Caitlin L Hurd, Donna Livingstone, Allison Smith, Jaynie F Yang
{"title":"通过早期积极治疗(ELEVATE)参与下肢是可行的，并可能改善痉挛性双侧脑瘫儿童的大运动功能:一个病例系列。","authors":"Caitlin L Hurd, Donna Livingstone, Allison Smith, Jaynie F Yang","doi":"10.3138/ptc-2023-0005","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The feasibility of ELEVATE with respect to adherence and preliminary efficacy was determined for children with spastic bilateral cerebral palsy (CP) from encephalopathy of prematurity.</p><p><strong>Methods: </strong>A case series was used. Participants were randomized to receive ELEVATE immediately or delay the intervention by 3 months before receiving the intervention. The outcomes included feasibility measures of (1) number of children recruited, (2) percentage of sessions attended, (3) stride counts during the intervention, and preliminary efficacy measures of change over the intervention period in (4) Gross Motor Function Measure-66 (GMFM-66), and (5) kinematics and weight-bearing during treadmill walking.</p><p><strong>Results: </strong>Four boys under 3 years of age participated. All participants tolerated 60-minute intervention sessions four times/week for 12 weeks, and attended 75%-94% (min-max) of the targeted sessions. The median step count per session ranged from 833 to 2484 steps (min-max) during the final week of training. Participants showed an increase in GMFM-66 score of 2.4-7.5 points (min-max) over the 3-month intervention phase, as compared to a decrease of 1.7 for one participant and an increase of 1.3 for another over the delay period. Three participants demonstrated small improvements in their gait with the intervention.</p><p><strong>Conclusions: </strong>Engaging young children with bilateral CP in intensive rehabilitation targeting gross motor function was feasible and demonstrated preliminary efficacy. The results have guided the design of a larger clinical trial to assess efficacy of early, active interventions for children with spastic bilateral CP.</p>","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":"75 4","pages":"311-321"},"PeriodicalIF":0.9000,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686296/pdf/","citationCount":"0","resultStr":"{\"title\":\"Engaging the Lower Extremity via Active Therapy Early (ELEVATE) Is Feasible and May Improve Gross Motor Function in Children with Spastic Bilateral Cerebral Palsy: A Case Series.\",\"authors\":\"Caitlin L Hurd, Donna Livingstone, Allison Smith, Jaynie F Yang\",\"doi\":\"10.3138/ptc-2023-0005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The feasibility of ELEVATE with respect to adherence and preliminary efficacy was determined for children with spastic bilateral cerebral palsy (CP) from encephalopathy of prematurity.</p><p><strong>Methods: </strong>A case series was used. Participants were randomized to receive ELEVATE immediately or delay the intervention by 3 months before receiving the intervention. The outcomes included feasibility measures of (1) number of children recruited, (2) percentage of sessions attended, (3) stride counts during the intervention, and preliminary efficacy measures of change over the intervention period in (4) Gross Motor Function Measure-66 (GMFM-66), and (5) kinematics and weight-bearing during treadmill walking.</p><p><strong>Results: </strong>Four boys under 3 years of age participated. All participants tolerated 60-minute intervention sessions four times/week for 12 weeks, and attended 75%-94% (min-max) of the targeted sessions. The median step count per session ranged from 833 to 2484 steps (min-max) during the final week of training. Participants showed an increase in GMFM-66 score of 2.4-7.5 points (min-max) over the 3-month intervention phase, as compared to a decrease of 1.7 for one participant and an increase of 1.3 for another over the delay period. Three participants demonstrated small improvements in their gait with the intervention.</p><p><strong>Conclusions: </strong>Engaging young children with bilateral CP in intensive rehabilitation targeting gross motor function was feasible and demonstrated preliminary efficacy. The results have guided the design of a larger clinical trial to assess efficacy of early, active interventions for children with spastic bilateral CP.</p>\",\"PeriodicalId\":54606,\"journal\":{\"name\":\"Physiotherapy Canada\",\"volume\":\"75 4\",\"pages\":\"311-321\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2023-11-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686296/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physiotherapy Canada\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3138/ptc-2023-0005\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/11/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physiotherapy Canada","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3138/ptc-2023-0005","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"REHABILITATION","Score":null,"Total":0}
Engaging the Lower Extremity via Active Therapy Early (ELEVATE) Is Feasible and May Improve Gross Motor Function in Children with Spastic Bilateral Cerebral Palsy: A Case Series.
Purpose: The feasibility of ELEVATE with respect to adherence and preliminary efficacy was determined for children with spastic bilateral cerebral palsy (CP) from encephalopathy of prematurity.
Methods: A case series was used. Participants were randomized to receive ELEVATE immediately or delay the intervention by 3 months before receiving the intervention. The outcomes included feasibility measures of (1) number of children recruited, (2) percentage of sessions attended, (3) stride counts during the intervention, and preliminary efficacy measures of change over the intervention period in (4) Gross Motor Function Measure-66 (GMFM-66), and (5) kinematics and weight-bearing during treadmill walking.
Results: Four boys under 3 years of age participated. All participants tolerated 60-minute intervention sessions four times/week for 12 weeks, and attended 75%-94% (min-max) of the targeted sessions. The median step count per session ranged from 833 to 2484 steps (min-max) during the final week of training. Participants showed an increase in GMFM-66 score of 2.4-7.5 points (min-max) over the 3-month intervention phase, as compared to a decrease of 1.7 for one participant and an increase of 1.3 for another over the delay period. Three participants demonstrated small improvements in their gait with the intervention.
Conclusions: Engaging young children with bilateral CP in intensive rehabilitation targeting gross motor function was feasible and demonstrated preliminary efficacy. The results have guided the design of a larger clinical trial to assess efficacy of early, active interventions for children with spastic bilateral CP.
期刊介绍：
Physiotherapy Canada is the official, scholarly, refereed journal of the Canadian Physiotherapy Association (CPA), giving direction to excellence in clinical science and reasoning, knowledge translation, therapeutic skills and patient-centred care.
Founded in 1923, Physiotherapy Canada meets the diverse needs of national and international readers and serves as a key repository of inquiries, evidence and advances in the practice of physiotherapy.
Physiotherapy Canada publishes the results of qualitative and quantitative research including systematic reviews, meta analyses, meta syntheses, public/health policy research, clinical practice guidelines, and case reports. Key messages, clinical commentaries, brief reports and book reviews support knowledge translation to clinical practice.
In addition to delivering authoritative, original scientific articles and reports of significant clinical studies, Physiotherapy Canada’s editorials and abstracts are presented in both English and French, expanding the journal’s reach nationally and internationally. Key messages form an integral part of each research article, providing a succinct summary for readers of all levels. This approach also allows readers to quickly get a feel for ‘what is already known’ and ‘what this study adds to’ the subject.
Clinician’s commentaries for key articles assist in bridging research and practice by discussing the article’s impact at the clinical level. The journal also features special themed series which bring readers up to date research supporting evidence-informed practice.
The Canadian Physiotherapy Association (CPA) is the national professional association representing almost 15,000 members distributed throughout all provinces and territories. CPA’s mission is to provide leadership and direction to the physiotherapy profession, foster excellence in practice, education and research, and promote high standards of health in Canada.
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