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Intensive intermittent physical therapy in infants with cerebral palsy: a randomized controlled pilot study |
Shamir M, Dickstein R, Tirosh E |
Israel Medical Association Journal 2012 Dec;14(12):737-741 |
clinical trial |
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: The effectiveness of intensive versus standard physical therapy for motor progress in children with cerebral palsy is controversial. Sitting acquisition is considered an important developmental milestone. OBJECTIVES: To assess the acquisition of sitting and gross motor progress in infants with cerebral palsy treated with intermittent intensive physical therapy as compared to a matched group treated with a standard physical therapy regimen. METHODS: We conducted a randomized controlled crossover study in 10 infants aged 12 to 22 months with cerebral palsy; 5 were assigned to the intensive intermittent therapy group and 5 to the control group. After 4 weeks of baseline intervention, the intervention program was administered to the experimental group for 8 weeks and the regularly scheduled weekly program to the comparison group, targeting sitting as the treatment goal. Thereafter the comparison group crossed over. The Gross Motor Function Measure 66 and 88 (GMFM 66 and 88) were used at 4 week intervals. RESULTS: The intermittent intensive regimen yielded a mean improvement of 7.8% as compared to 1.2% with the standard treatment. However, these results were attributed to infants with a low functional level only (p < 0.01). CONCLUSIONS: Goal-directed intensive intermittent regimen could possibly be beneficial in infants with a low functional level.
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