Gait
A pre-post study (Hamed et al, 2011) evaluated the effect of pedometer-based gait training programme with the conventional gait programme in improving gait parameters on children with spastic hemiplegia. Statistically significant increase of velocity (p<0.0001), stride length (p<0.0001), cycle time (p<0.0001) and cadence (p<0.008) were found.
A quasi-experimental study (Van den Broeck et al, 2010) investigated the effectiveness of an individually defined physiotherapy program on gait. After individual program the step length, stride length, cadence, gait velocity, ankle velocity, ankle power, max knee extension in stance, maximum knee velocity and all hip parameters improved.
Conclusion: There is limited (level 2b) evidence from two quasi-experimental studies of the effectiveness of physical therapy programs on gait in children with cerebral palsy.
Strengthening
A systematic review (Martin et al, 2010) aimed to establish the current level of evidence for the effectiveness of commonly used physiotherapy interventions for children with CP between 4-18 years old. It was found that the highest level of evidence existed demonstrating the positive effects of strengthening programs however these work best for individual muscle groups with little carryover into gross motor function.
Another systematic review (Franki et al, 2012) summarized the effectiveness of different basic physical therapy techniques used in children with cerebral palsy and categorized outcomes based on the ICF. It was found that Interventions targeting body function and structure mainly impact upon those areas with little overflow. Strength training is effective in increasing muscle strength and to a lesser extent gait and motor function but effects quickly lost after cessation of programme.
Conclusion: There is limited (level 2b) evidence from two systematic reviews supporting the positive effects of strengthening program in children with cerebral palsy.
