Affiliations: [a] Montgomery County Infants and Toddlers Program, Rockville, MD, USA | [b] Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA | [c] Sunny Hill Health Centre for Children, Vancouver, BC, Canada
Correspondence:
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Corresponding author: Ginny Paleg, Montgomery County Infants and Toddlers Program, 420 Hillmoor Dr, Silver Spring, MD 20901, USA. Tel.: +1 301 452 4656; E-mail: ginny@paleg.com.
Abstract: OBJECTIVE: To evaluate evidence supporting physical and occupational therapy interventions used to improve sensory and motor outcomes for children 0–6 years with central hypotonia. METHODS: Four electronic databases were searched from 1996 to March 2017. Level of evidence and study conduct was evaluated using American Academy of Cerebral Palsy and Developmental Medicine criteria. Traffic lighting classification identified interventions that were green (proven effective), yellow (possibly effective) or red (proven ineffective or contraindicated). RESULTS: Thirty-seven articles were included. Nine studies measured orthotic interventions while four distinct studies published over nine articles measured treadmill interventions. Remaining studies measured impact of compression garments, massage, motor and sensori-motor interventions, positioning and mobility interventions. CONCLUSIONS: Green light evidence supports treadmill training (to promote ambulation and gait characteristics) and massage (to positively affect muscle tone, motor development and use of vision) for infants with Down syndrome. These interventions are considered Yellow (possibly effective) for other populations. Green light evidence supports impact of orthoses on foot alignment for ambulatory children with hypotonia, while impact on gait characteristics is Yellow light and motor development may be negatively impacted (Red light) in pre-ambulatory children. All other interventions rated Yellow (possibly effective) and therapists should monitor using sensitive outcome measures.
Keywords: Congenital hypotonia, hypotonic, children
