Occupational and Physical Therapy Interventions for Young Children with Developmental Central Hypotonia: An Overview of Systematic Reviews

Ginny S. Paleg (), Álvaro Hidalgo Robles, Pragashnie Govender and Roslyn W. Livingstone
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Ginny S. Paleg: CanChild, McMaster University, Hamilton, ON L8S 1C7, Canada
Álvaro Hidalgo Robles: Facultad de Educación, Universidad Internacional de La Rioja, 26006 Logroño, Spain
Pragashnie Govender: Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa
Roslyn W. Livingstone: Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada

Disabilities, 2025, vol. 5, issue 1, 1-43

Abstract: Developmental central hypotonia describes children with decreased muscle tone due to non-progressive central damage, and includes many genetic conditions (e.g., Down, Prader–Willi or Joubert syndromes etc.), cerebral palsy with hypotonia as the main motor type, developmental delays and congenital hypotonia with favorable outcome. This umbrella review aims to systematically describe the best available evidence for interventions that may be used by early intervention therapists in home and community settings. We conducted electronic searches in PubMed, Medline, CINAHL, EMBASE, EBM Reviews and PEDro during August 2024. Methodological quality and risk-of-bias were rated by all authors, and included reviews were compared and contrasted. Eight systematic reviews (SRs) and two overviews of interventions for children with developmental central hypotonia under 6 years of age were identified through databases and other search methods. Four SRs and one overview evaluated treadmill training, one SR evaluated use of orthotics, another evaluated therapeutic exercise, and two SRs and one overview evaluated a range of occupational and physical therapy interventions. Methodological quality and risk-of-bias of included reviews were variable. Most evidence is related to children with Down syndrome, with few studies addressing children with central hypotonia from other causes. Low-quality (GRADE) evidence supports treadmill training to promote walking onset in children with Down syndrome. Motor, sensorimotor, orthotics, positioning, mobility and infant massage interventions are supported by positive but low- or very-low-quality evidence, and recommendations in favor are all conditional. Primary research on effectiveness of all occupational and physical therapy early interventions for children with developmental central hypotonia from all causes is warranted.

Keywords: low muscle tone; muscle; hypotonia; rehabilitation; early intervention; physical activity (search for similar items in EconPapers)
JEL-codes: I (search for similar items in EconPapers)
Date: 2025
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