The Healthy Strides Foundation, Perth, Western Australia, Australia.
School of Allied Health, Curtin University, Perth, Western Australia, Australia.
BMJ Open. 2023 May 11;13(5):e068816. doi: 10.1136/bmjopen-2022-068816.
To determine the feasibility of an intensive interdisciplinary programme in improving goal and motor outcomes for preschool-aged children with non-progressive neurodisabilities. The primary hypothesis was that the intervention would be feasible.
A single group feasibility study.
An Australian paediatric community therapy provider.
Forty children were recruited. Inclusion criteria were age 2-5 years with a non-progressive neurodisability, Gross Motor Function Classification System (GMFCS) levels III-V or equivalent, and goals relating to mobility, communication and upper limb function. Exclusion criteria included orthopaedic surgery in the past 6 months, unstable hip subluxation, uncontrolled seizure disorder or treadmill training in the past month.
A goal-directed programme of three 2-hour sessions per week for 4 weeks (24 hours total). This consisted of treadmill and overground walking, communication practice, and upper limb tasks tailored by an interdisciplinary team.
Limited-efficacy measures from preintervention (T1) to postintervention (T2) and 4-week follow-up (T3) included the Goal Attainment Scaling (GAS), Canadian Occupational Performance Measure (COPM), Gross Motor Function Measure (GMFM-66) and 10-Metre Walk Test (10MWT). Acceptability, demand, implementation and practicality were also explored.
There were improvements at T2 compared with T1 for all limited-efficacy measures. The GAS improved at T2 (mean difference (MD) 27.7, 95% CI 25.8 to 29.5) as well as COPM performance (MD 3.2, 95% CI 2.8 to 3.6) and satisfaction (MD 3.3, 95% CI 2.8 to 3.8). The GMFM-66 (MD 2.3, 95% CI 1.0 to 3.5) and 10MWT (median difference -2.3, 95% CI -28.8 to 0.0) improved at T2. Almost all improvements were maintained at T3. Other feasibility components were also demonstrated. There were no adverse events.
An intensive interdisciplinary programme is feasible in improving goal and motor outcomes for preschool children with neurodisabilities (GMFCS III-V or equivalent). A randomised controlled trial is warranted to establish efficacy.
ACTRN12619000064101.
确定强化跨学科方案在改善学龄前非进行性神经发育障碍儿童的目标和运动结果方面的可行性。主要假设是干预是可行的。
单组可行性研究。
澳大利亚儿科社区治疗提供者。
招募了 40 名儿童。纳入标准为年龄 2-5 岁，患有非进行性神经发育障碍，粗大运动功能分类系统（GMFCS）水平 III-V 或同等水平，以及与移动、沟通和上肢功能相关的目标。排除标准包括过去 6 个月内的骨科手术、不稳定的髋关节半脱位、无法控制的癫痫发作或过去一个月内的跑步机训练。
每周进行三次 2 小时的课程，共 4 周（共 24 小时）。这包括跑步机和地面行走、沟通练习以及由跨学科团队定制的上肢任务。
从干预前（T1）到干预后（T2）和 4 周随访（T3）的有限疗效测量包括目标实现量表（GAS）、加拿大职业表现量表（COPM）、粗大运动功能测量量表（GMFM-66）和 10 米步行测试（10MWT）。还探讨了可接受性、需求、实施和实用性。
与 T1 相比，所有有限疗效测量在 T2 时均有所改善。GAS 在 T2 时有所改善（平均差异（MD）27.7，95%CI 25.8 至 29.5），COPM 表现（MD 3.2，95%CI 2.8 至 3.6）和满意度（MD 3.3，95%CI 2.8 至 3.8）也有所改善。GMFM-66（MD 2.3，95%CI 1.0 至 3.5）和 10MWT（中位数差异-2.3，95%CI-28.8 至 0.0）在 T2 时有所改善。在 T3 时，几乎所有的改善都得到了维持。其他可行性组成部分也得到了证明。没有不良事件。
强化跨学科方案在改善学龄前神经发育障碍儿童（GMFCS III-V 或同等水平）的目标和运动结果方面是可行的。需要进行随机对照试验来确定疗效。
ACTRN12619000064101。
