How effective is stretching in maintaining range of movement for children with cerebral palsy? A critical review

Background/Aims: Cerebral palsy is the most common childhood disorder, affecting 4% of children born in the UK. It is common for children with cerebral palsy to have reduced range of movement (ROM) due to spasticity and contractures. Stretching is commonly used in physiotherapy programmes to manage this. This critical review aims to evaluate the evidence base behind the use of stretching for children with cerebral palsy. Methods: A systematic literature search of AMED, CINAHL, MEDLINE and Cochrane Library Trials was conducted. Returned searches were assessed against strict criteria according to a predefined PICOS (Population, Intervention, Comparison, Outcome, Study). These studies were then critically appraised to assess the validity, reliability and clinical relevance. Results: There is evidence supporting the use of stretching in children with cerebral palsy. However, there is also some evidence to suggest very little or no positive change. All of the included studies have methodological limitations, which questions the validity of the results. Conclusions: The research suggests some positive outcomes for the use of stretching in cerebral palsy; studies that did not find positive outcomes found no adverse effects. However, further research in the area is required to validate the effectiveness of stretching to maintain ROM in children with cerebral palsy.