SPORTS STARS study protocol: a randomised, controlled trial of the effectiveness of a physiotherapist-led modified sport intervention for ambulant school-aged children with cerebral palsy

Abstract

BackgroundModified sport interventions run by physiotherapists have shown potential as cost-effective, engaging, and effective interventions to improve gross motor skills and support transition to real-world sports participation for children with cerebral palsy. At present, this population demonstrates decreased participation in physical activities and sport compared to peers due to barriers ranging from body function to accessibility challenges. Sport provides culturally relevant opportunities for social integration, community participation and physical activity and has been shown to improve the fitness, self-esteem, confidence and quality of life of children with disabilities. The Sports Stars physiotherapy group has been designed to support the development of a range of fundamental movement and sports skills through activity skill practice and participation in modified popular Australian sports.MethodsThis randomised, waitlist controlled, assessor blinded, superiority trial with two parallel groups will aim to compare the effectiveness of Sports Stars to standard care across all ICF domains. Children in the Sports Stars group are expected to demonstrate greater improvement in their individually-selected, sports related goals measured by the Canadian Occupational Performance Measure. This study will aim to assess sixty ambulant children aged six to 12 years with a diagnosis of cerebral palsy. Children will be excluded if they have had recent Botox or neurological/orthopaedic surgery. The Sports Stars intervention includes eight, one-hour, weekly physiotherapy group sessions with four to six participants and one lead physiotherapist. Outcome measures will be collected pre, post and 12 weeks post the immediate Sports Stars group to assess change immediately after, and at follow up time points.DiscussionThis will be the first study of its kind to investigate a culturally relevant sports-focussed fundamental movement skills physiotherapy group for ambulant children with cerebral palsy. The findings will add to a growing pool of evidence supporting group physiotherapy for children with cerebral palsy and the Sports Stars group will provide an avenue for children to transition from individual physiotherapy to mainstream and modified recreational and competitive sports.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12617000313336 Registered 28, February 2017.WHO Universal Trial Number: U1111–1189-3355 Registered 1, November 2016.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1190-z) contains supplementary material, which is available to authorized users.

Evaluation of Respiratory Muscular Strength Compared to Predicted Values in Patients with Stroke

“…This can be explained by the fact that, when young, this patient performed activities that may develop strength in the body and, therefore, part of his muscular strength was preserved. This is in line with the literature, where it has been reported that resistance exercise from childhood is beneficial in preventing muscle loss as the individual ages, making it an important strategy for maintaining and increasing muscular mass and strength [18,19].…”

Standardized Outcomes Measures in Physical Therapy Practice for Treatment and Rehabilitation of Cerebral PALSY: A Systematic Review

“…Some authors did not reference palsy typography, referring only to CP [ 12 , 13 , 14 , 15 , 16 , 17 ]. From the other studies, 12 focused on spastic hemiplegia/paresis, 9 focused on spastic diplegia/paresis, 7 on just spastic CP, 7 investigated unilateral and bilateral spastic CP and 2 studies included subjects with all types of CP [ 18 , 19 ]. The participants were also classified according to the Gross Motor Function Classification System (GMFCS).…”

“…A few authors investigated areas such as manual therapy [ 53 ], respiratory physical therapy [ 54 ], and alternative therapies [ 55 ]. Finally, [ 16 ] analyzed the effect of segmental training in gross motor function, whereas [ 19 ] focused their attention on sports-specific fundamental movement skills training.…”

“…Others physical capacities, such as muscle strength, gait, and anaerobic fitness, were also well investigated in the studies selected. The instruments preferred for measuring outcomes for each variable were the hand-held dynamometer [25,33,34,36,37,45], 3D gait analysis [24,29,44,50], and the Muscle Power Sprint Test [14,17,19,43,45]. Similarly, when the studies focused on the assessment of gait, muscle balance, and activity performance, the authors preferred technological resources.…”

“…In order to assess dynamic balance, the authors only performed three tests and were not developed for children with CP. Time Up and Go test (TUG) was the instrument more widely used [ 12 , 15 , 19 , 27 , 29 , 41 , 42 , 43 , 45 , 51 , 52 ], probably due to the simplicity of the test administration. To measure spasticity, authors had primarily used the Modified Ashworth Scale (MAS) [ 25 , 28 , 38 , 40 , 52 , 53 ]; this tool shows a solid, literature-based, inter- and intra-rater agreement, exhibiting a better reliability when measuring upper rather than lower extremities [ 59 ].…”