Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trial
Abstract Background Recent research indicates that intensive rehabilitation tends to be effective for children with cerebral palsy (CP). Intensive Neurophysiological Rehabilitation System (INRS) is a multi-component approach that combines various interventions and addresses different functional goal...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Neurology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12883-023-03216-4 |
| _version_ | 1797840918630367232 |
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| author | A Kushnir O Kachmar |
| author_facet | A Kushnir O Kachmar |
| author_sort | A Kushnir |
| collection | DOAJ |
| description | Abstract Background Recent research indicates that intensive rehabilitation tends to be effective for children with cerebral palsy (CP). Intensive Neurophysiological Rehabilitation System (INRS) is a multi-component approach that combines various interventions and addresses different functional goals.. This study aimed to examine the effectiveness of the INRS treatment in children with bilateral CP. Methods In this quasi-randomized controlled study, 48 children with spastic bilateral CP (age 5–12 years, GMFCS Levels I-IV, MACS Levels I-IV) were assigned to an experimental or control group in order they have been enrolled. The experimental group underwent INRS treatment in the tertiary care facility for about four hours daily for ten days and continued routine home treatment for four weeks. After the first evaluation, participants from the control group stayed on the waiting list for four weeks receiving home treatment and then starting the INRS treatment. Thereby, all participants were assessed three times. The primary outcome measure was a Gross Motor Function Measure 66 Item Set (GMFM). The secondary outcome measures included the Jebsen-Taylor Hand Function test, Box and Blocks test, ABILHAND-Kids Questionnaire, Self-care and Mobility domain of the Pediatric Evaluation of Disability Inventory, and the ankle dorsiflexion passive range of motion. Results There was a statistically significant increase in the GMFM score after the INRS treatment in both the experimental group (mean difference (MD) 2.0, P < 0.01) and control group (MD 1.5, P < 0.05), with a large size effect (partial eta squared (η2) = 0.21 and η2 = 0.14). The mean difference between groups during the first study period was 2.89 points (p < 0.01) in the GMFM score with a medium effect size (η2 = 0.12). Statistically significant superiority of the INRS treatment over home treatment was also obtained by Jebsen-Taylor Hand Function Test and the Box and Blocks Test in both dominant and non-dominant hands. Conclusions The study indicates that the INRS treatment can be beneficial for improving both gross motor functions and hand function in children with bilateral CP. Further longitudinal studies are required to evaluate the effects of the INRS treatment on the participation level of children with CP. Trial registration The study protocol was registered on ClinicalTrials.gov under the identifier: NCT04093180 on 17/09/2019. |
| first_indexed | 2024-04-09T16:22:41Z |
| format | Article |
| id | doaj.art-49bf37194f1245bd9ee6193d0b8c832c |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-04-09T16:22:41Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-49bf37194f1245bd9ee6193d0b8c832c2023-04-23T11:21:01ZengBMCBMC Neurology1471-23772023-04-0123111010.1186/s12883-023-03216-4Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trialA Kushnir0O Kachmar1Elita Rehabilitation CenterElita Rehabilitation CenterAbstract Background Recent research indicates that intensive rehabilitation tends to be effective for children with cerebral palsy (CP). Intensive Neurophysiological Rehabilitation System (INRS) is a multi-component approach that combines various interventions and addresses different functional goals.. This study aimed to examine the effectiveness of the INRS treatment in children with bilateral CP. Methods In this quasi-randomized controlled study, 48 children with spastic bilateral CP (age 5–12 years, GMFCS Levels I-IV, MACS Levels I-IV) were assigned to an experimental or control group in order they have been enrolled. The experimental group underwent INRS treatment in the tertiary care facility for about four hours daily for ten days and continued routine home treatment for four weeks. After the first evaluation, participants from the control group stayed on the waiting list for four weeks receiving home treatment and then starting the INRS treatment. Thereby, all participants were assessed three times. The primary outcome measure was a Gross Motor Function Measure 66 Item Set (GMFM). The secondary outcome measures included the Jebsen-Taylor Hand Function test, Box and Blocks test, ABILHAND-Kids Questionnaire, Self-care and Mobility domain of the Pediatric Evaluation of Disability Inventory, and the ankle dorsiflexion passive range of motion. Results There was a statistically significant increase in the GMFM score after the INRS treatment in both the experimental group (mean difference (MD) 2.0, P < 0.01) and control group (MD 1.5, P < 0.05), with a large size effect (partial eta squared (η2) = 0.21 and η2 = 0.14). The mean difference between groups during the first study period was 2.89 points (p < 0.01) in the GMFM score with a medium effect size (η2 = 0.12). Statistically significant superiority of the INRS treatment over home treatment was also obtained by Jebsen-Taylor Hand Function Test and the Box and Blocks Test in both dominant and non-dominant hands. Conclusions The study indicates that the INRS treatment can be beneficial for improving both gross motor functions and hand function in children with bilateral CP. Further longitudinal studies are required to evaluate the effects of the INRS treatment on the participation level of children with CP. Trial registration The study protocol was registered on ClinicalTrials.gov under the identifier: NCT04093180 on 17/09/2019.https://doi.org/10.1186/s12883-023-03216-4Cerebral palsyDevelopmental disabilitiesNeurological rehabilitationMotor skillsRandomized controlled trial [Publication Type] |
| spellingShingle | A Kushnir O Kachmar Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trial BMC Neurology Cerebral palsy Developmental disabilities Neurological rehabilitation Motor skills Randomized controlled trial [Publication Type] |
| title | Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trial |
| title_full | Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trial |
| title_fullStr | Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trial |
| title_full_unstemmed | Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trial |
| title_short | Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trial |
| title_sort | intensive neurophysiological rehabilitation system for children with cerebral palsy a quasi randomized controlled trial |
| topic | Cerebral palsy Developmental disabilities Neurological rehabilitation Motor skills Randomized controlled trial [Publication Type] |
| url | https://doi.org/10.1186/s12883-023-03216-4 |
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