Activity training on the ground in children with cerebral palsy: Systematic review and meta-analysis

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Neurology

Background:

• Cerebral palsy (CP) affects motor function in children, impacting their daily activities and participation.
• Activity-based therapies are crucial for improving functional outcomes in children with CP.
• Ground-based activity training is a common intervention, but its efficacy requires systematic evaluation.

Purpose of the Study:

• To systematically review evidence on the effectiveness of ground-based activity training for activity and participation in children with cerebral palsy.
• To synthesize findings from randomized controlled trials (RCTs) to determine the impact of this intervention.

Main Methods:

• Systematic review of RCTs involving children (≤18 years) with cerebral palsy.
• Included interventions: ground-based activity training alone or combined with other physiotherapy.
• Analyzed outcomes related to activity and participation as defined by the International Classification of Functioning, Disability, and Health (ICF).

Main Results:

• Nine RCTs with 257 participants were included.
• Meta-analysis indicated no significant difference between ground-based activity training and no intervention (SMD: 0.18; CI: -1.49 to 1.86).
• No significant difference was found when compared to other therapies (SMD: -0.09; CI: -0.86 to 0.69) or in a single study combining it with other physiotherapy (SMD: -0.18; CI: -0.89 to 0.54).

Conclusions:

• Current evidence suggests minimal effectiveness of ground-based activity training for enhancing activity or participation in children with cerebral palsy.
• The review highlights the need for more rigorous trials with larger sample sizes and increased intervention 'dosage'.
• Future research should focus on optimizing ground-based activity training protocols for this population.