PT Critically Appraised Topics
 

Document Type

Critically Appraised Topic

Publication Date

2010

Clinical Scenario

I am currently seeing a number of patients whose parents are questioning whether or not intensive physical therapy is appropriate for them. One patient is a four-year-old boy with cerebral palsy. His mother is currently taking him to Portland for intensive suit therapy for 3 weeks. These intensive sessions occur five days a week for five hours each day. After completing his three weeks at intensive, the patient will then return to getting physical therapy once a week in a traditional outpatient pediatric clinic.

Clinical Question

Do young children with cerebral palsy demonstrate greater gross motor function with intensive physical therapy or traditional physical therapy?

Clinical Bottom Line

Based on the results from the studies conducted by Bailes, et al. and Bar-Haim, et al. intensive suit therapy does not improve gross motor function more than traditional physical therapy interventions. The article by Bailes, et al. was methodologically weak making it difficult to draw conclusions that related to my clinical question. The article by Bar-Haim, et al. was strong in methodology and it found that over a ten month period, traditional neurodevelopmental treatment resulted in greater gross motor function improvements when compared to intensive treatment in the Adeli suit. Both articles had populations that matched my clinical situation, although the comparison group in each was different than the treatment I would provide. Bar-Haim, et al. used a comparison group that received ten hours of treatment each week, while I am only treating my patient for one hour a week. Overall, more research is needed to address the efficacy of intensive suit therapy. Specifically, a study comparing intensive suit therapy in short bursts (four, one month sessions) to one visit a week on gross motor function for an entire year would be valuable. Future studies should use an appropriate comparison group, a longer intervention period, and have strong internal validity. Higher quality evidence is needed to justify the use of intensive suit therapy for this population given the cost and time commitment.

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