PMID- 26220326
OWN - NLM
STAT- MEDLINE
DCOM- 20161018
LR  - 20161230
IS  - 1973-9095 (Electronic)
IS  - 1973-9087 (Linking)
VI  - 51
IP  - 6
DP  - 2015 Dec
TI  - An evaluator-blinded randomized controlled trial evaluating therapy effects and 
      prognostic factors for a general and an individually defined physical therapy 
      program in ambulant children with bilateral spastic cerebral palsy.
PG  - 677-91
AB  - BACKGROUND: Cerebral palsy (CP) is characterized by a heterogeneous nature with a 
      variety of problems. Therefore, individualized physical therapy might be more 
      appropriate to address the needs for these children. AIM: The first aim was to 
      compare the effectiveness of an individually-defined therapy program (IT) and a 
      general therapy program (GT) on gait and gross motor function in children with 
      CP. The second aim was to evaluate interaction-effects, time-effects, treatment 
      with botulinum toxin A, age, gross Motor Function Classification Scale (GMFCS), 
      treatment frequency and quality as factors influencing outcome. DESIGN: An 
      evaluator-blinded, randomized controlled trial. SETTING: Outpatient 
      rehabilitation unit. POPULATION: Forty ambulant children with spastic bilateral 
      CP (mean age 6 years 1 month). METHODS: All children were randomly assigned to 
      receive either IT or GT over a 10 week period. Nineteen of these children were 
      enrolled into a second and/or third program, resulting in 60 interventions. 
      Primary outcome was assessed with the Goal Attainment Scale (GAS) for gross motor 
      function goals and z-scores for goals based on specific 3D gait parameters. 
      Secondary outcome included the Gross Motor Function Measure-88 (GMFM-88) scores, 
      time and distance gait parameters, Gait Profile Score, Movement Analysis Profiles 
      and time needed to complete Timed-Up-and-Go and Five-Times-Sit-To-Stand tests. 
      RESULTS: There were higher, but non-significant GAS and z-score changes following 
      the IT program compared to the GT program (GAS: 46.2 for the IT versus 42.2 for 
      the GT group, P=0.332, ES 0.15; z-score: 0.135 for the IT compared to 0.072 for 
      the GT group, P=0.669, ES 0.05). Significant time-effects could be found on the 
      GAS (P<0.001) and the GMFM-88 total score (P<0.001). Age was identified as a 
      predictor for GAS and GMFM-88 improvement (P=0.023 and P=0.044). CONCLUSION: No 
      significant differences could be registered between the effects of the IT and the 
      GT. The favorable outcome after the IT program was only a trend and needs to be 
      confirmed on larger groups and with programs of longer duration. CLINICAL 
      REHABILITATION IMPACT: Both programs had a positive impact on the children's 
      motor functioning. It is useful to involve older children more actively in the 
      process of goal setting.
FAU - Franki, I
AU  - Franki I
AD  - Rehabilitation Sciences and Physiotherapy, Ghent University, Gent, Belgium - 
      inge.franki@kuleuven.be.
FAU - Desloovere, K
AU  - Desloovere K
FAU - De Cat, J
AU  - De Cat J
FAU - Tijhuis, W
AU  - Tijhuis W
FAU - Molenaers, G
AU  - Molenaers G
FAU - Feys, H
AU  - Feys H
FAU - Vanderstraeten, G
AU  - Vanderstraeten G
FAU - Van Den Broeck, C
AU  - Van Den Broeck C
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20150727
PL  - Italy
TA  - Eur J Phys Rehabil Med
JT  - European journal of physical and rehabilitation medicine
JID - 101465662
SB  - IM
MH  - Belgium
MH  - Cerebral Palsy/physiopathology/*therapy
MH  - Child
MH  - Female
MH  - Humans
MH  - Male
MH  - *Physical Therapy Modalities
MH  - *Precision Medicine
MH  - Prognosis
MH  - *Psychomotor Performance
EDAT- 2015/07/30 06:00
MHDA- 2016/10/19 06:00
CRDT- 2015/07/30 06:00
PHST- 2015/07/30 06:00 [entrez]
PHST- 2015/07/30 06:00 [pubmed]
PHST- 2016/10/19 06:00 [medline]
AID - R33Y9999N00A150058 [pii]
PST - ppublish
SO  - Eur J Phys Rehabil Med. 2015 Dec;51(6):677-91. Epub 2015 Jul 27.