Comparison of Two Alternatives of Intensive Training for Children with Cerebral Palsy, 3/2002

Comparison between Conductive Education, and Motor and Communication Therapy

At the meeting of the European Academy of Childhood Disabilities held in Goteborg, Sweden in 2000, the following paper was presented and discussed.

Pia Odman and her colleagues Birgitta Oberg, Ph.D., et al, Department of Neurosciences and Locomotion, Faculty of Health Sciences, Linkoping University, Sweden evaluated the effects of two methods of intensive training for children with cerebral palsy: "a conductive education approach" and "a combination of training of motor capacity and communication skills." Children 3-16 years of age with a motor disability were included; however, children who could walk 500 meters (574 yards) without a walking aid or with a severe learning disability were not included. The study period was 12 weeks with a baseline intervention of 4 weeks of training. Prior to and after completion of training, a series of well recognized tests of performance were administered to each group and the results compared.

The results of the study were that there were only small differences in the children s performance between the two therapies, with a minimal advantage of the combined motor and communication therapy.

Comment:

This is the third clinical trial reported on by the Foundation (see note below) that has demonstrated very similar results when comparing conductive education and conventional therapies for disabilities associated with cerebral palsy if both approaches are administered for the same period of time (duration) and number of hours weekly (intensity). The important issue, therefore, may not be the techniques of the specific physiotherapy special education approach, but rather how much intervention and for how long. In addition, there are also two results that need to be considered in evaluating a therapy: improved performance and duration of improved performance.

Most studies only address improvement immediately after therapy and for a relatively short follow-up period. But in order to maintain improved performance, does the therapy need to be repeated in 3 months? 6 months? 1 year? Thus, the longer term consequence of early improvement is also an important issue when evaluating an intervention. Too often, this isn't included.

Note:

In a 1998 article in the scientific journal DMCN (Vol 40; pgs. 763-770), Dr. D.S. Reddihough and her colleagues in Australia reported the results of a randomized clinical trial of the results of conductive education (CE) compared with traditional programs of neurodevelopmental rehabilitation in children with cerebral palsy. The children in both groups received therapy of similar intensity and duration. The authors conclude that "children involved in CE based programs made similar progress to those involved in traditional programs. Children with CP made developmental gains regardless of program type." The results of this study are similar to those reported several years ago in a non-randomized study in England.