ABSTRACT
OBJECTIVE: To determine the effect of a six-week exercise intervention on gross motor function for non-ambulant children with cerebral palsy. DESIGN: A parallel arm randomized controlled trial. SETTING: Four special schools. PARTICIPANTS: Thirty-five children aged 8-17 with bilateral cerebral palsy; Gross Motor Function Classification System levels IV-V. METHOD: Participants were randomly allocated to a static bike group, a treadmill group or control group. Participants in the bike and treadmill groups received exercise training sessions, three times weekly for six weeks. The control group received their usual care. Blinded assessments were performed at baseline and six weeks and followed up at 12 and 18 weeks. OUTCOME MEASURES: Gross Motor Function Measures GMFM-66, GMFM-88D and GMFM-88E. RESULTS: At six weeks significant differences were found in GMFM-88D scores between the bike group and the control group, and the treadmill group and the control group (P < 0.05). The mean change (SD) in GMFM-88D score was 5.9 (6.8) for the bike group; 3.7 (4.4) for the treadmill group and 0.5 (1.9) for the control group. No significant differences were found for GMFM-66 or GMFM-88E scores between the bike group and control group, or the treadmill group and control group, although trends of improvement were observed for both exercise groups. The improvements observed declined during the follow-up period. CONCLUSION: This study provides preliminary evidence that exercising on a bike or treadmill may provide short-term improvements in gross motor function for non-ambulant children with cerebral palsy. This needs to be tested in a large-scale randomized trial.
Subject(s)
Cerebral Palsy/physiopathology , Cerebral Palsy/rehabilitation , Exercise Therapy , Mobility Limitation , Motor Activity/physiology , Adolescent , Bicycling , Child , Cohort Studies , Female , Humans , Male , Pilot Projects , Time Factors , Treatment Outcome , WalkingABSTRACT
AIM: The aims of this study were to identify all people with Lesch-Nyhan disease (LND) born in the UK between 1988 and 2008, and to obtain a clinical profile including age at diagnosis, genetic background, family history, neurological signs, and medications. METHOD: Potential participants were contacted through the British Paediatric Neurology Surveillance Unit. Questionnaires were sent to each child's paediatric neurologist or primary consultant. Two purine laboratories provided metabolic information. RESULTS: Twenty-three live males with LND in the 0- to 20-year age band and eight live males over the age of 20 years were identified. Thirty-one live people with LND were identified in the UK in 2008, giving a prevalence of 1 in 2 million people. Over the 20 years of study, there was a mean incidence rate of 0.18 per 100 000 live births, range 0 to 0.5. INTERPRETATION: To our knowledge, this study is the first to provide details of the prevalence and incidence of LND in the UK. The data highlight that clinical profiles, at the time of diagnosis, and management of the disease are variable. There is the need for ongoing monitoring of allopurinol dosage and metabolic screening.
