Effectiveness of functional intensive therapy on mobility and self-care activities in children and adolescents with cerebral palsy - a prospective clinical study.

PURPOSE: Cerebral palsy (CP) is a major cause of childhood disability. Children with CP often lack motor skills to effectively perform activities of daily living. The aim is to assess the effectiveness of a functional intensive therapy program focused on improving individual goals in the domain of mobility and self-care in children and adolescents with CP. MATERIAL AND METHODS: Thirty-five CP patients, aged 11-19 years, GMFCS I-IV, received daily 6-7 h of functional therapy for 15 days. Outcomes were assessed at baseline, immediately after the program and at three months follow-up. RESULTS: Significant post-intervention improvement was seen on all primary and secondary outcome measures; personal goals (GAS score; COPM performance and COPM satisfaction), daily activities (ACTIVLIM), hand function (ABILHAND-Kids), mobility (ABILOCO-Kids; GMFM-66-IS score). There was no loss to follow up during the program and after three months. At follow-up, improvements were retained except for ABILOCO and GMFM-66-IS. CONCLUSIONS: Functional intensive therapy appears feasible and seems to be effective in improving treatment goals focused on mobility and self-care, even in older and more severely affected children and adolescents with CP. After three months, these possible effects were still present.Implications for rehabilitationShort intensive functional training is feasible and showing no loss to follow up in the older and more severely affected children and adolescents with cerebral palsy (CP).Short intensive functional training appears effective in improving individual goals in children and adolescents with CP and improvements endorse three months.Short intensive functional training seems to be effective on both mobility and self-care domains of the ICF-CY.

Changes in endurance and walking ability through functional physical training in children with cerebral palsy.

PURPOSE: To investigate the feasibility and effect of a functional physical training program on aerobic endurance and walking ability of children with cerebral palsy. METHODS: Thirteen children (8-13 years, Gross Motor Function Classification System level I or II, with normal intelligence or mild retardation) participated in this study. A functional physical training program addressing aerobic endurance, walking distance, walking velocity, and ambulation, consisted of a circuit with 4 stations and lasted 30 minutes twice weekly for 9 weeks. The Bruce, 6-minute-run test, Timed Up and Down Stairs Test, and Ambulation Questionnaire were administered 2 weeks before the start, immediately after, and 11 weeks after the intervention. RESULTS: Significant improvement in aerobic endurance, walking distance, and ambulation were observed immediately after the intervention. Maximum treadmill time had improved significantly at 11 weeks. CONCLUSION: A functional physical training improves the aerobic endurance and the functional walking ability of children with cerebral palsy.

Fast responses to target changes are not impaired in children with spastic hemiplegia.

Humans are able to correct an ongoing movement very quickly in response to a suddenly moving target. Such fast responses possibly bypass the motor cortex and if so, one would expect that damage to the motor cortex would not greatly affect them. A group of children with congenital spastic hemiplegia were asked to move to a target, which, in some trials, jumped to a new position. It was found that the congenital spastic hemiplegia group was not affected more by the target jumps than the typically developing children. The moving targets made adaptive movements faster instead of slower for the affected hand. It is concluded that fast-adjusting movements do not necessarily rely on the motor cortex in these children.