Your Therapy Source Blog

Developmental Medicine and Child Neurology published research on the relationship of physical fitness and Gross Motor Function Measure scores in children with cerebral palsy (45 with hemiplegia and 23 with spastic diplegia). The study results indicated no relationship between aerobic capacity and body mass index and sections D (standing) and E (walking, running and jumping) on the GMFM. There was a moderate to high correlation between short term muscle power, agility, functional muscle strength and sections D and E on the GMFM. The authors conclude that this correlation can help to guide treatment planning to improve motor capacity in children with cerebral palsy.

Again, we see that muscle power and strength correlate with function in children with cerebral palsy. Always keep this in mind when working with children with cerebral palsy – increasing muscle strength can translate into improved function. Give parents simple activities to carry out during the day that will help to maximize muscle strengthening i.e. stair climbing, heavy work chores, etc. Try making muscle strengthening fun for children. Foster games and activities that children will want to participate in instead of just basic therapeutic exercises.

I was surprised to see that body mass index and aerobic capacity did not effect motor abilities.

Visit www.YourTherapySource.com/playstrong for an electronic activity book on muscle strengthening through play. For simple activities to carry out during the day check out Therapeutic Activities for Home and School at www.YourTherapySource.com/therexbook.

Reference: OLAF VERSCHUREN, MARJOLIJN KETELAAR, JAN WILLEM GORTER, PAUL J M HELDERS, TIM TAKKEN Relation between physical fitness and gross motor capacity in children and adolescents with cerebral palsy Developmental Medicine & Child Neurology
2009 1469-8749 PN: 0012-1622 DOI: 10.1111/j.1469-8749.2009.03301.x US: http://dx.doi.org/10.1111/j.1469-8749.2009.03301.x

Recent research in Pediatric Physical Therapy reports on thirteen children with cerebral palsy who participated in functional physical training 2x/wk for 9 weeks resulting in significant improvements in ambulation, aerobic endurance, and walking distance.

This might seem obvious but I think therapists need to be reminded frequently what works time and time again – aerobic training results in improved functioning. Sometimes therapists can go off on too many tangents when working with kids. Sticking to the basics, muscle strengthening, practice and aerobic training gets results.

Now how to apply this study to school based therapy. Most children do not receive PT or OT 2x/week. Although, many receive PE or APE that many times. Try consulting with the PE teachers and help to create stations that work on aerobic conditioning. Also, try offering parents suggestions to do at home with aerobic stations that are simple to set up. Get the child motivated to participate. Create a chart – when 18 sessions are reached award that child with a prize. Any other ideas? Please comment.

Reference: Gorter, Hetty PT; Holty, Lian PT; Rameckers, Eugène E.A. PT, MRes; Elvers, Hans J.W.H. RI, MSc; Oostendorp, Rob A.B. Prof Dr (2008) Changes in Endurance and Walking Ability Through Functional Physical Training in Children with Cerebral Palsy [Research Report] Pediatric Physical Therapy:Volume 21(1)Spring 2009pp 31-37