Intermittent versus continuous physiotherapy in children with cerebral palsy.

The aim of this study was to compare the effect of the delivery of the same amount of intermittent versus continuous physiotherapy given to children with cerebral palsy (CP). This was organized either in an intermittent regime four times a week for 4 weeks alternating with a 6-week treatment pause, or a continuous once or twice a week regime, both for a total of 30 weeks. Therapy was administered according to generally accepted physiotherapeutic principles. A prospective, randomized controlled design was used. Twenty-five children (16 males, nine females; median age 3 y, range 1 y-8 y 1 mo) participated. The children were stratified by age and function level (all levels represented) using the Gross Motor Function Classification System and assigned to continuous or intermittent treatment. The Gross Motor Function Measure 66 (GMFM-66) was used as the outcome measure before and after intervention. Statistical analysis revealed that both groups increased their GMFM scores during intervention (intermittent group p=0.028; continuous group p=0.038), while there was no significant difference comparing delta scores between groups (p=0.81). Compliance was significantly higher in the intermittent group (p=0.005), but there was no association between GMFM score and compliance. The study shows that organizing physiotherapy in two markedly different ways yields identical outcome measures for children with CP.