Physiotherapy for children with cerebral palsy. Evidence for its efficacy
E. Tirosh and S. Rabino
Hannah Khoushy Child Development Center, Bnai Zion Medical Center, Haifa, Israel.
Physiotherapy is currently the most popular therapeutic intervention for
cerebral palsy. This therapy requires highly trained personnel, diverse
equipment, and parental cooperation. Notwithstanding the expense and
commitment required for the implementation of a therapeutic program, a
computer search of the literature published in English during the past 15
years revealed only nine studies pertaining to the efficacy and no study
addressing the effectiveness of this intervention. A critical review of
this literature, employing 14 methodological and reporting criteria,
revealed that only three studies adequately fulfilled nine of the criteria;
the remaining studies used a less rigorous design. Of those three articles,
two used statistical analysis and concluded that the results were negative,
while the third utilized clinical analysis only and demonstrated positive
results. Evidence for the usefulness of this therapy has yet to be
demonstrated; with the presently available methodologies it is ethically
imperative to institute a properly designed, collaborative, multicenter,
randomized, controlled trial.
