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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Online ISSN 1973-9095
Odoardo PICCIOLINI 1, Michel Le MÉTAYER 2, Dario CONSONNI 3, Massimo COZZAGLIO 1, Matteo PORRO 1, Verusca GASPARRONI 4 , Artemisia PANOU 5, Fabio MOSCA 6, Nicola M. PORTINARO 5
1 Pediatric Rehabilitation Unit, NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; 2 Responsible of Cours de Perfectionnement sur l’Infermité Motrice Cérébrale, Faculté de Médicine et Chirurgie, Université Paris Sud, Paris, France; 3 Unit of Epidemiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; 4 Centre of Pediatric Rehabilitation, M. Montessori, Fermo, Italy; 5 Orthopaedic Department, University of Milan, Paediatric Orthopaedic Unit, Istituto Clinico Humanitas, Rozzano, Milan, Italy; 6 NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
BACKGROUND: Hip dislocation is common in children with cerebral palsy (CP). At birth they don’t have musculoskeletal deformities but they develop over time due to the combined effects of the movement disorder and impaired gross motor function. Early detection and treatment of a hip at risk is needed to modify the natural of hip development in CP.
AIM: To determine the effect of postural management treatment on hip displacement’s progression in children CP.
DESIGN: Prospective comparative non-randomized study.
SETTING: Rehabilitative outpatient unit. Pediatric Rehabilitation Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico – Università degli Studi di Milano.
POPULATION: 51 children with CP were studied; the treated group (n=30) was compared to a control group (n=21).
METHODS: The treated group followed a two year’s long combined treatment program consisting a neurodevelopment treatment (NDT) two times a week and a 5 hours daily siège moulé postural program. The control group underwent only NDT twice a week for two years. Hip radiographs were measured with the migration percentage (MP) method at baseline, at 1 and 2 years of follow-up.
RESULTS: A significant difference has been observed in the MP (%) trend (p<0.001) between treatment and control groups. At 2 years, there was a marked worsening (MP from 23.0 to 37.7) in the control group, compared to the stability (from 28.8 to 26.8) in the treatment group.
CONCLUSIONS: This study supports the evidence that conservative postural management of hip deformity is useful to prevent the natural progression of hip dislocation.