Development and implementation of a child-specific dynamic stretching exercise programme for ambulant children with spastic cerebral palsy: The SPELL trial.
Catherine Barry, Helen Wood, Sally Hopewell et al.
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In 30 seconds
This paper describes the development and implementation of physiotherapy interventions for the SPELL trial, a multicentre, two-arm superiority randomised controlled trial in ambulant children with spastic cerebral palsy. The intervention is an individually tailored dynamic stretching programme comprising 6 physiotherapist-overseen sessions over 16 weeks, with exercises prescribed 4–5 times per week and supported by a web-based app and behaviour-change strategies. Usual care includes one physiotherapy session alongside ongoing usual physiotherapy. The paper reports that a widely accepted, well-defined programme was developed; it does not report trial outcomes or an effect on mobility.
Key findings
- The programme comprises 6 physiotherapist-overseen sessions over 16 weeks, with dynamic stretching exercises prescribed 4–5 times per week.
- A web-based app with exercise videos and behaviour-change strategies supports exercise delivery and intended long-term adherence.
- Usual care consists of one face-to-face physiotherapy session, standardised core content, and continuation of normal physiotherapy care.
- The six-month internal pilot tested whether the interventions could be delivered across the UK's National Health Service.
Why it matters
The paper provides a detailed account of how a child-specific exercise intervention and comparator were designed for a multicentre trial, including input from clinicians, researchers, experts and patient representatives. Clear intervention components and delivery procedures can support consistent implementation and interpretation of the forthcoming trial, which is intended to assess functional mobility.
What to keep in mind
This paper describes intervention development and implementation, not comparative clinical outcomes; it therefore cannot establish whether the programme improves functional mobility.