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How does the intensity of physical therapy affect the Gross Motor Function Measure (GMFM-66) total score in children
Mary Rahlin1, Burris Duncan2, Carol L Howe3
1Department of Physical Therapy, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA Mary.Rahlin@rosalindfranklin.edu.
Insights
This systematic review examines physical therapy intensity for children with cerebral palsy (CP). It assesses the Gross Motor Function Measure-66 (GMFM-66) scores based on intervention intensity, type, age, and classification level.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Evidence-Based Practice
Background:
- Intensive physical therapy (PT) for children with cerebral palsy (CP) is widely studied.
- Optimal PT intervention dosing and intensity lack clear definition in current literature.
- Clinicians need evidence-based guidance for effective CP management.
Purpose of the Study:
- To systematically review the Gross Motor Function Measure-66 (GMFM-66) change scores in relation to PT intervention intensity.
- To explore the influence of PT type, child's age, and Gross Motor Function Classification System (GMFCS) level on GMFM-66 outcomes.
Main Methods:
- Systematic review protocol based on PRISMA-P 2015 guidelines.
- Comprehensive search of nine databases for relevant clinical trials and single-subject studies.
- Independent review and consensus-based selection of studies using GMFM-66 for children with CP (up to 18 years).
Main Results:
- Data extraction will focus on GMFM-66 scores correlated with PT intervention intensity.
- Analysis will investigate how intervention type, patient age, and GMFCS level impact GMFM-66 outcomes.
- Updated searches will ensure comprehensive data inclusion.
Conclusions:
- This review aims to clarify the relationship between PT intensity and functional outcomes in children with CP.
- Findings will inform clinical practice by providing evidence on optimal intervention parameters.
- Dissemination through peer-reviewed publication and conference presentations is planned.
Introduction:
Intensive physical therapy (PT) interventions administered to children with cerebral palsy (CP) have received a significant amount of attention in published literature. However, there is considerable variability in therapy intensity among studies and notable lack of information on optimal intervention dosing. This makes it difficult for clinicians to use evidence to inform practice. Many studies use the Gross Motor Function Measure (GMFM-66) to assess functional progress in children with CP. The purpose of this systematic review will be to identify the GMFM-66 change score reported in published studies, with outcomes based on intervention intensity. Whether the type of PT intervention, child's age, and Gross Motor Function Classification System level influence the GMFM-66 scores will be also assessed.
Methods And Analysis:
This systematic review protocol was developed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) 2015 checklist. In March 2018, nine databases (PubMed, Ovid MEDLINE, Cochrane Library, Embase, Scopus, Web of Science, CINAHL, ClinicalTrials.gov, and REHABDATA) were searched for controlled clinical trials and single-subject design studies of PT interventions of any kind and intensity that used the GMFM-66 as an outcome measure for children with CP, age up to 18 years. Two authors independently reviewed the titles and abstracts and arrived at consensus on paper selection for a full-text review. The same process was used for a full-text article screening based on further detailed inclusion criteria, with a final selection made for those suitable for data extraction. Prior to commencement of data extraction, all searches will be updated, and new results re-screened.
Ethics And Dissemination:
This study will involve a systematic review of published articles and no primary data collection. Therefore, no ethical approval will be necessary. Results will be disseminated in a peer-reviewed publication and presented at scientific conferences.
Prospero Registration Number:
CRD42020147669.
