Physiotherapy Intervention on Premature Infants-A Pilot Study

Background and Objectives: Considering the fact that prematurity echoes in terms of motor development even up to the age of adolescence, through the presence of deficiencies, the importance of starting kinetotherapeutic treatment as soon as possible is highlighted, even in the absence of brain damage or obvious motor delays. Therefore, the objectives of this study are to analyze the factors that influence the level of motor development of premature babies up to 9 months and identify the motor development curve of premature babies according to the three stages of motor development: the position of symmetrical support on the elbows at 3 months, sitting with support at 6 months, and verticalization at 9 months. Materials and Methods: This prospective pilot study was conducted within a rehabilitation facility located in Targu Mureș, Romania, spanning a duration of 2 years from June 2021 to 2023. Results: The study involved a population of 78 children, all premature infants, selected from the patient pool of the rehabilitation facility, specifically chosen based on adherence to the predetermined inclusion and exclusion criteria outlined in the study protocol. Two physiotherapists specialized in child recovery were involved in the study, and one performed the assessments and the other applied the Bobath therapy. Conclusions: Early physiotherapy interventions can have a positive influence in terms of reducing differences in motor development between preterm and full-term infants. This study identified several factors that influence the motor development of premature infants. Among these, the most prominent biological factors were gestational age and birth weight.

Balance Rehabilitation Approach by Bobath and Vojta Methods in Cerebral Palsy: A Pilot Study

In cerebral palsy (CP) the basis for rehabilitation comes from neuroplasticity. One of the leading therapeutic approaches used in the management of CP is the NDT Bobath therapy and Vojta therapy consists in trying to program the ideal movement patterns for the age. The aim of our research was to analyze, from a functional point of view, the evolution of the biomechanical parameters characterizing the balance, in children with CP. The group of 12 subjects average age of 7 ± 3.28 years. The subject’s evaluation included a functional clinical evaluation by Berg pediatric scale and a biomechanical evaluation performed using the “Stabilometry footboard PoData 2.00” for evaluation the body weight distribution on the foot level. The rehabilitation program was developed based on two methods, NDT Bobath and Vojta. A 90-min physiotherapy session starts with a Vojta therapy activation, for 20 min. Between the two therapies there is a 10-min break, then the session continues with NDT Bobath exercises within the 3 physical exercises proposed for 60 min. 5 days per week, 6 months. The analysis of the data collected before and after the application of the rehabilitation program, regarding the using the Berg scale indicates a progress of 32.35%, (p = 0.0001 < 0.05) and the effect size is large. The evolution of the data that indicate the distribution of body weight at the level of the two lower limbs, at the two moments pre/post, evaluation. For left side a progress of 8.39%, (p = 0.027 < 0.05) but a small effect size of 0.86. For right side a progress of 10.36% (p = 0.027 < 0.05) and also a small effect size of 0.86. Analyzing the results, we find that there is a left-right rebalancing in most patients. The favorable results that were obtained by drawing up a physiotherapy program composed of the combination of the two Vojta and NDT Bobath methods are proof of the fact that both methods are based on the creation of a stimulating peripheral pressure, which, if maintained, generates an extended stereotyped motor response. A pattern of symmetrical muscle contraction is thus created and thus balance and postural control can be achieved. The left-right rebalancing, proven by the percentage distribution analysis of the weight at the lower segmental level, demonstrated that the body alignment approach through the Vojta method on the one hand and the inhibitory facilitating postures/exercises promoted by the NDT Bobath method, allows obtaining a symmetry.

Reliability and validity of the Turkish version of Fullerton Advanced Balance Scale in cerebral palsy

BACKGROUND

The Fullerton Advanced Balance Scale (FAB) is a multi-item balance assessment test designed to measure balance in relatively higher functioning individuals. The aim of this study was to examine the reliability and validity of the Turkish version of the FAB (FAB-T) in children with cerebral palsy (CP).

RESEARCH QUESTION

Is the Turkish version of the Fullerton Advance Balance Scale valid and reliable in determining balance problems in children with cerebral palsy and determining the underlying cause of this condition?

METHODS

Forty-six children with CP participated in this study. Rasch analysis was used to investigate item adherence. Internal consistency of the FAB-T was established using Cronbach's alpha coefficient. Test-retest reliability was also evaluated. In addition, to assess concurrent validity, FAB-T scores were compared with the Pediatric Balance Scale (PBS) using the Spearman correlation coefficient.

RESULTS

The FAB-T showed satisfactory internal consistency (Cronbach's alpha value=0.94) and excellent test-retest reliability (ICC=0.99). The FAB and the PBS exhibited concurrent positive validity (r = 0.913; p < 0.001). All items of the FAB-T were found to fit the Rasch Model (Chi-square 16.01(df=20), p = 0.716).

SIGNIFICANCE

The FAB-T is a reliable and valid tool that can be used to measure balance skills and to identify the source of the problem in children with CP.