Case report: training neck and head control in children with chronic paralysis due to acute flaccid myelitis.
Kathryn Noonan-Eaton, Danielle Stout, MacKenzie Goode-Roberts and 3 others
PMID 37275404WHAT IT FOUND
Three children with chronic paralysis from acute flaccid myelitis gained head control through intensive activity-based therapy.
They progressed from needing passive head support to holding their heads upright for one to two minutes. This shows recovery is possible, but does not prove the treatment works for others.
Key findings
01All three patients achieved independent head control in sitting for an average of 1 to 2 minutes consecutively.
02Two of the three patients achieved independent head control in static standing.
03The therapy involved 3 hours of activity-based restorative therapies delivered by physical and occupational therapists 5 days a week.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a case series of only three patients, so the results cannot be generalized to all children with AFM. There was no control group, so it is impossible to determine if the improvements were due to the specific ABRT intervention or natural recovery or other concurrent therapies. The patients received multiple concurrent treatments (locomotor training, electrical stimulation, manual facilitation, and various supports), making it impossible to isolate which component caused the head control gains. The study did not include a standardized assessment specifically for head control, relying instead on modifications of trunk control measures. Long-term retention of gains was not reported beyond the final evaluation sessions.
Declared interests
Funding for the center was provided by Kosair Charities. The authors did not declare specific personal conflicts of interest related to the devices used, but the study was conducted at a center funded by a charitable organization.
The easy way to misread this
Do not assume that activity-based restorative therapy will restore head control in all children with chronic AFM. This report describes improvements in three specific individuals without a control group, so the effect cannot be separated from natural recovery or other concurrent treatments.