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Effect of physical therapy interventions on spatiotemporal gait parameters in children with cerebral palsy: a
Carolina Corsi1,2, Mariana M Santos1, Roberta F C Moreira1
1Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
Insights
Physical therapy interventions like vibratory platform training and gait training can improve spatiotemporal gait parameters in children with cerebral palsy. Isolated strength training was not effective, and long-term effects remain unclear.
Area of Science:
- Rehabilitation Medicine
- Pediatric Physical Therapy
- Movement Science
Background:
- Cerebral palsy (CP) significantly impacts motor function, particularly gait.
- Improving spatiotemporal gait parameters is crucial for functional mobility in children with CP.
- Current rehabilitation strategies require evidence-based optimization.
Purpose of the Study:
- To systematically review the efficacy of physical therapy interventions on spatiotemporal gait parameters in children with cerebral palsy.
- To synthesize evidence regarding various therapeutic approaches for gait improvement in pediatric CP.
Main Methods:
- A comprehensive literature search was conducted across six major databases.
- Randomized controlled trials were selected by two independent reviewers.
- Data extraction and quality assessment (PEDro Scale) were performed, with evidence synthesized using GRADE.
Main Results:
- Twenty-six studies evaluated interventions including electrical stimulation, gait training, and vibratory platform training.
- Moderate evidence supports vibratory platform training, gait training, and transcranial stimulation for improving gait velocity.
- Moderate evidence suggests electrical stimulation improves stride length; isolated strength training showed negative effects on gait velocity.
Conclusions:
- Vibratory platform, gait training, electrical stimulation, and transcranial stimulation demonstrate effectiveness in enhancing spatiotemporal gait parameters, particularly gait velocity, in children with CP.
- Isolated strength training is not recommended for improving gait parameters in this population.
- Further research is needed to clarify the long-term effects of these interventions.
Aim:
To investigate the effect of physical therapy interventions on spatiotemporal gait parameters in children with cerebral palsy.
Methods:
Six databases were searched: PubMed, Embase, Web of Science, Science Direct, Lilacs, and Scopus. Two independent reviewers worked on primary study selection based on titles, abstracts, and full text reading. We included randomized controlled trials investigating the role of therapeutic interventions on gait kinematics in children with cerebral palsy. The independent reviewers extracted information about study population, intervention type, main outcomes, and methodological quality according to PEDro Scale. The body of evidence was synthesized through GRADE.
Results:
Twenty-six studies were found addressing the following treatment categories: functional electrical stimulation, transcranial stimulation, gait training, muscular strengthening, vibratory platform training, and serial casting. A moderate level of evidence was identified for vibratory platform training, gait training, transcranial stimulation (positive effect), and isolated muscle strengthening (negative effect) in relation to gait velocity. Electrical stimulation showed a moderate level of evidence regarding stride length. The evidence for other outcomes was of low or very low quality.
Conclusion:
Vibratory platform, gait training, electrical stimulation, and transcranial stimulation were effective to improve spatiotemporal gait parameters, especially velocity in children with cerebral palsy.Implication for rehabilitationImprovement and maintenance of gait of children with cerebral palsy is a great challenge to rehabilitation professionalsVibratory platform, gait training, electrical stimulation, and transcranial stimulation improve gait parameters.Isolated strength training was not effective to improve gait parameters in Cerebral Palsy.Long-term effect of most techniques on gait parameters until unclear.
