[MS3-2C-3] Comparison of Home-centred Activity-based Therapy and Conventional Physiotherapy in Children with Diplegic Cerebral Palsy : A Randomized Controlled Trial
[Introduction]:Home-centred, activity- based therapy in children with spastic diplegic CP is poorly studied in resource-constrained settings. This RCT was conducted to compare the efficacy of home-centred, activity-based therapy and conventional physiotherapy in children (5-12 year old) with spastic diplegic CP.[Primary Objective]: To compare change in distance covered in 6-Minute-Walk-Test (6MWT) by diplegic CP children (5-12years) receiving six months home-centred activity-based therapy versus those receiving conventional physiotherapy.[Methodology]: Consecutive children (5-12yrs) with spastic diplegic CP (Gross Motor Function Classification Scale scores II and III) were randomized into ‘Intervention’ and ‘Control’ arms. All children received conventional physiotherapy.Those in ‘Intervention arm’ received additional home-centred activity-based therapy. Outcomes were assessed at 3 and 6 months using 6-Minute-Walk-Test,10-Metre-Fast-Walk-Test,Modified Ashworth Scale,Modified Tardieu Scale,Gross Motor Function Measure-88,Cerebral Palsy Quality of Life (CPQoL)(Primary Caregiver version) scale.[Results]: Assessed for eligibility: 262; Fulfilled inclusion criteria :169; Excluded:110;Randomized:59 (Intervention Arm:30, Control Arm:29) .Baseline characteristics were similar in the two arms. Primary outcome (mean change in 6MWT score at 6 months) was comparable in both arms [(-4.1)+ 36.4 vs 0.3+ 11). Secondary outcomes, namely, change in 10-Metre-Fast-Walk-Test,Modified Ashworth Scale,Modified Tardieu Scale,Gross Motor Function Measure-88,Cerebral Palsy Quality of Life (CPQoL)(Primary Caregiver version) scores at 3 and 6 months were also comparable.[Conclusions]: In this small-sample study, home-centred activity- based therapy was not found to be more effective than conventional physiotherapy in diplegic CP children. Hence, a study with more intensive activity- based therapy is recommended with longer follow-up time.