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Cerebral Palsy Cologne Concept

Cologne Children’s Hospital, Jan 2013

Intensive Physiotherapy and Home Based Vibration Training for Children with Cerebral Palsy: 

E. Schoenau, C. Stark, O. Semler – Children’s Hospital, University of Cologne, Germany

Background: Rehabilitation of children with Cerebral Palsy (CP) aims to reduce sequelae and enhance function. Physiotherapy is a rehabilitative strategy for the treatment of patients with CP, but with little supporting evidence for the different treatment concepts. The Cologne Concept “Auf die Beine” combines Interval-Rehabilitation consisting of short and intensive in-patient stays with 6 months home-based whole body vibration training. “Auf die Beine” is a routine procedure supported by the German health care system. We are presenting the gross motor function results after 6 months of training and additional 6 months follow-up.

Design: Retrospective analysis of 356 children and adolescents

Participants and Setting: 356 children and adolescents diagnosed with CP were included in the retrospective analysis. Mean age was 8.9 years (SD 4.4) and GMFCS levels were 7.3% level I, 14.9% level II, 30.3% level III, 31.2% level IV and 7.6% level V. All patients completed 6 months of home based whole body vibration training, two blocks of intensive physiotherapy and the 12 month visit (6 months follow-up).

Methods: Gross motor function was assessed with the Gross Motor Function Measure (GMFM-66) total score after 6 and 12 (Follow-up) months and the GMFM-88-Goal-Dimensions after 6 months.

Results: GMFM-66-Totalscore improved by 2.9 points (Mean 3.35; p<0.001) after 6 months and by 0.2 points (Mean 0.63; p=0.033) after 6 months follow-up. Goal dimension A (lying) improved by 2.0% (Mean 3.8; p=0.001), B (sitting) by 3.3% (Mean 5.9; p<0.001), C (crawling) by 4.8% (Mean 6.7; p<0.001), D (standing) by 5.1% (Mean 8.0; p<0.001) and E (walking) by 2.8% (Median 4.6; p<0.001).

Conclusion: The Interval-Rehabilitation combined with home-based training shows a significant positive effect on gross motor function in patients with CP. The results could be sustained after 6 months follow-up. To our knowledge this is the first retrospective evaluation of a routine health care concept for children with mobility problems.