Clinical Scenario: Cerebral palsy (CP) is the most frequently reported diagnosis for children who receive physical therapy, with spastic CP being the most common.
Clinical Bottom Line: In an outpatient setting, frequency and duration of PT should be individualized and based on child and family needs. Periodic and episodic care is used in the management of children with spastic diplegia. Intensity of services may be higher for children with increased impairment or those who undergo surgery. Regardless of intervention environment, each session should be designed to meet the learning style/abilities of the child and family, provide meaningful activities to achieve child and family needs, and be integrated into the child and family routines to achieve success.
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Search terms: child, cerebral palsy, physical therapy/procedures, practice guidelines
Citation: O’Niel, M., et al. Physical Therapy Clinical Management Recommendations for Children with Cerebral Palsy- Spastic Diplegia: Achieving Functional Mobility Outcomes. Pediatric Physical Therapy 2006; 18:49-72.
Appraisal: Pros- Recommendations help therapists develop systematic approaches to service delivery and documentation that will contribute to evidence-based practice and enhanced outcomes.
Cons- Limited research findings are available to determine the optimal amount of intervention required for the best/most effective function outcomes for children with cerebral palsy.
The Evidence: See Figure 1.
Appraised by: Amanda Fulmer, DPT, October 2014, as part of the Best Practices & Clinical Innovation Committee. Recommend for clinical management be revised periodically to reflect the current literature and new trends in medical and rehab management of children with spastic diplegia.
Cerebral Palsy Clinical Practice Guideline
Masse LC, Schiariti V, et al. Identifying relevant areas of functioning in children and youth with Cerebral Palsy using the ICF-CY coding system: From whose perspective? European Journal of Paediatric Neurology 2014; 609-617.
Physical Therapy Clinical Management Recommendations for Children with Cerebral Palsy –
Spastic Diplegia: Achieving Functional Mobility Outcomes