Effects of Physical Therapy Management on Gross Motor Function and Spasticity among Diplegic Cerebral Palsy

Abstract

Background: Cerebral Palsy is the one of leading cause of disability among pediatric population, especially in Asia. Permanent disability is mostly due to the spasticity and poor gross motor function, adding significant socioeconomic burden on healthcare system. This study evaluate the effectiveness of Physical Therapy based interventions on improving Gross Motor Function and reducing Spasticity.
Material and Methods: A thorough search on CINAHL, PubMed, PEDro, Web of Science, and Scopus from February to July 2024 for studies assessing spasticity by Modified Ashworth Scale and gross motor function by GMFM-88 Standing/Walking dimensions in children with diplegic CP. Seventeen eligible trials were analyzed using fixed/random effects models in MedCalc.
Results: The analysis showed significant improvements in walking ability p < 0.0001 (CI 95%= (0.20. 0.50), SMD= 0.563, Q=43.9325) and standing ability p = 0.0004 (CI 95%= (0.20. 0.50), SMD= 0.187, Q=22.5239) in the experimental group, as measured by the GMFM-88. However, there was no overall significant impact on all dimensions of GMFM-88 p = 0.5821 (CI 95%= (-0.0508. 0.301), SMD= 0.125, Q=6.5843). Additionally, interventions targeting spasticity reduction showed no significant effects p = 0.1018 (CI 95%= (0.20. 0.50), SMD= 0.306, Q=10.5922) according to the Modified Ashworth scale.
Conclusion: This meta-analysis reveals that modified suit therapy, vibration therapy, and hippotherapy enhance standing and walking in the GMFM-88 but did not reveal significant effects of physical therapy interventions in improving overall gross motor function or reducing spasticity in children with diplegic cerebral palsy.