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Gross Motor Function Outcome After Intensive Rehabilitation in Children With Bilateral Spastic Cerebral Palsy
Seung Hoon Lee1, Jae Sun Shim1, Kiyoung Kim1
1Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Insights
Intensive inpatient rehabilitation significantly improved gross motor function in children with bilateral spastic cerebral palsy (CP) more than outpatient therapy. Younger children with CP showed greater gains from intensive therapy.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Physical Therapy
Background:
- Bilateral spastic cerebral palsy (CP) affects gross motor function.
- Rehabilitation strategies vary in intensity and setting.
- Optimizing functional outcomes in children with CP is a key clinical goal.
Purpose of the Study:
- To compare gross motor function outcomes in children with moderate to severe bilateral spastic CP.
- To evaluate the effectiveness of intensive inpatient rehabilitation versus intermittent outpatient rehabilitation.
Main Methods:
- Retrospective chart review of patients with bilateral spastic CP.
- Comparison of an intensive inpatient group (22 sessions/week for 1 month) with an outpatient group (4 sessions/week for 3 months).
- Analysis of changes in Gross Motor Function Measure (GMFM) scores from baseline to follow-up.
Main Results:
- Both rehabilitation approaches led to significant improvements in GMFM scores.
- The intensive inpatient group demonstrated a significantly greater increase in GMFM scores after 1 month.
- Younger age correlated with a higher increase in GMFM scores, indicating better response in younger subjects.
Conclusions:
- Intensive inpatient rehabilitation is more effective for improving gross motor function in children with moderate to severe bilateral spastic CP.
- The findings support tailored, intensive therapeutic interventions for this population.
- Age is a significant factor influencing motor function recovery in pediatric CP.
Objective:
To compare gross motor function outcomes in children with moderate to severe degrees of bilateral spastic cerebral palsy (CP) who received either intensive inpatient rehabilitation or intermittent rehabilitation on an outpatient basis.
Methods:
A non-biased retrospective chart review was done for patients diagnosed with bilateral spastic CP who received rehabilitation therapy. The intensive rehabilitation group (inpatient group) agreed to be hospitalized to receive 22 sessions of physical and occupational therapy per week for 1 month. The intermittent rehabilitation group (outpatient group) received four sessions of physical and occupational therapy per week for 3 months in an outpatient setting. Changes in the total score on the Gross Motor Function Measure (GMFM) between baseline and the follow-up period were analyzed.
Results:
Both groups showed significant improvements in total GMFM scores at the follow-up assessment compared to that at baseline (p=0.000 for inpatient group, p=0.001 for outpatient group). The increase in mean total GMFM score after 1 month was significantly greater in the inpatient group than that in the outpatient group (p=0.020). Higher increase in GMFM score was observed in younger subjects as revealed by the negative correlation between age and the increase in GMFM score after 1 month (p=0.002, r=-0.460).
Conclusion:
Intensive inpatient rehabilitation therapy for patients with bilateral spastic CP of moderate to severe degree was more effective for improving gross motor function than intermittent rehabilitation therapy on an outpatient basis.
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