Intensive mobility training postcerebral hemispherectomy: early surgery shows best functional improvements
S L Fritz1, E D Rivers, A M Merlo
1Department of Exercise Science Physical Therapy Program, Blanchard Machinery Company Rehabilitation Laboratory, School of Arnold Public Health University of South Carolina, Columbia, SC, USA. sfritz@mailbox.sc.edu
European Journal of Physical and Rehabilitation Medicine
|April 22, 2011
Summary
Intensive Mobility Training (IMT) improved gait and balance in children after cerebral hemispherectomy. Younger patients showed greater gains, suggesting earlier surgery enhances neuroplasticity for better rehabilitation outcomes.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Pediatric Neurology
Background:
- Limited research addresses post-cerebral hemispherectomy rehabilitation.
- Hemiparesis often persists after hemispherectomy, impacting patient function.
Purpose of the Study:
- To evaluate the efficacy of Intensive Mobility Training (IMT) in improving gait, balance, and mobility in patients post-cerebral hemispherectomy.
- To compare IMT outcomes with clinical variables for signs of developmental neuroplasticity.
Main Methods:
- 19 patients post-cerebral hemispherectomy underwent 10 days of IMT (3 hours/day).
- Outcomes measured pre- and post-intervention included gait parameters (GAITRite), balance scales (Berg, Fugl-Meyer), and functional mobility tests (Timed Up and Go, Six-Minute Walk).
- A Combined Functional Index (CFI) was developed to assess global therapy impact.
Main Results:
- Significant improvements observed in toe in/out, unaffected leg step length, Dynamic Gait Index, Berg Balance Scale, and Six-Minute Walk (P<0.05).
- CFI improved from 77.3% to 82.7% post-IMT.
- Younger patients (≤5 years at surgery) showed greater CFI improvements (+7.7%) compared to older patients (+3.2%), accounting for 22% of score variability.
Conclusions:
- Younger age at surgery correlates with greater improvements following IMT.
- Earlier contralateral surgery may enhance remaining hemisphere neuroplasticity, leading to better rehabilitation outcomes.
