Case report: training neck and head control in children with chronic paralysis due to acute ﬂaccid myelitis

Front. Rehabil. Sci., 2023 · DOI: 10.3389/fresc.2023.1063724 · Published: May 19, 2023

Simple Explanation

This case series explores whether children with AFM can regain head control through activity-based restorative therapies (ABRTs). These therapies are guided by principles aimed at improving motor control. Three children with AFM, aged 6, 9, and 7, participated in an outpatient program that focused on activating the neuromuscular system. All three children initially lacked head control. The study showed that a structured approach, progressing from full support to independent control, helped the children improve their head control during various activities.

Study Duration

Not specified

Participants

Three children with chronic paralysis due to AFM

Evidence Level

Level 4: Case Series

Key Findings

1
Children with SCI and chronic paralysis due to AFM can begin to develop head control through a multiphase approach when paired with activity-based restorative therapies.
2
Patients progressed from having no head control to maintaining midline head positioning with and without trunk support.
3
Two of the three patients achieved independent head control in static standing.

Research Summary

This case series presents proof of concept for the application of interventions targeting pre-injury neuromuscular head control. Each patient progressed in head control; however, patients who returned for further ABRT continued to improve head control. All three children arrived using passive head support or compensatory positioning...Both passive and compensatory positioning were not consistent with functioning head and neck control posture for communication, visual engagement, eating, mobility, and other daily activities.

Practical Implications

Therapeutic Intervention

Head control may be a key element worthy of revisiting via therapeutic, activity-based restorative efforts in chronic AFM patients.

Clinical Practice

Healthcare professionals may assume that children have met full recovery in the chronic stages of AFM, however this study shows gains can still be made.

Assessment Tool

The SATCo could be expanded to include the assessment of head control.

Study Limitations

1
Gaps in sensitive and responsive measurement instruments
2
Gaps in treatment technologies persist in guiding assistance
3
Small sample size

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