Changes in motor functions in children with cerebral palsy after the course of Intensive Neurophysiological Rehabilitation: a single-blind study

•International Rehabilitation Clinic•Ternopil National Medical University

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Published in InternationalNeurological Journal, 2019, 5 (107)

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DOI: 10.22141/2224-0713.5.107.2019.176700

Aim of the study

To assess changes in gross motor functions, muscle spasticity and passive range of motion (PROM) in children with spastic forms of Cerebral Palsy (CP) after the two-week INRS treatment course

Patients

Inclusion criteria:

    Spastic bilateral cerebral palsy
    Age 4-12 years
    GMFCS II-IV levels

Exclusion criteria:

    Severe epileptic syndrome
    Ongoing antispastic medication intake
    Inability to understand and comply with instructions

Demographic characteristics

(n=57)

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Pre - postsingle blinded study

Patients were evaluated before and after two-weeks treatment course

Performance of gross motor functions was recorded on video

Video was assessed independently by two blinded reviewers, not knowing which (pre or post) video they were rating

Gross Motor Function Measure

The GMFM-66 is a valid and reliable tool consisting of 66 activities that range in difficulty from lying and reaching for a toy to walking, running, and jumping.

Individual item scores are converted into the total score with the dedicated software Gross Motor Ability Estimator

Spasticity measurement (Modified Ashworth scale)

● Hip Flexion● Hip Adduction● Knee Flexion● Knee Extension● Foot dorsiflexion

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Measurement of Hip, Knee and Foot passive range of motion using handheld Goniometer

Results

GMFM scores at baseline and post intervention

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Correlation between change of the GMFM score and age

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Passive range of motion

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Muscle spasticity

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* Statistically significant difference (p<0.05) calculated using Wilcoxon signed rank test for related samples

Conclusion

Improvements of gross motor functions, increase in PROM and reduction of muscle spasticity in lower extremities were noted in children with CP after the two-week intensive multimodal INRS treatment course.

More detailed investigation of the INRS treatment requires further studies, including double-blinded randomized controlled trials.