title: Evaluating intense rehabilitative therapies with and without acupuncture for children with cerebral palsy: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the outcomes of conventional therapies (physical, occupational, and hydrotherapies) plus acupuncture with those without acupuncture when administered intensely in the management of children with spastic cerebral palsy (CP).
  
  
  METHODS
  Evaluation-blind, prospective randomized controlled trial.
  
  
  METHODS
  Therapies and video-recorded assessments at a children's hospital in Beijing, China, and blind scoring and data analyses at a university in the United States.
  
  
  METHODS
  Children (N=75), 12 to 72 months of age, with spastic CP.
  
  
  METHODS
  Intensely administered (5 times per week for 12wk) physical therapy, occupational therapy, and hydrotherapy either with acupuncture (group 1) or without acupuncture (group 2). To satisfy standard of care, group 2 subsequently received acupuncture (weeks 16-28).
  
  
  METHODS
  The Gross Motor Function Measure (GMFM)-66 and the Pediatric Evaluation of Disability Inventory (PEDI) assessments at 0, 4, 8, 12, 16, and 28 weeks.
  
  
  RESULTS
  At the end of 12 weeks, there was no statistically significant difference between the 2 groups, but when group 2 received acupuncture (16-28wk) there was a shift toward improvement in the GMFM-66 and the PEDI-Functional Skills Self-Care and Mobility domain. When groups were combined, statistically significant improvements after intense therapies occurred from baseline to 12 weeks for each outcome measure at each Gross Motor Function Classification System (GMFCS) level. After adjusting for expected normative maturational gains based on age, the GMFM gains for children with GMFCS II level was statistically significant (P<.05) with a mean gain of 6.5 versus a predicted gain of 3.4.
  
  
  CONCLUSIONS
  Intense early administered rehabilitation improves function in children with spastic CP. The contribution from acupuncture was unclear. Children's response varied widely, suggesting the importance of defining clinical profiles that identify which children might benefit most. Further research should explore how this approach might apply in the U.S.
authors.affiliation: Mel and Enid Zuckerman College of Public Health, University of Arizona Health Sciences Center, Tucson, AZ 85724, USA. bduncan@peds.arizona.edu
authors.forename: Burris
authors.initials: B
authors.lastname: Duncan
authors.forename: Kungling
authors.initials: K
authors.lastname: Shen
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Zou
authors.forename: Tong-Li
authors.initials: TL
authors.lastname: Han
authors.forename: Zhegh-Li
authors.initials: ZL
authors.lastname: Lu
authors.forename: Hua
authors.initials: H
authors.lastname: Zheng
authors.forename: Michele
authors.initials: M
authors.lastname: Walsh
authors.forename: Claire
authors.initials: C
authors.lastname: Venker
authors.forename: Yani
authors.initials: Y
authors.lastname: Su
authors.forename: Rosa
authors.initials: R
authors.lastname: Schnyer
authors.forename: Opher
authors.initials: O
authors.lastname: Caspi
mesh_terms: D015670:Acupuncture Therapy; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D006875:Hydrotherapy; D007223:Infant; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D009788:Occupational Therapy; D026741:Physical Therapy Modalities; D016037:Single-Blind Method