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A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy.

Abstract：

OBJECTIVE:A pilot study to compare the effectiveness of an individual therapy program with the effects of a general physical therapy program. DESIGN:A randomized, single-blind cross-over design. PARTICIPANTS:Ten ambulant children with bilateral spastic cerebral palsy, age four to nine years. INTERVENTION:Participants were randomly assigned into a ten-week individually defined, targeted or a general program, followed by a cross-over. MAIN OUTCOME MEASURES:Evaluation was performed using the Gross Motor Function Measure-88 and three-dimensional gait analysis. General outcome parameters were Gross Motor Function Measure-88 scores, time and distance parameters, gait profile score and movement analysis profiles. Individual goal achievement was evaluated using z-scores for gait parameters and Goal Attainment Scale for gross motor function. RESULTS:No significant changes were observed regarding gross motor function. Only after individualized therapy, step- and stride-length increased significantly (p = 0.022; p = 0.017). Change in step-length was higher after the individualized program (p = 0.045). Within-group effects were found for the pelvis in transversal plane after the individualized program (p = 0.047) and in coronal plane after the general program (p = 0.047). Between-program differences were found for changes in the knee in sagittal plane, in the advantage of the individual program (p = 0.047). A median difference in z-score of 0.279 and 0.419 was measured after the general and individualized program, respectively. Functional goal attainment was higher after the individual therapy program compared with the general program (48 to 43.5). CONCLUSION:The results indicate slightly favorable effects towards the individualized program. To detect clinically significant changes, future studies require a minimal sample size of 72 to 90 participants.

journal_name

Clin Rehabil

journal_title

Clinical rehabilitation

authors

Franki I,Van den Broeck C,De Cat J,Tijhuis W,Molenaers G,Vanderstraeten G,Desloovere K

doi

10.1177/0269215514544984

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

1039-52

issue

eissn

0269-2155

issn

1477-0873

pii

0269215514544984

journal_volume

pub_type

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A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy.