Department of Physical Therapy, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Division of Rehabilitation Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Phys Occup Ther Pediatr. 2021;41(2):166-175. doi: 10.1080/01942638.2020.1766638. Epub 2020 May 19.
Typical infant movement is characterized by a high degree of motor exploration, error, and variability. However, children with cerebral palsy (CP) often cannot create these experiences due to their neuromotor impairments. The purpose of this case study is to describe a 6-month course of physical therapy (PT) incorporating principles of infant motor learning using dynamic weight support (DWS) in a child with CP.
The child was a 27-month-old girl with diplegic CP who functioned at Gross Motor Function Classification System Level IV. The child received 68 PT sessions over a six-month period. DWS was used during therapy to encourage motor practice. The therapy area was arranged to encourage active exploration, motor variability, and error experience. Gross motor function, postural control, parent perception of performance, and parent satisfaction were measured before, during, and after the course of therapy.
Gross motor function increased during the treatment beyond the level predicted from natural progression. Postural control fluctuated and demonstrated no appreciable improvement. Parent-perceived performance and satisfaction improved on three of four goals.
Using DWS to incorporate principles of infant learning may have facilitated the development of gross motor skills in a child with diplegic CP.
典型婴儿运动的特点是具有高度的运动探索、错误和可变性。然而,脑瘫(CP)患儿由于神经运动障碍,往往无法产生这些体验。本病例研究的目的是描述一名患有偏瘫 CP 的 27 月龄女孩在接受包含动态体重支持(DWS)的婴儿运动学习原理的物理治疗(PT) 6 个月过程。
患儿为功能处于粗大运动功能分级系统(GMFCS)IV 级的偏瘫 CP 女孩。在 6 个月的时间里,她接受了 68 次 PT 治疗。治疗中使用 DWS 以鼓励运动练习。治疗区域的布置旨在鼓励主动探索、运动变化和体验错误。在治疗前、治疗中和治疗后测量粗大运动功能、姿势控制、家长对表现的感知以及家长满意度。
在治疗过程中,患儿的粗大运动功能提高超出了自然进展的预期水平。姿势控制波动,没有明显改善。在四项目标中的三项中,家长感知的表现和满意度有所提高。
使用 DWS 来整合婴儿学习的原理可能促进了患有偏瘫 CP 的儿童粗大运动技能的发展。