Article

AIM: To estimate the impact of dynamic motor control on treatment outcomes in
children with cerebral palsy. METHOD: We used multiple regression on a
retrospective cohort of 473 ambulatory children with cerebral palsy who underwent
conservative treatment, single-level orthopaedic surgery, single-event
multi-level orthopaedic surgery, or selective dorsal rhizotomy. Outcomes included
gait pattern, gait speed, energy cost of walking, and the Pediatric Outcomes Data
Collection Instrument. Explanatory variables considered were pre-treatment levels
of each outcome, treatment group, prior treatment, age, and dynamic motor control
computed from surface electromyography using synergy analysis. Effect sizes were
estimated from the adjusted response. RESULTS: Pre-treatment levels had effect
sizes 2 to 13 times larger than the next largest variable. Individuals with
milder pre-treatment involvement had smaller gains or actual declines. Dynamic
motor control was significant in all domains except energy cost. The effect size
of dynamic motor control was second only to pre-treatment level, and was
substantially larger than the effect size of treatment group for outcomes where
both were significant (gait pattern 2:1, gait speed 4:1).
The effect of dynamic
motor control was independent of treatment group. INTERPRETATION:
Dynamic motor
control is an important factor in treatment outcomes. Better dynamic motor
control is associated with better outcomes, regardless of treatment.
CI - (c) 2016 Mac Keith Press.

Langue : ANGLAIS