Home-based balance training for children with cerebral palsy

Abstract

Background:This systematic review shows which home-based training is effective for sitting and/or standing balance in children between 0-18 year with CP. Method: The literature search was performed on PubMed and Web of Science until April 2020. Articles were assessed on quality and data (design, participants, intervention, outcomes and results) was extracted. Included studies reported clinical and biomechanical sitting and standing balance outcomes. Results: Four single-group design, one cross-over design, four comparative and one randomized controlled trial design were included. This review included 169 participants with spastic CP (n=163), dystonic (n=1), hypotonic (n=1) and at risk for CP (n=4). Six weeks robotic ankle training and 2-10 years individualized exercise training improved standing balance and PBS respectively for children with Gross Motor Function Classification System (GMFCS) level I-III. Electrical stimulation, MiTii games, strength training, Wii Fit and lower extremity functional training did not. Discussion and conclusion: Home-based interventions can improve balance in children with CP. However evidence is necessary to optimize training modalities. Limited evidence for children with GMFCS-level IV-V is available. Operationalisation research question: Comparing a one-year home-based MiTii training with a one-year home-based robotic ankle training. PBS is evaluated at baseline, after the intervention and at six weeks follow-up to measure balance.