Clinical Motion Analysis Laboratory, University Hospital Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium.
Eur J Paediatr Neurol. 2012 Jan;16(1):20-8. doi: 10.1016/j.ejpn.2011.08.009. Epub 2011 Sep 25.
To distinguish the effects of different physiotherapeutic programs in a post BTX-A regime for children with Cerebral Palsy (CP).
Retrospective, controlled intervention study.
A group of 38 children (X¯ = 7y7m, GMFCS I-III, 27 bilateral, 11 unilateral CP) receiving an individually defined Neurodevelopment Treatment (NDT) program, was matched and compared to a group of children with the same age, GMFCS and diagnosis, receiving more conventional physiotherapy treatment. All patients received selective tone-reduction by means of multilevel BTX-A injections and adequate follow-up treatment, including physiotherapy.
Three-dimensional gait analyses and clinical examination was performed pre and two months post-injection. Treatment success was defined using the Goal Attainment Scale (GAS).
Both groups' mean converted GAS scores were above 50. The average converted GAS score was higher in the group of children receiving NDT than in the group receiving conventional physiotherapy (p < 0.05). In the NDT group, overall treatment success was achieved in 76% of the goals, compared to 67% of the goals defined for the conventional physiotherapy group. Especially for the goals based on gait analyses (p < 0.05) and in the group of children with bilateral CP (p < 0.05), treatment success was higher in the NDT group.
In a post-BTX-A regime, the short-term effects of an NDT approach are more pronouncedthan these from a conventional physiotherapy approach.
区分不同物理治疗方案在后肉毒毒素 A 治疗脑瘫（CP）儿童中的效果。
回顾性、对照干预研究。
一组 38 名儿童（X¯=7y7m，GMFCS I-III，27 名双侧，11 名单侧 CP）接受个体化神经发育治疗（NDT）方案，与具有相同年龄、GMFCS 和诊断的儿童相匹配，并接受更传统的物理治疗。所有患者均通过多水平肉毒毒素 A 注射进行选择性肌张力降低，并接受适当的后续治疗，包括物理治疗。
在注射前和注射后两个月进行三维步态分析和临床检查。使用目标实现量表（GAS）定义治疗成功。
两组平均转换 GAS 评分均高于 50。接受 NDT 的儿童组的平均转换 GAS 评分高于接受传统物理治疗的儿童组（p<0.05）。在 NDT 组中，76%的目标实现了整体治疗成功，而接受传统物理治疗的儿童组中这一比例为 67%。特别是对于基于步态分析的目标（p<0.05）和双侧 CP 儿童组（p<0.05），NDT 组的治疗成功率更高。
在后肉毒毒素 A 治疗阶段，NDT 方法的短期效果比传统物理治疗方法更显著。
