By K. Mason. University of South Florida.
Physical Therapy Applying physical therapy to children with CP is common and has a large body of published data arimidex 1 mg line. Since 1990 arimidex 1mg amex, there have been approximately 300 ci- tations in the National Library of Medicine reporting the use of physical therapy in children with CP. Most of these papers report physical therapy being used in conjunction with other treatments, such as surgical hip recon- structions or lower extremity reconstructions for gait improvement, or fol- lowing dorsal rhizotomy and Botox injections. Many of these reports are case series without controls to evaluate the index procedure, and most make no objective attempt to evaluate the impact of the therapy program sepa- rately from other modalities. The number of reports attempting to evaluate the impact of specific therapy programs is increasing; however, many con- tain few patients and no control groups. Many reports presume that physical therapy is like medication in that it can be evaluated by having a control group with no treatment. This research approach has some merit if no effect is found, such as the evaluation of therapy in infant stimulation programs. Recognizing these complex interactions has led to recommending more complex and global evaluations using multivariate analysis in research protocols. For example, a treat- ment protocol where physical therapy modalities along with casting and Botox are used to treat gait abnormality in young children cannot be rea- sonably evaluated by any other means. Recognizing the complex interaction of physical therapy in its own right will lead to improved research techniques for other treatments as well. The long history of physical therapy has been predominated by different theories of development and specific protocols to impact childhood devel- opment. In this theory the spinal cord-mediated activities, such as single synapse reflexes and spasticity, have to be corrected first be- fore the more primitive higher reflexes can be addressed. These primitive reflexes then have to be corrected before high-functioning cortical motor 5. Therapy, Education, and Other Treatment Modalities 153 activities, such as walking, can develop properly.
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