BMC Pediatrics published a research study on the changes of basic motor abilities, quality of movement and everyday activities after intensive, goal directed, activity focused physical therapy is a group setting for children with cerebral palsy. Twenty two children (mean age 5 years, 6 months), hemiplegia (7), diplegia (11), quadriplegia (2) and ataxia (2), participated in goal directed, activity focused group physical therapy for five days a week for three weeks. Each session was three hours.
The sessions consisted of:
1. functional goal directed training practicing specific activities
2. family centered practice
3. carry over training to parents and other persons associated with the child's everyday life
4. motor learning techniques regarding motivation, environments and variation.
Immediately following treatment, the Gross Motor Function Measure scores significantly improved. Children in GMFCS Levels I and II improved more that Levels III-V. Positive changes were seen on the Quality of Upper Extremity Skills Test but no significant difference was found. The Pediatric Evaluation of Disability Inventory scores displayed significant improvement in the self care int he functional skills dimension, self care and mobility dimension and the Caregiver Assistance dimension. Goal Attainment Scales were developed for the children. Following the intervention, on average the children reached the pre-determined goals. Seventy one percent of the activity goals, 50% of the movement goals and 80% of the combined goals were reached.
The researchers concluded that intensive training in a group setting may be a cost effective method to optimize function in young children with cerebral palsy.
Reference: Anne Brit Sorsdahl1, Rolf Moe-Nilssen1, Helga K Kaale, Jannike Rieber, Liv Inger Strand Change in basic motor abilities, quality of movement and everyday activities following intensive, goal-directed, activity-focused physiotherapy in a group setting for children with cerebral palsy BMC Pediatrics 2010, 10:26 doi:10.1186/1471-2431-10-26
4 comments:
While I do not doubt the cost-effectiveness of group treatment, the design of this study fails to meet every criteria for drawing that conclusion. What they should have said is that the children progressed well with therapy provided in group. No doubt it costs less. Did the children progress as much as they would have having individual therapy? - not possible to know from this study. Barbara
I agree it is not possible to know from this study whether group was as effective as individual treatments. In the discussion section, the authors do compare their results with other intensive individual physical therapy studies that yielded similar results.
In addition to cost effectiveness, another positive is that in rural areas where therapists are not available to provide individual treatments this is a viable option.
I would like to see what the exact group activities were that the children participated in while at therapy. While treating children regularly in the community at parks, playgrounds and the like, there is nothing more motivating to my clients than trying to keep up with and play alongside their typical peers. So much is this the case that I rarely take my clients out unless I have arranged for a sibling, cousin or friend to come along. Good luck in your research.
Michaelj,
Good point about the motivational factors present during group therapy sessions. In addition, the peers also provide modeling for many children with motor planning issues.
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