Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-15T13:23:17.588Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluating the Effects of Performance-Focused Swimming Training on People with Cerebral Palsy Who Have High Support Needs – A Study Protocol Using Single-Case Experimental Design

Published online by Cambridge University Press:  05 July 2019

I. M. Dutia ,
M. J. Connick ,
E. M. Beckman ,
L. M. Johnston ,
P. J. Wilson ,
A. Macaro  and
S. M. Tweedy
I. M. Dutia*
Affiliation:
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
M. J. Connick
Affiliation:
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
E. M. Beckman
Affiliation:
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
L. M. Johnston
Affiliation:
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
P. J. Wilson
Affiliation:
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
A. Macaro
Affiliation:
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
S. M. Tweedy
Affiliation:
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
*
*Corresponding author. Email: [email protected]
Get access

Abstract

Background:

People with cerebral palsy (CP) are less physically active than the general population and, consequently, are at increased risk of preventable disease. Evidence indicates that low-moderate doses of physical activity can reduce disease risk and improve fitness and function in people with CP. Para athletes with CP typically engage in ‘performance-focused’ sports training, which is undertaken for the sole purpose of enhancing sports performance. Anecdotally, many Para athletes report that participation in performance-focused sports training confers meaningful clinical benefits which exceed those reported in the literature; however, supporting scientific evidence is lacking. The aim of this paper is to describe the protocol for an 18-month study evaluating the clinical effects of a performance-focused swimming training programme for people with CP who have high support needs.

Methods:

This study will use a concurrent multiple-baseline, single-case experimental design across three participants with CP who have high support needs. Each participant will complete a five-phase trial comprising: baseline (A1); training phase 1 (B1); maintenance phase 1 (A2); training phase 2 (B2); and maintenance phase 2 (A3). For each participant, measurement of swim velocity, health-related quality of life and gross motor functioning will be carried out a minimum of five times in each of the five phases.

Discussion:

The study described will produce Level II evidence regarding the effects of performance-focused swimming training on clinical outcomes in people with CP who have high support needs. Findings are expected to provide an indication of the potential for sport to augment outcomes in neurological rehabilitation.

Keywords

Cerebral palsyfunctionhealthPara sportsport
Type
Research Protocol
Information
Brain Impairment , Volume 21 , Issue 2 , September 2020 , pp. 217 - 234
Copyright
© Australasian Society for the Study of Brain Impairment 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arem, H., Moore, S. C., Patel, A., Hartge, P., de Gonzalez, A. B., Visvanathan, K., … Matthews, C. E. (2015). Leisure time physical activity and mortality a detailed pooled analysis of the dose-response relationship. JAMA Internal Medicine, 175(6), 959–967.CrossRefGoogle ScholarPubMed
Avery, L. M., Russell, D. J., & Rosenbaum, P. L. (2013). Criterion validity of the GMFM‐66 item set and the GMFM‐66 basal and ceiling approaches for estimating GMFM‐66 scores. Developmental Medicine & Child Neurology, 55(6), 534–538.CrossRefGoogle ScholarPubMed
Banister, E. W., Carter, J. B., & Zarkadas, P. C. (1999). Training theory and taper: Validation in triathlon athletes. European Journal of Applied Physiology and Occupational Physiology, 79(2), 182–191.CrossRefGoogle ScholarPubMed
Bar-Haim, S., Harries, N., Nammourah, I., Oraibi, S., Malhees, W., Loeppky, J., … Lahat, E. (2010). Effectiveness of motor learning coaching in children with cerebral palsy: A randomized controlled trial. Clinical Rehabilitation, 24(11), 1009–1020.CrossRefGoogle ScholarPubMed
Bax, M., Goldstein, M., Rosenbaum, P., Leviton, A., Paneth, N., Dan, B., … Damiano, D. (2005). Proposed definition and classification of cerebral palsy, April 2005. Developmental Medicine & Child Neurology, 47(08), 571–576.CrossRefGoogle ScholarPubMed
Beckung, E., & Hagberg, G. (2002). Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Developmental Medicine & Child Neurology, 44(5), 309–316.CrossRefGoogle ScholarPubMed
Carlon, S. L., Taylor, N. F., Dodd, K. J., & Shields, N. (2013). Differences in habitual physical activity levels of young people with cerebral palsy and their typically developing peers: A systematic review. Disability and Rehabilitation, 35(8), 647–655.CrossRefGoogle ScholarPubMed
Clutterbuck, G., Auld, M., & Johnston, L. (2018). Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy: A systematic review. Disability and Rehabilitation, 18(1), 1–21.Google Scholar
Coakley, J. J. (2015). Sports in society: Issues and controversies (11th ed.). New York, NY: McGraw-Hill Education.Google Scholar
Foster, C. (1998). Monitoring training in athletes with reference to overtraining syndrome. Medicine & Science in Sports & Exercise, 30(7), 1164–1168.CrossRefGoogle ScholarPubMed
Fragala‐Pinkham, M., O′Neil, M. E., Lennon, N., Forman, J. L., & Trost, S. G. (2015). Validity of the OMNI rating of perceived exertion scale for children and adolescents with cerebral palsy. Developmental Medicine and Child Neurology, 57(8), 748–753.CrossRefGoogle ScholarPubMed
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., … Swain, D.P. (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Medicine & Science in Sports & Exercise, 43(7), 1334–1359.CrossRefGoogle ScholarPubMed
Genner, M. K., & Weston, M. M. (2014). A comparison of workload quantification methods in relation to physiological responses to resistance exercise. Journal of Strength and Conditioning Research, 28(9), 2621–2627.CrossRefGoogle ScholarPubMed
Gillett, J. G., Lichtwark, G. A., Boyd, R. N., & Barber, L. A. (2015). FAST CP: Protocol of a randomised controlled trial of the efficacy of a 12-week combined Functional Anaerobic and Strength Training programme on muscle properties and mechanical gait deficiencies in adolescents and young adults with spastic-type cerebral palsy. BMJ Open, 5(6), 1–16.CrossRefGoogle Scholar
Gorter, J. W., & Currie, S. J. (2011). Aquatic exercise programs for children and adolescents with cerebral palsy: What do we know and where do we go? International Journal of Pediatrics, 2011, Article ID 712165.CrossRefGoogle Scholar
Hitchcock, J. H., Kratochwill, T. R., & Chezan, L. C. (2015). What works clearinghouse standards and generalization of single-case design evidence. Journal of Behavioral Education, 24(4), 459–469.CrossRefGoogle Scholar
Howard, J., Soo, B., Graham, H. K., Boyd, R. N., Reid, S., Lanigan, A., … Reddihough, D. S. (2005). Cerebral palsy in Victoria: Motor types, topography and gross motor function. Journal of Paediatrics and Child Health, 41(9–10), 479–483.CrossRefGoogle ScholarPubMed
Huitema, B. E. (1980). The analysis of covariance and alternatives / Bradley E. Huitema. New York, NY: Wiley.Google Scholar
Ketelaar, M., Vermeer, A., Hart, H. V. P.-V. B., & Helders, P. J. M. (2001). Effects of a functional therapy program on motor abilities of children with cerebral palsy. (Statistical Data Included). Physical Therapy, 81(9), 1534.CrossRefGoogle Scholar
Krupp, L. B., LaRocca, N. G., Muir-Nash, J., & Steinberg, A. D. (1989). The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46(10), 1121–1123.CrossRefGoogle ScholarPubMed
Logan, L. R., Hickman, R. R., Harris, S. R., & Heriza, C. B. (2008). Single-subject research design: Recommendations for levels of evidence and quality rating. Developmental Medicine and Child Neurology, 50(2), 99–103.CrossRefGoogle Scholar
Lundberg, A., Ovenfors, C. O., & Saltin, B. (1967). Effect of physical training on school‐children with cerebral palsy. Acta Pædiatrica, 56(2), 182–188.CrossRefGoogle ScholarPubMed
Nikles, J., Nikles, J., & Mitchell, G. (2015). The essential guide to N-of-1 trials in health (1st ed.). Dordrecht: Springer Netherlands. Imprint: Springer.CrossRefGoogle Scholar
OCEBM Levels of Evidence Working Group. (2011). The Oxford 2011 Levels of Evidence. “The Oxford Levels of Evidence 2”. Oxford Centre for Evidence-Based Medicine. https://www.cebm.net/index.aspx?o=5653. Last accessed 26/06/2019.Google Scholar
Opheim, A., Jahnsen, R., Olsson, E., & Stanghelle, J. K. (2009). Walking function, pain, and fatigue in adults with cerebral palsy: A 7-year follow-up study. Developmental Medicine and Child Neurology, 51(5), 381–388.CrossRefGoogle ScholarPubMed
Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galuppi, B. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine & Child Neurology, 39(4), 214–223.CrossRefGoogle ScholarPubMed
Powell, K. E., Paluch, A. E., & Blair, S. N. (2011). Physical activity for health: What kind? How much? How intense? On top of what? Annual Review of Public Health, 32, 349–365.CrossRefGoogle Scholar
Retarekar, A. R., Fragala-Pinkham, L. M., & Townsend, L. E. (2009). Effects of aquatic aerobic exercise for a child with cerebral palsy: Single-subject design. Pediatric Physical Therapy, 21(4), 336–344.CrossRefGoogle ScholarPubMed
Roostaei, M., Baharlouei, H., Azadi, H., & Fragala-Pinkham, M. A. (2017). Effects of aquatic intervention on gross motor skills in children with cerebral palsy: A systematic review. Physical and Occupational Therapy in Paediatrics, 37(5), 496–515.CrossRefGoogle ScholarPubMed
Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., & Bax, M. (2007). A report: The definition and classification of cerebral palsy - April 2006. Developmental Medicine and Child Neurology, 49, 8–14.Google Scholar
Ryan, J. M., Allen, E., Gormley, J., Hurvitz, E. A., & Peterson, M. D. (2018). The risk, burden, and management of non-communicable diseases in cerebral palsy: A scoping review. Developmental Medicine and Child Neurology, 60(8), 753–764.CrossRefGoogle ScholarPubMed
Saris, W., Baak, V. M., Berg-Emons, V. D. R., & Speth, L. (1998). Physical training of school children with spastic cerebral palsy: Effects on daily activity, fat mass and fitness. International Journal of Rehabilitation Research, 21(2), 179–194.Google Scholar
Scott, B. R., Duthie, G. M., Thornton, H. R., & Dascombe, B. J. (2016). Training monitoring for resistance exercise: Theory and applications. Sports Medicine, 46(5), 687–698.CrossRefGoogle ScholarPubMed
Shadish, W., & Sullivan, K. (2011). Characteristics of single-case designs used to assess intervention effects in 2008. Behavior Research Methods, 43(4), 971–980.CrossRefGoogle ScholarPubMed
Shinohara, T., Suzuki, N., Oba, M., Kawasumi, M., Kimizuka, M., & Mita, K. (2002). Effect of exercise at the AT point for children with cerebral palsy. Bulletin: Hospital for Joint Diseases, 61(1–2), 63–67.Google ScholarPubMed
Snyder, A. R., Valovich McLeod, T. C., & Sauers, E. L. (2007). Defining, valuing, and teaching clinical outcomes assessment in professional and post-professional athletic training education programs. Athletic Training Education Journal, 2(2), 31–41.CrossRefGoogle Scholar
Størvold, G. V., & Jahnsen, R. (2010). Intensive motor skills training program combining group and individual sessions for children with cerebral palsy. Pediatric Physical Therapy, 22(2), 150–159.CrossRefGoogle ScholarPubMed
Stubbs, P. W., & Diong, J. (2016). The effect of strengthening interventions on strength and physical performance in people with cerebral palsy (PEDro synthesis). British Journal of Sports Medicine, 50(3), 189–190.CrossRefGoogle Scholar
Tate, R. L. (2015). The Risk of Bias in N-of-1 Trials (RoBiNT) scale: An expanded manual for the critical appraisal of single-case reports. St Leonards NSW: John Walsh Centre for Rehabilitation Research.Google Scholar
Tweedy, S. M., Beckman, E. M., Johnston, L. M., & Connick, M. J. (2016). Performance-focussed sport – An avenue to gold-medal clinical outcomes for people with neurological impairments? Brain Impairment, 17(01), 99–110.CrossRefGoogle Scholar
Varni, J. W., Burwinkle, T. M., Berrin, S. J., Sherman, S. A., Ba, K. A., Malcarne, V. L., & Chambers, H. G. (2006). The PedsQL in pediatric cerebral palsy: Reliability, validity, and sensitivity of the Generic Core Scales and Cerebral Palsy Module. Developmental Medicine & Child Neurology, 48(6), 442–449.CrossRefGoogle ScholarPubMed
Varni, J. W., Burwinkle, T. M., Sherman, S. A., Hanna, K., Berrin, S. J., Malcarne, V. L., & Chambers, H. G. (2005). Health-related quality of life of children and adolescents with cerebral palsy: Hearing the voices of the children. Developmental Medicine and Child Neurology, 47(9), 592–597.CrossRefGoogle ScholarPubMed
Varni, J. W., Seid, M., & Rode, C. A. (1999). The PedsQL: Measurement model for the pediatric quality of life inventory. Medical Care, 37(2), 126.CrossRefGoogle ScholarPubMed
Verschuren, O., Peterson, M. D., Balemans, A. C. J., & Hurvitz, E. A. (2016). Exercise and physical activity recommendations for people with cerebral palsy. Developmental Medicine & Child Neurology, 58(8), 798–808.CrossRefGoogle ScholarPubMed
Ware, J. E., Kosinski, M., & Gandek, B. (2000). SF-36 Health Survey: Manual & interpretation guide. Lincoln, RI: QualityMetric.Google Scholar
World Health Organisation. (2013). Global Recommendations on Physical Activity for Health. Available: https://www.who.int/dietphysicalactivity/factsheet_recommendations/en/. Last accessed 26th June 2019.Google Scholar
Supplementary material: File

Dutia et al. supplementary material

Dutia et al. supplementary material 1

Download Dutia et al. supplementary material(File)
File 17.7 KB