Randomized controlled trial of physiotherapy in 56 children with cerebral palsy followed for 18 months

This study aimed to determine whether motor function and performance is bet ter enhanced by intensive physiotherapy or collaborative goal-setting in ch ildren with cerebral palsy (CP). Participants were a convenience sample of 56 children with bilateral CP classified at level III or below on the Gross Motor Function Classification System (GMFCS), aged between 3 and 12 years. A 2 x 2 factorial design was used to compare the effects of routine amount s of physiotherapy with intensive amounts, and to compare the use of genera lized aims set by the child's physiotherapist with the use of specific, mea surable goals negotiated by the child's physiotherapist with each child, ca rer, and teacher. Following the six-month treatment period there was a furt her six-month period of observation. Changes in motor function and performa nce were assessed by a masked assessor using the Gross Motor Function Measu re (GMFM) and, the Gross Motor Performance Measure (GMPM) at three-month in tervals. There was no statistically significant difference in the scores ac hieved between intensive and routine amounts of therapy or between aim-dire cted and goal-directed therapy in either function or performance. Inclusion of additional covariates of age and severity levels showed a trend towards a statistically significant difference in children receiving intensive the rapy during the treatment period. This advantage declined over the subseque nt six months during which therapy had reverted to ifs usual amount. Differ ences in goal-setting procedures did not produce any detectable effect on t he acquisition of gross motor function or performance.