Article

A commonly used treatment for cerebral palsy in children is so-called
'conventional therapy', which includes physiotherapy or the neurodevelopmental
approach. Although more intensive rehabilitative treatment is thought to be more
effective than less intensive interventions, this assumption has not been proven.
In this study we compared the efficacy of intensive versus nonintensive
rehabilitative treatment in children with cerebral palsy.
A meta-analysis of the
studies published between January 1996 and July 2007 was performed. Inclusion
criteria: infants/children/adolescents (1-18 years old); randomized controlled
trials using, as outcome measure, the Gross Motor Function Measure score.
Exclusion criteria: studies that included therapies not generally used in
'so-called' conventional treatment (i.e. constraint, taping). Treatment effects
were combined using the weighted mean difference method. Fixed and random effect
meta-analyses were carried out and results were compared. Heterogeneity was also
assessed. Funnel plots were examined and the presence of small-study effects was
tested. Intensive therapy tended to have a greater effect than nonintensive
therapy (1.32; 95% confidence interval: 0.55-2.10). The effect of intensive
treatment tended to be apparently stronger for children 2 years of age. Our
meta-analysis shows that, in children with cerebral palsy, intensive conventional
therapy may improve the functional motor outcome, but the effect size seems to be
modest.

Langue : ANGLAIS