The effectiveness of intensive versus standard physical therapy for motor progress in children with spastic cerebral palsy

Abstract EN

Background Cerebral palsy (CP) remains the most common cause of physical disability in children that results from a static brain lesion during pregnancy or early life.

Although the brain lesion is static, the physical manifestations and medical issues may progress, leading to altered motor patterns.

Objective The aim of the study was to assess gross motor progress in children with spastic (quadriplegic and diplegic) CP treated with intensive physical therapy (PT) as compared with a matched group treated with a standard PT regimen.

Patients and methods Out of 45 patients with spastic CP aged 2-6 years, 25 patients were assigned to an intensive therapy group (group A), whereas 20 patients were assigned to standard therapy (control group B).

Patients were classified according to the gross motor function classification system.

The intervention program was administered for 16 weeks, with sitting and walking as the treatment goal.

The gross motor function measures 88 and 66 (GMFM-88 and GMFM-66) and gross motor performance measure (GMPM) were used for assessment at baseline, at 8 weeks, and at 16 weeks after intervention.

Results At baseline, there were no statistically significant differences between the two groups.

After 8 weeks, there were significant differences between the two groups as regards the total scores of GMFM-88 and GMPM (P < 0.05).

However, highly significant differences for GMFM-88 (P < 0.001) and only significant differences (P < 0.05) for GMPM were observed after 16 weeks.

No statistically significant differences were found between the two groups as regards GMFM-66 scores after 8 weeks, and significant differences were found only after 16 weeks (P < 0.05).

After 16 weeks, all dimensions of GMFM-88 were significantly increased in both groups (P < 0.001).

Only sitting showed no statistically significant difference in group B (P > 0.05).

Conclusion Intensive PT regimens were more beneficial than standard therapy in spastic CP, especially in children with a low functional level.