Studying the Research-Practice Gap in Physical Therapies for Cerebral Palsy: Preliminary Outcomes Based on a Survey of Spanish Clinicians

Int J Environ Res Public Health. 2022 Nov 5;19(21):14535. doi: 10.3390/ijerph192114535.

Abstract

The purpose of this work is to study the gap between the research evidence and the clinical practice in the physical rehabilitation of people with cerebral palsy. A review process was performed to (1) identify physical therapies to improve postural control in children with cerebral palsy and (2) determine the scientific evidence supporting the effectiveness of those therapies. A Likert-based survey addressing a total of 43 healthcare professionals involved in pediatric physical therapy departments in Spain was carried out. The discussion was mainly supported by studies of level I or II evidence (according to the Oxford scale). The search process yielded 50 studies reporting 16 therapies. A strong positive correlation between the most used treatments and elevated levels of satisfaction was found. Some well-known but not often used techniques, such as hippotherapy, were identified. The treatment with the highest degree of use and satisfaction-neurodevelopment therapy (Bobath)-and some emerging techniques, such as virtual reality, were also identified. The fact that there is a meaningful gap between clinical practice and the scientific evidence was confirmed. The identified gap brings a certain degree of controversy. While some classic and well-known therapies had poor levels of supporting evidence, other relatively new approaches showed promising results.

Keywords: cerebral palsy; clinical practice; motor control; occupational therapy; physical therapies; physiotherapy; postural control; rehabilitation; scientific evidence; survey; trunk control.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebral Palsy* / rehabilitation
  • Child
  • Equine-Assisted Therapy*
  • Humans
  • Physical Therapy Modalities
  • Postural Balance
  • Professional Practice Gaps

Grants and funding

This research was funded by MCIN/AEI/10.13039/501100011033/FEDER, UE, grant numbers RTI2018-097122-A-I00 and PID2021-127096OB-I00.