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Sit-to-stand training for self-care and mobility in children with cerebral palsy: a randomized controlled trial
Sirawee Chaovalit1,2, Karen J Dodd1,3, Nicholas F Taylor1,4
1School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
Insights
A sit-to-stand exercise program improved self-care and mobility in children with cerebral palsy (CP). This training also reduced caregiver strain, offering a beneficial home-based option for families managing CP.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Physical Therapy
Background:
- Cerebral palsy (CP) significantly impacts children's self-care and mobility.
- Children with CP classified in Gross Motor Function Classification System (GMFCS) levels III and IV face particular challenges.
- Effective interventions are crucial to enhance functional independence and reduce caregiver burden.
Purpose of the Study:
- To evaluate the efficacy of a sit-to-stand exercise program for improving self-care and mobility in children with CP.
- To assess the program's impact on sit-to-stand performance and caregiver strain.
Main Methods:
- A randomized controlled trial involving 38 children with CP (GMFCS levels III-IV) and their caregivers.
- Participants were assigned to either sit-to-stand training plus routine physiotherapy or routine physiotherapy alone.
- Training was conducted five times weekly for six weeks, with blinded outcome assessments.
Main Results:
- The sit-to-stand group showed significant improvements in self-care (2.2 units) and mobility (2.2 units) compared to controls.
- Sit-to-stand performance, measured by the Five Times Sit-to-Stand Test (FTSST), improved by 4.0 seconds.
- Caregiver strain, assessed by the Modified Caregiver Strain Index (MCSI), decreased by 0.8 units in the intervention group.
Conclusions:
- Sit-to-stand exercise programs can enhance independence in self-care and mobility for children with CP.
- Home-based training offers a practical approach to improve functional outcomes and alleviate caregiver burden.
Aim:
To investigate if a sit-to-stand exercise programme for children with cerebral palsy (CP) would improve self-care and mobility.
Method:
Thirty-eight children with CP (19 males, 19 females; mean age 8y 0mo, SD 2y 4mo, age range 4y 0mo-12y 4mo) classified in Gross Motor Function Classification System (GMFCS) levels III and IV and their caregivers were randomly allocated to sit-to-stand training plus routine physiotherapy (balance and gait training) or routine physiotherapy only (controls). Task-specific sit-to-stand training was completed five times a week for 6 weeks under physiotherapist (twice weekly) and caregiver (three times weekly) supervision. Blinded outcome assessments at week 7 were the self-care and mobility domains of the Functional Independence Measure for Children, Five Times Sit-to-Stand Test (FTSST), and Modified Caregiver Strain Index (MCSI).
Results:
The sit-to-stand group self-care increased by 2.2 units (95% confidence interval [CI] 1.3-3.1) and mobility increased by 2.2 units (95% CI 1.4-3.0) compared to the control group. In the sit-to-stand group, the FTSST was reduced by 4.0 seconds (95% CI -4.7 to -3.2) and the MCSI was reduced by 0.8 units (95% CI -1.2 to -0.4) compared to the control group.
Interpretation:
A sit-to-stand exercise programme for children with CP classified in GMFCS levels III and IV improved sit-to-stand performance and resulted in small improvements in self-care and mobility, while reducing caregiver strain. What this paper adds Sit-to-stand training improved independence in self-care and mobility for children with cerebral palsy (CP). Home-based sit-to-stand training programmes for children with CP can reduce the burden on supervising caregivers.
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