A successful new rehabilitation approach to treating children with cerebral palsy puts its focus on where a child lives and plays, not just improving the child's balance, posture and movement skills.
Called a "context-focused intervention", McMaster University and the University of Alberta researchers report in a new study this approach is just as beneficial as traditional child-focused therapy, offering parents an additional treatment option for their child.
The McMaster study, in conjunction with researchers at the University of Alberta's Faculty of Rehabilitation Medicine and Alberta Health Services in Calgary, is the first randomized trial to examine the effects of therapy focused on changing a child's task or environment, not the child. It appeared in the July issue of the medical journal Developmental Medicine and Child Neurology.
Context-focused and child-focused therapies were evaluated in a randomized controlled trial of 128 children with cerebral palsy ranging in age from one year to almost six year old. The children, from 19 different rehabilitation centres in Ontario and Alberta, received one of the two approaches for six months. Therapy was provided by occupational therapists and physical therapists. Between assessments at six and nine months, they returned to their regular therapy schedule.
Researchers found that while both groups improved significantly over the study, there were "no significant differences in daily functioning" between the two treatment groups, reported lead author Mary Law, professor in McMaster's School of Rehabilitation Science and co-founder of the university's CanChild Centre for Childhood Disability Research.
Cerebral palsy is caused by damage in the brain before or just after birth that results in problems with muscle tone and movement, and impacts ability to perform everyday activities. More than 50,000 Canadians have cerebral palsy, which occurs in about two of 1,000 babies.
During the study, parents in both groups received general information and education about their child's disability as well as specific strategies to practice at home.
In the child-focused approach, therapists identified the underlying impairment – tone, posture, range of motion – and provided therapy to improve the child's skills and abilities.
Emphasis in the context therapy approach was on changing the task or environment. For example, one parent's goal was for their child to finger-feed himself Cheerios independently. The therapist experimented with putting peanut butter on the tips of his fingers so that the Cheerios would stick to it. The child was successful in one intervention session, even though he did not have the fine grasp to pick them up without it. Having experienced success, the child went on to be able to finger feed Cheerios by himself.
"This study provides evidence that each intervention approach yields equivalent important change after a six-month intervention," Law said. "We also found no difference between the therapy approaches for the outcome of parent empowerment."
If both approaches are equally effective, Law said therapists and families are able to discuss the treatment approach that best fits the intervention goals for their child and their family situation.
Law is co-author in a second article in the same journal, describing the context-focused approach with lead author Johanna Darrah, a professor of physical therapy in the Faculty of Rehabilitation Medicine at the University of Alberta. Darrah said the experience with context therapy was positive: "The benefits of working in the child's natural environment were striking."
Darrah added researchers found this approach was more challenging with children who have a severe disability, as some therapists felt that by not providing hands-on treatment, the approach is not true therapy. However, the study found that the context approach was equally effective for children with mild or severe cerebral palsy.
The study was supported by a grant from the National Institutes of Health in the United States and the Alberta Centre for Child Family and Community Research. Mary Law holds the John and Margaret Lillie Chair in Childhood Disability Research.
Veronica McGuire | EurekAlert!
Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland
Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
27.03.2017 | Health and Medicine
27.03.2017 | Life Sciences
27.03.2017 | Earth Sciences