Effectiveness of Task-Oriented Training Versus Conventional Physiotherapy on Gross Motor Function, Balance, and Functional Independence in Children With Spastic Cerebral Palsy: A Randomized Controlled Trial
Article Sidebar
Main Article Content
Abstract
Background: Children with spastic cerebral palsy frequently experience impaired gross motor performance, postural instability, and dependence in daily activities. Task-oriented training emphasizes repetitive practice of meaningful functional activities and may promote greater transfer of motor gains than conventional physiotherapy. Objective: To compare the immediate effects of task-oriented training and conventional physiotherapy on gross motor function, balance, and functional independence in children with spastic cerebral palsy. Methods: In this parallel-group randomized controlled trial, 26 children were allocated equally to task-oriented training or conventional physiotherapy. Gross motor function was assessed using the Gross Motor Function Measure-88, balance using the Pediatric Balance Scale, and independence using the Functional Independence Measure for Children. Outcomes were evaluated at baseline and immediately after treatment. Between-group differences in change scores were reported with 95% confidence intervals, p-values, and standardized effects. Results: Task-oriented training produced greater improvements than conventional physiotherapy in GMFM-88 scores (10.5 ± 4.2 vs 4.9 ± 3.8; mean difference 5.6, 95% CI 2.4–8.8; p=0.002), Pediatric Balance Scale scores (9.6 ± 3.7 vs 4.3 ± 3.4; difference 5.3, 95% CI 2.4–8.2; p=0.001), and WeeFIM scores (10.4 ± 4.6 vs 4.7 ± 4.1; difference 5.7, 95% CI 2.2–9.2; p=0.003). No serious adverse events occurred. Conclusion: Task-oriented training was associated with larger immediate functional gains, although confirmation in larger, longer-term trials is required
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8–14.
2. McIntyre S, Goldsmith S, Webb A, Ehlinger V, Hollung SJ, McConnell K, et al. Global prevalence of cerebral palsy: a systematic analysis. Dev Med Child Neurol. 2022;64(12):1494–1506.
3. World Health Organization. International classification of functioning, disability and health: ICF. Geneva: World Health Organization; 2001.
4. Novak I, McIntyre S, Morgan C, Campbell L, Dark L, Morton N, et al. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol. 2013;55(10):885–910.
5. Damiano DL. Activity, activity, activity: rethinking our physical therapy approach to cerebral palsy. Phys Ther. 2006;86(11):1534–1540.
6. Ketelaar M, Vermeer A, Hart H, van Petegem-van Beek E, Helders PJM. Effects of a functional therapy program on motor abilities of children with cerebral palsy. Phys Ther. 2001;81(9):1534–1545.
7. Salem Y, Godwin EM. Effects of task-oriented training on mobility function in children with cerebral palsy. NeuroRehabilitation. 2009;24(4):307–313.
8. Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, et al. State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Curr Neurol Neurosci Rep. 2020;20(2):3.
9. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39(4):214–223.
10. Russell DJ, Rosenbaum PL, Cadman DT, Gowland C, Hardy S, Jarvis S. The Gross Motor Function Measure: a means to evaluate the effects of physical therapy. Dev Med Child Neurol. 1989;31(3):341–352.
11. Franjoine MR, Gunther JS, Taylor MJ. Pediatric Balance Scale: a modified version of the Berg Balance Scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther. 2003;15(2):114–128.
12. Msall ME, DiGaudio K, Rogers BT, LaForest S, Catanzaro NL, Campbell J, et al. The Functional Independence Measure for Children: conceptual basis and pilot use in children with developmental disabilities. Clin Pediatr (Phila). 1994;33(7):421–430.
13. Law MC, Darrah J, Pollock N, Wilson B, Russell DJ, Walter SD, et al. Focus on function: a cluster, randomized controlled trial comparing child-versus context-focused intervention for young children with cerebral palsy. Dev Med Child Neurol. 2011;53(7):621–629.
14. Löwing K, Bexelius A, Brogren Carlberg E. Activity-focused and goal-directed therapy for children with cerebral palsy: do goals make a difference? Disabil Rehabil. 2009;31(22):1808–1816.
15. Ahl LE, Johansson E, Granat T, Carlberg EB. Functional therapy for children with cerebral palsy: an ecological approach. Dev Med Child Neurol. 2005;47(9):613–619.
16. Verschuren O, Ketelaar M, Takken T, Helders PJM, Gorter JW. Exercise programs for children with cerebral palsy: a systematic review of the literature. Am J Phys Med Rehabil. 2008;87(5):404–417.
17. Scholtes VA, Becher JG, Comuth A, Dekkers H, van Dijk L, Dallmeijer AJ. Effectiveness of functional progressive resistance exercise strength training on muscle strength and mobility in children with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol. 2010;52(6).
18. Dodd KJ, Taylor NF, Damiano DL. A systematic review of the effectiveness of strength-training programs for people with cerebral palsy. Arch Phys Med Rehabil. 2002;83(8):1157–1164.
19. Anttila H, Autti-Rämö I, Suoranta J, Mäkelä M, Malmivaara A. Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review. BMC Pediatr. 2008;8:14..