Intensive physical therapy helps preserve motor skills in children with CP

Children with cerebral palsy may benefit significantly over the long-term from intensive physical training that prevents deterioration of their motor skills.

Shriners Hospitals for Children in Springfield, Mass

Alice Melão, Cerebral Palsy News Today May 11, 2018

The study with that finding was published recently in the journal Physical & Occupational Therapy In Pediatrics.

Cerebral palsy is caused mainly by perinatal brain injury due to oxygen deprivation. It can manifest with different symptoms and severity of degrees, including mental retardation, seizure, speech delay, and behavioral problems. But the major feature of this condition, and the most challenging, is motor disability.

Gross motor function is fundamental for children to explore and interact with their surroundings. As such, it becomes crucial to identify which factors influence gross motor progress and are of particular therapeutic relevance for children with cerebral palsy.

“Some factors have shown to benefit short-term gross motor progress, but possible long-term influences are still unclear, and longitudinal studies based on large cohorts of children have been requested,” researchers wrote.

This study focused on the evaluation of potential associations between physical activity interventions and gross motor progress in children with cerebral palsy.

Researchers collected information from the Cerebral Palsy Follow-up Program (CPOP) and The Cerebral Palsy Register of Norway (CPRN), which together comprise data on 90 percent of children with cerebral palsy in Norway. The team analyzed the clinical records of 442 children aged 2 to 12 years, of whom 256 were boys and 186 girls; they were followed for a mean period of 2.9 years.

Children who underwent three or more sessions per week of physical therapy, or participated in an intensive physical therapy program, were the ones who experienced enhanced progress on their gross motor function during the study period.

As in previous studies, the team found this positive effect is dependent on the number of training periods. While one period with intensive training enhanced gross motor progress by 3.3 percentiles, two periods could enhance gross motor progress by 6.6 percentiles.

Intellectual disability was found to be a strong negative prognostic factor, as it was associated with lower gross motor function abilities — on average 24.2 percentiles below that reported on others. Also, eating problems and ankle contractures negatively impacted long-term progress of gross motor function in these children.

According to researchers “intensive training enhances gross motor progress in all children with cerebral palsy… the results give reasons to recommend intensive training independent of intellectual ability or any of the other factors included,” they wrote.

Factors Associated with Enhanced Gross Motor Progress in Children with Cerebral Palsy: A Register-Based Study. Størvold GV, Jahnsen RB, Evensen KAI, Romild UK, Bratberg GH. Phys Occup Ther Pediatr. 2018 May 1:1-14. doi: 10.1080/01942638.2018.1462288. [Epub ahead of print]

Source Cerebral Palsy News Today

The Danish Cerebral Palsy Follow-up Program, Rasmussen HM, Nordbye-Nielsen K, Møller-Madsen B, Johansen M, Ellitsgaard N, Pedersen CR, Rackauskaite G, Engberg H, Pedersen NW. Clin Epidemiol. 2016 Oct 25;8:457-460. eCollection 2016. Review.

Cerebral palsy in Norway: prevalence, subtypes and severity, Andersen GL, Irgens LM, Haagaas I, Skranes JS, Meberg AE, Vik T. Eur J Paediatr Neurol. 2008 Jan;12(1):4-13. Epub 2007 Jun 15.

Exercise interventions for cerebral palsy, Ryan JM, Cassidy EE, Noorduyn SG, O’Connell NE. Cochrane Database Syst Rev. 2017 Jun 11;6:CD011660. doi: 10.1002/14651858.CD011660.pub2. Review.

Health status of children with cerebral palsy living in Europe: a multi-centre study, Beckung E, White-Koning M, Marcelli M, McManus V, Michelsen S, Parkes J, Parkinson K, Thyen U, Arnaud C, Fauconnier J, Colver A. Child Care Health Dev. 2008 Nov;34(6):806-14. doi: 10.1111/j.1365-2214.2008.00877.x.

Nine-year-old Emma felt sad when she could not join her friends to play sports. She was in a wheelchair because of cerebral palsy, a neurological disorder that affects body movement and muscle coordination. Today, she’s using a walker more and able to participate in movement exercises thanks to BFit, a program her parents discovered at Shriners Hospitals for Children in Springfield, Mass. BFit is a unique power-based exercise program provided by UHart Professor of Physical Therapy Mary Gannotti and her students, in partnership with clinicians from Shriners Hospitals—Springfield. University of Hartford. Published on Jul 12, 2017

Also see
Physical Therapy Students and Professor Pioneer an Exercise Program for Children with Disabilities that Fills a National Void in University of Hartford

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