Targeted Physical Therapy Combined with Spasticity Management Changes Motor Development Trajectory for a 2-Year-Old with Cerebral Palsy

DOI

10.3390/jpm11030163

Corri L. Stuyvenberg, Rehabilitation Science Graduate Program, University of Minnesota Medical School, MMC 388, 420 Delaware St. SE, Minneapolis, MN 55455, USA.
Shaaron E. Brown, Department of Physical Therapy, Virginia Commonwealth University Health System, 1300 East Marshall Street, PO Box 980419, Richmond, VA 23298, USA.
Ketaki Inamdar, Rehabilitation and Movement Science Program, College of Health Professions, Virginia Commonwealth University, 900 E. Leigh Street, Richmond, VA 23298, USA.
Megan Evans, College of Health Professions, Virginia Commonwealth University, 900 E. Leigh Street, Richmond, VA 23298, USA.
Lin-Ya Hsu, Department of Rehabilitation Medicine, Division of Physical Therapy, University of Washington, 1959 NE Pacific Street, Box 356490, Seattle, WA 98195, USA.
Olivier Rolin, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Sciences, 1223 E. Marshall Street PO Box 980677, Richmond, VA 23298, USA.
Regina T. Harbourne, Rangos School of Health Sciences, Physical Therapy, Duquesne University, 600 Forbes Ave., Pittsburgh, PA 15282, USA.
Sarah Westcott McCoy, Department of Rehabilitation Medicine, Division of Physical Therapy, University of Washington, 1959 NE Pacific Street, Box 356490, Seattle, WA 98195, USA.
Michele A. Lobo, Department of Physical Therapy and Biomechanics & Movement Science Program, University of Delaware, 540 S. College Ave., Newark, DE 19711, USA.
Natalie A. Koziol, Nebraska Center for Research on Children, Youth, Families & Schools, University of Nebraska Lincoln, 160 Prem S. Paul Research Center at Whittier School, Lincoln, NE 68583, USA.
Stacey C. Dusing, Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E Alcazar Street. CHP 155, Los Angeles, CA 90033, USA.

Document Type

Journal Article

Publication Date

2-27-2021

Publication Title

Journal of personalized medicine

Volume

11

Issue

3

ISSN

2075-4426

Keywords

Botulinum toxin-A, cerebral palsy, early intervention, phenol, physical therapy

Abstract

Therapies for children with cerebral palsy (CP) often fail to address essential components of early rehabilitation: intensity, child initiation, and an embodied approach. Sitting Together And Reaching To Play (START-Play) addresses these issues while incorporating intensive family involvement to maximize therapeutic dosage. While START-Play was developed and tested on children aged 7-16 months with motor delays, the theoretical construct can be applied to intervention in children of broader ages and skills levels. This study quantifies the impact of a broader START-Play intervention combined with Botulinum toxin-A (BoNT-A) and phenol on the developmental trajectory of a 24 month-old child with bilateral spastic CP. In this AB +1 study, A consisted of multiple baseline assessments with the Gross Motor Function Measure-66 and the Assessment of Problem Solving in Play. The research participant demonstrated a stable baseline during A and changes in response to the combination of BoNT-A/phenol and 12 START-Play sessions during B, surpassing the minimal clinically important difference on the Gross Motor Function Measure-66. The follow-up data point (+1) was completed after a second round of BoNT-A/phenol injections. While the findings suggest the participant improved his gross motor skills with BoNT-A/phenol and START-Play, further research is needed to generalize these findings.

Open Access

OA

Preprint

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