Related Experiment Video
Updated: May 19, 2026
Abdominal Massage to Improve Motor Dysfunction in Rats with Cerebral Palsy
Published on: August 11, 2023
Management of children with ambulatory cerebral palsy: an evidence-based review
1Divisions of Orthopaedic Surgery & Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada. unni.narayanan@sickkids.ca
Insights
This review examines evidence for treating ambulatory cerebral palsy (CP) in children. It covers spasticity management, orthopedic surgery, and gait analysis to improve mobility and function in children with CP.
Area of Science:
- Pediatric Orthopedics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) presents significant heterogeneity in pathophysiology and natural history.
- Effective interventions require understanding CP's complexities and defining clear management goals.
- Ambulatory CP necessitates tailored approaches to optimize musculoskeletal function.
Purpose of the Study:
- To review the best available evidence for musculoskeletal interventions in ambulatory cerebral palsy (CP).
- To contextualize intervention effectiveness by discussing CP definitions, classification, and natural history.
- To outline management goals and outcome measures for ambulatory CP.
Main Methods:
- Systematic review of current evidence on musculoskeletal interventions for ambulatory CP.
- Analysis of definitions, classification, and natural history of CP.
- Evaluation of outcome measures relevant to ambulatory CP management.
Main Results:
- Evidence reviewed for spasticity management (botulinum toxin A, selective dorsal rhizotomy).
- Effectiveness of multilevel orthopedic surgery for contractures and bony deformities assessed.
- Role of gait analysis in surgical decision-making for ambulatory CP highlighted.
Conclusions:
- Current evidence supports specific interventions for ambulatory CP, including spasticity management and surgery.
- Gait analysis is crucial for informed surgical planning in ambulatory CP.
- Further research is needed to refine interventions and outcome measures for pediatric CP.
Abstract:
This article reviews the current best evidence for musculoskeletal interventions in children with ambulatory cerebral palsy (CP). The effectiveness of interventions in CP must first consider what CP and its associated pathophysiology are and take into account the heterogeneity and natural history of CP to put definitions of "effectiveness" into perspective. This article reviews the current standards of the definition and classification of CP, discusses the natural history and specific goals for the management of ambulatory CP, as well as the outcome measures available to measure these goals. The current best evidence of effectiveness is reviewed for specific interventions in children with ambulatory CP including spasticity management with botulinum toxin A injections and selective dorsal rhizotomy; multilevel orthopaedic surgery to address contractures and bony deformity; and the role of gait analysis for surgical decision-making before orthopaedic surgery.
