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A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy

(2014) CLINICAL REHABILITATION. 28(10). p.1039-1052
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Abstract
Objective: A pilot study to compare the effectiveness of an individual therapy program with the effects of a general physical therapy program. Design: A randomized, single-blind cross-over design. Participants: Ten ambulant children with bilateral spastic cerebral palsy, age four to nine years. Intervention: Participants were randomly assigned into a ten-week individually defined, targeted or a general program, followed by a cross-over. Main outcome measures: Evaluation was performed using the Gross Motor Function Measure-88 and three-dimensional gait analysis. General outcome parameters were Gross Motor Function Measure-88 scores, time and distance parameters, gait profile score and movement analysis profiles. Individual goal achievement was evaluated using z-scores for gait parameters and Goal Attainment Scale for gross motor function. Results: No significant changes were observed regarding gross motor function. Only after individualized therapy, step-and stride-length increased significantly (p = 0.022; p = 0.017). Change in step-length was higher after the individualized program (p = 0.045). Within-group effects were found for the pelvis in transversal plane after the individualized program (p = 0.047) and in coronal plane after the general program (p = 0.047). Between-program differences were found for changes in the knee in sagittal plane, in the advantage of the individual program (p = 0.047). A median difference in z-score of 0.279 and 0.419 was measured after the general and individualized program, respectively. Functional goal attainment was higher after the individual therapy program compared with the general program (48 to 43.5). Conclusion: The results indicate slightly favorable effects towards the individualized program. To detect clinically significant changes, future studies require a minimal sample size of 72 to 90 participants.
Keywords
child rehabilitation, Cerebral palsy, Physical Therapy, gait analysis, Goal Attainment Scaling, GROSS MOTOR FUNCTION, EVIDENCE-BASE, LOWER-LIMB FUNCTION, CONTROLLED-TRIAL, FRAMEWORK, REHABILITATION, INTERVENTIONS, PHYSIOTHERAPY, FUNCTIONAL THERAPY, INTERNATIONAL CLASSIFICATION

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Please use this url to cite or link to this publication:

Chicago
Franki, Inge, Christine Van den Broeck, Josse De Cat, Wieke Tijhuis, Guy Molenaers, Guy Vanderstraeten, and Kaat Desloovere. 2014. “A Randomized, Single-blind Cross-over Design Evaluating the Effectiveness of an Individually Defined, Targeted Physical Therapy Approach in Treatment of Children with Cerebral Palsy.” Clinical Rehabilitation 28 (10): 1039–1052.
APA
Franki, I., Van den Broeck, C., De Cat, J., Tijhuis, W., Molenaers, G., Vanderstraeten, G., & Desloovere, K. (2014). A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy. CLINICAL REHABILITATION, 28(10), 1039–1052.
Vancouver
1.
Franki I, Van den Broeck C, De Cat J, Tijhuis W, Molenaers G, Vanderstraeten G, et al. A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy. CLINICAL REHABILITATION. 2014;28(10):1039–52.
MLA
Franki, Inge, Christine Van den Broeck, Josse De Cat, et al. “A Randomized, Single-blind Cross-over Design Evaluating the Effectiveness of an Individually Defined, Targeted Physical Therapy Approach in Treatment of Children with Cerebral Palsy.” CLINICAL REHABILITATION 28.10 (2014): 1039–1052. Print.
@article{5640030,
  abstract     = {Objective: A pilot study to compare the effectiveness of an individual therapy program with the effects of a general physical therapy program. 
Design: A randomized, single-blind cross-over design. 
Participants: Ten ambulant children with bilateral spastic cerebral palsy, age four to nine years. 
Intervention: Participants were randomly assigned into a ten-week individually defined, targeted or a general program, followed by a cross-over. 
Main outcome measures: Evaluation was performed using the Gross Motor Function Measure-88 and three-dimensional gait analysis. General outcome parameters were Gross Motor Function Measure-88 scores, time and distance parameters, gait profile score and movement analysis profiles. Individual goal achievement was evaluated using z-scores for gait parameters and Goal Attainment Scale for gross motor function. 
Results: No significant changes were observed regarding gross motor function. Only after individualized therapy, step-and stride-length increased significantly (p = 0.022; p = 0.017). Change in step-length was higher after the individualized program (p = 0.045). Within-group effects were found for the pelvis in transversal plane after the individualized program (p = 0.047) and in coronal plane after the general program (p = 0.047). Between-program differences were found for changes in the knee in sagittal plane, in the advantage of the individual program (p = 0.047). A median difference in z-score of 0.279 and 0.419 was measured after the general and individualized program, respectively. Functional goal attainment was higher after the individual therapy program compared with the general program (48 to 43.5). 
Conclusion: The results indicate slightly favorable effects towards the individualized program. To detect clinically significant changes, future studies require a minimal sample size of 72 to 90 participants.},
  author       = {Franki, Inge and Van den Broeck, Christine and De Cat, Josse and Tijhuis, Wieke and Molenaers, Guy and Vanderstraeten, Guy and Desloovere, Kaat},
  issn         = {0269-2155},
  journal      = {CLINICAL REHABILITATION},
  keyword      = {child rehabilitation,Cerebral palsy,Physical Therapy,gait analysis,Goal Attainment Scaling,GROSS MOTOR FUNCTION,EVIDENCE-BASE,LOWER-LIMB FUNCTION,CONTROLLED-TRIAL,FRAMEWORK,REHABILITATION,INTERVENTIONS,PHYSIOTHERAPY,FUNCTIONAL THERAPY,INTERNATIONAL CLASSIFICATION},
  language     = {eng},
  number       = {10},
  pages        = {1039--1052},
  title        = {A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy},
  url          = {http://dx.doi.org/10.1177/0269215514544984},
  volume       = {28},
  year         = {2014},
}

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