Neurodevelopmental therapy and casting: A comparison of intensive neurodevelopmental therapy plus casting
The purpose of this study was to evaluate the combined effect of intensive neurodevelopmental therapy (NDT) and casting in improving hand function, quality of upper extremity movement and range of motion in children 18 months to 4 years of age who have cerebral palsy. Findings indicated there to be no significant differences between intensive NDT plus casting and a less intensive regular occupational therapy program.
At the time of this study, children with cerebral palsy in Ontario receiving ongoing therapy at children's treatment centres often received NDT, a therapy widely practised by occupational therapists. Upper extremity inhibitive casting has also been implemented in conjunction with NDT to improve hand function. A randomized cross-over design was used to evaluate the difference between intensive NDT plus casting and a less intensive regular occupational therapy program.
Blinded assessment of hand function, quality of upper extremity movement and parents' perception of hand function performance were performed at baseline, four months (end of first intervention period), six months (after a 2 month washout period), and ten months (end of second intervention period). Analysis of the outcomes revealed no significant differences in hand function, quality of upper extremity movement, or parents' perception of hand function performance between intensive NDT plus casting or regular occupational therapy programs. There does not appear to be any beneficial effect of an increased amount of therapy for the children in this study.
Law, M., Russell, D., Pollock, N., Rosenbaum, P., Walter, S., & King, G. (1997). A comparison of intensive neurodevelopmental therapy plus casting and a regular occupational therapy program for children with cerebral palsy. Developmental Medicine and Child Neurology, 39, 664-670.
This study demonstrates that occupational therapy for young children with cerebral palsy, with a focus on improving hand function skills and delivered one to three times per month, achieves the same outcomes as a more intensive neurodevelopmental therapy approach with casting provided 6 to 8 times per month. Children appear to benefit equally from less intensive, but functionally focused therapy.
Ontario Ministry of Health - $223,000 (1990 - 1993)