Article

OBJECTIVE: To compare the outcomes of conventional therapies (physical,
occupational, and hydrotherapies) plus acupuncture with those without acupuncture
when administered intensely in the management of children with spastic cerebral
palsy (CP). DESIGN: Evaluation-blind, prospective randomized controlled trial.
SETTING: Therapies and video-recorded assessments at a children's hospital in
Beijing, China, and blind scoring and data analyses at a university in the United
States. PARTICIPANTS: Children (N=75), 12 to 72 months of age, with spastic CP.
INTERVENTIONS: Intensely administered (5 times per week for 12wk) physical
therapy, occupational therapy, and hydrotherapy either with acupuncture (group 1)
or without acupuncture (group 2). To satisfy standard of care, group 2
subsequently received acupuncture (weeks 16-28).
MAIN OUTCOME MEASURES: The Gross
Motor Function Measure (GMFM)-66 and the Pediatric Evaluation of Disability
Inventory (PEDI) assessments at 0, 4, 8, 12, 16, and 28 weeks. RESULTS: At the
end of 12 weeks, there was no statistically significant difference between the 2
groups, but when group 2 received acupuncture (16-28wk) there was a shift toward
improvement in the GMFM-66 and the PEDI-Functional Skills Self-Care and Mobility
domain. When groups were combined, statistically significant improvements after
intense therapies occurred from baseline to 12 weeks for each outcome measure at
each Gross Motor Function Classification System (GMFCS) level. After adjusting
for expected normative maturational gains based on age, the GMFM gains for
children with GMFCS II level was statistically significant (P<.05) with a mean
gain of 6.5 versus a predicted gain of 3.4. CONCLUSIONS: Intense early
administered rehabilitation improves function in children with spastic CP. The
contribution from acupuncture was unclear. Children's response varied widely,
suggesting the importance of defining clinical profiles that identify which
children might benefit most. Further research should explore how this approach
might apply in the U.S.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS