Efficacy of three therapy approaches in preschool children with cerebral palsy: a randomized controlled trial

AimTo examine the efficacy of child‐focused, context‐focused, and regular care approaches, delivered in a rehabilitation setting by physical or occupational therapists to preschool children with cerebral palsy (CP), in optimizing the child's self‐care and mobility capabilities.MethodA multicentre randomized controlled trial clustered at therapist level was conducted in 13 rehabilitation centres. It included 68 children with CP (38 males, 30 females; mean age 3y, SD 6mo, range 1y 11mo–4y), classified as Gross Motor Function Classification System levels I to IV, who were already receiving therapy. Children received a child‐focused, context‐focused, or regular care approach during a 6‐month period. Self‐care and mobility capabilities were assessed with the Functional Skills Scale of the Pediatric Evaluation of Disability Inventory.ResultsThe child‐focused, context‐focused, and regular care approaches all resulted in significant but similar improvements in self‐care (regular: reference; child‐focused: β=−0.11, 95% confidence interval [CI] −0.68 to 0.46; context‐focused: β=0.13, CI −0.38 to 0.64) and mobility (regular: reference; child‐focused: β=−0.09, CI=−0.93 to 0.75; and context‐focused: β=0.14, CI −0.65 to 0.94) capabilities.InterpretationThe results suggest that the three therapy approaches were equally efficacious for preschool children with CP. Depending on a child's individual situation each approach can be selected.

Efficacy of three therapy approaches in preschool children with cerebral palsy: a randomized controlled trial Journal Articles