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The effect of frequency of cerebral palsy treatment: a matched-pair pilot study
Chiara Gagliardi1, Cristina Maghini, Chiara Germiniasi
1IRCCS "Eugenio Medea", Via don Luigi Monza 20, Bosisio Parini, Lecco, Italy. chiara.gagliardi@bp.lnf.it
Insights
An integrated rehabilitation program improved gross motor function in young children with cerebral palsy. Intensive, intermittent therapy schedules yielded the greatest gains, highlighting the benefit of higher-frequency interventions.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function in young children.
- Early and intensive rehabilitation is crucial for optimizing motor outcomes in children with CP.
- Evaluating different intervention schedules can inform best practices for pediatric CP rehabilitation.
Purpose of the Study:
- To assess the feasibility and effectiveness of a year-long integrated rehabilitation program for children under 6 with CP.
- To compare the efficacy of two distinct treatment schedules: continuous integrated intervention versus an intermittent, intensive, integrated (3i) approach.
Main Methods:
- Forty young children (mean age 3 years) with CP (20 tetraparesis, 12 diparesis, 8 hemiparesis) participated.
- Motor abilities were assessed using the Gross Motor Function Measure (GMFM) at baseline and after 1 year.
- Children were randomized to either twice-weekly continuous integrated intervention or the 3i intervention (1 month intensive, 5 months continuous).
Main Results:
- Overall improvement in gross motor function was observed in 37% of participants; no children showed functional decline.
- Children receiving the intermittent, intensive, integrated (3i) intervention demonstrated the most significant improvements in motor function.
- Initial gross motor function was a significant predictor of improvement, whereas age and general cognitive abilities were not.
Conclusions:
- Integrated rehabilitation programs are effective for improving gross motor function in young children with cerebral palsy.
- Periods of higher-frequency, intensive intervention (like the 3i model) appear particularly beneficial for enhancing motor gains.
- These findings support the adaptation of treatment schedules to incorporate intensive phases for children with CP.
Abstract:
The feasibility and effectiveness of a year-long integrated rehabilitation program for young children (less than 6 years old) with cerebral palsy was evaluated, and efficacy of different treatment schedules was compared. A sample of 40 children (20 male; mean age, 3 years +/-1.22) took part: 20 presented with tetraparesis, 12 with diparesis, and 8 with hemiparesis. Participants' motor abilities were classified according to the Gross Motor Function Measure classification system at baseline and after 1 year of treatment. For half of the participants, treatment consisted of continuous integrated intervention twice a week; for the other half, treatment was the 3i intervention (Intermittent, Intensive, Integrated), in which a month of intensive, twice-a-day treatment was followed by a continuous, twice-a-week phase, lasting 5 months. Overall, there was an improvement in gross motor function, with 37% of children improving and no children showing lowered function. Neither baseline general cognitive abilities nor age had a significant effect on the level of improvement, although initial gross motor function did. Children undergoing the intensive intermittent intervention showed the greatest motor function improvement. Results support the effectiveness of the integrated intervention and of periods of higher frequency intervention in young children.
