Measuring motor goals in children with cerebral palsy

Abstract

Four children aged two to three years with four limb cerebral palsy and apparently 'normal' intellect received randomized periods of conventional amounts of physiotherapy and a period of intensive physiotherapy directed at goals with both functional and pattern motor skill objectives. Using a single case experimental design, functional motor change was found to be continuous throughout the study period in all four children. Changes in the pattern of movement were difficult to detect or grade objectively and none of these goals was achieved, in contrast to the functional goals of which 58% were achieved. Intensive physiotherapy directed at goals that could not be achieved was associated with an increase in unco-operative behaviour in some children.

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References

Bower E. , McLellan D. Effect of increased exposure to physiotherapy on skill acquisition of children with cerebral palsy. Dev Med Child Neurol 1992; 34: 25-39.

Illingworth RS 'Mental retardation' in the development of the infant and young child normal and abnormal, third edition. Edinburgh, London: E & S Livingstone, 1966 : 325.

Egan DF Developmental examination of gross motor skills. In: Developmental examination of infants and preschool children. Clinics in developmental medicine , No. 112. London: MacKeith Press with Blackwell Scientific , 1990: 71, 74.

Schmidt RA Motor control and learning: a behavioural emphasis. Illinois : Human Kinetics Publishers, 1992 : 438.

Russell D. , Rosenbaum PL , Cadman DT , Gowland C, Hardy S, Jarvis S. Gross Motor Function Measure: a means to evaluate the effects of physical therapy. Dev Med Child Neurol 1989; 31: 431-52.

Bobath K. , Bobath B. The neurodevelopmental treatment. In: Scrutton D ed. Management of the motor disorders of children with cerebral palsy. Clinics in developmental medicine, No. 90. London: SIMP; Oxford: Blackwell Scientific Publications; Philadelphia : JB Lipincott, 1984: 6-18.

O'Dwyer NJ , Neilson PD , Nash J. Mechanisms of muscle growth related to muscle contracture in cerebral palsy . Dev Med Child Neurol 1989; 31: 543-52.

Tarbary JC , Tardieu C. , Tardieu G. , Tarbary C. Experimental rapid sarcomere loss with concommitant hypo-extensibility . Muscle Nerve 1981; 4: 198-203.

Hersen M , Barlow DH eds. Single case experimental designs: strategies for studying behaviour change. New York: Pergamon Press, 1976.

10.

Evans P. , Johnson A. , Mutch L. , Alberman E. A standard form for recording clinical findings in children with a motor deficit of central origin. Dev Med Child Neurol 1989 ; 31: 119-27.

11.

Bobath K. A neurophysiological basis of the treatment of cerebral palsy. Clinics in Developmental Medicine, No. 75. London: SIMP with Blackwell Scientific, Philadelphia : Lipincott, 1980: 50.

12.

Hofer MM Principles of the orthopaedic management of cerebral palsy. In: Galasko CSB ed. Neuromuscular problems in orthopaedics. Oxford: Blackwell Scientific Publications, 1987: 2.12.