Cerebral palsy is a condition that affects movement and coordination due to damaged areas of the brain. Different types of cerebral palsy exist, depending on the severity, the limbs affected, and the degree of motor function. There are several different interventions that physical therapists and occupational therapists use to treat children with this condition. The purpose of this literature review is to compare several research studies on pediatric cerebral palsy rehabilitation, specifically looking at the upper limbs, trunk, and lower limbs.
Barriers and Enablers Identified by Three Pediatric Teams
This is a non-experimental qualitative research design used to discover the restrictions found by therapists that provide evidence-based upper-limb rehabilitation to children with cerebral palsy. The researchers hypothesized that the reason children were not receiving the best treatment as possible, was because many therapists did not have the knowledge or the means to create a proper intervention for them (Sakewski 2014). Three teams of pediatric occupational therapists were recruited. Two teams were from a pediatric rehabilitation center and one team was from a regional hospital, to make nine therapists total. Convenience sampling was used to recruit subjects, over a phone interview, and if they wanted to participate, they could. Each interview lasted around one hour, and was performed by a physical therapist that had worked with the selected therapists previously. Twelve domains were identified to determine the behavior change of the therapist towards treatment of the patients (Sakewski 2014). More restrictions to therapy were found than enablers, such as: the child and their family did not have enough time to complete treatment, there was not enough space to properly treat the child in the clinic, families of the children were not attending therapy with their child, etc (Sakewski 2014). There was also a barrier due to the therapist lack of knowledge of CIMT (constraint induced movement therapy). The only common enabler listed was that each individual therapist always believed that the child would benefit from upper-limb rehab. Some of the outcomes were not significant because the therapists were inconsistent to determine the important factors of rehabilitation (Sakewski 2014). The researchers concluded that this study could be the framework for a larger study to find more problems with therapist behavior change in the treatment of children with unilateral cerebral palsy (Sakewski 2014). Modified Constraint-Induced Movement Therapy The researchers of this study are looking at the effect that the environment has on the treatment of modified constraint-induced movement therapy, specifically in children with hemiplegic cerebral palsy. …show more content…
In this disorder, one half of the body has more deficits than the other half. The modified CIMT attempts to improve function by restraining the unaffected upper limb in order to train the affected upper limb. The therapists believe that treatment at home is a necessary component on the road to recovery, which is why they are comparing the results of this intervention at home and in the clinic (Rostami, 2012) This experimental study included fourteen children who were diagnosed with cerebral palsy and had greater difficulty in the movement of one upper extremity. Random assignment was used to put the subjects …show more content…
There has not been a study that compared specific motor interventions for sitting. The investigators choose to compare a home program, which is the standard of care in early intervention with a perceptual motor program in a pediatric outpatient setting. It is hypothesized that the perceptual motor program will have a more positive effect compared to the home program (Harbourne et al., 2010).
The sample consisted of 32 infants with cerebral palsy or risk factors for cerebral palsy randomly assigned to one of the two intervention groups. A group of 15 infants with typical development for sitting were used as the control variable. The home program was family focused, and training occurred once per week at home. Static focus on positioning and repositioning of the child with supports when errors occurred. The perceptual motor program was child focused and occurred twice weekly in a pediatric outpatient setting. Dynamic focus on the child to solve problems with touch cues. The study lasted for 8 weeks. The intervention groups were measured prior to intervention and 1 month after the intervention was completed. Using the linear RMS (Root Mean Scale), nonlinear ApEn (approximate enthropy) and the linear Sway Path (measure of velocity), the COP (Center
Barriers and Enablers Identified by Three Pediatric Teams
This is a non-experimental qualitative research design used to discover the restrictions found by therapists that provide evidence-based upper-limb rehabilitation to children with cerebral palsy. The researchers hypothesized that the reason children were not receiving the best treatment as possible, was because many therapists did not have the knowledge or the means to create a proper intervention for them (Sakewski 2014). Three teams of pediatric occupational therapists were recruited. Two teams were from a pediatric rehabilitation center and one team was from a regional hospital, to make nine therapists total. Convenience sampling was used to recruit subjects, over a phone interview, and if they wanted to participate, they could. Each interview lasted around one hour, and was performed by a physical therapist that had worked with the selected therapists previously. Twelve domains were identified to determine the behavior change of the therapist towards treatment of the patients (Sakewski 2014). More restrictions to therapy were found than enablers, such as: the child and their family did not have enough time to complete treatment, there was not enough space to properly treat the child in the clinic, families of the children were not attending therapy with their child, etc (Sakewski 2014). There was also a barrier due to the therapist lack of knowledge of CIMT (constraint induced movement therapy). The only common enabler listed was that each individual therapist always believed that the child would benefit from upper-limb rehab. Some of the outcomes were not significant because the therapists were inconsistent to determine the important factors of rehabilitation (Sakewski 2014). The researchers concluded that this study could be the framework for a larger study to find more problems with therapist behavior change in the treatment of children with unilateral cerebral palsy (Sakewski 2014). Modified Constraint-Induced Movement Therapy The researchers of this study are looking at the effect that the environment has on the treatment of modified constraint-induced movement therapy, specifically in children with hemiplegic cerebral palsy. …show more content…
In this disorder, one half of the body has more deficits than the other half. The modified CIMT attempts to improve function by restraining the unaffected upper limb in order to train the affected upper limb. The therapists believe that treatment at home is a necessary component on the road to recovery, which is why they are comparing the results of this intervention at home and in the clinic (Rostami, 2012) This experimental study included fourteen children who were diagnosed with cerebral palsy and had greater difficulty in the movement of one upper extremity. Random assignment was used to put the subjects …show more content…
There has not been a study that compared specific motor interventions for sitting. The investigators choose to compare a home program, which is the standard of care in early intervention with a perceptual motor program in a pediatric outpatient setting. It is hypothesized that the perceptual motor program will have a more positive effect compared to the home program (Harbourne et al., 2010).
The sample consisted of 32 infants with cerebral palsy or risk factors for cerebral palsy randomly assigned to one of the two intervention groups. A group of 15 infants with typical development for sitting were used as the control variable. The home program was family focused, and training occurred once per week at home. Static focus on positioning and repositioning of the child with supports when errors occurred. The perceptual motor program was child focused and occurred twice weekly in a pediatric outpatient setting. Dynamic focus on the child to solve problems with touch cues. The study lasted for 8 weeks. The intervention groups were measured prior to intervention and 1 month after the intervention was completed. Using the linear RMS (Root Mean Scale), nonlinear ApEn (approximate enthropy) and the linear Sway Path (measure of velocity), the COP (Center