New clinical and research trends in lower extremity management for ambulatory children with cerebral palsy

Phys Med Rehabil Clin N Am. 2009 Aug;20(3):469-91. doi: 10.1016/j.pmr.2009.04.005.


Cerebral palsy (CP) is the most prevalent physical disability in childhood and includes a group of disorders with varying manifestations. This article focuses on current and future intervention strategies for improving mobility and participation during the lifespan for ambulatory children with CP. The provision and integration of physical therapy and medical and orthopedic surgery management focused primarily on the lower extremities are discussed here. Some of the newer trends are more intense and task-related exercise strategies, greater precision in tone identification and management, and a shift towards musculoskeletal surgery that focuses more on promoting dynamic bony alignment and less on releasing or lengthening tendons. Advances in basic and clinical science and technology development are changing existing paradigms and offering renewed hope for improved functioning for children with CP who face a lifelong disability with unique challenges at each stage in life.

Publication types

  • Review

MeSH terms

  • Biomedical Research / trends*
  • Botulinum Toxins / therapeutic use
  • Cerebral Palsy / complications*
  • Cerebral Palsy / rehabilitation
  • Child
  • Gait
  • Humans
  • Leg*
  • Mobility Limitation*
  • Muscle Spasticity / etiology
  • Muscle Spasticity / rehabilitation*
  • Neuromuscular Agents / therapeutic use
  • Orthopedic Procedures / methods*
  • Outpatients*
  • Physical Therapy Modalities
  • Treatment Outcome


  • Neuromuscular Agents
  • Botulinum Toxins