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Neuropediatrics 2020; 51(06): 407-416
DOI: 10.1055/s-0040-1715489
Original Article

Effect of Long-Term Repeated Interval Rehabilitation on the Gross Motor Function Measure in Children with Cerebral Palsy

Christina Stark    *
1   Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
2   Cologne Centre for Musculoskeletal Biomechanics (CCMB), University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
3   Center of Prevention and Rehabilitation, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
,
Ibrahim Duran    *
3   Center of Prevention and Rehabilitation, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
,
Kyriakos Martakis 
1   Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
4   Department of International Health, Maastricht University, School CAPHRI, Care and Public Health Research Institute, Maastricht, The Netherlands
5   Department of Pediatric Neurology, University Children's Hospital (UKGM) and Medical Faculty, Justus Liebig University of Giessen, Giessen, Germany
,
Karoline Spiess
3   Center of Prevention and Rehabilitation, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
,
Oliver Semler 
1   Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
2   Cologne Centre for Musculoskeletal Biomechanics (CCMB), University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
,
Eckhard Schoenau
1   Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
2   Cologne Centre for Musculoskeletal Biomechanics (CCMB), University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
3   Center of Prevention and Rehabilitation, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
› Author Affiliations Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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Abstract

Background The efficacy of interventions for cerebral palsy (CP) has been frequently investigated with inconclusive results and motor function measured by the Gross Motor Function Measure (GMFM-66) is common.

Objective In this observational analysis, we quantify the GMFM-66 change scores of the second and third year of a multimodal rehabilitation program (interval rehabilitation including home-based, vibration-assisted training) in children with CP.

Methods The study was a retrospective analysis of children with CP (2–13 years) participating for a second (n = 262) and third year (n = 86) in the rehabilitation program with GMFM-66 scores at start (M0), after 4 months (M4) of intensive training, and after 8 months of follow-up (M12). A method was previously developed to differentiate between possible treatment effects and expected development under standard of care for GMFM-66 scores using Cohen's d effect size (ES; size of difference).

Results After the treatment phase of 4 months (M4) in the second year, 125 of 262 children were responder (ES ≥ 0.2) and 137 children nonresponder (ES < 0.2); mean ES for nonresponder was −0.212 (trivial) and for responder 0.836 (large). After M4 in the third year, 43 children of 86 were responder (ES = 0.881 [large]) and 43 nonresponder (ES = −0.124 [trivial]).

Discussion and Conclusion Repeated rehabilitation shows a large additional treatment effect to standard of care in 50% of children which is likely due to the intervention, because in the follow-up period (standard of care), no additional treatment effect was observed and the children followed their expected development.

Keywords

cerebral palsy - gross motor function - GMFM-66 - effect size - long-term

Author Contributions

All authors fulfil the four criteria for authorship recommended by ICJME and all who meet the four criteria are identified as authors.


Ethical Approval

This study was approved by the Ethics Committee of the University of Cologne, Germany.


* Shared first authors.




Publication History

Received: 02 April 2020

Accepted: 02 July 2020

Article published online:
16 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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