title: A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy.
abstract: OBJECTIVE
  A pilot study to compare the effectiveness of an individual therapy program with the effects of a general physical therapy program.
  
  
  METHODS
  A randomized, single-blind cross-over design.
  
  
  METHODS
  Ten ambulant children with bilateral spastic cerebral palsy, age four to nine years.
  
  
  METHODS
  Participants were randomly assigned into a ten-week individually defined, targeted or a general program, followed by a cross-over.
  
  
  METHODS
  Evaluation was performed using the Gross Motor Function Measure-88 and three-dimensional gait analysis. General outcome parameters were Gross Motor Function Measure-88 scores, time and distance parameters, gait profile score and movement analysis profiles. Individual goal achievement was evaluated using z-scores for gait parameters and Goal Attainment Scale for gross motor function.
  
  
  RESULTS
  No significant changes were observed regarding gross motor function. Only after individualized therapy, step- and stride-length increased significantly (p = 0.022; p = 0.017). Change in step-length was higher after the individualized program (p = 0.045). Within-group effects were found for the pelvis in transversal plane after the individualized program (p = 0.047) and in coronal plane after the general program (p = 0.047). Between-program differences were found for changes in the knee in sagittal plane, in the advantage of the individual program (p = 0.047). A median difference in z-score of 0.279 and 0.419 was measured after the general and individualized program, respectively. Functional goal attainment was higher after the individual therapy program compared with the general program (48 to 43.5).
  
  
  CONCLUSIONS
  The results indicate slightly favorable effects towards the individualized program. To detect clinically significant changes, future studies require a minimal sample size of 72 to 90 participants.
authors.affiliation: Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium Clinical Motion Analysis Laboratory, University Hospital Leuven, Pellenberg, Belgium inge.franki@ugent.be.
authors.forename: Inge
authors.initials: I
authors.lastname: Franki
authors.affiliation: Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
authors.forename: Christine
authors.initials: C
authors.lastname: Van den Broeck
authors.affiliation: Department of Rehabilitation Sciences, K.U.Leuven, Belgium Clinical Motion Analysis Laboratory, University Hospital Leuven, Pellenberg, Belgium Department of Pediatric Orthopaedics, K.U.Leuven, Belgium.
authors.forename: Josse
authors.initials: J
authors.lastname: De Cat
authors.affiliation: Department of Rehabilitation Sciences, K.U.Leuven, Belgium.
authors.forename: Wieke
authors.initials: W
authors.lastname: Tijhuis
authors.affiliation: Department of Rehabilitation Sciences, K.U.Leuven, Belgium Clinical Motion Analysis Laboratory, University Hospital Leuven, Pellenberg, Belgium Department of Pediatric Orthopaedics, K.U.Leuven, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Molenaers
authors.affiliation: Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Vanderstraeten
authors.affiliation: Department of Rehabilitation Sciences, K.U.Leuven, Belgium Clinical Motion Analysis Laboratory, University Hospital Leuven, Pellenberg, Belgium.
authors.forename: Kaat
authors.initials: K
authors.lastname: Desloovere
mesh_terms: D001530:Belgium; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities / Q000592:standards*; D010865:Pilot Projects; D057285:Precision Medicine / Q000379:methods* / Q000706:statistics & numerical data
keywords: Cerebral palsy; goal-setting; individualized therapy; physical therapy