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Seyhan-Bıyık K, Delioğlu K, Tunçdemir M, Üneş S, Özal C, Kerem-Günel M. Asymmetric involvement of hands: Psychometric properties of the Turkish version of the Bimanual Fine Motor Function 2.0 classification in children with cerebral palsy. J Hand Ther 2024; 37:429-437. [PMID: 37777439 DOI: 10.1016/j.jht.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 07/25/2023] [Accepted: 08/15/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Manual functions affect more than a half of children with Cerebral palsy (CP). Asymmetric involvement of hands may also affect unilateral and bilateral activities of daily life. The Bimanual Fine Motor Function version 2.0 (BFMF-2.0) is a unique functional classification that categorizes the capacity of each hand (what the child can do) during bimanual functions. PURPOSE The aim of this study was to investigate the validity and reliability of the Turkish version of the BFMF-2.0 in children with CP. STUDY DESIGN Clinical measurement and cross-sectional study. METHODS The study included 91 children with CP (56 girls, mean age; 7.41 ± 4.23 years [4-18 years]) and their parents. The Manual Ability Classification System (MACS), the Quality of Upper Extremity Skills Test (QUEST), and the Box and Block Test (BBT) were used for construct and concurrent validity. Experienced/inexperienced therapists and parents classified fine motor capacities of the children via live or video-based observation to assess inter-rater reliability. Three weeks later, the children were reclassified for intra-rater reliability. RESULTS The Turkish version of the BFMF-2.0 classification was strongly correlated with the MACS (rho = -0.88, p < 0.001), the QUEST (rho = 0.80, p < 0.001), and the BBT (rho = -0.77, p < 0.001). The inter-rater reliability scores were weak to excellent between the parents and the therapists (via live observation, κw = 0.57) and also between experienced/inexperienced therapists (via live or video-based observation, κw = 0.66-0.79). Intra-rater reliability scores were good to excellent (Intraclass Correlation Coefficient [ICC] = 0.87-0.95). CONCLUSIONS The Turkish version of the BFMF-2.0 classification is valid and reliable and could be applied by experienced and inexperienced therapists via live or video-based observation and by parents via live observation.
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Affiliation(s)
- Kübra Seyhan-Bıyık
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
| | - Kıvanç Delioğlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Merve Tunçdemir
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Sefa Üneş
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Cemil Özal
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Mintaze Kerem-Günel
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
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Hwang Y, Kwon JY. Filtering walking actigraphy data in children with unilateral cerebral palsy: A preliminary study. PLoS One 2024; 19:e0303090. [PMID: 38722902 PMCID: PMC11081346 DOI: 10.1371/journal.pone.0303090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/15/2024] [Indexed: 05/13/2024] Open
Abstract
This study aimed to determine whether filtering out walking-related actigraphy data improves the reliability and accuracy of real-world upper extremity activity assessment in children with unilateral cerebral palsy. Twenty-two children aged 4-12 years diagnosed with unilateral cerebral palsy were included in this study, which was drawn from a two-phase randomized controlled trial conducted from July 2021 to December 2022. Data were collected from a tertiary hospital in Seoul, Republic of Korea. Participants were monitored using tri-axial accelerometers on both wrists across three time points (namely, T0, T1, and T2) over 3 days; interventions were used between each time point. Concurrently, an in-laboratory study focusing on walking and bimanual tasks was conducted with four participants. Data filtration resulted in a reduction of 8.20% in total data entry. With respect to reliability assessment, the intra-class correlation coefficients indicated enhanced consistency after filtration, with increased values for both the affected and less-affected sides. Before filtration, the magnitude counts for both sides showed varying tendencies, depending on the time points; however, they presented a consistent and stable trend after filtration. The findings of this research underscore the importance of accurately interpreting actigraphy measurements in children with unilateral cerebral palsy for targeted upper limb intervention by filtering walking-induced data.
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Affiliation(s)
- Youngsub Hwang
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jeong-Yi Kwon
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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Conroy S, Evans T, Butler-Moburg D, Beuttler R, Robinson J, Huebert M, O Mahony E, Grant-Beuttler M. Clinical application and feasibility of utilizing the PEDI-CAT to assess activity and participation among children receiving physical therapy incorporating hippotherapy. Physiother Theory Pract 2023; 39:2300-2313. [PMID: 35594061 DOI: 10.1080/09593985.2022.2072250] [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: 12/08/2020] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Hippotherapy (HPOT) is a physical therapy (PT) treatment tool using equine movement to improve mobility for children with movement impairments. Although research suggests HPOT improves body structure and function, there is limited evidence regarding its impact on activity and participation outcomes in a clinical setting. The Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) may be useful in HPOT settings to highlight changes in activity and participation. PURPOSE 1) Evaluate the PEDI-CAT's sensitivity to changes in activity and participation among children receiving PT using HPOT; 2) determine feasibility of administering the PEDI-CAT in a HPOT setting; and 3) examine how PEDI-CAT scores influence clinical decision-making. METHODS Participants (N = 34) were children who attended weekly PT using HPOT for 6 months. The PEDI-CAT was completed for all participants by a parent or caregiver at initial treatment (T1) and 6 months later (T2). A linear mixed effects model was used to evaluate changes in scores over time. Team meetings occurred monthly to discuss how PEDI-CAT scores impacted treatment. RESULTS There were significant improvements across 3 PEDI-CAT domains between T1 and T2 for all children with small effect sizes and nonsignificant changes noted within two diagnostic subgroups with small-to-medium effect sizes. The PEDI-CAT was completed by all participants without interrupting treatment flow. PEDI-CAT score reports enriched therapist-client conversations increasing shared decision-making. CONCLUSION PTs who treat children using HPOT may feasibly use the PEDI-CAT to assess changes in activity level outcomes and to assist clinical decision-making.
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Affiliation(s)
- Susan Conroy
- Therapy services, Shea Center for Therapeutic Riding, San Juan Capistrano, CA, USA
| | - Trish Evans
- Therapy services, Shea Center for Therapeutic Riding, San Juan Capistrano, CA, USA
| | - Dana Butler-Moburg
- Therapy services, Shea Center for Therapeutic Riding, San Juan Capistrano, CA, USA
| | | | - Janelle Robinson
- Therapy services, Shea Center for Therapeutic Riding, San Juan Capistrano, CA, USA
| | - Matt Huebert
- Therapy services, Shea Center for Therapeutic Riding, San Juan Capistrano, CA, USA
| | - Erin O Mahony
- Therapy services, Shea Center for Therapeutic Riding, San Juan Capistrano, CA, USA
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Pahwa PK, Mani S. Current Profile of Physical Impairments in Children with Cerebral Palsy in Inclusive Education Settings: A Cross-Sectional Study. J Neurosci Rural Pract 2022; 13:424-430. [PMID: 35946009 PMCID: PMC9357468 DOI: 10.1055/s-0042-1744556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Cerebral palsy (CP) excerpts a heterogeneous corral of neurological disorders occurring due to injury to the developing brain leading to motor dysfunctions. The CP children enjoy success and progress in normal school education and curriculum program. The principle of inclusive education has been acknowledged over recent decades in all countries supporting the schooling of children with disabilities into mainstream settings for constructing an inclusive society. Objective The objective of this study was to determine the current status of physical impairments in children with CP in inclusive education settings in district Mandi, Himachal Pradesh. Materials and Methods A survey using the physical examination of all CP children ( n = 20) between the age group of 6 and 12 years in inclusive education settings with an organized interview of special educators in school settings was conducted. Descriptive analysis was conducted by using SPSS IBM 22. Results A total of 20 CP children (11 boys and 9 girls, with the mean age of 9.8 ± 1.69) were enrolled in the study. Mean and standard deviation of Visual Analog Scale (6.5 ± 0.82), Pediatric Balance Scale (21.4 ± 17.1), Gross Motor Function Classification System, Expanded and Revised (2.8 ± 1.46), Manual Ability Classification System (2.5 ± 1.1), Gross Motor Function Measurement-88 (36.40 ± 22.94), and Goal Attainment Scale (35.9 ± 0.40) with the total WeeFIM score (75.7 ± 3.4) were analyzed as the score of all outcome measures. Conclusion Right to Education act promotes the compulsory education of such children, and limiting disability by knowing the current profile of impairments could help in improving physical and functional status in children.
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Affiliation(s)
- Pardeep K. Pahwa
- Department of Physiotherapy, Composite Regional Centre (CRC) for Skill Development, Rehabilitation and Empowerment of Persons with Disabilities, Under Ministry of Social Justice and Empowerment, Government of India, Mandi, Himachal Pradesh, India
| | - Suresh Mani
- Department of Physiotherapy, Lovely Professional University, Phagwara, Punjab, India
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Predictors of gross motor function and activities of daily living in children with cerebral palsy. Int J Rehabil Res 2021; 44:330-335. [PMID: 34545854 DOI: 10.1097/mrr.0000000000000497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To determine the influence of selected impairment variables, spasticity, trunk control, upper limb function and selective motor control of the lower limb on gross motor function and activities of daily living in children with cerebral palsy (CP). Seventy children with CP, 40 boys and 30 girls, with age range between 11 and 156 months were recruited in this cross-sectional study. Data on spasticity, selective motor control of the lower limb, upper limb function and trunk control were assessed using modified Ashworth scale (MAS), selective motor control of the lower limb (SCALE), paediatric arm function test, trunk motor control assessment and GMFM88, respectively. Among all the variables assessed, only trunk control significantly predicted gross motor function (beta = 0.880; P < 0.001) and activities of daily living (beta = 0.550; P < 0.05). However, gross motor function and activities of daily living have significant (P < 0.05) negative correlations with spasticity, and positive correlations with selective motor control of the lower limb and trunk control. Trunk control is the most influencing factor on gross motor function and activities of daily living in children with CP. Therefore, achieving trunk control especially in those at GMFCS levels V and VI should be a priority during the rehabilitation of children with CP.
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Hornáček K, Kujawa J, Varela Donoso E, Dincer F, Ilieva E, Takáč P, Petronic Markovic I, Votava J, Vetra A, Nikolic D, Christodoulou N, Zampolini M, Kiekens C. Evidence Based Position Paper on Physical and Rehabilitation Medicine professional practice for persons with cerebral palsy. Eur J Phys Rehabil Med 2021; 57:1020-1035. [PMID: 33861040 DOI: 10.23736/s1973-9087.21.06983-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Cerebral palsy (CP) is a group of the most common developmental disorders affecting movement and posture of the body, causing activity limitations and participation restrictions. The motor disorders of persons with CP are often accompanied by disturbances of sensation, cognition, communication and perception. The symptoms of CP are very diverse and persons with CP are usually presented with a mixed type of symptoms. The non-progressive disturbances can be attributed to disorders that were developed during pregnancy, birth and/or infant stage. AIM The aim of this study was to improve Physical and Rehabilitation Medicine physician´s professional practice for persons with cerebral palsy in order to improve their functionality, social and community integration, and to reduce activity limitations and/or participation restrictions. MATERIAL AND METHODS A systematic review of the literature including an eighteen-year period and consensus procedure by means of a Delphi process was performed and involved the delegates of all European countries represented in the Union of European Medical Specialists Physical and Rehabilitation Medicine (UEMS PRM) Section. RESULTS As the result of a Consensus Delphi procedure process 74 recommendations are presented together with the systematic literature review. CONCLUSIONS The PRM physician´s role for persons with cerebral palsy is to lead and coordinate the multiprofessional team, working in an interdisciplinary way. They should propose and manage the complex but individual PRM programme developed in conjunction with other health professionals, medical specialists and importantly in agreement with the patient, their family and care giver. This should be, according to the specific medical diagnosis to improve patients´ health, functioning, social and education status, considering all impairments, comorbidities and complications, activity limitations and participation restrictions.
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Affiliation(s)
- Karol Hornáček
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia
| | - Jolanta Kujawa
- Department of Physical and Rehabilitation Medicine, Medical University of Lodz, Lodz, Poland
| | - Enrique Varela Donoso
- Physical and Rehabilitation Medicine Department, Complutense University of School of Medicine, Madrid, Spain
| | - Fitnat Dincer
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elena Ilieva
- Department of Physical and Rehabilitation Medicine, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Peter Takáč
- Department of Physical and Rehabilitation Medicine, L. Pasteur University Hospital, Faculty of Medicine, Pavol Jozef Šafárik University, Košice, Slovak Republic -
| | - Ivana Petronic Markovic
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jiří Votava
- Faculty of Health Studies, University of J. E. Purkyně, Ústí nad Labem, Czech Republic
| | - Anita Vetra
- Rehabilitation Department, Riga Stradins University, Riga, Latvia
| | - Dejan Nikolic
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Mauro Zampolini
- Department of Rehabilitation, Foligno Hospital, USL Umbria 2, Perugia, Italy
| | - Carlotte Kiekens
- Spinal Unit, Montecatone Rehabilitation Institute, Imola Bologna, Italy
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Diaphragmatic mobility in children with spastic cerebral palsy and differing motor performance levels. Respir Physiol Neurobiol 2019; 266:163-170. [DOI: 10.1016/j.resp.2019.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/24/2019] [Accepted: 05/18/2019] [Indexed: 11/23/2022]
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Mishra K, Siddharth V, Elhence A, Jalan D, Khera D, Yasir M. Effectiveness of individualized, goal directed institutional based rehabilitation programme in children with developmental delay disorders, in a region with limited rehabilitation accessibility. J Pediatr Rehabil Med 2019; 12:49-56. [PMID: 30883370 DOI: 10.3233/prm-170521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To evaluate effectiveness of individualized, goal directed rehabilitation protocol in improving functional outcomes in children with developmental delay disorders in a region with limited rehabilitation accessibility and to explore if goal setting influences changes observed in functional levels. METHODS Children (6 months to 17 years) with developmental delay, who visited as out-patients to the Department of Physical Medicine and Rehabilitation and whose care givers were willing to participate in the study, were enrolled for a period of one year. Individualized rehabilitation protocol targeting the child's specific problems with a simultaneous home programme was performed. A single group pre-post study design was used to assess the protocol's effectiveness. OUTCOME MEASURES Goal attainment scale (GAS), Gross Motor Function Classification System (GMFCS) Level, Gross Motor Functional Measure (GMFM) and Manual Ability Classification System (MACS) were administered pre and post-intervention monthly for 3 months. Statistical analysis was done using SPSS statistics version-22. RESULTS Total of 32 children participated in the study. Significant differences between pre and post scores of GAS score (Wilcoxon's signed rank test [W value] = 4.937, p-value < 0.005), GMFCS (W value: -3.435, p-value < 0.005), GMFM (W value: 4.937, p-value < 0.005) and MAC score (W value: -4.714, p-value < 0.005) were noted at 3 months. No correlation was observed between the GAS pre-post score and GMFM, GMFCS and MAC pre-post scores. CONCLUSION An effective rehabilitation programme in children with developmental delay should be individualized and should be goal directed to achieve maximum functional improvement. Improvement in the goals set were independent of the improvement in functional outcome levels. Care-givers play a pivotal role in both individualization and goal setting for rehabilitation, especially in a region with limited rehabilitation accessibility.
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Affiliation(s)
- Kriti Mishra
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - V Siddharth
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Abhay Elhence
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Divesh Jalan
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Daisy Khera
- Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mohammed Yasir
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Mélo TR, Yamaguchi B, Silva AZD, Israel VL. Motor abilities, activities, and participation of institutionalized Brazilian children and adolescents with cerebral palsy. MOTRIZ: REVISTA DE EDUCACAO FISICA 2017. [DOI: 10.1590/s1980-6574201700si0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Tainá Ribas Mélo
- Universidade Federal do Paraná, Brazil; Centro Universitário Campos de Andrade, Brazil; Instituto Brasileiro de Therapias e Ensino, Brazil
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Santos PDD, Silva FCD, Ferreira EG, Iop RDR, Bento GG, Silva RD. Instrumentos que avaliam a independência funcional em crianças com paralisia cerebral: uma revisão sistemática de estudos observacionais. FISIOTERAPIA E PESQUISA 2016. [DOI: 10.1590/1809-2950/15260723032016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Este artigo teve como objetivo fazer uma revisão sistemática de instrumentos que avaliam a independência funcional de crianças com paralisia cerebral. As bases eletrônicas da MEDLINE/PubMed, Scopus e Web of Science foram usadas para as buscas. Estudos observacionais dos últimos cinco anos, com texto completo disponível e sem restrição de idioma foram incluídos nesta revisão. Foram encontrados 222 artigos, dos quais, 63 foram analisados e 24 foram incluídos no estudo. Os principais instrumentos encontrados foram: PEDI, WeeFIM, ASK, PODCI, VABS-II, LIFE-H e CAPE/PAC.
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Park ES, Rha DW, Shin JS, Kim S, Jung S. Effects of hippotherapy on gross motor function and functional performance of children with cerebral palsy. Yonsei Med J 2014; 55:1736-42. [PMID: 25323914 PMCID: PMC4205717 DOI: 10.3349/ymj.2014.55.6.1736] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of our study was to investigate the effects of hippotherapy on gross motor function and functional performance in children with spastic cerebral palsy (CP). MATERIALS AND METHODS We recruited 34 children (M:F=15:19, age: 3-12 years) with spastic CP who underwent hippotherapy for 45 minutes twice a week for 8 weeks. Twenty-one children with spastic CP were recruited for control group. The distribution of gross motor function classification system level and mean age were not significantly different between the two groups. Outcome measures, including the Gross Motor Function Measure (GMFM)-66, GMFM-88 and the Pediatric Evaluation of Disability Inventory: Functional Skills Scale (PEDI-FSS), were assessed before therapy and after the 8-weeks intervention as outcome measures. RESULTS There were no significant differences between intervention and control groups in mean baseline total scores of GMFM-66, GMFM-88 or PEDI-FSS. After the 8-weeks intervention, mean GMFM-66 and GMFM-88 scores were significantly improved in both groups. However, the hippotherapy group had significantly greater improvement in dimension E and GMFM-66 total score than the control group. The total PEDI-FSS score and the sub-scores of its 3 domains were significantly improved in the hippotherapy group, but not in the control group. CONCLUSION The results of our study demonstrate the beneficial effects of hippotherapy on gross motor function and functional performance in children with CP compared to control group. The significant improvement in PEDI-FSS scores suggests that hippotherapy may be useful to maximize the functional performance of children with CP.
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Affiliation(s)
- Eun Sook Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Wook Rha
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Soon Shin
- Horse Riding Academy of Korea Racing Authority, Gwacheon, Korea
| | - Soohyeon Kim
- Horse Riding Promotion Team of Korea Racing Authority, Gwacheon, Korea
| | - Soojin Jung
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
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How do changes in motor capacity, motor capability, and motor performance relate in children and adolescents with cerebral palsy? Arch Phys Med Rehabil 2014; 95:1577-84. [PMID: 24792140 DOI: 10.1016/j.apmr.2014.04.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 03/21/2014] [Accepted: 04/01/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the relations between changes in motor capacity (can do, in standardized environment), motor capability (can do, in daily environment), and motor performance (does do, in daily environment) among children with cerebral palsy (CP). DESIGN Prospective longitudinal study. After baseline measurements (at the age of 18 mo, 30 mo, 5 y, 7 y, 9 y, 11 y, or 13 y), 2-year follow-up measurements were performed. Change scores were calculated, and Pearson correlations were used for change score relations. SETTING Outpatient clinic. PARTICIPANTS Toddlers, school-age children, and adolescents with CP (N=321; 200 boys, 121 girls). Levels of severity according to the Gross Motor Function Classification System included level I (42%), level II (15%), level III (17%), level IV (13%), and level V (13%). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Change in motor capacity was assessed with the Gross Motor Function Measure-66. Changes in motor capability and motor performance were assessed with the Pediatric Evaluation of Disability Inventory using the Functional Skills Scale and Caregiver Assistance Scale, respectively. RESULTS Within the total group, change score correlations were moderate (.52-.67) and significant (P<.001). For age groups, correlations were significantly higher in toddlers than school-age children and adolescents. For severity levels, correlations were significantly higher in children at level III than level I, IV, and V. CONCLUSIONS Results imply that change in motor capacity does not automatically translate to change in motor capability and change in motor capability does not automatically translate to change in motor performance. Results also show different relations for clinically relevant subgroups. These are important insights for clinical practice because they can guide evidence-based interventions with a focus on activities.
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