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Continuous versus blocks of physiotherapy for motor development in children with cerebral palsy and similar syndromes: a prospective randomized study
Brunner A-L, Rutz E, Juenemann S, Brunner R
Developmental Neurorehabilitation 2014;17(6):426-432
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To determine whether physiotherapy is more effective when applied in blocks or continuously in children with cerebral palsy (CP). METHODS: A prospective randomized cross-over design study compared the effect of regular physiotherapy (baseline) with blocks of physiotherapy alternating with no physiotherapy over one year. Thirty-nine institutionalized children with CP and clinically similar syndromes (6 to 16 years old, Gross Motor Function Classification Scale II to IV) were included. During the first scholastic year, group A received regular physiotherapy, group B blocks of physiotherapy and vice versa in the second year. The Gross Motor Function Measure 66 (GMFM-66) was the outcome measure. RESULTS: Thirteen children in each group completed the study. GMFM-66 improved (p < 0.05) over the study period in both groups in total; changes (p < 0.05) were seen only in dimension D (group B) and E (both groups) during regular therapy. CONCLUSION: Physiotherapy may be more effective when provided regularly rather than in blocks.

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