Evidence-based Approach to Physical Therapy in Cerebral Palsy

Abstract

Physiotherapy plays a key role in the management of cerebral palsy (CP) and comprises of various therapeutic interventions in enhancing the various physiological and functional outcomes. Though physiotherapy is used widely and recommended by all members of the health-care team, the effectiveness of physiotherapy is inconsistent. The objective of this review was to summarize and evaluate the effectiveness of physiotherapy interventions in children with CP. PubMed and Cochrane database were searched from January 2006 to April 2017 using the Medical Subject Heading and general keywords. Only systematic reviews and meta-analysis on PT interventions in children diagnosed with CP were included. Two reviewers independently assessed the methodological quality and retrieved the results. Thirty-four systematic reviews were identified that distinguished 15 different interventions. Moderate evidence of effectiveness was found for constraint-induced movement therapy for upper limb recovery, goal-directed/functional training, and gait training to improve gait speed. Conflicting evidence was found for the role of exercises on strength training and cardiorespiratory training. Intervention such as neurodevelopmental therapy (NDT) was found ineffective. This review suffer from limitations such as including reviews that had small sample size and that had considered heterogeneity of treatment interventions. Hence, the effectiveness of most PT interventions is found to be limited. On the basis of the present evidence, functional goal-oriented approaches are found to be effective and future research is required to determine the best ways to improve functional outcomes in children with CP.

Assessment of the Different Modalities of Treatment in Paediatric Cerebral Palsy Patients

“…Physical therapy equipment power and elasticity exercises, heat treatment, massages and special gear to give children with cerebral palsy more autonomy. [14,15] The degree to which physical therapy assists depends on the severity and form of every case of cerebral palsy. Children with milder cases of CP may simply need some physical therapy to treat their situation.…”

Effects of the Combination of Music Therapy and Physiotherapy in the Improvement of Motor Function in Cerebral Palsy: A Challenge for Research

“…Physical therapy (PT) plays a key role in its treatment through several therapeutic interventions that achieve improved physiological and functional outcomes [4]. Based on recent evidence, current goal-oriented functional approaches are considered effective, although more research is needed to determine the best ways to achieve even more improved functional outcomes in children with CP [5]. Music therapy (MT) might be a new avenue that, in combination with PT, would help to improve motor function in patients with CP [6,7].…”

Efficacy of axial TheraTogs on gait pattern in children with dyskinetic cerebral palsy: a randomized controlled trial

“…The designed exercise protocol is used to encourage adjustment and repositioning of skeletal segments which in turn produce static posture realignment. It has been reported that the exercise program is insufficient alone without additional physical therapy modalities to produce adaptive changes in postural control [16,17].…”