TY - JOUR
T1 - Improved parent-reported mobility and achievement of individual goals on activity and participation level after functional power-training in young children with cerebral palsy
T2 - a double-baseline controlled trial
AU - van Vulpen, Liesbeth F.
AU - de Groot, Sonja
AU - Rameckers, Eugene A.
AU - Becher, Jules G.
AU - Dallmeijer, Annet J.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - BACKGROUND: In children with cerebral palsy (CP), strength training programs to improve walking capacity and participation in activities of daily living are commonly used in clinical practice. despite lacking evidence of its effectiveness. It has been suggested that strength training with high movement velocity could be more effective than traditional resistance training to improve functional abilities such as walking. In a recently published study, we have demonstrated the positive effects of functional high-velocity resistance (power) training on muscle strength and walking capacity in young children with CP Whether this type of training is also effective in achieving individual predefined goals in daily activities and self-reported mobility limitations, has not yet been described however. AIM: To evaluate the effect of functional power-training on parent-reported mobility and achievement of individual goals on activity and participation level in young children with CP. DESIGN: A double-baseline design was used to compare a 14-week period usual care with a 14-week period of functional power-training (3 times a week) and a follow-up period of 14 weeks. SETTING: A rehabilitation center, two special needs schools for children with physical disabilities, and a university medical center outpatient clinic. POPULATION: Twenty-two children with spastic CP (13 bilateral, GMFCS level I [N.=10] and level II [N.=12]. mean age 7.5 years [SD 1.8, range 4-10 years]) and their parents participated. METHODS: Outcome measures were goal attainment scaling (GAS) of individual daily activity related treatment goals, mobility performance as measured using the Functional Mobility Scale (FMS-5 m. 50 m and 500 m), and the parent-reported Mobility Questionnaire (MobQues). RESULTS: After power-training, 86% of children achieved or exceeded their goal, compared with 14% in the usual care period (P<.001). The probability of improvement by one point or more on the FMS-500 meter after functional power-training was 10 times higher, compared with the usual care period (Relative Risk=10.0 with 95% CI 1.4 - 71.3). No changes were found in the FMS-5m and FMS-50m categories. Improvement on the MobQues was significantly greater after power-training compared with usual care (7.9% (95% CI 2.7 -13.0, P=.005)). The improvement in performance in the activities defined in the treatment goals continued during the follow-up period. CONCLUSIONS AND CLINICAL REHABILITATION IMPACT: The results indicated that functional power-training is an effective training to achieve personalized treatment goals for activities in daily life and parent-reported mobility performance in young children with cerebral palsy.
AB - BACKGROUND: In children with cerebral palsy (CP), strength training programs to improve walking capacity and participation in activities of daily living are commonly used in clinical practice. despite lacking evidence of its effectiveness. It has been suggested that strength training with high movement velocity could be more effective than traditional resistance training to improve functional abilities such as walking. In a recently published study, we have demonstrated the positive effects of functional high-velocity resistance (power) training on muscle strength and walking capacity in young children with CP Whether this type of training is also effective in achieving individual predefined goals in daily activities and self-reported mobility limitations, has not yet been described however. AIM: To evaluate the effect of functional power-training on parent-reported mobility and achievement of individual goals on activity and participation level in young children with CP. DESIGN: A double-baseline design was used to compare a 14-week period usual care with a 14-week period of functional power-training (3 times a week) and a follow-up period of 14 weeks. SETTING: A rehabilitation center, two special needs schools for children with physical disabilities, and a university medical center outpatient clinic. POPULATION: Twenty-two children with spastic CP (13 bilateral, GMFCS level I [N.=10] and level II [N.=12]. mean age 7.5 years [SD 1.8, range 4-10 years]) and their parents participated. METHODS: Outcome measures were goal attainment scaling (GAS) of individual daily activity related treatment goals, mobility performance as measured using the Functional Mobility Scale (FMS-5 m. 50 m and 500 m), and the parent-reported Mobility Questionnaire (MobQues). RESULTS: After power-training, 86% of children achieved or exceeded their goal, compared with 14% in the usual care period (P<.001). The probability of improvement by one point or more on the FMS-500 meter after functional power-training was 10 times higher, compared with the usual care period (Relative Risk=10.0 with 95% CI 1.4 - 71.3). No changes were found in the FMS-5m and FMS-50m categories. Improvement on the MobQues was significantly greater after power-training compared with usual care (7.9% (95% CI 2.7 -13.0, P=.005)). The improvement in performance in the activities defined in the treatment goals continued during the follow-up period. CONCLUSIONS AND CLINICAL REHABILITATION IMPACT: The results indicated that functional power-training is an effective training to achieve personalized treatment goals for activities in daily life and parent-reported mobility performance in young children with cerebral palsy.
KW - Goals
KW - Resistance training
KW - Cerebral palsy
KW - Child
KW - EVENT MULTILEVEL SURGERY
KW - PHYSICAL-DISABILITIES
KW - QUESTIONNAIRE MOBQUES
KW - ORTHOPEDIC-SURGERY
KW - WALKING ABILITY
KW - CLASSIFICATION
KW - RELIABILITY
KW - SCALE
KW - YOUTH
KW - REHABILITATION
U2 - 10.23736/S1973-9087.18.04921-3
DO - 10.23736/S1973-9087.18.04921-3
M3 - Article
C2 - 29517188
SN - 1973-9087
VL - 54
SP - 730
EP - 737
JO - European Journal of Physical and Rehabilitation Medicine
JF - European Journal of Physical and Rehabilitation Medicine
IS - 5
ER -