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Exercise interventions improve postural control in children with cerebral palsy: a systematic review
Author(s) -
Dewar Rosalee,
Love Sarah,
Johnston Leanne Marie
Publication year - 2015
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12660
Subject(s) - cerebral palsy , psychological intervention , physical medicine and rehabilitation , physical therapy , medicine , rehabilitation , biofeedback , balance (ability) , psychology , psychiatry
Aim The aim of this study was to evaluate the efficacy and effectiveness of exercise interventions that may improve postural control in children with cerebral palsy (CP). Method A systematic review was performed using American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methodology. Six databases were searched using the following keywords: (‘cerebral palsy’ OR ‘brain injury’); AND (‘postur*’ OR ‘balance’ OR ‘postural balance’ [MeSH]); AND (‘intervention’ OR ‘therapy’ OR ‘exercise’ OR ‘treatment’). Articles were evaluated based on their level of evidence and conduct. Results Searches yielded 45 studies reporting 13 exercise interventions with postural control outcomes for children with CP. Five interventions were supported by a moderate level of evidence: gross motor task training, hippotherapy, treadmill training with no body weight support (no‐BWS), trunk‐targeted training, and reactive balance training. Six of the interventions had weak or conflicting evidence: functional electrical stimulation (FES), hippotherapy simulators, neurodevelopmental therapy (NDT), treadmill training with body weight support, virtual reality, and visual biofeedback. Progressive resistance exercise was an ineffective intervention, and upper limb interventions lacked high‐level evidence. Interpretation The use of exercise‐based treatments to improve postural control in children with CP has increased significantly in the last decade. Improved study design provides more clarity regarding broad treatment efficacy. Research is required to establish links between postural control impairments, treatment options, and outcome measures. Low‐burden, low‐cost, child‐engaging, and mainstream interventions also need to be explored.