TECHNOLOGY-BASED PHYSIOTHERAPY INTERVENTION FOR HEAD AND TRUNK CONTROL IN CHILDREN WITH CEREBRAL PALSY: A REVIEW

S. Shakya¹, S.S. Madapura², H.B. Shetty², S. Gopalakrishnan³, V.S. Venkatesan², B.K. Rao¹

¹Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India, ²Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India, ³Department of Physiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India

Background: Head and trunk control is a prerequisite skill that maximizes engagement and participation in the environment by integrating vision, oromotor skills, arm control, and respiration. Various physiotherapy interventions are utilized to help children with Cerebral Palsy (CP) develop head and trunk control. Children with CP require regular physiotherapy for prolonged duration, which may eventually set in boredom and monotonicity in the regime. In contrast, technology-based intervention may provide the children with a sense of curiosity and motivation for the therapy session.

Purpose: To investigate the available technology-based physiotherapy interventions for head and trunk control in children with CP.

Methods: A thorough literature search was conducted on five electronic databases (PubMed, CINAHL, Embase, ProQuest, Scopus) from inception to 8th September 2022. We included all the articles that used technology-based physiotherapy interventions to facilitate head and trunk control among children with CP. The review was not restricted to any study designs. Following deduplication, two reviewers independently screened the articles, after which the data was extracted.

Results: A total of 5188 records were retrieved, of which 96 were screened for full-text, and five studies were included for data extraction. The review reported 40 children with CP, aged between 2 and 21 years, with a GMFCS level ranging between III-V. The included studies had one RCT, one quasi-experimental study with a control group, one pre-post study, one pilot study, and a case series. The technology-based interventions that were used for the CP children with poor head and trunk control were ENLAZA interface (n = 2), Headpod device (n = 1), Head position trainer (n = 1), and targeted training device (n = 1). The devices, along with conventional therapies, were used for an average duration of 15-30 minutes. The outcomes were measured using Gross Motor Function Measure (GMFM-66-IS) (n = 1), GMFM-88 (n = 1), Visual Analogue Scale (n = 1), Goal attainment Scale (n = 1), Trunk Control Measurement Scale (n = 1), Cervical range of Motion-active and passive (n = 1), active time of head lift (n = 1), head bobs (n = 1), head alignment (n = 1). All five studies showed a positive outcome within interventional groups, except one that showed a significant between group change (p<0.05). No adverse events were reported in any of the studies.

Conclusions: This review found five studies that utilized technology-based physiotherapy intervention with conventional therapies that facilitated head and trunk control in children with CP. Early implementation of these techniques may accentuate neuroplastic changes resulting in enhanced functional activities and quality of life. Moreover, outcome measures that specifically assess head control in different positions (supine, prone, pull-to-sit, supported sitting) were not reported in this review.

Implications: The technology-based physiotherapy interventions, if found useful, can be applied to enhance the competency of therapy sessions by making the sessions engaging and interactive. Additional studies with a better study design and specific outcome measures that assess the head control in different positions can be implemented in the future study.

Funding acknowledgements: This work was not funded by any specific grant or funding agency in the public, commercial, or not-for-profit sectors.

Keywords:
Cerebral Palsy
Technology-based intervention
Head and trunk control

Topics:
Paediatrics
Paediatrics: cerebral palsy

Did this work require ethics approval? No

Reason: N/A for institution and ethics committee as this was a review and there was no direct involvement of the participant, and the information is available in public domain.