Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy). Balance training with visual feedback in children with hemiplegic cerebral palsy: effect on stance and gait. The Effects of Physical Therapy on Cerebral Palsy: A Controlled Trial in Infants with Spastic Diplegia Strength training in adolescent learners with cerebral palsy: a randomized controlled trial Randomized controlled trial of physiotherapy in 56 children with cerebral palsy followed for 18 months. A randomized clinical trial of strength training in young people with cerebral palsy. Strength Training Can Have Unexpected Effects on the Self-Concept of Children with Cerebral Palsy Effectiveness of two different sensory-integration programmes for children with spastic diplegic cerebral palsy A randomised controlled trial of different intensities of physiotherapy and different goal-setting procedures in 44 children with cerebral palsy. Comparison of efficacy of Adeli suit and neurodevelopmental treatments in children with cerebral palsy. Efficacy of constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairment. Effects of a functional therapy program on motor abilities of children with cerebral palsy. Effects of a postoperative strength-training program on the walking ability of children with cerebral palsy: a randomized controlled trial. Functional outcomes of intramuscular botulinum toxin type a and occupational therapy in the upper limbs of children with cerebral palsy: a randomized controlled trial. Infant stimulation curriculum for infants with cerebral palsy: effects on infant temperament, parent-infant interaction, and home environment. Effectiveness of Loaded Sit-to-Stand Resistance Exercise for Children With Mild Spastic Diplegia: A Randomized Clinical Trial Effects of a postoperative resistive exercise program on the knee extension and flexion torque in children with cerebral palsy: a randomized clinical trial. A study of therapeutic effects of horseback riding for children with cerebral palsy. Effect of intensive neurodevelopmental treatment in gross motor function of children with cerebral palsy. A Comparison of Intensive Neurodevelopmental Therapy Plus Casting and a Regular Occupational Therapy Program for Children with Cerebral Palsy The effect of a weight-bearing physical activity program on bone mineral content and estimated volumetric density in children with spastic cerebral palsy. Physical training of school children with spastic cerebral palsy: effects on daily activity, fat mass and fitness Neurodevelopmental therapy and upper-extremity inhibitive casting for children with cerebral palsy.
OBJECTIVE To evaluate the effect of hippotherapy ( physical therapy utilizing the movement of a horse ) on muscle activity in children with spastic cerebral palsy . DESIGN Pretest/post-test control group . SETTING /LOCATION Therapeutic Riding of Tucson ( TROT ) , Tucson , AZ . SUBJECTS Fifteen ( 15 ) children ranging from 4 to 12 years of age diagnosed with spastic cerebral palsy . INTERVENTIONS Children meeting inclusion criteria were r and omized to either 8 minutes of hippotherapy or 8 minutes astride a stationary barrel . OUTCOME MEASURES Remote surface electromyography ( EMG ) was used to measure muscle activity of the trunk and upper legs during sitting , st and ing , and walking tasks before and after each intervention . RESULTS After hippotherapy , significant improvement in symmetry of muscle activity was noted in those muscle groups displaying the highest asymmetry prior to hippotherapy . No significant change was noted after sitting astride a barrel . CONCLUSIONS Eight minutes of hippotherapy , but not stationary sitting astride a barrel , result ed in improved symmetry in muscle activity in children with spastic cerebral palsy . These results suggest that the movement of the horse rather than passive stretching accounts for the measured improvements The aim of the present study was to examine the effects of balance training with visual feedback on stance and gait in school-age children with hemiplegic cerebral palsy . Ten participants between 5 and 11 years of age were assigned to either the training or the control group according to an aged-stratified r and omization . The training corresponded to three sessions per week during six weeks . Stance and gait parameters- based on force plate data , were assessed three times in both groups : ( a ) at the beginning of the study ( before training ) ; ( b ) after six weeks ; ( c ) after ten weeks . Spatial and temporal parameters were calculated . The results for stance showed that the training improved the performances on the tasks that were trained . More interesting , the results for gait showed that the walking pattern became more symmetrical after the training Legislatively m and ated programs for early intervention on behalf of h and icapped infants often stipulate the inclusion of physical therapy as a major component of treatment for cerebral palsy . To evaluate the effects of physical therapy , we r and omly assigned 48 infants ( 12 to 19 months of age ) with mild to severe spastic diplegia to receive either 12 months of physical therapy ( Group A ) or 6 months of physical therapy preceded by 6 months of infant stimulation ( Group B ) . The infant-stimulation program included motor , sensory , language , and cognitive activities of increasing complexity . Masked outcome assessment was performed after both 6 and 12 months of therapy to evaluate motor quotient , motor ability , and mental quotient . After six months , the infants in Group A had a lower mean motor quotient than those in Group B ( 49.1 vs. 58.1 , P = 0.02 ) and were less likely to walk ( 12 vs. 35 percent , P = 0.07 ) . These differences persisted after 12 months of therapy ( 47.9 vs. 63.3 , P less than 0.01 , and 36 vs. 73 percent , P = 0.01 , respectively ) . We noted no significant differences between the groups in the incidence of contractures or the need for bracing or orthopedic surgery . Group A also had a lower mean mental quotient than Group B after six months of therapy ( 65.6 vs. 75.5 , P = 0.05 ) . The routine use of physical therapy in infants with spastic diplegia offered no short-term advantage over infant stimulation . Because of the limited scope of the trial , our conclusions favoring infant stimulation are preliminary . The results suggest that further study of the effects of both physical therapy and infant stimulation is indicated Objective : To evaluate the impact of an eight-week strength training program targeting multiple muscle groups using basic inexpensive free weights and resistance devices , on gait and perceptions of body image and functional competence . Design : A r and omized control trial . Setting : A school for children with special needs in a disadvantaged suburb in Cape Town . Subjects : Thirty-one independently ambulant senior learners with spastic cerebral palsy ( 19 males , 12 females ; aged 13 - 18 years ; 15 diplegics and 16 hemiplegics ) . Intervention : Eight-week strength training programme in circuit format executed during school hours , one to three times per week for 40 - 60 min per session . Programmes were individually design ed and included 8 - 12 exercises selected from a 28-station circuit to target upper and lower limbs and trunk . Twenty-one subjects took part in the strength training programme and were compared with 10 control subjects . Main outcome measures : Three-dimensional gait analysis and a question naire were used to evaluate the various parameters of gait and perceptions of body image and functional competence respectively . Results were analysed using repeated measures ANOVA and bootstrap analysis . Results : The experimental group differed significantly from the control group for measure of crouch gait ( sum of the ankle , knee and hip angles at midstance ) ( P = 0.05 ) and perceptions of body image ( P = 0.01 ) . Walking velocity , cadence and stride length as well as perceptions of functional ability did not change significantly after training . Conclusion : Participation in a school-based strength training programme targeting multiple muscle groups can lead to improved degree of crouch gait and improve perception of body image This study aim ed to determine whether motor function and performance is better enhanced by intensive physiotherapy or collaborative goal - setting in children with cerebral palsy ( CP ) . Participants were a convenience sample of 56 children with bilateral CP classified at level III or below on the Gross Motor Function Classification System ( GMFCS ) , aged between 3 and 12 years . A 2 x 2 factorial design was used to compare the effects of routine amounts of physiotherapy with intensive amounts , and to compare the use of generalized aims set by the child 's physiotherapist with the use of specific , measurable goals negotiated by the child 's physiotherapist with each child , carer , and teacher . Following the six-month treatment period there was a further six-month period of observation . Changes in motor function and performance were assessed by a masked assessor using the Gross Motor Function Measure ( GMFM ) and the Gross Motor Performance Measure ( GMPM ) at three-month intervals . There was no statistically significant difference in the scores achieved between intensive and routine amounts of therapy or between aim -directed and goal -directed therapy  in either function or performance . Inclusion of additional covariates of age and severity levels showed a trend towards a statistically significant difference in children receiving intensive therapy during the treatment period . This advantage declined over the subsequent six months during which therapy had reverted to its usual amount . Differences in goal - setting procedures did not produce any detectable effect on the acquisition of gross motor function or performance This r and omized clinical trial evaluated the effects of a home-based , six-week strength-training programme on lower limb strength and physical activity of 21 young people ( 11 females , 10 males ; mean age 13 years 1 month , SD 3 years 1 month ; range 8 to 18 years ) with spastic diplegic cerebral palsy ( CP ) with independent ambulation , with or without gait aids ; ( Gross Motor Function Classification System levels I to III ) . Compared with the 10 controls , the 11 participants in the strength-training programme increased their lower limb strength ( combined ankle plantarflexor and knee extensor strength as measured by a h and -held dynamometer ) at 6 weeks ( F(1,19)=4.58 , p=0.046 ) and at a follow-up 12 weeks later ( F(1,18)=6.25 , p=0.041 ) . At 6 weeks , trends were also evident for improved scores in Gross Motor Function Measure dimensions D and E for st and ing , running and jumping , and faster stair climbing . A relatively short clinical ly feasible home-based training programme can lead to lasting changes in the strength of key lower-limb muscles that may impact on the daily function of young people with CP Purpose : This study was design ed to evaluate the effect of a home-based progressive resistance strength-training program on the self-concept of children with cerebral palsy . Methods : A r and omized , controlled trial was used to evaluate the effects of a six-week strength-training program on self-concept immediately after completion of the program ( week six ) and at a follow-up session held 18 weeks after the initial assessment . Seventeen children [ eight boys , nine girls ; mean age 12.1 years ( SD 2.5 ) ] with spastic diplegic cerebral palsy were recruited . Participants in the experimental group completed a home-based progressive resistance strength-training program using three exercises to strengthen the major support muscles of the lower limb . Participants in the control group undertook their normal daily activities .  Self-concept was measured by the Self-Perception Profile for Children . Results : Overall , the self-concept of both groups was positive at baseline and at six and 18 weeks . However , compared with controls , the experimental group showed decreased self-concept in the domain of scholastic competence and a trend for a decrease in social acceptance at six weeks . At follow-up , the experimental group had reduced self-concept in the domains of scholastic competence and social acceptance compared with the control group . Conclusion : These unexpected results suggest that participation in a relatively short home-based strength-training program may have an inhibitory effect on the self-concept of children with cerebral palsy . Despite the inhibitory effect , self-concept in the experimental group remained positive after strength training , suggesting that clinicians should not be overly concerned about the psychological effects of the intervention Purpose : This study was planned to investigate the effects of individual and group approaches to sensory-perceptual-motor ( SPM ) training on children with cerebral palsy . Method : This study was carried out at the School of Physical Therapy and Rehabilitation of Hacettepe University , Occupational Therapy Unit . Forty-one children who were diagnosed as having spastic diplegic cerebral palsy by the Department of Paediatric Neurology of Hacettepe University were assessed . Forty-one children with cerebral palsy were r and omly divided into three groups . Individual and group SPM training were given to first group ( IND ) ( n 16 ) and second group ( GRP ) ( n 16 ) respectively . The third group was determined as a control group ( n 9 ) and only the home programme was given . All children were evaluated with Ayres Southern California Sensory Integration Test and Physical Ability Test before and after training . The SPM training programmes were applied for 1.5 hours , 3 days per week for 3 months . Results : Estimates of effect sizes were calculated for group , individual and control treatments . Results indicated that both group and individual treatments had a measurable effect that was consistently greater than that of controls . Conclusions : This study shows that programmes of SPM training in individuals and group treatments affect children with cerebral palsy . It was concluded that SPM training in children with cerebral palsy will be applied to combined programmes and the relationship with individual and group treatments developed Forty-four children aged 3 to 11 years with quadriplegic cerebral palsy were prospect ively stratified and r and omised into four treatment groups . The acquisition of motor skills was assessed in a 2 x 2 factorial design using the Gross Motor Function Measure . The two factors were conventional amounts of physiotherapy vs intensive amounts of physiotherapy , and the use of broad , generalised aims vs the use of specific measurable goals directed at motor skill acquisition . 82 % of the children improved . Over the two-week period , intensive physiotherapy produced a slightly greater effect than conventional physiotherapy but the factor more strongly associated with increased motor skill acquisition was the use of specific measurable goals This study compared the efficacy of Adeli suit treatment ( AST ) with neurodevelopmental treatment ( NDT ) in children with cerebral palsy ( CP ) . Twenty-four children with CP , Levels II to IV according to the Gross Motor Function Classification System ( GMFCS ) , were matched by age and functional status and r and omly assigned to the AST or  NDT treatment groups . In the AST group ( n=12 ; eight males , four females ; mean age 8.3 y [ SD 2.0 ] ) , six children had spastic/ataxic diplegia , one triplegia and five spastic/mixed quadriplegia . In the NDT group ( n=12 ; nine males , three females ; mean age 8.1 y [ SD 2.2 ] ) , five children had spastic diplegia and seven had spastic/mixed quadriplegia . Both groups were treated for 4 weeks ( 2 hours daily , 5 days per week , 20 sessions ) . To compare treatments , the Gross Motor Function Measure ( GMFM-66 ) and the mechanical efficiency index ( EIHB ) during stair-climbing were measured at baseline , immediately after 1 month of treatment , and 10 months after baseline . The small but significant time effects for GMFM-66 and EIHB that were noted after 1 month of both intensive physiotherapy courses were greater than expected from natural maturation of children with CP at this age . Improvements in motor skills and their retention 9 months after treatment were not significantly different between the two treatment modes . Post hoc analysis indicated a greater increase in EIHB after 1 month ( p=0.16 ) and 10 months ( p=0.004 ) in AST than that in NDT , predominantly in the children with higher motor function ( GMFCS Levels II and III ) . The results suggest that AST might improve mechanical efficiency without a corresponding gain in gross motor skills , especially in children with higher levels of motor function OBJECTIVE Constraint-Induced Movement ( CI ) therapy has been found to be a promising treatment for substantially increasing the use of extremities affected by such neurologic injuries as stroke and traumatic brain injury in adults . The purpose of this study was to determine the applicability of this intervention to young children with cerebral palsy . METHODS A r and omized , controlled clinical trial of pediatric CI therapy in which 18 children with diagnosed hemiparesis associated with cerebral palsy ( 7 - 96 months old ) were r and omly assigned to receive either pediatric CI therapy or conventional treatment . Pediatric CI therapy involved promoting increased use of the more-affected arm and h and by intensive training ( using shaping ) of the more-impaired upper extremity for 6 hours/day for 21 consecutive days coupled with bivalved casting of the child 's less-affected upper extremity for that period . Children 's functional upper-extremity skills were assessed in the laboratory ( blinded scoring ) and at home ( parent ratings ) just prior , after , and 3 weeks posttreatment . Treated children were followed for 6 months . RESULTS Children receiving pediatric CI therapy compared with controls acquired significantly more new classes of motoric skills ( 9.3 vs 2.2 ) ; demonstrated significant gains in the mean amount ( 2.1 vs 0.1 ) and quality ( 1.7 vs 0.3 ) of more-affected arm use at home ; and in a laboratory motor function test displayed substantial improvement including increases in unprompted use of the more-affected upper extremity ( 52.1 % vs 2.1 % of items ) . Benefits were maintained over 6 months , with supplemental evidence of quality -of-life changes for many children . CONCLUSION Pediatric CI therapy produced major and sustained improvement in motoric function in the young children with hemiparesis in the study BACKGROUND AND PURPOSE The purpose of this study was to determine whether the motor abilities of children with spastic cerebral palsy who were receiving functional physical therapy ( physical therapy with an emphasis on practicing functional activities ) improved more than the motor abilities of children in a reference group whose physical therapy was based on the principle of normalization of the quality of movement . SUBJECTS The subjects were 55 children with mild or moderate cerebral palsy aged 2 to 7 years ( median=55 months ) . METHODS A r and omized block design was used to assign the children to the 2 groups . After a pretest , the physical therapists for the functional physical therapy group received training in the systematic application of functional physical therapy . There were 3 follow-up assessment s : 6 , 12 , and 18 months after the pretest . Both basic gross motor abilities and motor abilities in daily situations were studied , using the Gross Motor Function Measure ( GMFM ) and the self-care and mobility domains of the Pediatric Evaluation of Disability Inventory ( PEDI ) , respectively . RESULTS Both groups had improved GMFM and PEDI scores after treatment . No time x group interactions were found on the GMFM . For the PEDI , time x group interactions were found for the functional skills and caregiver assistance scales in both the self-care and mobility domains . DISCUSSION AND CONCLUSION The groups ' improvements in basic gross motor abilities , as measured by the GMFM in a st and ardized environment , did not differ . When examining functional skills in daily situations , as measured by the PEDI , children in the functional physical therapy group improved more than children in the reference group OBJECTIVE To investigate the effect of a postoperative strength-training program on the walking of children with cerebral palsy ( CP ) . DESIGN R and omized controlled trial . SETTING Hospital rehabilitation department . PARTICIPANTS Thirty-nine children with CP ( age range , 6 - 16 y ) . After orthopedic surgery , the control group ( n=20 ) followed a conventional physiotherapy ( PT ) program , and the strength-training group ( n=19 ) followed a strength-training program in addition to the conventional PT .  Twenty-nine age-matched healthy children were used as references . INTERVENTION A 9-month strength-training program . MAIN OUTCOME MEASURES Spatiotemporal , kinematic , and kinetic parameters during gait analysis were analyzed before ( E0 ) and 1 year after ( E1 ) the surgery . For 22 children , a 2-year postoperative gait analysis ( E2 ) took place as well . RESULTS At E1 , several kinematic and kinetic parameters improved , although there was no significant difference between the groups . Spatiotemporal parameters showed a worsening at E1 and a recovery to preoperative values at E2 . CONCLUSIONS The examined parameters may be more substantially influenced by factors such as the surgery outcome and the variability of pathologic characteristics than by the strength-training program per se . However , a more significant effect of the strength-training may appear if more intense and short-term training protocol s are used , considering factors such as patients ' motivations , ages , and postoperative statuses OBJECTIVE To investigate the functional outcomes of botulinum toxin type A ( BTX-A ) injections to the upper limb in combination with occupational therapy ( OT ) in children with cerebral palsy ( CP ) . DESIGN R and omized controlled trial with follow-up at 2 weeks , 3 months , and 6 months . SETTING Specialist outpatient physical disabilities clinic within a public pediatric teaching hospital . PARTICIPANTS Eighty children with spastic quadriplegic , triplegic , or hemiplegic CP from these clinics were r and omly assigned to BTX-A plus OT , BTX-A alone , OT alone , or a no-treatment control group . INTERVENTIONS Single set of BTX-A ( Botox ) injections and 12 weeks of OT . MAIN OUTCOME MEASURES Canadian Occupational Performance Measure ( COPM ) and Goal Attainment Scale ( GAS ) . RESULTS The combination of BTX-A and OT result ed in accelerated attainment of functional goals measured by the COPM and GAS . There were no differences between groups on the Melbourne Assessment of Unilateral Upper Limb Function , Quality of Upper Extremity Skills Test , Pediatric Evaluation of Disability Inventory , Child Health Question naire , or active and passive range of motion . As expected , there was a significant reduction in muscle tone at follow-up 2 weeks after injection , which returned to baseline level by 6 months . CONCLUSIONS OT enhanced individualized functional outcomes following BTX-A injections in the upper limbs of children with CP To assess the effects of intervention in cerebral palsy , 48 infants 12 to 19 months of age , with mild to severe spastic diplegia , were r and omly assigned to receive either 6 months of infant stimulation followed by 6 months of physical therapy ( test group ) or 12 months of neurodevelopmental physical therapy ( contrast group ) . The infant stimulation protocol consisted of cognitive , motor , sensory , and language activities . Outcome was assessed after 12 months by using Carey Infant Temperament Question naire subscores ( activity , rhythmicity , adaptability , approach , threshold , intensity , mood , distractibility , and persistence ) ; Roth Mother-Child Relationship Evaluation subscores ( acceptance , overprotection , overindulgence , rejection ) ; and Home Observation for Measurement of the Environment subscores ( maternal responsiveness , avoidance of restriction and punishment , organization of environment , play material s , maternal involvement , and variety of daily stimulation ) . Motor and cognitive outcomes suggesting advantage for the test group have been reported previously . After 12 months of intervention , mothers with infants in the contrast group showed a greater improvement in emotional and verbal responsiveness as measured by the Home Observation for Measurement of the Environment ( mean score change in control group = 1.2 , test group = 0.3 P less than .04 ) . None of the 19 other measures differed significantly between treatment groups in change from baseline . This study demonstrates no short-term systematic effect on temperament , maternal-infant interaction , or home environment attributable to the inclusion of an infant stimulation curriculum in an intervention program for infants with spastic diplegia . It suggests that motor and cognitive advantages associated with infant stimulation are not mediated by measurable changes in the psychosocial variables studied Abstract Liao H-F , Liu Y-C , Liu W-Y , Lin Y-T. Effectiveness of loaded sit-to-st and resistance exercise for children with mild spastic diplegia : a r and omized clinical trial . Objective To investigate effectiveness of a functional strengthening program , the loaded sit-to-st and ( STS ) resistance exercise , for children with cerebral palsy ( CP ) . Design A single-blind , r and omized block design . Setting STS exercises were carried out at the children ’s homes . Participants Twenty children ( 12 boys , 8 girls ; age range , 5−12y ) with spastic diplegia CP and classified by the Gross Motor Function Classification System as level I or II were stratified by their severity and age and r and omly allocated into either the experimental or control group . Intervention Both groups received their regular physical therapy . The experimental group underwent loaded STS exercise 3 times a week for 6 weeks . Main Outcome Measures Goal dimension scores of the Gross Motor Function Measure ( GMFM ) , gait speed , 1 repetition maximum ( 1-RM ) of the loaded STS , isometric strength of knee extensor , and Physiological Cost Index ( PCI ) . The outcome measures were conducted at the beginning and end of the 6-week study . Results After loaded STS exercise , the experimental group showed statistically significant differences in GMFM goal dimension scores , 1-RM STS , and PCI from the control group . The changes in gait speed and isometric strength of the knee extensor did not differ significantly between the 2 groups . Conclusions After the loaded STS exercise , children with mild spastic diplegia improved their basic motor abilities , functional muscle strength , and walking efficiency OBJECTIVE To investigate the effects of resistive exercise on the knee extension and flexion torque production during the rehabilitation period after multilevel orthopedic surgery . DESIGN R and omized clinical trial . SETTING Hospital rehabilitation department . PARTICIPANTS Thirty-nine children with spastic diplegic cerebral palsy ( CP ) ( age range , 6 - 16 y ) , r and omly allocated to an exercise group ( n=19 ) and a control group ( n=20 ) . All received conventional physiotherapy ( PT ) , and the exercise group also followed a resistive exercise program . INTERVENTION A 9-month st and ardized home-based resistive exercise program , which started about 3 months after the surgery . MAIN OUTCOME MEASURES The Gross Motor Functional Measurement ( GMFM ) assessed before ( E(0 ) ) and 1 year ( E(1 ) ) after the surgery . The Modified Ashworth Scale and the isometric and isokinetic torque of the knee extensors and flexors were evaluated at E(0 ) , E(1 ) , and 6 months after the surgery . RESULTS The knee extension and flexion moments had decreased 6 months after the surgery and recovered to the preoperative level 1 year after surgery . These changes were not group dependent . CONCLUSIONS Additional long-term , home-based , low-cost resistive exercise that starts soon after the operation of patients with CP was not more beneficial than conventional PT only , in terms of strength and GMFM This article describes major findings from a study of the therapeutic benefits of horseback riding for children with cerebral palsy . Nineteen children ( aged 4 - 12 years ) with mild or moderate degrees of cerebral palsy were recruited from a children 's treatment centre . Prior to r and omization , the children were stratified according to their degree of disability . Ten children were allocated to a riding ( experimental ) group , and participated in one-hour weekly riding classes for six months . The remaining nine children were put on a waiting list for riding . The results of the study were inconclusive as so often in the case with children with cerebral palsy . Qualitative results gleaned from the weekly progress recordings of the riding instructor , reports of the on-site physical therapist , and reports from parents showed clear progressions in physical and psychosocial functioning . Results of st and ardized quantitative assessment s showed few statistically significant changes in the children . The study clearly indicates a need for further research and for finding or developing instruments that are able to capture and reveal meaningful changes in physical and psychosocial status This study examined the effect of neurodevelopmental treatment ( NDT ) and differences in its intensity on gross motor function of children with cerebral palsy ( CP ) . Participants were 34 children ( 12 females , 22 males ; mean age 7y 3mo [ SD 3y 6mo ] , age range 3 to 14y ) with mild to moderate spasticity and hemiplegia ( n=10 ) , diplegia ( n=12 ) , and tetraplegia ( n=12 ) . Gross Motor Function Classification System levels were : I ( n=10 ) , II ( n=10 ) , and III ( n=14 ) . The paired sample , which was obtained by ratio stratification and matching by sex , age , and distribution of impairment from a total of 114 children with CP , was assigned r and omly to two groups : group A underwent NDT twice a week and group B five times a week for 16 weeks . The outcome measure used was the Gross Motor Function Measure , which assessed the performance of the children before and after intervention . The paired- sample t-test revealed that gross motor function of children from both groups improved significantly after intervention ( p<0.05 ) . Children in group B performed better and showed significantly greater improvement than those in group A ( p<0.05 ) . Results support the effectiveness of NDT and underline the need for intensive application of the treatment The purpose of this research was to evaluate the combined effect of intensive neurodevelopmental therapy ( NDT ) and casting in improving h and function , quality of upper-extremity movement and range of motion in children aged between 18 months and 4 years with cerebral palsy ( CP ) . A r and omized crossover design was used to evaluate the difference between intensive NDT plus casting and a less intensive regular occupational therapy ( OT ) program . Blinded assessment s of h and function , quality of upper-extremity movement , and parents ' perception of h and -function performance were carried out at baseline , 4 months ( end of first intervention period ) , 6 months ( after a 2-month ' washout ' period ) , and 10 months ( end of second intervention period ) . Analysis of the outcomes revealed no significant differences in h and function , quality of upper-extremity movement , or parents ' perception of h and -function performance between the two treatment groups-intensive NDT plus casting or regular OT programs . There does not appear to be any beneficial effect of an increased amount of therapy for the children in this study After an 8-month physical activity intervention in children with cerebral palsy , increases in femoral neck bone mineral content ( BMC ) ( 9.6 % ) , volumetric bone mineral density ( v BMD ) ( 5.6 % ) , and total proximal femur BMC ( 11.5 % ) were observed in the intervention group ( n = 9 ) compared with control subjects ( n = 9 ; femoral neck BMC , -5 . 8 % ; v BMD , -6.3 % ; total proximal femur BMC , 3.5 % ) Effects of two 9-month sports programmes ( four or two sessions per week ) on level of daily physical activity ( PA ) , fat mass ( FM ) , and physical fitness were assessed in children with spastic cerebral palsy ( CP ; n = 20 , 9.2 + /- 1.4 yr ) , r and omly assigned to an experimental and control group after matching . Four sessions per week tended to increase PA ratio ( 24-h energy expenditure/sleeping ( resting ) energy expenditure ) after 9 months from 1.34 + /- 0.25 to 1.55 + /- 0.18 ( P = 0.07 ; not different versus controls ) . FM increased continuously in the control group ( after 9 months + 1.1 + /- 1.6 kg , P < 0.05 ) , whereas the experimental groups showed no changes . Training ( respectively four and two sessions ) increased peak aerobic power 35 % ( P < 0.01 ; P < 0.05 versus controls ) and 21 % ( P < 0.01 ; P = 0.17 versus controls ) . Results also suggest that training has a favourable effect on isokinetic muscle strength . No training-related effects were found on anaerobic power . It was concluded that although aerobic training has a limited effect on PA in children with CP , it may prevent deterioration in body composition and muscle strength . Furthermore , training has a favourable effect on peak aerobic power The purpose of this research was to study the effect of intensive neurodevelopmental therapy ( NDT ) and upper-extremity inhibitive casting , separately or in combination , on h and function , quality of upper-extremity movement and range of motion of 73 children with spastic cerebral palsy aged 18 months to eight years . There was no significant difference between intensive or regular therapy and casting or no casting for h and function , between intensive and regular NDT , or between intensive NDT plus casting and the other groups for quality of movement and range of motion .  Casting led to increased quality of movement and wrist extension after six months . Casting with NDT improved the quality of upper-extremity movement and range of motion . There appear to be no immediate benefits from intensive therapy alone
Background To assess the effectiveness of physical therapy ( PT ) interventions on functioning in children with cerebral palsy ( CP ) .