Lee Kyoung Hwan, Park Jin Woo, Lee Ho Jun, Nam Ki Yeun, Park Tae June, Kim Hee Jae, Kwon Bum Sun
Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea.
Ann Rehabil Med. 2017 Feb;41(1):90-96. doi: 10.5535/arm.2017.41.1.90. Epub 2017 Feb 28.
To evaluate the effectiveness of intensive neurodevelopmental treatment (NDT) on gross motor function for the children having developmental delay (DD), with or without cerebral palsy (CP).
Forty-two children had intensive NDT three times weekly, 60 minutes a day, for 3 months, immediately followed by conventional NDT once or twice a week, 30 minutes a day, for another 3 months. We assessed Gross Motor Function Measure (GMFM) over three time points: before conventional NDT, before and after intensive NDT, and after 3 months of additional conventional NDT.
The GMFM score in DD children significantly improved after intensive NDT, and the improvement maintained after 3 months of conventional NDT (p<0.05). The children were further divided into two groups: DD with CP and DD without CP. Both groups showed significant improvement and maintained the improvements, after intensive NDT (p<0.05). Also, there was no significant difference in treatment efficacy between the two groups. When we calculate the absence rate for comparing the compliance between intensive and conventional NDT, the absence rate was lower during the intensive NDT.
Intensive NDT showed significantly improved gross motor function and higher compliance than conventional NDT. Additionally, all improvements were maintained through subsequent short-term conventional NDT. Thus, we recommend the intensive NDT program by day-hospital centers for children with DD, irrespective of accompanying CP.
评估强化神经发育治疗(NDT)对发育迟缓(DD)儿童(无论是否伴有脑瘫(CP))粗大运动功能的有效性。
42名儿童每周接受3次强化NDT治疗,每次60分钟,共3个月,随后立即接受每周1次或2次的常规NDT治疗,每次30分钟,持续3个月。我们在三个时间点评估粗大运动功能测量(GMFM):常规NDT治疗前、强化NDT治疗前后以及额外常规NDT治疗3个月后。
强化NDT治疗后,DD儿童的GMFM评分显著提高,常规NDT治疗3个月后仍保持改善(p<0.05)。儿童进一步分为两组:伴有CP的DD组和不伴有CP的DD组。两组在强化NDT治疗后均显示出显著改善并维持了改善效果(p<0.05)。此外,两组之间的治疗效果无显著差异。当我们计算缺勤率以比较强化NDT和常规NDT的依从性时,强化NDT期间的缺勤率较低。
与常规NDT相比,强化NDT显著改善了粗大运动功能且依从性更高。此外,所有改善通过后续短期常规NDT得以维持。因此,我们建议日间医院中心为DD儿童开展强化NDT项目,无论其是否伴有CP。