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Joint mobilization for children with central nervous system disorders: indications and precautions
1School of Rehabilitation Medicine, University of British Columbia, Vancouver, Canada.
Insights
This review examines joint mobilization for children with cerebral palsy, discussing its scientific basis, efficacy, and contraindications. It aims to guide clinicians on safe and effective application in pediatric central nervous system disorders.
Area of Science:
- Physical Therapy
- Pediatric Rehabilitation
- Neuroscience
Background:
- Clinicians are increasingly using joint mobilization for children with cerebral palsy.
- Understanding the scientific basis and efficacy of this technique is crucial for pediatric practice.
Purpose of the Study:
- To define joint mobilization and its rationales for adults with musculoskeletal disabilities.
- To review the efficacy, contraindications, and precautions of joint mobilization.
- To explore the application of joint mobilization in children with central nervous system disorders, including cerebral palsy.
Main Methods:
- Literature review of joint mobilization techniques and their scientific basis.
- Description of musculoskeletal development in typically developing children and those with spastic cerebral palsy.
- Analysis of indications and contraindications for joint mobilization in pediatric populations.
Main Results:
- Joint mobilization definitions, rationales, and efficacy in adults are discussed.
- Musculoskeletal development and specific considerations for children with cerebral palsy are outlined.
- Indications and contraindications for joint mobilization in pediatric neurodevelopmental disorders are presented.
Conclusions:
- Joint mobilization shows potential for pediatric cerebral palsy treatment, but requires careful consideration of developmental factors and contraindications.
- Further research is needed to establish reliability in assessing joint dysfunction and efficacy of joint mobilization in children.
- This review provides a foundation for evidence-based application of joint mobilization in pediatric rehabilitation.
Abstract:
Because clinicians are introducing joint mobilization into treatment programs for children with cerebral palsy, we felt that a review of the procedure and its scientific basis would be timely. The goals of the introductory section of this article are to define joint mobilization as it has been used for adults with musculoskeletal disabilities, to discuss various rationales for its effects, to describe contraindications and precautions for its use, and to discuss its efficacy as reported in the research literature. The latter part of the article deals with the use of joint mobilization for children with central nervous system (CNS) disorders. In an effort to understand precautions for the use of joint mobilization in children, musculoskeletal development will be described both for typically developing children and for children with spastic cerebral palsy. Indications for using joint mobilization techniques in children with spasticity will be outlined. Specific neurodevelopmental disabilities for which joint mobilization would be strongly contraindicated will be listed. Finally, future research directions in evaluating reliability of assessment of joint dysfunction and efficacy of joint mobilization in children will be discussed.