Pediatric Physical Therapy:
Clinical Bottom Line
The Nisonger Center, UCEDD, The Ohio State University Columbus, Ohio
Division of Physical Therapy, The Ohio State University Columbus, Ohio
The authors declare no conflicts of interest.
“How should I apply this information?”
A description of a plyometric training program for 3 children with hemiparesis in this case series provides an example that could be used in a clinical setting. The protocol was reasonable to complete and distinctively included a child-directed exercise for motivation. The dose of this intervention is greater, and likely more aggressive, than standard care. The child's safety during plyometric training using this protocol should be considered because falls and injuries during training were reported. A variety of outcomes for gross motor function, muscle power, and suggestions for clinical decision making for duration are included. Each child maintained improvements at a 6-week follow-up on the gross motor function measure but not on other measures. Multiple data collection time points highlight intra- and intersubject variability before, during, and after training, suggesting that variability can be expected.
“What should I be mindful about in applying the information?”
This case series can be applied only to boys in Gross Motor Function Classification System level I, Manual Ability Classification System levels I and II, with spastic hemiparesis between the ages of 8 and 10 years, who are over- or underweight. The validity of the agility, running speed, and power measures including the ball throw test are not well established for children with CP; therefore, these measures should be used with caution. Although a clinically important difference in gross motor changes was found, the results of this study were not evaluated relative to participation, which could be an important outcome for these subjects because of their higher level of baseline motor function. Although gross motor function improved with plyometric training in all of the 3 subjects, muscle power improvements were inconsistent. Because muscle power improvements were inconsistent, one must consider whether these results were a limitation of the muscle power tests, a limitation of the training method, or not relevant to function as measured
Helen Carey, PT, MS, PCS
The Nisonger Center, UCEDD, The Ohio State University
Jill C. Heathcock, MPT, PhD
Division of Physical Therapy, The Ohio State University