ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This feasibility study describes the development and application of a new intensive treadmill locomotor training program for young children with cerebral palsy (CP). The premise is that early, intensive, and task-specific locomotor training initiated even before independent walking is attained will promote improved locomotor skills. Four children, three girls and one boy, with spastic cerebral palsy (age range: 1.7–2.3 years) received a combination of conventional therapy and treadmill training four times per week for four months. To enable treadmill locomotor training, a customized treadmill capable of very low speeds and with several safety features, including a harness that could also be used for weight support, was custom built. Change in locomotor performance was evaluated with three clinical measures: the Gross Motor Function Measure (GMFM), a gait videographic test and the Supported Walker Ambulation Performance Scale (SWAPS). In addition, a full laboratory gait analysis was performed at baseline and at two and four months posttherapy. The results confirm the feasibility of early and intensive treadmill locomotor training in young children with CP even before independent walking is attained. Gait spatiotemporal parameters and the GMFM total score did not reveal changes observed in the video records by trained observers while laboratory gait evaluations were confounded by the poor locomotor capacity, especially at baseline. The GMFM D and E subscore and the SWAPS, were more sensitive to changes in the supported locomotor status and may be more appropriate than the GMFM total score for future studies requiring the matching of children who are nonindependent walkers. The results of this study pave the way for additional work on the SWAPS or for future efficacy trials using treadmills.

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The Infant Neuromotor Assessment (INA) is a screening test that aims to identify high-risk infants who require comprehensive neuromotor evaluation. The test consists of 20 items and takes 10 to 15 minutes to complete. Good interobserver reliability (r (s) = 0.96) was found when 15 infants were assessed independently by two testers. The predictive value was assessed on 242 high-risk infants who were evaluated between 16 and 24 weeks corrected age and again after 12 months of age. A positive predictive value of 85.3% was found with five or more deviant signs and a negative predictive value of 98.6% in the presence of zero or one deviant sign. The practical implications of these findings are discussed and a policy for follow-up of infants at risk for developmental disability is suggested.

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The purpose of this descriptive study is to report the outcomes of a case series of children treated with physical therapy for developmental muscular torticollis (DMT). The treatment program described emphasizes parental home programs of positioning and strengthening as opposed to hands-on passive range of motion. We studied a sample of convenience of 23 children (mean age = 18 months, SD = 9.7 months) whose parents agreed to a follow-up evaluation. Initial evaluations were reviewed retrospectively and compared with the follow-up, posttest data. Results showed that at an average of 14 months postinitial examination, 83% of the children had no observable head tilt, only slightly decreased (three to six degrees) passive and active cervical range of motion on the involved sides, and full lateral head righting in all but one child, and there was no residual facial asymmetry or plagiocephaly in 66% of the children. Ninety-five percent of the parents categorized the physical therapy from helpful to very helpful. Overall outcome was judged utilizing a point system that incorporated a variety of clinical aspects of torticollis. Good to excellent results were achieved in 96% of the children based on these criteria.

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Development of the musculoskeletal system in children with cerebral palsy can be very different from development in children without disabilities. Hip and spine problems are common in children who are more severely involved. The purpose of this article is to review the literature related to the development of the hip and spine in children with cerebral palsy and to discuss the clinical implications of this information. According to the literature, primary causes of abnormal development of the hip and spine include muscle imbalances, abnormal positioning, and delayed or insufficient weight-bearing. Secondary complications include contractures, malformation of joints, decreased bone mineral density, and increased incidence of fractures. Development of musculoskeletal deformities is often accompanied by pain, difficulty in maintaining sitting and standing postures, and limited functional abilities. Physical therapy should focus on slowing the progression of deformity, avoiding positioning that contributes to its development, and improving bone modeling by weight-bearing with good alignment.

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID