Physiotherapy for children with cerebral palsy. Evidence for its efficacy

Physiotherapy is currently the most popular therapeutic intervention for cerebral palsy. This therapy requires highly trained personnel, diverse equipment, and parental cooperation. Notwithstanding the expense and commitment required for the implementation of a therapeutic program, a computer search of the literature published in English during the past 15 years revealed only nine studies pertaining to the efficacy and no study addressing the effectiveness of this intervention. A critical review of this literature, employing 14 methodological and reporting criteria, revealed that only three studies adequately fulfilled nine of the criteria; the remaining studies used a less rigorous design. Of those three articles, two used statistical analysis and concluded that the results were negative, while the third utilized clinical analysis only and demonstrated positive results. Evidence for the usefulness of this therapy has yet to be demonstrated; with the presently available methodologies it is ethically imperative to institute a properly designed, collaborative, multicenter, randomized, controlled trial.