Evidence in Practice: Literature Review Regarding the Effect of Physical Therapy on Improving Gait and Balance in Children with Cerebral Palsy
Groszek A., SPT; Hastings L., SPT; Matting K., SPT; Penrod E., SPT; Wiles J., SPT
Faculty Mentor: Mohamed Kohia, PT, Ph.D., MS
Groszek A., SPT; Hastings L., SPT; Matting K., SPT; Penrod E., SPT; Wiles J., SPT
Faculty Mentor: Mohamed Kohia, PT, Ph.D., MS
Institution(s): Rockhurst University Department of Physical Therapy, Kansas City, MO
Purpose/Hypothesis: The purpose of this review is to evaluate the current literature pertaining to the most effective physical therapy interventions on improving gait and balance in children with cerebral palsy (CP). This review will assist physical therapists, and all members of the rehabilitation team, to utilize evidence-based therapeutic approaches in the clinical setting.
Subjects: Studies were reviewed that included Physical Therapy intervention for children with CP.
Methods/ Materials: Articles for this review were located using PubMed database. Articles included were written in English, peer-reviewed and published between 2007 and 2017. Key search words included: “physical therapy”, “children”, “cerebral palsy” and “gait or balance”. Only studies that included physical therapy management or intervention for children with cerebral palsy were used. Articles that looked at alternative therapies such as hippotherapy or medical injections such as botulism toxin were excluded as well as systematic reviews and meta-analyses. The studies were evaluated using Sackett’s 5 levels of evidence and the scientific rigor of each study was classified using criteria created by Megen and Harris.
Results: A total of twenty-five studies were critically evaluated and classified according to Sackett’s Levels of Evidence. Six studies were categorized as level I evidence and received a Grade A recommendation; seven studies as level II evidence receiving a Grade B recommendation; and twelve studies as level V evidence, receiving a Grade C recommendation. Three of the twenty-five studies reviewed met five or more criteria for scientific rigor indicating a strong confidence that outcomes of these studies can be recommended to use with this patient population.
Conclusions: Several treatment approaches for children with CP are supported by strong research reports. Of the studies evaluated, it was found that some physical therapy interventions were more effective than others. However, it is important to note that careful consideration should be taken when putting these recommendations into application due to the wide age range of patients, types of cerebral palsy, number of extremities affected, and the varying degrees of severity of baseline gait and balance impairments.
Funding Source: No additional sources of funding
Purpose/Hypothesis: The purpose of this review is to evaluate the current literature pertaining to the most effective physical therapy interventions on improving gait and balance in children with cerebral palsy (CP). This review will assist physical therapists, and all members of the rehabilitation team, to utilize evidence-based therapeutic approaches in the clinical setting.
Subjects: Studies were reviewed that included Physical Therapy intervention for children with CP.
Methods/ Materials: Articles for this review were located using PubMed database. Articles included were written in English, peer-reviewed and published between 2007 and 2017. Key search words included: “physical therapy”, “children”, “cerebral palsy” and “gait or balance”. Only studies that included physical therapy management or intervention for children with cerebral palsy were used. Articles that looked at alternative therapies such as hippotherapy or medical injections such as botulism toxin were excluded as well as systematic reviews and meta-analyses. The studies were evaluated using Sackett’s 5 levels of evidence and the scientific rigor of each study was classified using criteria created by Megen and Harris.
Results: A total of twenty-five studies were critically evaluated and classified according to Sackett’s Levels of Evidence. Six studies were categorized as level I evidence and received a Grade A recommendation; seven studies as level II evidence receiving a Grade B recommendation; and twelve studies as level V evidence, receiving a Grade C recommendation. Three of the twenty-five studies reviewed met five or more criteria for scientific rigor indicating a strong confidence that outcomes of these studies can be recommended to use with this patient population.
Conclusions: Several treatment approaches for children with CP are supported by strong research reports. Of the studies evaluated, it was found that some physical therapy interventions were more effective than others. However, it is important to note that careful consideration should be taken when putting these recommendations into application due to the wide age range of patients, types of cerebral palsy, number of extremities affected, and the varying degrees of severity of baseline gait and balance impairments.
Funding Source: No additional sources of funding