebral palsy. These findings suggest a variety of applications for conservative therapeutic methods that require future clinical trials in children with cerebral palsy.
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Affiliation(s)
- Byoung-Hee Lee
- Department of Physical Therapy, College of Health Science,
Sahmyook University: 815 Hwarang-ro, Nowon-gu, Seoul 139-742, Republic of Korea
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