The Effectiveness of

Passive Stretching in
Children with Cerebral
Palsy

Introduction
Cerebral Palsy
Non progressive
Motor impairment syndromes
Lesions of the brain
Early stages of brain development

Introduction
Cerebral Palsy
Secondary complications
Weakness
Abnormalities in bone structures
Gait deviations
Tightness/Contractures

Introduction
Passive stretching
Most common tx used by PTs to
address tightness
Can be done manually, or by other
external devices

Research Question

Does passive stretching improve

passive joint range and movements
and reduce spasticity than no
passive stretching in CP patients?

Inclusion Criteria
Children <18 y/o c spasticity d/t CP
Articles/studies about effectiveness
of passive stretching programs
Studies with all research designs
except expert opinions
Fully published studies in reviewed
journals

Assessment of the studies

Assessment of the studies

Outcome Measures
Changes in Spasticity
Changes in ROM
Changes in Gait

Results

Results

Conclusion
there appears to be some evidence favouring
passive stretching in increasing range of
movements in children with CP.
there is some favourable evidence indicating
that passive stretching may reduce spasticity
there is some evidence to indicate that
sustained stretching is preferable to
manual stretching in improving range of
movement and reducing spasticity in targeted
joints and muscles in studies of children with
spasticity.

Conclusion

The current level of evidence to

support the effectiveness of passive
stretching in children with spastic CP
remains weak.

Limitations
Small number of participants in each study
The childrens ages varied at the point of
investigation, implying variability in their
growth rate and their stage of neuronal
plasticity
Most of the studies were in the middle
range in the total PEDro score.
Inadequate rigorousness of the research
designs

Clinical Implications
The findings of this review prompt
clinicians to rethink the use of passive
stretching in their clinical settings.
Parents of these children also like passive
stretching as they feel that they are
doing something for their children.
Passive stretching should only be used as
an adjunct to other treatment
techniques, rather than solely on its own.