Research Report Abstracts - Gesundheit

WPT2011, Research Report Abstracts eS267
Research Fund and the University of Applied Sciences,
Utrecht, The Netherlands.
Ethics approval: This study has been approved by the ethics
committee of the University Medical Center in Utrecht, The
Netherlands.
Research Report Poster Display
Number: RR-PO-307-24-Wed Wednesday 22 June 13:00
RAI: Exhibit Halls 2&3
RANDOMIZED CONTROLLED STUDY OF
HOME-BASED TREADMILL TRAINING FOR
AMBULATORY CHILDREN WITH SPINA BIFIDA
de Groot J. 1,2 , Takken T. 1 , van Brussel M. 1 , Gooskens R. 3 ,
Schoenmakers M. 1 , Versteeg C. 4 , Vanhees L. 2,5 , Helders P. 1
1Wilhelmina’s Children’s Hospital, University Medical Center
Utrecht, Child Development and Exercise Center, Utrecht,
Netherlands, 2University of Applied Sciences Utrecht,
Research Group Lifestyle and Health, Utrecht, Netherlands,
3Rudolf Magnus Institute of Neuroscience, University Medical
Center Utrecht, Department of Childneurology, Utrecht,
Netherlands, 4University of Applied Sciences Utrecht, School
of Pharmacy, Utrecht, Netherlands, 5Catholic University of
Leuven (KULeuven), Department of Rehabilitation Sciences,
Leuven, Belgium
Purpose: Purpose of this study was to evaluate the effects of
a home-based treadmill training program on both ambulatory
measures and aerobic fitness.
Relevance: Many ambulatory children with Spina Bifida
(SB) experience functional decline in ambulation despite
stable or even improving motor exams. Improving or maintaining
locomotion during childhood and throughout the
teenage years, could be an important goal for children with
SB. Only limited evidence is available for improving ambulation
in children with SB.
Participants: 32 normal and community ambulatory children
with SB completed the RCT.
Methods: In this blinded randomized clinical trial, main
outcomes measures were functional ambulation and aerobic
endurance. Ambulation was measured using the six-minute
walk test (6MWT). Gross energy consumption (ECSgross)
and energy cost during ambulation were calculated. Maximal
exercise capacity was measured using an incremental
treadmill test. Both VO2peak and speedpeak were recorded
as outcome parameters. The intervention consisted of supervised
treadmill-training for twelve weeks at home. Patients
exercised two times a week, with intensity set at 66% of
HRpeak. Intervals of training consisted of 70–140% of individual
walking speed during initial exercise testing, with
speeds increasing during the training period.
Analysis: For effect of training, T-tests or Mann–Whitney
tests and effect sizes were calculated using Cohen’s d. Mixed
between within subjects analysis of variance was used to
analyze long-term effects of intervention, with eta for effect
size.
Results: After training, significant changes were seen
between the groups for 6MWT (p = 0.002; d = 1.08), speedpeak
(p = 0.001; d = 1.14), VO2peak (p = 0.034; d = 0.78)
and ECSgross (p = 0.004; d = 1.01). Long-term effects were
recorded for 6MWT (p = 0.003; eta = 0.34), speedpeak
(p = 0.003; eta = 0.35) and ECSgross (p = 0.014; eta = 0.29),
but not for VO2peak.
Conclusions: A home-based, progressive treadmill-training
program for ambulatory children with SB has a large longterm
effect on 6MWT and speedpeak, with a moderate shortterm
effect on VO2peak.
Implications: When aiming to improve ambulation in ambulatory
children with SB, a progressive treadmill training
program seems indicated.
Keywords: Treadmill training; Ambulation; Spina Bifida
Funding acknowledgements: This study is part of the
Utrecht Spina Bifida And Graded Exercise study (The
USAGE study) and was financially supported by Stichting
BIO-Kinderrevalidatie Arnhem, the Dutch Royal Society
for Physiotherapy, the Wilhelmina’s Children’s Hospital
Research Fund and the University of Applied Sciences,
Utrecht, The Netherlands.
Ethics approval: All study procedures have been approved
by the ethics committee of the University Medical Center in
Utrecht, The Netherlands.
Research Report Poster Display
Number: RR-PO-308-11-Wed Wednesday 22 June 12:00
RAI: Exhibit Halls2&3
HEAD MOVEMENT EVOLUTION IN 2-TO-4
MONTHS PRETERM NEWBORN
de Lima-Alvarez C.D., Rodrigues B.F., Tudella E.
Federal University of Sao Carlos, Physical Therapy, São
Carlos, Brazil
Purpose: Analyse the evolution of the range of motion
(flexion-extension, inclination and rotation) and angular
mean velocity of head movement in preterm newborns to
2-to-4 months old.
Relevance: The head control is an important milestone for
motor development, however in preterm newborn the acquisition
of head control can be difficult by some organic
characteristics, like hypotonic muscles and neurological
immaturity, compromising their global development.
Participants: Eight healthy preterm newborns (32 ± 3 weeks
of gestational age), with corrected age were evaluated longitudinally
on 2 (65 ± 7.5 days), 3 (92 ± 5 days) and 4
(121 ± 5.25 days) months.
Methods: The assessment was conducted at the Laboratory
of Research and Analysis of Movement (LAPAM) at Federal
University of São Carlos – São Paulo/Brazil. Three spher-