Motor Function Improvement in Children with Ataxia Receiving Interval
                    Rehabilitation, Including Vibration-Assisted Hometraining: A Retrospective
                    Study

Kyriakos Martakis; Christina Stark; Evelyn Alberg; Christiane Bossier; Oliver Semler; Eckhard Schönau; Ibrahim Duran

doi:10.1055/a-1001-2284

Klin Padiatr 2019; 231(06): 304-312
DOI: 10.1055/a-1001-2284

Original Article

Motor Function Improvement in Children with Ataxia Receiving Interval Rehabilitation, Including Vibration-Assisted Hometraining: A Retrospective Study

Verbesserung der Grobmotorik bei Kindern mit Ataxie unter Intervall-Rehabilitation mit vibrationsgestütztem Heimtraining: eine retrospektive Analyse

Kyriakos Martakis

¹University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, Cologne, Germany

²CAPHRI—School of Public Health and Primary Care, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Department of International Health, Maastricht, Netherlands

³University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Prevention and Rehabilitation, UniReha GmbH, Cologne, Germany

⁴Department of Pediatric Neurology, University Children’s Hospital (UKGM) and Medical Faculty, Justus Liebig University of Giessen, Giessen, Germany

,

Christina Stark

¹University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, Cologne, Germany

,

Evelyn Alberg

³University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Prevention and Rehabilitation, UniReha GmbH, Cologne, Germany

,

Christiane Bossier

³University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Prevention and Rehabilitation, UniReha GmbH, Cologne, Germany

,

Oliver Semler

¹University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, Cologne, Germany

³University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Prevention and Rehabilitation, UniReha GmbH, Cologne, Germany

,

Eckhard Schönau

¹University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, Cologne, Germany

³University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Prevention and Rehabilitation, UniReha GmbH, Cologne, Germany

,

Ibrahim Duran

³University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Prevention and Rehabilitation, UniReha GmbH, Cologne, Germany

› Author Affiliations

Abstract

Background Physiotherapy, including vibration-assisted therapy, has been proven to be effective for patients with ataxic cerebral palsy. Herewith, we studied the effect of a functional, goal-oriented interval rehabilitation program, including vibration-assisted home-training on the motor function of children with congenital ataxias.

Patients 45 children (mean age 7.7 years, SD 4.70) with ataxia, having received a 6-month home-based side-alternating vibration-assisted therapy combined with intensive, goal-oriented, functional rehabilitation intervals, were included in the study, classified according to the progressive or non-progressive ataxia character.

Method Retrospective analysis of the prospectively collected data of the registry of the Cologne rehabilitation program “Auf die Beine”. Motor abilities have been assessed prior to the intervention (M0), after 6 months of home-training (M6) as well as in a follow-up 6 months later (M12). We performed a gait analysis, a 1-minute walking test (1-MWT), and the Gross Motor Function Measure (GMFM-66).

Results The GMFM-66 improvement (M6–M0 vs. M12–M6) was statistically significant with median improvement of 2.4 points (non-progressive) and 2.9 points (progressive) respectively, and clinically relevant. The 1-MWT improvement was statistically significant and clinically relevant for non-progressive ataxia.

Conclusion The intensive training, including vibration-assisted therapy significantly improved the motor function of children with ataxia. Six months later the skills were preserved in children with progressive ataxia and could be further developed in non-progressive forms.

Zusammenfassung

Hintergrund Vibrationstherapie hat sich bei Patienten mit ataktischer Zerebralparese als wirksam erwiesen. Dabei untersuchten wir, wie sich ein funktionelles, zielgerichtetes Intervallrehabilitationsprogramm mit vibrationsgestütztem Heimtraining auf die motorische Funktion von Kindern mit angeborener Ataxie auswirkt.

Patienten 45 Kinder (mittleres Alter 7,7 Jahre, SD 4,70) mit Ataxie, die eine 6-monatige seitenalternierende vibrationsunterstützte Therapie in Kombination mit intensiven, zielgerichteten, funktionellen Rehabilitationsintervallen erhielten, wurden in die Studie eingeschlossen und nach dem nicht progressiven oder progressivem klinischen Verlauf in 2 Gruppen eingeteilt.

Methode Retrospektive Analyse aus dem Register des Kölner Rehabilitationsprogramms „Auf die Beine“. Die motorischen Fähigkeiten wurden vor dem Training (M0), nach 6-monatigem Heimtraining (M6) sowie nach weiteren 6 Monaten (M12) beurteilt. Wir führten eine Ganganalyse, einen Ein-Minuten-Gehtest (1-MWT) sowie ein Gross Motor Function Measure (GMFM-66) durch.

Ergebnisse Die GMFM-66-Verbesserung (M6–M0 vs. M12–M6) war statistisch signifikant mit medianer Verbesserung von 2,4 Punkten (nicht progressiv) bzw. 2,9 Punkten (progressiv) und klinisch relevant. Ähnlich war die 1-MWT-Verbesserung statistisch signifikant und klinisch relevant für nicht-progressive Ataxie.

Schlussfolgerung Das intensive Training, einschließlich der häuslichen, vibrationsgestützten Physiotherapie, hat die motorische Funktion von Kindern mit Ataxie signifikant verbessert. Sechs Monate später waren die motorischen Fähigkeiten der Kindern mit progressiver Ataxie gleichgeblieben und konnten in der nicht-progressiven Gruppe weiter gesteigert werden.

Key words

ataxia - physiotherapy - whole body vibration - gross motor function - neuromuscular interaction

Schlüsselwörter

Ataxie - Plysiotherapie - Ganzkörper-Vibrationstherapie - Grobmotorik - neuromuskuläre Interaktion

Full Text

References

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