Effect of physical therapy interventions on spatiotemporal gait parameters in children with cerebral palsy: a systematic review

Abstract

Aim

To investigate the effect of physical therapy interventions on spatiotemporal gait parameters in children with cerebral palsy.

Methods

Six databases were searched: PubMed, Embase, Web of Science, Science Direct, Lilacs, and Scopus. Two independent reviewers worked on primary study selection based on titles, abstracts, and full text reading. We included randomized controlled trials investigating the role of therapeutic interventions on gait kinematics in children with cerebral palsy. The independent reviewers extracted information about study population, intervention type, main outcomes, and methodological quality according to PEDro Scale. The body of evidence was synthesized through GRADE.

Results

Twenty-six studies were found addressing the following treatment categories: functional electrical stimulation, transcranial stimulation, gait training, muscular strengthening, vibratory platform training, and serial casting. A moderate level of evidence was identified for vibratory platform training, gait training, transcranial stimulation (positive effect), and isolated muscle strengthening (negative effect) in relation to gait velocity. Electrical stimulation showed a moderate level of evidence regarding stride length. The evidence for other outcomes was of low or very low quality.

Conclusion

Vibratory platform, gait training, electrical stimulation, and transcranial stimulation were effective to improve spatiotemporal gait parameters, especially velocity in children with cerebral palsy.

Implication for rehabilitation

• Improvement and maintenance of gait of children with cerebral palsy is a great challenge to rehabilitation professionals

• Vibratory platform, gait training, electrical stimulation, and transcranial stimulation improve gait parameters.

• Isolated strength training was not effective to improve gait parameters in Cerebral Palsy.

• Long-term effect of most techniques on gait parameters until unclear.

Keywords:

• Gait
• cerebral palsy
• physical therapy interventions
• children

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by São Paulo Research Foundation (FAPESP) scholarship (grant no. # 2015/08811–3 and 2016/21309–8).