Comparative study of lower limb intensive functional training (LIFT) versus task-oriented training (TOT) for children with spastic bilateral cerebral palsy

Abstract

Background

Children with spastic bilateral cerebral palsy (CP) often face significant challenges related to mobility and balance due to muscle stiffness and weakness in their lower limb. Despite the challenges, innovative rehabilitation strategies such as lower limb intensive functional training (LIFT) and task-oriented training (TOT) offer promising avenues for improving functional outcomes and promoting holistic development in affected children.

Objective

To compare the effectiveness of lower limb intensive functional training (LIFT) and task-oriented training (TOT) on gross motor function and mobility for children with spastic bilateral cerebral palsy (CP).

Method

Children who met the inclusion criteria, that is, children aged between 7 and 14 years diagnosed with spastic bilateral CP classified within levels I and II on the Gross Motor Function Classification System (GMFCS) took part in this study. They were randomly allocated into two groups: Group A underwent LIFT that has three domains: Strength, balance and coordination and Group B underwent TOT based on therapeutic play. Outcome measures (Gross Motor Function Measure-66, Timed Up and Go test) were assessed pre-intervention and post-intervention, and collected data was statistically analyzed using mean, SD, and Student’s t-test.

Results

Both groups showed significant improvements from pre-test to post-test in GMFM-66 and TUG scores (p < .0001 for both measures). The changes in GMFM-66 scores (LIFT: +3.93; TOT: +7.99) and TUG times (LIFT: −2 seconds; TOT: −4 seconds) exceeded the minimally clinically interpretable differences (MCIDs), demonstrating clinical significance. However, TOT demonstrated significantly larger improvements compared to LIFT (p < .0001), and the differences were clinically meaningful.

Conclusion

The study provided evidence supporting the superiority of TOT over LIFT for improving gross motor function and mobility in children with spastic bilateral cerebral palsy.