Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 9:11:1090919.
doi: 10.3389/fped.2023.1090919. eCollection 2023.

Effect of hip CPM on gross motor function and development of the hip joint: a single-center randomized controlled study on spastic cerebral palsy children with hip dysplasia

Lulu Wang  1 , Nuochen Zhang  1 , Liwei Fang  1 , Zhenzhen Cui  1 , Huihui Niu  1 , Fuli Lv  1 , Dayong Hu  2 , De Wu  1   2
Affiliations

Effect of hip CPM on gross motor function and development of the hip joint: a single-center randomized controlled study on spastic cerebral palsy children with hip dysplasia

Lulu Wang et al. Front Pediatr. .

Abstract

Objective: To investigate the effectiveness of hip continuous passive motion (hCPM) on hip development at skeletal maturity and gross motor function for spastic cerebral palsy children with hip dysplasia.

Methods: Prospective case-control research of hCPM with goal-directed training versus merely goal-directed training. On the basis of goal-directed training, the hCPM group used the hip joint CPM instrument (the external fixator was connected to the power device to make the hip joint carry out continuous passive movement) for 40-60 min, twice a day, and five times a week, and received continuous training for 8 weeks simultaneously. The control group received only goal-directed training for 8 weeks. Functional outcomes pertaining to the affected hip joints were assessed via gross motor function measure (GMFM), migration percentage (MP), acetabular index (AI), and Harris hip functional score (HHS) at the time of enrollment and the end of the intervention.

Results: The case-control research included 65 participants (mean age = 46.20 months, SD = 17.09 months; Gross Motor Function Grading System level: III = 41, IV = 24) who were randomly selected to either the hCPM (n = 45) or the control group (n = 20). No differences were found in baseline (acquisition phase) GMFM, MP, AI, or HHS (t = -1.720, P = 0.090; t* = 1.836, P* = 0.071; t# = -1.517, P# = 0.139; t* = -1.310, P* = 0.195; t# = -1.084, P# = 0.097; t = -1.041, P = 0.301). At the 8-week follow-up, GMFM, MP, AI, and HHS significantly improved over baseline in the hCPM group (hCPM group: t = 18.59, 20.172*, 40.291#, 16.820*, 32.900#, 28.081; P < 0.001). Between-group differences at 8-week follow-up times points favored the hCPM group for GMFM (t = -2.637, P = 0.011), MP (t* = 2.615, P* = 0.014; t# = 3.000, P# = 0.006), AI (t* = 2.055, P* = 0.044; t# = 2.223, P# = 0.030), HHS (t = -4.685, P < 0.001) (*: left side; #: right side).

Conclusion: Spastic cerebral palsy children with hip dysplasia achieved meaningful functional improvement after 8 weeks of goal-directed training with hCPM therapy.

Keywords: AI—acetabular index; GMFM—gross motor function measure; HHS—Harris hip functional score; MP—migration percentage; goal-directed; hCPM—hip continuous passive motion; hip continuous passive motion; hip dysplasia.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Consort flow diagram showing the flow of participants through the trial.
Figure 2
Figure 2
A child in hCPM group was undergoing hip continuous passive motion (Figure 2A was codirection hCPM therapy and Figure 2B was interaction hCPM therapy).
Figure 3
Figure 3
Calculation methods of MP and AI values in plain hip x-ray films. MP, migration percentage; AI, acetabular index.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Alberman E, Mutch L. Commentary on the revised versions of the definition and classification of cerebral palsy. Dev Med Child Neurol Suppl. (2007) 109:32. 10.1111/j.1469-8749.2007.tb12624.x - DOI - PubMed
    1. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J, et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. (2017) 171(9):897–907. 10.1001/jamapediatrics.2017.1689 - DOI - PMC - PubMed
    1. Novak I, Hines M, Goldsmith S, Barclay R. Clinical prognostic messages from a systematic review on cerebral palsy. Pediatrics. (2012) 130(5):e1285–312. 10.1542/peds.2012-0924 - DOI - PubMed
    1. Rosenbaum PL, Dan B. The continuing evolution of “cerebral palsy”. Ann Phys Rehabil Med. (2020) 63(5):387–8. 10.1016/j.rehab.2019.09.008 - DOI - PubMed
    1. Pruszczynski B, Sees J, Miller F. Risk factors for hip displacement in children with cerebral palsy: systematic review. J Pediatr Orthop. (2015) 36(8):829–33. 10.1097/BPO.0000000000000577 - DOI - PubMed

LinkOut - more resources