Studying the Research–Practice Gap in Physical Therapies for Cerebral Palsy: Preliminary Outcomes Based on a Survey of Spanish Clinicians

Abstract

The purpose of this work is to study the gap between the research evidence and the clinical practice in the physical rehabilitation of people with cerebral palsy. A review process was performed to (1) identify physical therapies to improve postural control in children with cerebral palsy and (2) determine the scientific evidence supporting the effectiveness of those therapies. A Likert-based survey addressing a total of 43 healthcare professionals involved in pediatric physical therapy departments in Spain was carried out. The discussion was mainly supported by studies of level I or II evidence (according to the Oxford scale). The search process yielded 50 studies reporting 16 therapies. A strong positive correlation between the most used treatments and elevated levels of satisfaction was found. Some well-known but not often used techniques, such as hippotherapy, were identified. The treatment with the highest degree of use and satisfaction—neurodevelopment therapy (Bobath)—and some emerging techniques, such as virtual reality, were also identified. The fact that there is a meaningful gap between clinical practice and the scientific evidence was confirmed. The identified gap brings a certain degree of controversy. While some classic and well-known therapies had poor levels of supporting evidence, other relatively new approaches showed promising results.

Effectiveness of a Telecare Physical Therapy Program in Improving Functionality in Children and Adolescents with Cerebral Palsy: A Cases Study

“…It depends on the capabilities of the neuromuscular and musculoskeletal systems. The restricted ability to coordinate the muscles in postural synergies gives rise to dysfunctions in the activation of the postural response and in the adaptation of the posture in space, creating limitations in motor skills that require balance, such as walking or upper limb activities [ 6 ]. The gait alteration is conditioned by the area and location of the damage, affecting 90% of children with CP and producing a decrease in walking speed, endurance and cadence [ 7 , 8 ].…”