Sunday, 22 March 2009

Mystery research report on CE and ataxia

More research still needed...

Google Alerts has just slipped me the following link, a (to me) unknown research report, undated and unreferenced:


There is no indication of where this comes from but I do rather suspect from the content, scale and style that it might hail from mainland China (I could be very wrong here). It is part of a blog-format site, Cerebral palsy: all the info about children with cerebral palsy, very technical and already very extensive despite having apparently only just opened. Any help in identifying its source would be much appreciated.

There seems to have been a further technical item (or maybe two) on CE on that site, back on 2 March, but Iwas led into a blind cyber-alley and my Chimerical quarry vanished. Maybe those with more time and patience might be luckier.

Meanwhile the following piece of apparently scientific whizzdingery is up there in Cyberspace, part of that ‘more research’, that, I am so often told, is always needed.

This is what it says, in its entirety:

[Effect of conductive education combined with Frenkel training on balance disability in children with cerebral palsy.]

OBJECTIVE: To study the efficacy of conductive education combined with Frenkel training in the improvement of balance function in children with cerebral palsy.

METHODS: One hundred and fifteen children with cerebral palsy were randomly administered with conductive education and Frenkel training (study group, n=60) or conventional training (control group, n=55). Activities of daily living (ADL) scale and gross motor function measurement (GMFM) of physical performances were used to assess the balance function.

RESULTS: The scores of ADL scale and GMFM of physical performances in both the study and the control groups increased after training. The study group showed higher scores of ADL scale (37.91+/-10.12 vs 34.18+/-6.13; p<0.05)>

CONCLUSIONS: Conductive education combined with Frenkel training is more effective for the improvement of balance function in children cerebral palsy.

Very interesting.

Question 1. What is ‘Frenkel training’? As far as I can tell it comprises ‘exercises’ for balance, and has therefore been provided for children with ataxia:

To clear an immediate possible source of confusion out of the way, this is not Viktor Frankl. We must I guess wait a little longer, till Franz Schaffhausser’s new graduate conductors come off stream, before we see Conductive Education combined with Frankl, and very interesting that will be too.

This is your man, and the book by which he was known in the English-speaking world:

The treatment of tabetic ataxia by means of systematic exercise
Heinrich S. Frenkel and L. Freyberger
P. Blakiston's Son & Co., 1902, second edition 1917
(Freyberger translated it into English.)

I am not sympathetic to those would-be academics who decry ‘old references‘, and I am not alone in this with respect to Heinrich Frenkel:


I see that there are currently a couple of copies of the book floating around in the antiquarian book system (each at over a hundred pounds sterling), and the National Library of Scotland has one too…

Conductive Education

Just please nobody say that I have written that CE is based on Frenkel! I have no idea whether there are any links, theoretical or practical.

On the other hand, students of the history of medicine and medical ideas may one day like to see what influence the approach of the Swiss Frenkel had in Central Europe upon physicians dealing with chronic disease. All that movement… hmm. I have never heard Frenkel’s name mentioned in respect to the prehistory of what has become Conductive Education but then I have not been looking out for it and, anyway, all this is so very far outside my field of competence. I have to leave it gratefully to others to follow through.

More practically, those who are concerned with ataxic children might care to have a look at the ‘Frenkel exercises’ that have come down into common wisdom, such as this example from the National Ataxia Foundation in the US:

http://www.ataxia.org/pdf/Frenkel.pdf

‘Exercises’ of themselves of course will not teach a child anything (other perhaps than an attitude towards exercises!). I do wonder what Frenkel himself had to say about this. Within an appropriate context and towards an appropriate goal, however, such tasks might help create useful pedagogic tools. What do conductors say of those outlined above by the National Ataxia Foundation?

There is remains an inportant question about the research study that prompted this item. This is not the (minor?) query of whether the researchers really had adopted appropriate measuring tools for the outcome of ‘balance‘. More fundamentally, I have just argued here about possibly including, within the necessary motivating and sense-granting context of conductive pedagogy, certain movements apparently representing something of the work of Frankel (past experience and well-honed caution always have me include the caveat ’allegedly’). It looks at face value like this is what is reported in my mystery article.

Question 3. Unfortunately, the summary provided offers no assurance that there was one iota of conductive pedagogy present. Scientific standards demand something a little deeper than ’37.91+/-10.12 vs 34.18+/-6.13; p<0.05)’

As stated before on these pages, long before competent researchers get that far, they should have paid attention to manualisation, to defining/specifying precisely what it is that they are doing in the first place under the rubric of 'Conductive Education'. Just what was it that 60 chidren in the study group did, with whom, under what circumstances, when they were 'randomly administered with conductive education'?

Might this have everything to do with us, or nothing? We should be told, or at least be provided with easier acess to finding out.

Note

3 comments:

  1. "randomly administered with conductive education". Isn't that wonderful?

    Thankfully, my own education at Ilford County High School was not "randomly administered", other than to the extent I was not where I was supposed to be when I was supposed to be there!

    I guess that makes it an "electively randomly administered" education?

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  2. To be absolutely fair, this is only a Summary, written in the style of such things which is wholly appropraie in the proper context.

    Unfortumate;y here,the proper context would be for the reader to be able to follow uo on the Summary and read the article itself. This I was unable to do, but I would like to reiterate how much I should appreciate it if somebody could write in and tell me how...

    Authors/publishers surely have some sort of responsibilities towards the publicatoon of their work which go beyond teasing with it. These responsibilities are owed to their own hard work, to the people whose hard work they are describing, and to readers who might wish to work further with what they have read to integrate it into the wider field of knowledge.

    None of these responsibilities have been discharged by the way in whic this Summary has been uncaringly tossed into Cyberspace, as a 'meaningless' commodity. It has been rendered academically unuseable.

    The full report of this study might be deeply humane, and really facinating both practically and theoretically. As things stand, however, unless I have missed something glaringly obvious (it happens!) we cannot know!

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  3. Andrew,
    I don't know why this Blog jumped into my mail today. I thought it is a new Blog and made a search in the PUBMED. These are the results, which our colleagues from HK might help us better understand:

    Zhongguo Dang Dai Er Ke Za Zhi. 2009 Mar;11(3):207-9.
    [Effect of conductive education combined with Frenkel training on balance disability in children with cerebral palsy]
    [Article in Chinese]
    Yang L, Wu D, Tang JL, Jin L, Li XY.
    Pediatric Neurology Rehabilitation Center, First Hospital Affiliated to Anhui Medical University, Hefei 230022, China.
    Abstract
    OBJECTIVE: To study the efficacy of conductive education combined with Frenkel training in the improvement of balance function in children with cerebral palsy.
    METHODS: One hundred and fifteen children with cerebral palsy were randomly administered with conductive education and Frenkel training (study group, n=60) or conventional training (control group, n=55). Activities of daily living (ADL) scale and gross motor function measurement (GMFM) of physical performances were used to assess the balance function.
    RESULTS: The scores of ADL scale and GMFM of physical performances in both the study and the control groups increased after training. The study group showed higher scores of ADL scale (37.91+/-10.12 vs 34.18+/-6.13; p<0.05)and GMFM (62.93+/-15.00 vs 54.53+/-14.11) than the control group (p<0.05).
    CONCLUSIONS: Conductive education combined with Frenkel training is more effective for the improvement of balance function in children cerebral palsy.

    ReplyDelete