Regis Class Of 2009 Cerebral Palsy Project

Postural Perturbation Training in Children with Cerebral Palsy, Spastic Hemiplegia Meredith Hogan Kate Smulligan Ashley Chandler Rebecca Downey Susan Hunt Pete Smith Andrea Whalen Dr. Cheryl Footer, Faculty Advisor

Introduction

Recent Research

Rosenbaum, 2002

Purpose Multi-planar Perturbation Training Massed Practice Gross Motor Function

Subjects .

I Level

Subject Age Gender GMFCS 1

3

M

I

2

7

M

II

3

13

M

I

I.

I Level

Single Subject Design: A-B-A-A GMFM Outcomes

A

B

2 wk Baseline 5-Day Post 30-Day Post

Intervention 5 Day Massed Practice Balance Training

Results/Discussion: GMFM-66 Child 2

100

90

90

GMFM Score

100

80 70

80 70

Child 3

60

60

100 50

Ba

se

Ba 1

se

50

Ba 2

P Po se 90ostst5 30 3

GMFM Score

GMFM Score

Child 1

Ba s

e

80 70 60 50

Ba

se

Ba 1

se

Ba 2

se

Po 3

st-

5

Po

st-

30

Ba 1

se

2

Ba se

3

Po s

t-5

Po s

t-3

0

Results/Discussion: BOT-2 Child 2

40 30

Child 3

20

50

10 0

Ba

se

1

Ba se

Ba 2

se

Po 3

st-

5

Po

st30

BOT-2 Score

BOT-2 Score

50

40 30 20 10 0

Ba se

1

Ba se

2

Ba se

3

Po s

t-5

Po st

-3

0

Results/Discussion: DMA Score Baseline 5-day

1000 900 800 700 600 500 400 300 200 100 0

30-day

i Ch

i Ch

i Ch

ld

ld

ld 3

2

1

Cerebral Palsy

Massed Practice

Perturbation Training

Clinical Relevance

Limitations

Future Research

Future Research

Acknowledgements • • • •

Dr. Cheryl Footer, Faculty Advisor Dr. Barbara Tschoepe SPARC Grant Our subjects and their families: Jamie, Evan, Logan

References 1. 2.

Krigger KW. Cerebral palsy: An overview. Am Fam Physician. 2006;73:91-100. Rosenbaum PL, Walter SD, Hanna SE, et al. Prognosis for gross motor function in cerebral palsy. JAMA. 2002;288:1357-1363. 3. Ledebt A, Becher JG, Kapper J. Balance training with visual feedback in children with hemiplegic cerebral palsy: Effect on stance and gait. Motor Cont. . 2005;9:459-468. 4. Liao H, Jeng S, Lai J. The relation between standing balance and walking function in children with spastic diplegic cerebral palsy. Dev Med & Child Neurol. 1997;39:106-112. 5. Rose J, Wolff DR, Jones VK. Postural balance in children with cerebral palsy. Dev Med & Child Neurol. 2002;44:58-63. 6. Shumway-Cook A, Hutchinson S, Kartin D, Price R, Woollacott M. Effect of balance training on recovery of stability in children with cerebral palsy. Developmental Medicine & Child Neurology. 2003;45:591-602. 7. Woollacott MH, Shumway-Cook A. Postural dysfunction during standing and walking in children with cerebral palsy: What are the underlying problems and what new therapies might improve balance? Neural Plast. 2005;12:211. 8. Woollacott M, Shumway-Cook A, Hutchinson S, Ciol M, Price R, Kartin D. Effect of balance training on muscle activity used in recovery of stability in children with cerebral palsy: a pilot study. Developmental Medicine & Child Neurology. 2005;47(7):455-461. 9. Deitz JC, Kartin D, Kopp K. Review of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-.2). Physical & Occupational Therapy in Pediatrics. 2007;27(4):87102. 10. Finch E, Brooks D, Stratford PW, Mayo NE. Physical Rehabilitation Outcome Measures: A Guide to Enhanced Clinical Decision Making. 2nd ed. Baltimore Md: Lippincott, Williams & Wilkins; 2002.