Effectiveness of task-specific training for improving balance performance in children with cerebral palsy (CP): a narrative systematic review

Introduction A body of research has focused on helping children with disabilities stay physically active. As poor balance has been found as a major limitation in physical activities, a systematic review exploring balance intervention programs is warranted. Methods The primary aim of this is to systematically evaluate evidence for the effect of task-specific training to improve balance outcomes in ambulant children with cerebral palsy. Seven databases were searched for studies involving ambulant children with cerebral palsy (4–15 years old); balance TST; and balance-related outcomes. The quality of the studies was appraised using the JBI Critical Appraisal Checklists for risk of bias, study design, and quality of evidence. Continuous data were transformed and summarised using standardised mean difference and 95%CI. Results Seven randomised controlled trials met the inclusion criteria. The risk of bias was deemed low in most of the studies. Due to heterogeneity of study design and outcome measures, a narrative synthesis was conducted. Positive between-group effects favouring TST were found across the six studies (BBS d = 1.528, 95% CI = 0.7747–2.2813) and follow-up (BBS d = –1.667, 95% CI = –2.459 ÷ –0.874). Despite poor reporting of motor learning strategies, repetitive practice, feedback, and task modulation strategies were used consistently in balance TST. Conclusions TST could be recommended to be a part of an intervention programme to improve balance performance in children with CP. However, more studies with rigorous study design and adequately powered implementation of a more fun task-oriented training programme are needed.