Developmental neurorehabilitation最新文献

This pilot clinical trial aimed to evaluate the effects of vestibular stimulation, through Hammock-positioning therapy (HPT) or by multidirectional balancing, administered during physical therapy, on movement repertoire, sleep-wakefulness state, and pain in late preterm infants. The newborns were randomly allocated into two groups: 1) vestibular sensory stimulation by HPT (HG) and 2) conventional vestibular stimulation (CG). Movement repertoire was evaluated using the General Movement Assessment (GMA), sleep-wakefulness state was evaluated using the Adapted Brazelton Scale, finally pain was evaluated by the Neonatal Facial Activity Coding System (NFCS). An increase in normal GMAs and a reduction in abnormal GMAs was observed in the HG group after intervention. An Improvement in the sleep-wakefulness state scores was observed in the HG group. In the CG group, same improvements were seen. In conclusion, HPT has a positive effect on the sleep-wakefulness state and movement repertoire in late preterm infants similar to the conventional group.

Introduction: Impairments caused by cerebral palsy (CP) restrict participation and function in activities of daily living (ADL) that leave children with CP vulnerable and dependent on others to perform basic daily needs.

Method: The study explored caregivers' perceived barriers and facilitators to attending CP clinic sessions at Queen Elizabeth Central Hospital (QECH) and Feed the Children and completing a home exercise programme in Blantyre, Malawi, using qualitative descriptive research.

Results: Facilitators included issues relating to (1) religious factors, (2) positive change in the child's condition, and (3) the support that the therapist provided. The major themes perceived as barriers included (1) poor economic status, (2) lack of time, (3) lack of family support, and (4) discrimination.

Conclusion: We have identified several strategies to improve physiotherapy support for caregivers of children with cerebral palsy in Blantyre, Malawi. Therapists should establish rapport and motivate caregivers, and the government should expand the rehabilitation workforce and implement community advocacy programmes that reduce stigma.

Aim: Investigating the effect of Neurodevelopmental Treatment (NDT) on the risk of falling and balance in children diagnosed with Cerebral Palsy (CP).

Methods: Participants were randomly assigned to experimental and control groups. At baseline, the balancing skills of all participants was assessed using the Pediatric Balance Scale, and the gait parameters and fall risk was measured using the LEGSys. The experimental group underwent an 8-week, case-specific, NDT program with intensive gait and balance training for 45-minute sessions, twice a week. The control group received only conventional physiotherapy for the duration of the study. Balancing, gait, and fall risk evaluations repeated after treatment was completed.

Results: A total of 44 cases (Experimental: 22, Control: 22) were analyzed. Pre- and post-treatment comparisons were made within groups and change rates for both groups were compared. The differences in the change rates of specific fall risk parameters between groups was significant.

Conclusion: The eight-week NDT and conventional physiotherapy combined program effectively reduced the risk of falling in children with spastic CP.

Background: The optimal number of sessions for pediatric solution-focused coaching (SFC-peds) is unknown.

Objective: Compare delivery intensities of a virtual-based SCF-peds with youth with neuromuscular conditions.

Methods: The study was an explanatory sequential, assessor-blinded randomized trial comparing single session and intensive (five sessions) coaching intensities. Goal attainment was measured using COPM and GAS. Pre-post COPM and GAS scores were compared. Participants completed semi-structured interviews.

Results: Fourteen participants (single: n = 5; intensive: n = 9) completed the study. Both groups achieved improvements in COPM performance (single: p = .01; intensive: p = .01) and satisfaction (single: p = .02; intensive: p = .01). No differences were observed between groups for COPM (performance: p = .75; satisfaction: p = .50) or GAS (p = .68).

Conclusions: Youth with neuromuscular conditions identified and achieved personally meaningful goals with SFC-peds, regardless of the number of coaching sessions. SFC-peds can be personalized.

Objective: The aim of this study was to evaluate the effect of whole-body vibration (WBV) on spasticity, gait, balance, and motor performance in children with spastic cerebral palsy (CP).

Methods: Groups were administered the conventional physiotherapy program for 8 weeks. WBV group received an additional 2 sessions of WBV a week.

Results: The WBV training combined with conventional physiotherapy is superior to conventional physiotherapy alone in improving gross motor functions (GMFM-D&E), functional walking ability assessment (1-MWT distance) and dynamic balance ability (PDS score) (p < 0,05).

Conclusions: WBV training program added to a conventional physiotherapy program could provide more gains in terms of functionality and the motor functional level of children with spastic diplegic CP.

This longitudinal prospective cohort study examined participation between 6 months and 1.5 years after pediatric mild Traumatic Brain Injury (mTBI) in 68 children aged 6-18 years. Levels of participation in different settings remain mostly stable between 6 months and 1.5 years after mTBI, with a substantial proportion of children continuing to indicate less than full functioning. Future studies should examine risk factors and opportunities for early identification to prevent long-term negative consequences of pediatric mTBI regarding participation.

Purpose: Identify relations of gross motor function and primary motor cortex (M1) functional activity pre and post gross motor interventions for children with unilateral cerebral palsy (UCP).

Methods: Thirteen children with UCP completed a gross motor intervention. Pre/post-intervention functional MRI outcomes included the laterality index (LI), activation volume, and spatial overlap of M1 activation during active ankle dorsiflexion. Advanced gross motor function (Challenge) was assessed pre/post-intervention, and 2-6 months later. Bivariate correlations and linear regression assessed relations between neuroimaging and motor function.

Results: Mean pre-intervention M1 activity was contralateral during dominant (LI =  +0.85, SD 0.21) but variable during the affected (LI =  +0.43, SD 0.57) ankle dorsiflexion. Changes in motor function and neuroimaging outcomes were not significantly associated. However, smaller affected ankle activation and less spatial overlap between ankle activations pre-intervention predicted Challenge improvements post-intervention (adjusted R² = 0.74, p = .001.).

Conclusions: This exploratory study identified pre-intervention neuroimaging predictors of post-intervention improvements in advanced gross motor function.

Purpose: This correlational study aimed to determine the reliability and validity of the Turkish version of the Visual Function Classification System (VFCS) for children with CP.

Method: Two physiotherapists and caregivers (n = 56) applied the VFCS (n = 120) two times at a 15-day interval. Physiotherapists' classifications were compared for interrater reliability. Same physiotherapists and caregivers' classifications' were compared for intrarater reliability. Expanded & Revised Gross Motor Function Classification System (GMFCS E&R), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) were used for assessing validity of the culturally adapted VFCS.

Results: The interrater reliability between physiotherapists was excellent (ICC = 0.974, ICC = 0.988), while interrater reliability between the first physiotherapist and caregivers was good (ICC = 0.866, ICC = 0.893). The intrarater reliability was excellent (ICC = 0.971, ICC = 0.996, ICC = 0.984). A correlation was detected between the VFCS and the GMFCS E&R, MACS, and CFCS levels (r = 0.415, p < .001, r = 0.450, p < .001, r = 0.491, p < .001).

Conclusion: The findings of this study demonstrate the utility, compatibility and reliability of the Turkish version of the VFCS.

Trial registration number: NCT05102955.

This single group pre and posttest study evaluated the feasibility of a new 10-week group-based motor skills enhancement intervention: "Moving Together," and associated use of the Challenge assessment and Gait Outcomes Assessment List (GOAL). Participant attendance/completion and satisfaction with the assessments and intervention were evaluated, and a first estimate of associated motor skill-related changes obtained. Ten ambulatory children with cerebral palsy (7-14 years) and their parents participated. Ninety percent of Challenge sessions were attended and 82.5% of GOAL questionnaires completed. Program attendance was 83% overall. Satisfaction with assessments was high for the Challenge and moderate for the GOAL, and intervention satisfaction was high. Mean change scores (95% CI) post-intervention for the Challenge and GOAL were 4.2 (-11.4 to 3.1) and 3.6 (-14.4 to 4.0) points (/100) respectively. Challenge and GOAL use was feasible and appropriate for "MovingTogether" and associated with gains in motor skill performance and functional abilities.

The aim of this correlational study was to compare the participation in out of school activities, activity preferences, and quality of life (QoL) of children between 8 and 12 years of age with cerebral palsy (CP) (n = 30) and typical development (n = 60) in Turkey. Outcome measures included the Children's Assessment of Participation and Enjoyment, Preferences for Activity of Children, and the Health-Related Quality of Life Questionnaire. Results suggest children with CP were at a disadvantage compared to their typically developing peers in participating in out-of-school activities, however they tended to report greater preference for these activities than their typically developing peers. Based on these findings, we recommended health professionals aim to increase the quality of life for clients with CP by including social participation as one component of rehabilitation.