How effective is stretching in maintaining range of movement for children with cerebral palsy?

Abstract

Cerebral Palsy (CP) is the most common childhood disorder affecting four percent of children born in the UK. It is common for children with CP to have reduced range of movement (ROM) due to spasticity and contractures. Stretching is commonly used in physiotherapy programmes to manage this. This critical review aims to evaluate the evidence base behind the use of stretching for children with CP. Methods: A systematic literature search of AMED, CINAHL, MEDLINE and Cochrane Library Trials was conducted. Returned searches were assessed against strict criteria according to a predefined PICOS (Population, Intervention, Comparison, Outcome, Study). These studies were then critically appraised to assess the validity, reliability and clinical relevance. Findings: There is evidence supporting the use of stretching in children with CP. However there is also some evidence to suggest very little or no positive change. All of the included studies have methodological limitations, which questions the validity of the results. Conclusions/Recommendations: The research suggests some positive outcomes for the use of stretching in CP, studies that did not find positive outcomes found no adverse effects; however further research in the area is required to validate the effectiveness of stretching to maintain ROM in children with CP.