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J Child Neurol. 2009 Sep;24(9):1200-4. doi: 10.1177/0883073809337919. Epub 2009 Jun 12.

Rehabilitative therapies in cerebral palsy: the good, the not as good, and the possible.

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National Institutes of Health, Rehabilitation Medicine Department, Bethesda, Maryland 20892, USA.


In the past decade, growing recognition of the importance of motor activity for the development and maintenance of central nervous system pathways and for recovery of function post injury has provided new avenues for rehabilitation. Physical therapy is likely to have a prominent role in stimulating neuroplastic changes in damaged developing nervous systems that may finally alter the natural history of these disorders, which has not yet been possible. In this article, we discuss the scientific evidence for various physical therapy treatment options for children with cerebral palsy. Newer, more intense, and task-related exercise programs show the strongest level of evidence. Traditional approaches and newer ''packaged'' approaches have failed to provide evidence of superiority. Their continued prevalence among clinicians is puzzling and disconcerting, as evidence supporting other approaches continues to accumulate.

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