Efeitos de diferentes formas de treino de marcha sobre a função motora e o endurance de crianças com paralisia cerebral

Abstract

Cerebral palsy is a neurological condition that impairs motor development and frequently causes gait abnormalities, reduced gross motor function, and decreased functional capacity in affected children. Given the variety of therapeutic strategies currently available, this study aimed to investigate the effects of different gait training approaches on gross motor function and endurance in children with cerebral palsy through the analysis of the main scientific evidence available. This study is a literature review conducted using the Scientific Electronic Library Online, Cochrane Library, PubMed, and Physiotherapy Evidence Database databases. Studies published between 2021 and 2026 with a Physiotherapy Evidence Database score of six or higher that investigated gait training interventions in children with cerebral palsy were included. The initial search identified 4,645 studies, of which eight met the eligibility criteria and were included in the final analysis. The findings demonstrated that different gait training modalities improved gross motor function, gait speed, and walking endurance, in addition to promoting benefits in balance, muscle strength, selective motor control, and spasticity. Robotic-assisted interventions and wearable exoskeletons showed superior outcomes in several functional measures, particularly when combined with individualized training protocols of appropriate intensity. Evidence of neuroplastic adaptations associated with increased functional brain connectivity following gait training was also observed. It is concluded that different gait training approaches are effective strategies for improving gross motor function and endurance in children with cerebral palsy, contributing to greater functional independence and quality of life. However, further long-term studies are needed to determine the persistence of these benefits.