Therapeutic exercise methods in children on the move in spastic cerebral palsy Métodos de ejercicios terapéuticos en niñas(os) sobre la marcha en la parálisis cerebral espástica Literature Review

Abstract

Introduction: Human gait is important for quality of life; in
childhood cerebral palsy, motor disorders occur that cause
deficits in this. Current advances allow us to guide different
exercise strategies that have shown significant effects that
help locomotion. The objective of this article is to present
the effects of the techniques and methods of therapeutic
walking exercises in spastic cerebral palsy in children
according to what was revealed in a review of the literature
resulting from an undergraduate research. Method: the
search was carried out through the Pubmed, PEDro, Ebsco
Host and Scopus databases. The methodological quality
was evaluated through three assessment scales: PRISMA,
Oxford and SING. The Boolean operators “AND”, “OR” were
used. And from the PICO strategy we wanted to establish
the effects of the different therapeutic intervention
strategies on the performance of patients with hemiplegia/
diplegia type spasticity. Scientific publications from
primary sources published between 2017 and 2021 were
used. Articles published in English, Spanish, French and
Portuguese were used. The criteria defined for the selection
of the articles were type of study, sample, intervention,
time, sessions, evaluation, conclusion. And the PRISMA 2020
method was used as verification tools. To evaluate biases,
scales to assess methodological quality such as Oxford
and SCOTTISH INTERCOLLEGIATE GUIDELINES NETWORK
(SING) were used. Results: from a total of 133 articles found
and following the guidelines of the scales used, 32 articles
in total were selected. The evidence showed the most
recurrent techniques used for gait rehabilitation in people
with spastic cerebral palsy (SCP) hemiplegia/diplegia, and
some evidence showed the pharmacological combination
in some techniques. The therapeutic exercises used are
described with respect to the duration of the session,
the execution time per week and the total duration of
the application of the exercise, the relationship between
the gait parameters and interventions, pointing out the
temporal and spatial parameters. and kinetics. Finally,
the evaluation tests that the evidence most recommends
as support in the treatment plan for this population are
named. The results show physiotherapeutic methods to
improve gait. Recommendations: expand the execution of
studies that demonstrate high levels of scientific evidence
and recommendation in this population, since, given
the heterogeneity of the included studies, a restriction
is observed in the scope of the study. As well as, adopt
diversified approaches, conduct longitudinal studies,
compare the effectiveness of different approaches,
personalize treatments according to individual needs,
include patients and families in design and execution,
consider multidisciplinary collaboration and cost
evaluation, analyze psychosocial effects and the long-term
impact on quality of life, perform a systematic review with
meta-analysis.