The effects of neurodevelopmental treatment versus practice on the reaching of children with spastic cerebral palsy

Background and Purpose. Children with cerebral palsy (CP) are frequently referred for physical therapy, yet the effectiveness of treatment has not been well-documented. In the relatively few available studies, outcomes are divided between support and lack of support for treatment. The purpose of this research was to document and evaluate the effects of a physical therapy program on the reaching movements of children with spastic CP. Subjects. Eight children with CP, 10 to 15 years of age, were treated daily for 5 days with a version of neurodevelopmental treatment (NDT) and for 5 days with practice of reaching tasks. Methods. Changes in movement time, path, and smoothness of reach were quantified and described using kinematic analysis. Results. There were no differences in any of the variables following 5 days of NDT. There was a difference in movement time, but in no other variables, following 5 days of practice. When time in treatment, rather than type of treatment, was the independent variable, the data showed changes. Both movement time and movement units were reduced following 5 days of treatment. Movement time, movement units, and displacement, but not reaction time, were reduced following the completion of both types of treatment. Conclusion and Discussion. The two treatments in combination may be necessary to achieve these results. Alternatively, either treatment type alone, when given for at least 2 weeks, may produce similar results.