“Improving balance, mobility, and dual-task performance in an adolescent with cerebral palsy: A case report” Article Summary
Purpose: To examine the effects of an 11-week physical therapy program with an intervention emphasis on task-oriented activities for improving functional mobility, address systems that limit functional mobility, and exhibit the effects of dual tasking during dynamic balance activities.
Study population: This was a case report on single subject – a 15-year-old female that has been diagnosed with spastic triplegic cerebral palsy (CP).
Methods: The second author, a Pediatric Clinical Specialist who has worked with adolescents and children with CP for over 28 years, performed the examinations on the subject. The first author conducted the interventions.
Outcome measures: Outcome measures utilized in this case report include the Canadian Occupational Performance Measure (COPM), the 6-minute walk test (6MWT), the Muscle Power Sprint Test (MPST), the 10 x 5-meter sprint test, the Timed Up and Down Stairs Test (TUDS), the Gillette Functional Assessment Questionnaire, and the Gross Motor Function Measure.
Intervention: Interventions began with a short warm-up (5-10 minutes) leading into 60-70 minutes of interval training, that included dynamic balance training, agility, gait activities on uneven surfaces, anaerobic conditioning, as well as core and lower extremity conditioning. The session was followed by a 5–10-minute cool down that included Achilles tendon stretches, hamstring stretches, and modified yoga positions. This intervention was performed 2 times a week for 11 weeks. The subject was also tasked with performing a home exercise program for 15-20 minutes involving walking on a treadmill and adapted yoga postures for flexibility and core stabilization for 2-3 times a week. Completion of the home exercise program was logged by the participant.
Results: The participant exhibited improvements in functional mobility, agility, anaerobic power, cardiorespiratory fitness, gross motor skills, and ascending/descending stairs. The subject also demonstrated improvements with mobility on uneven terrain and with dual tasking.
Strengths/limitations: Limitations to this study include the limited number of subjects as there was only one participant. It is mentioned in the case report that a limitation could be the fact that the subject was familiar with the assessments at post-testing. It is also stated that the patient’s enthusiasm about the interventions may have led to increased confidence in motor function and movement abilities based on what the subject desired for her outcomes.
Overall conclusion: After participating in an 11-week intervention that focused on improving dual task performance, dynamic balance, and functional mobility, the subject, a 15-year-old female with diagnosed spastic triplegic cerebral palsy, demonstrated advancements in both function and testing.