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Effect of intensive neurodevelopmental treatment in gross motor function of children with cerebral palsy
Nikos Tsorlakis1, Christina Evaggelinou, George Grouios
1Hellenic Society for Care and Rehabilitation of Children with Disabilities, Thessaloniki, Greece. lemamou@in.gr
Insights
Neurodevelopmental treatment (NDT) significantly improved gross motor function in children with cerebral palsy (CP). More intensive NDT (five times weekly) yielded greater improvements than less intensive therapy (twice weekly).
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture, significantly impacting gross motor function in children.
- Neurodevelopmental Treatment (NDT) is a common therapeutic approach aimed at improving motor control and function in individuals with neurological conditions like CP.
- The optimal intensity and dosage of NDT for maximizing functional gains in children with CP remain areas for further investigation.
Purpose of the Study:
- To evaluate the efficacy of Neurodevelopmental Treatment (NDT) on the gross motor function of children diagnosed with cerebral palsy (CP).
- To compare the effects of different NDT intensities (twice weekly vs. five times weekly) on motor function outcomes in this pediatric population.
Main Methods:
- A randomized controlled trial involving 34 children with mild to moderate spastic cerebral palsy (hemiplegia, diplegia, tetraplegia) across Gross Motor Function Classification System levels I-III.
- Participants were randomly assigned to receive NDT twice weekly (Group A) or five times weekly (Group B) for 16 weeks.
- Gross Motor Function Measure (GMFM) was administered pre- and post-intervention to assess changes in gross motor function.
Main Results:
- Both NDT intervention groups demonstrated statistically significant improvements in gross motor function following the 16-week treatment period (p<0.05).
- Children receiving the more intensive NDT regimen (Group B, five times weekly) exhibited significantly greater improvements in gross motor function compared to those receiving less intensive therapy (Group A, twice weekly) (p<0.05).
- The study highlights a dose-response relationship between NDT intensity and functional gains in children with CP.
Conclusions:
- Neurodevelopmental Treatment (NDT) is an effective intervention for enhancing gross motor function in children with cerebral palsy (CP).
- Higher intensity NDT application (five times per week) leads to superior functional outcomes compared to lower intensity (twice per week).
- These findings underscore the importance of intensive therapeutic programming to maximize rehabilitation benefits for children with CP.
Abstract:
This study examined the effect of neurodevelopmental treatment (NDT) and differences in its intensity on gross motor function of children with cerebral palsy (CP). Participants were 34 children (12 females, 22 males; mean age 7y 3mo [SD 3y 6mo], age range 3 to 14y) with mild to moderate spasticity and hemiplegia (n=10), diplegia (n=12), and tetraplegia (n=12). Gross Motor Function Classification System levels were: I (n=10), II (n=10), and III (n=14). The paired sample, which was obtained by ratio stratification and matching by sex, age, and distribution of impairment from a total of 114 children with CP, was assigned randomly to two groups: group A underwent NDT twice a week and group B five times a week for 16 weeks. The outcome measure used was the Gross Motor Function Measure, which assessed the performance of the children before and after intervention. The paired-sample t-test revealed that gross motor function of children from both groups improved significantly after intervention (p<0.05). Children in group B performed better and showed significantly greater improvement than those in group A (p<0.05). Results support the effectiveness of NDT and underline the need for intensive application of the treatment.
