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The safety and feasibility of an intervention to improve balance dysfunction in ambulant adults with cerebral palsy

MORGAN P; MURPHY A; OPHEIM A; POGREBNOY D; KRAVTSOV S; MCGINLEY J
CLIN REHABIL , 2015, vol. 29, n° 9, p. 907-919
Doc n°: 176625
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1177/0269215514556299
Descripteurs : AF93- PARALYSIE CEREBRALE ADULTE, DF11 - POSTURE. STATION DEBOUT

OBJECTIVE: To investigate the safety, feasibility and potential efficacy of
balance training in adults with cerebral palsy. DESIGN:
Phase 2, assessor-blinded
randomized controlled trial. SETTING: Outpatient rehabilitation facility.
SUBJECTS: A total of 17 ambulatory adults with cerebral palsy. INTERVENTIONS:
Participants were randomly allocated to an eight-week, once-weekly, small group
programme of balance training, or seated attention control activity. Balance
training was individually tailored using the Balance Evaluation Systems test.
MAIN MEASURES: Primary focus was feasibility, addressed by recruitment,
retention, adherence, and safety. Efficacy was primarily evaluated with the
Ambulatory Self-Confidence Questionnaire and the Balance Evaluation Systems test,
at intervention conclusion and Week 24. Secondary outcomes included gait speed,
walking distance, falls efficacy, fatigue, quality of life, and global impression
of change. RESULTS: Interventions were safe and feasible with no major adverse
events. Adherence was high. At eight and 24 weeks, there were negligible
between-group differences in Balance Evaluation systems test total. At 24 weeks,
there was a small, non-significant between-group difference in favour of the
balance group with effect sizes of 0.14 for ambulatory self-confidence, 0.10 for
falls efficacy, and 0.12 for fatigue. There were significant between-group
differences for self-reported walking confidence and balance change, in favour of
the balance group at Weeks 8 and 24 (p < 0.05). CONCLUSION: A customised balance
programme is feasible and safe for ambulant adults with cerebral palsy. Small
effects from balance training in selected outcomes occurred. Study replication
with at least 38 participants per group to confirm efficacy is warranted.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS

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