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A pragmatic community exercise programme for young people with cerebral palsy: A pilot study
S118
Abstracts / Gait & Posture 39S (2014) S1–S141
[5] Clark S, Iltis PW, Anthony CJ, Toews A. Comparison of older adult performance during the functional-reach and limits-of-stability tests. J Aging Phys Act 2005 Jul;13(3):266–75.
http://dx.doi.org/10.1016/j.gaitpost.2014.04.162 P50 A pragmatic community exercise programme for young people with cerebral palsy: A pilot study
Discussion and conclusions: This pilot study showed that for the majority of the participants with varying levels of function, exercising at a local leisure centre is feasible and safe. Preliminary results also indicate that this pragmatic community exercise programme can be efficacious in improving hip extensor strength, gross motor function and increasing self-esteem.
Reference [1] Bottos, et al. Dev Med Child Neurol 2003 2001;45:786–90. [2] Thompson, et al. Gait Posture 2011;33:321–5.
M.L. van der Linden 1,∗ , J.L. Herman 2 , K.V. Jagadamma 1 , A.M. Richardson 2 , C.D. Samaan 1
http://dx.doi.org/10.1016/j.gaitpost.2014.04.163
1
Rehabilitation Sciences, Queen Margaret University, Edinburgh, United Kingdom 2 Anderson Gait Analysis Laboratory, SMART Centre, Astley Ainslie Hospital, Edinburgh, United Kingdom
P51
Introduction and aim: People with cerebral palsy (CP) are often discharged from paediatric services at the age of 16–21 years. However, as they reach adolescence and body weight and height increases, the energy required to ambulate also increases [1]. In addition, people with CP often show reduced levels of muscle strength [2]. These factors may explain why 75% of people with CP who lose the ability to walk do so at around 25 years. Therefore the aim of this pilot study was to investigate the feasibility of a community based exercise programme and its effects on improving physical fitness and function in adolescents and young adults with CP. Patients/materials and methods: Eight participants with diplegic and hemiplegic CP (GMFCS I-III) (mean age 20 years) took part in an exercise programme which included a mix of strength and aerobic exercises at their local leisure centre under the supervision of a fitness instructor. Instruction was delivered by a physiotherapist on 2–3 occasions. The programme prescribed three sessions per week for weeks 1– followed by two prescribed sessions during weeks 7-12. The participants underwent gait analysis at baseline (BL) and after approximately six (T2) and 12 weeks (T3) of the exercise programme. The assessment also included measures of knee extensor, hip extensor and hip abductor strength (using an MIE Myometer), Gross Motor Function Measure (GMFM) dimensions D and E, a CP-specific 10 m shuttle run/walk (SRT), the Rosenberg scale for Self Esteem and step count. Results: Two participants dropped out the exercise programme and did not return for the T3 assessment. The other six participants showed good compliance with the exercise programme (91% and 75% attendance of prescribed sessions for the 1st and 2nd block of six weeks respectively) with no adverse events. Outcome measures at BL, T2 and T3 are shown in Table 1. Statistically significant effects of the exercise programme between BL and T3 for hip extensor strength and the Rosenberg Scale for Self-Esteem between BL and T3 for GMFM dimensions D&E were found. A trend (Cohen’s d = 0.90) toward improvement was also found for hip abductor strength.
Frequency domain characteristics of kinetic data from force platforms mounted in instrumented stairways T. Chesters 1,∗ , L. Alcock 2,3 , T.D. O’Brien 4,5 , N. Vanicek 3,6 , C.A. Dobson 1 1
Department of Engineering, University of Hull, UK Institute for Ageing and Health, Newcastle University, UK 3 Department of Sport, Health and Exercise Science, University of Hull, UK 4 School of Sport and Exercise Sciences, Liverpool John Moores University, UK 5 School of Sport, Health and Exercise Sciences, Bangor University, UK 6 Discipline of Exercise and Sport Science, The University of Sydney, Australia 2
Introduction and aim: Stair locomotion is a frequently performed daily task that poses high demands and risk. As such, it is a common task for biomechanical analysis. Musculoskeletal modelling of human movement requires the capture of accurate and valid kinetic data. Instrumented staircases are often unique in design and permit kinetic data collection via force platforms embedded into the individual/independent steps [1]. However, staircase design may introduce error when comparing stairwayvs. ground-mounted force platforms due to the material properties of the mounting structure. Many studies use three [2] or five [3] step wooden staircases [1], conforming to building regulation dimensions. This study aimed to quantify the power lost and signal filter introduced by two wooden custom-built staircases with differing step numbers. Patients/materials and methods: Vertical ground reaction forces (GRF) were collected from one piezoelectric platform (model 9286AA, Kistler, Winterthur, Switzerland) embedded into a concrete pit (control condition; FP1). A further 3 conditions were selected (Fig. 1): (A) the first step of a 3-step stairway (3STEP 1); (B) the second step of a 5-step stairway (5STEP 2); and (C) the third step of the same 5-step stairway (5STEP 3). A 3 kg medicine ball
Table 1 Mean and standard deviation of outcomes at baseline (BL) and at T2 and T3 (NM = not measured).
Knee ext strength (Nm/kg) Hip ext strength (Nm/kg) Hip abd strength (Nm/kg) SRT (shuttles) Walking speed (m/s) GMFM (D&E) Daily step count Self-esteem
BL
T2
1.32 (0.50) 1.13(0.46) 0.61(0.19) 11.2(4.1) 0.69(0.34) 64.3(8.9) 2619(1934) 22.7(2.9)
1.38(0.57) 1.38(0.67) 0.66(0.17) 12.1(4.2) 0.72(0.38) 67.1(10.9) NM NM
T3 1.55(0.71) 1.66(0.72) 0.72(0.22) 11.8(4.9) 0.75(0.39) 67.1(11.8) 3605(2772) 25.3(2.2)
p
%Change BL-T3
Cohen’s d at T3
0.121 0.046 0.051 0.545 0.223 0.027 0.196 0.007
17 47 18 6 9 4 38 11
0.38 0.90 0.54 0.14 0.16 0.27 0.42 1.02
Abstracts / Gait & Posture 39S (2014) S1–S141
[5] Clark S, Iltis PW, Anthony CJ, Toews A. Comparison of older adult performance during the functional-reach and limits-of-stability tests. J Aging Phys Act 2005 Jul;13(3):266–75.
http://dx.doi.org/10.1016/j.gaitpost.2014.04.162 P50 A pragmatic community exercise programme for young people with cerebral palsy: A pilot study
Discussion and conclusions: This pilot study showed that for the majority of the participants with varying levels of function, exercising at a local leisure centre is feasible and safe. Preliminary results also indicate that this pragmatic community exercise programme can be efficacious in improving hip extensor strength, gross motor function and increasing self-esteem.
Reference [1] Bottos, et al. Dev Med Child Neurol 2003 2001;45:786–90. [2] Thompson, et al. Gait Posture 2011;33:321–5.
M.L. van der Linden 1,∗ , J.L. Herman 2 , K.V. Jagadamma 1 , A.M. Richardson 2 , C.D. Samaan 1
http://dx.doi.org/10.1016/j.gaitpost.2014.04.163
1
Rehabilitation Sciences, Queen Margaret University, Edinburgh, United Kingdom 2 Anderson Gait Analysis Laboratory, SMART Centre, Astley Ainslie Hospital, Edinburgh, United Kingdom
P51
Introduction and aim: People with cerebral palsy (CP) are often discharged from paediatric services at the age of 16–21 years. However, as they reach adolescence and body weight and height increases, the energy required to ambulate also increases [1]. In addition, people with CP often show reduced levels of muscle strength [2]. These factors may explain why 75% of people with CP who lose the ability to walk do so at around 25 years. Therefore the aim of this pilot study was to investigate the feasibility of a community based exercise programme and its effects on improving physical fitness and function in adolescents and young adults with CP. Patients/materials and methods: Eight participants with diplegic and hemiplegic CP (GMFCS I-III) (mean age 20 years) took part in an exercise programme which included a mix of strength and aerobic exercises at their local leisure centre under the supervision of a fitness instructor. Instruction was delivered by a physiotherapist on 2–3 occasions. The programme prescribed three sessions per week for weeks 1– followed by two prescribed sessions during weeks 7-12. The participants underwent gait analysis at baseline (BL) and after approximately six (T2) and 12 weeks (T3) of the exercise programme. The assessment also included measures of knee extensor, hip extensor and hip abductor strength (using an MIE Myometer), Gross Motor Function Measure (GMFM) dimensions D and E, a CP-specific 10 m shuttle run/walk (SRT), the Rosenberg scale for Self Esteem and step count. Results: Two participants dropped out the exercise programme and did not return for the T3 assessment. The other six participants showed good compliance with the exercise programme (91% and 75% attendance of prescribed sessions for the 1st and 2nd block of six weeks respectively) with no adverse events. Outcome measures at BL, T2 and T3 are shown in Table 1. Statistically significant effects of the exercise programme between BL and T3 for hip extensor strength and the Rosenberg Scale for Self-Esteem between BL and T3 for GMFM dimensions D&E were found. A trend (Cohen’s d = 0.90) toward improvement was also found for hip abductor strength.
Frequency domain characteristics of kinetic data from force platforms mounted in instrumented stairways T. Chesters 1,∗ , L. Alcock 2,3 , T.D. O’Brien 4,5 , N. Vanicek 3,6 , C.A. Dobson 1 1
Department of Engineering, University of Hull, UK Institute for Ageing and Health, Newcastle University, UK 3 Department of Sport, Health and Exercise Science, University of Hull, UK 4 School of Sport and Exercise Sciences, Liverpool John Moores University, UK 5 School of Sport, Health and Exercise Sciences, Bangor University, UK 6 Discipline of Exercise and Sport Science, The University of Sydney, Australia 2
Introduction and aim: Stair locomotion is a frequently performed daily task that poses high demands and risk. As such, it is a common task for biomechanical analysis. Musculoskeletal modelling of human movement requires the capture of accurate and valid kinetic data. Instrumented staircases are often unique in design and permit kinetic data collection via force platforms embedded into the individual/independent steps [1]. However, staircase design may introduce error when comparing stairwayvs. ground-mounted force platforms due to the material properties of the mounting structure. Many studies use three [2] or five [3] step wooden staircases [1], conforming to building regulation dimensions. This study aimed to quantify the power lost and signal filter introduced by two wooden custom-built staircases with differing step numbers. Patients/materials and methods: Vertical ground reaction forces (GRF) were collected from one piezoelectric platform (model 9286AA, Kistler, Winterthur, Switzerland) embedded into a concrete pit (control condition; FP1). A further 3 conditions were selected (Fig. 1): (A) the first step of a 3-step stairway (3STEP 1); (B) the second step of a 5-step stairway (5STEP 2); and (C) the third step of the same 5-step stairway (5STEP 3). A 3 kg medicine ball
Table 1 Mean and standard deviation of outcomes at baseline (BL) and at T2 and T3 (NM = not measured).
Knee ext strength (Nm/kg) Hip ext strength (Nm/kg) Hip abd strength (Nm/kg) SRT (shuttles) Walking speed (m/s) GMFM (D&E) Daily step count Self-esteem
BL
T2
1.32 (0.50) 1.13(0.46) 0.61(0.19) 11.2(4.1) 0.69(0.34) 64.3(8.9) 2619(1934) 22.7(2.9)
1.38(0.57) 1.38(0.67) 0.66(0.17) 12.1(4.2) 0.72(0.38) 67.1(10.9) NM NM
T3 1.55(0.71) 1.66(0.72) 0.72(0.22) 11.8(4.9) 0.75(0.39) 67.1(11.8) 3605(2772) 25.3(2.2)
p
%Change BL-T3
Cohen’s d at T3
0.121 0.046 0.051 0.545 0.223 0.027 0.196 0.007
17 47 18 6 9 4 38 11
0.38 0.90 0.54 0.14 0.16 0.27 0.42 1.02