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Phys Ther, 2016; 96(12): 1938-1954, PMID: 27313240

Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis.

Year: 2016

Moreau NG, Bodkin AW, Bjornson K, Hobbs A, Soileau M, Lahasky K
N.G. Moreau, PT, PhD, Department of Physical Therapy, Louisiana State University Health Sciences Center, 1900 Gravier St, 7th Floor, New Orleans, LA 70112 (USA).


BACKGROUND: Children with cerebral palsy (CP) have decreased gait speeds, which can negatively impact participation and quality of life. However, evidence for effective rehabilitation interventions to improve gait speed remains unclear. PURPOSE: To determine the effectiveness of interventions for improving gait speed in ambulatory children with CP. DATA SOURCES: MEDLINE, CINAHL, ERIC, and PEDro were searched from inception through April 2014. STUDY SELECTION: Randomized controlled trials (RCTs) or experimental designs with a comparison group; included a physical therapy or rehabilitation intervention for children with CP; and reported gait speed as an outcome measure. DATA EXTRACTION: Methodological quality was assessed by PEDro scores. Means, standard deviations, and change scores for gait speed were extracted. General study information and dosing parameters of the intervention were recorded (frequency, duration, intensity, and volume). DATA SYNTHESIS: 24 studies were included. Three categories of interventions were identified: gait training (n=8), resistance training (n=9), and miscellaneous (n=7). Meta-analysis showed that gait training was effective in increasing gait speed with a standardized effect size of 0.92 (95% CI: 0.19 to 1.66; p = 0.01) while resistance training was shown to have a negligible effect (effect size = 0.06; 95% CI: -0.12 to 0.25; p = 0.51). Effect sizes from negative to large were reported for studies in the miscellaneous category. LIMITATIONS: Gait speed was the only outcome measure analyzed. CONCLUSIONS: Gait training was the most effective intervention in improving gait speed for ambulatory children with CP. Strength training, even if properly dosed, was not shown to be effective in improving gait speed. Velocity training, EMG biofeedback training, and whole-body vibration were effective in improving gait speed in individual studies and warrant further investigation.

Keywords: Metaanalysis
GID: 4182; Last update: 27.06.2016