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The evidence-base for basic physical therapy techniques targeting lower limb function in children with cerebral
Inge Franki1, Kaat Desloovere, Josse De Cat
1Rehabilitation Sciences and Physiotherapy, Artevelde University College, Ghent University, Ghent, Belgium. inge.franki@ugent.be
Insights
This review found strength training shows promise for improving gait and motor function in children with cerebral palsy (CP). More research is needed on optimal training parameters for CP physical therapy.
Area of Science:
- Pediatric Physical Therapy
- Cerebral Palsy Research
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) affects children's motor function, necessitating effective physical therapy.
- Evidence-based guidelines are crucial for optimizing lower limb physical therapy in children with CP.
Purpose of the Study:
- To systematically review the effectiveness of basic lower limb physical therapy techniques for children with CP.
- To inform the development of clinical guidelines for evidence-based physical therapy planning in pediatric CP.
Main Methods:
- Literature search of 5 electronic databases (1995-2009).
- Evaluation of 83 studies using the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) framework.
- Assessment of evidence strength and study quality by three independent evaluators.
Main Results:
- Studies categorized into stretching, massage, strengthening, electrical stimulation, weight-bearing, balance, treadmill, and endurance training.
- Interventions targeting body function/structure levels showed limited impact on activity levels.
- Recent studies indicate Level II evidence for strength training improving gait and gross motor function.
Conclusions:
- Strength training demonstrates potential for enhancing gait and gross motor function in pediatric CP.
- Limited evidence exists regarding optimal intensity, duration, and frequency for therapeutic interventions.
Objective:
This systematic review provides an overview of the effectiveness of basic techniques used in lower limb physical therapy of children with cerebral palsy. It aims to support the development of clinical guidelines for evidence-based physical therapy planning for these children.
Data Sources And Study Selection:
A literature search in 5 electronic databases extracted literature published between January 1995 and December 2009. Studies were evaluated using the framework recommended by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM), which classifies outcomes according to the International Classification of Functioning, Disability and Health.
Data Extraction:
Three independent evaluators rated the strength of evidence of the effects according to the AACPDM levels of evidence classification, and the quality of the studies according to the AACPDM conduct score system.
Data Synthesis:
A total of 83 studies was selected and divided into categories (stretching, massage, strengthening, electrical stimulation, weight-bearing, balance-, treadmill- and endurance training). Interventions targeting problems at body function and structure level generally influenced this level without significant overflow to activity level and vice versa.
Conclusion:
The more recent studies evaluating strength training mainly demonstrated level II evidence for improved gait and gross motor function. There was limited evidence for specific information on intensity, duration and frequency of training.
