Abstract
Forty-eight infants 12-19 months of age with mild to severe spastic diplegia were randomly assigned to either 12 months of neurodevelopmental PT (Group PT:PT, N=25) or 6 months of infant stimulation (IS) followed by 6 months of PT (Group IS:PT, N=23). No motor or mental intergroup differences were seen at baseline. Motor outcome assessed by masked observers after 6 and 12 months of therapy included motor quotient (MoQ) derived from the Bayley Scales and observation of walking. Also, parents reported age of attainment of walking.
Time-dependent analysis of parent reports showed earlier walking in Group IS:PT (p=0.01). Stepwise multiple regressions identified MoQ at enrollment as the greatest contributor to MoQ after 6 and 12 months' treatment (p<0.001). IS during the first 6 months also contributed (p<0.05 for 6 month MoQ, p<0.01 for 12 month MoQ). Mental development did not contribute to MoQ. Total variance explained: 6 months 42%, 12 months 50%.
In these infants with spastic diplegla, 6 months of PT, compared to similarly intense IS, did not improve motor outcome. Earlier applied PT offered no motor advantage over later PT. MoQ prior to treatment was the best indicator of short term motor outcome.
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Palmer, F., Shapiro, B., Wachtel, R. et al. A CLINICAL TRIAL OF PHYSICAL THERAPY (PT) IN SPASTIC DIPLEGIA. Pediatr Res 21 (Suppl 4), 285 (1987). https://doi.org/10.1203/00006450-198704010-00710
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DOI: https://doi.org/10.1203/00006450-198704010-00710