Effectiveness of exercise interventions for children with cerebral palsy: A systematic review and meta-analysis of randomized controlled trials.
Xianrong Liang, Zhujiang Tan, Guojun Yun and 4 others
PMID 33225375WHAT IT FOUND
Exercise interventions for children with cerebral palsy improved gait speed and muscle strength, but did not significantly improve gross motor function.
The positive findings for speed and strength were unstable, disappearing when certain trials were excluded from the analysis.
Key findings
01Exercise interventions showed no significant difference compared to control for gross motor function.
02Exercise interventions were associated with higher gait speed than control groups, though this conclusion was altered when specific studies were excluded.
03Exercise interventions were associated with an improvement in muscle strength, but this result changed to non-significant when one specific trial was excluded.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The included trials had low to moderate quality, with most scoring 3 or less on the Jadad scale. The types of exercise interventions varied widely across trials, making direct comparison difficult. The disease status of participants ranged from GMFCS levels I to V, leading to differences in baseline function. The positive findings for gait speed and muscle strength were highly sensitive to the exclusion of individual studies, suggesting the results are not robust. There was significant heterogeneity in the muscle strength results that was not fully explained by subgroup analyses.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume exercise interventions reliably improve gross motor function, as this outcome showed no significant difference. Furthermore, do not rely on the positive findings for gait speed and muscle strength as stable evidence, because the statistical significance disappeared when specific individual trials were excluded from the analysis.