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The effect of physical therapy for children with motor delay and cerebral palsy. A randomized clinical trial
1Jewish Rehabilitation Hospital, Chomedey-Laval, Quebec, Canada.
Insights
Intensive neurodevelopmental therapy (NDT) significantly improved motor development in infants with cerebral palsy compared to basic NDT. This finding supports more frequent therapy for better outcomes in early childhood intervention.
Area of Science:
- Pediatrics
- Neurology
- Physical Therapy
Background:
- Neurodevelopmental therapy (NDT) is recommended for cerebral palsy (CP).
- The effectiveness of NDT for CP requires further establishment.
- Early motor delays in infants necessitate timely intervention.
Purpose of the Study:
- To compare the effectiveness of intensive (weekly) versus basic (monthly) NDT.
- To evaluate the impact of NDT on motor development in infants with suspected CP.
- To establish the efficacy of NDT in early childhood intervention.
Main Methods:
- Randomized controlled trial comparing weekly and monthly NDT over 6 months.
- Inclusion criteria: infants ≤18 months with motor delay.
- Assessment of seven motor development domains.
Main Results:
- Infants receiving weekly NDT showed substantially better aggregate motor development.
- Statistical significance achieved (t = 3.49, P = 0.0019), adjusted for covariates.
- Intensive therapy demonstrated superior outcomes.
Conclusions:
- Weekly NDT is more effective than monthly NDT for improving infant motor development.
- Findings support intensive NDT for infants with suspected cerebral palsy.
- Early and intensive physical therapy can enhance motor function in infants.
Abstract:
Physical therapists recommend neurodevelopmental therapy for cerebral palsy, but its effectiveness has not been fully established. A randomized controlled trial was undertaken to compare the effects over 6 months, of weekly (intensive) and monthly (basic) neurodevelopmental therapy on the motor development of young children with suspected cerebral palsy. Subjects were no older than 18 months when referred for physical therapy because of a motor delay. All those meeting specified criteria were assessed on seven motor development tests: reflex activity, postural reactions, gross motor ability, fine motor skills, mental functioning, dominance of abnormal movement patterns and ability to participate in activities of daily living. The average proportional change in aggregate motor development for the 17 infants on the weekly (intensive) regimen was substantially better than that for the 12 on the monthly (basic) regimen, after adjusting for the child's age, whether the child was born at term or not, and mother's education. A statistical test led to an equivalent of a Student's t = 3.49, which with 24 df was associated with P = 0.0019 (two-sided).