ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study was designed to plot the motor development of infants with cerebral palsy (CP) from four to 12 months of age in terms of scores on the Gross Motor Function Measure (GMFM). Twelve infants at risk of CP and one infant with no abnormal history were tested weekly using the GMFM. An analysis of the scores of all children suggested very variable patterns of development and in some cases, a large fluctuation in scores from one week to the next. This fluctuation was also evident in the infant who was neurologically intact. Infants seemed to fall into one of three groups. The most severely affected group started with a score of less than 10 on the GMFM at the initiation of the study and gained scores at a mean rate of 0.21 per week. The next group started with scores between 19 and 30 and had a mean 0.34-point improvement per week. A characteristic of this group was that scores peaked between 30 and 40 weeks and were not equalled or exceeded by 52 weeks. The infants who demonstrated the most improvement started with scores higher than 23 and developed skills at the rate of one point per week. These patterns are in contrast with the infant who was neurologically intact and who started at 50 points at 19 weeks and whose score improved at the rate of 2.9 points per week throughout the year. It was not possible to identify variables that would predict (at the initiation of the study) the different patterns of development. Scores on the GMFM do not increase in a linear fashion, even in children who could be expected to develop “normally.” Because so little improvement was noted in some children (0.84 points per month in one group, 1.36 points per month in another group) counseling and maintenance might be legitimate aims of physical therapy treatment in such cases. Repeated measures of the dependent variable should be incorporated into monitoring of treatment effects of infants with CP as single pre- and postmeasures may be misleading.

ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The aim of the study was to monitor the changes over an eight-month period in gross motor performance of a group of children with different types of cerebral palsy (CP) using the GMFM (Gross Motor Function Measure). Fifty children aged between 12 and 79 months and undergoing active physical therapy (twice a week) participated in the study. The children were evaluated three times at four-month intervals (baseline, four, and 8 months later) with the GMFM test under standardized conditions. Children with quadriplegia (n = 24), hemiplegia (n = 16), and diplegia (n = 10) showed significant improvement of their gross motor function over the eight-month period (mean GMFM total change score = 6.2%; 4.2%, and 7.0%, respectively) and there was no difference in the rate of change across types. The mean GMFM scores of the children with quadriplegia were always significantly lower than corresponding scores of the two other groups (p < 0.001). Results indicate that, irrespective of the type of CP, the GMFM is sensitive to changes in motor performance of children over time.

ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

A community fitness program for adolescents with cerebral palsy was evaluated. Twenty-three subjects (mean age, 14.2 yr) completed a program of aerobics, strength training, and stretching three times a week for 10 weeks. They were tested three times before training, once at the end of the training, and again 10 weeks after training, on the following outcome measures: 1) energy expenditure index (EEI); 2) heart rate (HR) while cycling at a submaximal load; 3) isometric strength of shoulder flexors, knee extensors, and hip extensors and abductors; and 4) flexibility using the sit-and-reach test, the behind-the-back reach test, and intermalleolar distance. Perceived competence was measured before and after the program. Significant changes (p < 0.01) from pretest to posttest occurred in muscle strength and perception of physical appearance. A community fitness program can influence muscle strength and perceived competence in adolescents with CP; more rigorous training may be necessary to change exercise efficiency.

ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Increasingly, parents are enrolling their children with special health care needs (5HCN) in private and public sector managed care health plans. Although these plans have the potential to provide comprehensive and coordinated health services, it is not yet known if managed care arrangements will meet the special needs of this population.A pilot survey of 33 parents was conducted to examine the parents' perceptions of their children's health care plans. The parents who participated in this survey were state coordinators for Family Voices, a national advocacy organization for families of children with SHCN. This study investigated the impact of managed care and fee-for-service plans on access to health services and compared parent satisfaction with managed care to satisfaction with fee-for-service plans. Specific health services pertinent to pediatric physical therapy were identified for these comparisons.Parents reported overall satisfaction with services available in their children's health plans in most areas surveyed. However, only 29.6% of the parents surveyed were satisfied with their access to a care coordinator and only 46.7% were satisfied with the level of coordination among health professionals. Parents whose children were in fee-for-service health plans reported more satisfaction than those in managed care plans in the majority of areas surveyed. We discuss implications for pediatric physical therapists working in managed care plans concerning communication with administrators of these plans, documentation of therapy sessions, and implementation of family-centered care.

ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The purpose of this report is to discuss the status and ambulatory outcome of two children with mid- to low-lumbar myelomeningocele and hydrocephalus who were treated with a Ferrari knee-ankle-foot orthosis (FKAFO). One child was a girl six years old, and the other child was a boy seven years old. The first child had used the FKAFO over two years, and the other child had used the orthosis only two weeks. Patient examination was completed in musculoskeletal and functional areas related to standing and walking. Results of examination are presented. Evaluation of the data indicated one child was doing well as fit with the FKAFO. The other child's orthosis was felt to need adjustments to increase the flexibility of the FKAFO soleplates. Possible explanations for differences in evaluations of the two children are presented and the importance of unique management decisions based on individual patient findings is advocated.

ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1999

数据来源: OVID