Intensive Psychomotor Rehabilitation on Cognitive Motor Abilities and Adaptive Capacity on Children With Polyhandicap

As secondary objectives, the study aims to:

• compare and evaluate the impact of this intensive care of rehabilitation of psychomotor vs. the standard care on:

• result of evaluation with Vineland Scale of adaptive behaviour at 6 months after randomization;
• result of evaluation with Brunet-Lézine Scale of developement at 12 months after randomization;
• the pain evaluation at 12 months after randomization;
• the durability of acquired cognitive-motor improvement at 6 months after the end of intervention (18 months after randomization);
• the quality of life of the patients' family or relatives at 12 months after randomization;
• the clinical global impressions and the quality of life for work for the long-term professional caregivers at 12 months after randomization.
• evaluate the tolerance of intensive care in psychomotor rehabilitation at 6 and 12 months after randomization.
• study the concordance between the Vineland scale and the Brunet-Lézine scale.

Inclusion criteria

• Children between 4 and 13 years;
• With polyhandicap defined by association of the 5 following criteria:

• Causal brain injury occurred before the age of 3 years
• Severe or deep mental deficiency as defined by IQ < 40, or no evaluable by the psychometric tests
• Motor impairment: para / tetraparesis, hemiparesis, ataxia, or extrapyramidal motor disorders
• Score of Gross Motor Function Classification System [Palisano 1997] is III, IV or V
• Score of Functional Independence Measure < 50;
• Hospitalization in a clinical setting participating to the study;
• Beneficiary of a social protection;
• Written consent signed by personnel holding parental authority or legal representative.

Exclusion criteria

• Patient with progressive encephalopathies including metabolic origin, epileptic, or neurodegenerative diseases;
• Planned to move in another clinical setting;
• Foreseeable difficulty in the following up in the study.