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Effects of a Functional Therapy Program on Motor Abilities of Children With Cerebral Palsy

M Ketelaar, PhD, is Research Coordinator, Rehabilitation Center De Hoogstraat, Rembrandtkade 10, 3583 TM Utrecht, the Netherlands (M.Ketelaar{at}DeHoogstraat.nl).
A Vermeer, PhD, is Professor, Department of Educational Sciences, Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands
H't Hart, PhD, is Professor, Department of Methodology and Statistics, Faculty of Social Sciences, Utrecht University
E van Petegem-van Beek, PT, MSc, is Research Assistant, Department of Educational Sciences, Faculty of Social Sciences, Utrecht University
PJM Helders, PhD, is Professor, Department of Pediatrics, Faculty of Medicine, University Medical Center Utrecht, and University Children's Hospital, Wilhelmina Kinderziekenhuis, Utrecht, the Netherlands

Address all correspondence to Dr Ketelaar

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 randomized 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 assessments: 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 standardized 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.

Key Words: Cerebral palsy • Children • Function • Motor abilities • Physical therapy

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