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An individualized intermittent intensive physical therapy schedule for a child with spastic quadriparesis
1Department of Physical Therapy, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA. Mary.Rahlin@rosalindfranklin.edu
Insights
An individualized intermittent intensive physical therapy (PT) schedule may benefit children with cerebral palsy (CP). This approach showed improved gross motor skills and skill retention in a young spastic quadriplegia patient.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Current literature supports intensive physical therapy (PT) for pediatric cerebral palsy (CP).
- Consensus on optimal PT scheduling for children with CP remains elusive.
- Traditional PT schedules often involve twice-weekly sessions.
Observation:
- A case report details an individualized intermittent intensive PT schedule for a 4.5-year-old girl with spastic quadriplegia (GMFCS level III).
- The novel schedule comprised alternating 2-week intensive (5x/week) and 2-week resting phases over 3 months.
- Interventions included TAMO therapy and family instruction.
Findings:
- The patient demonstrated progressive improvement in Gross Motor Function Measure (GMFM-66) scores over 9 months.
- The greatest mean change in GMFM-66 scores occurred during the intermittent intensive PT schedule.
- Motor skills acquired during intensive phases were retained and improved during resting periods.
Implications:
- Individualized intermittent intensive PT schedules may offer an effective alternative for managing pediatric CP.
- This approach shows potential for enhancing motor function and skill consolidation in children with CP.
- Further research into optimized PT scheduling for CP is warranted.
Abstract:
Current research literature supports the use of intensive physical therapy (PT) for children with cerebral palsy (CP) but lacks consensus on the selection of a specific therapy schedule. The purpose of this case report was to describe the use of an individualized intermittent intensive PT schedule for a child with CP who was otherwise seen following a traditional, two times per week, schedule. The patient was a 4.5-year-old girl with spastic quadriparesis, GMFCS level III. The new schedule was tried over a 3-month period. Each of the 3 months included a 2-week, five times per week intensive therapy phase, followed by a 2-week resting phase. Outcomes were assessed by using the GMFM-66 and by documenting the attainment of functional gross motor skills related to the patient's PT goals. Intervention included TAMO therapy and family instruction. The patient demonstrated a gradual increase in GMFM-66 scores throughout the 9-month period covered by this case report, with the greatest mean change score obtained when the intermittent intensive therapy schedule was used. Acquired skills were retained and even improved during the resting phases. The child's parents expressed their interest in using the new PT schedule in the future.