Episodes listed in reverse chronological order

“More isn’t always better: getting smarter about therapy dosage in children with cerebral palsy”.

Across the world, there is an emerging trend for families of children with CP to seek massed practice, high-dose therapy approaches. Often, these approaches have little or no supporting research evidence but offer hope for optimising outcomes simply due to the amount of therapy provided. 

Guided by outcomes from contemporary research, including the absence of a linear relationship between dosage and therapy outcomes, we will explore the concept that more isn’t always better. In addition, we will explore why dosage is not a parameter that should be decided after the selection of an evidence-based therapy approach. 

Rather, dosage, along with many other specific motor learning strategies, is an inherent part of a specific and well-defined therapy approach. A specific dosage (amount of practice) is guided by the underlying theories that inform an approach. 

Within the different models of contemporary evidence-based therapies, e.g., bimanual therapy, there are vastly different therapy approaches/protocols that have been developed over the last 20 years. Many demonstrate similar levels of effectiveness across a range of outcomes, despite significant differences in dosage. These approaches are different as the organising theories and application of motor learning strategies are fundamentally different. 

Inspired by the workshop that was given at Oceania 2026 by Dr Brian Hoare and Dr Dayna Pool, we explore the impact of attempts to simplify therapy dosage by grouping therapy approaches by name or model, and specifying a single dosage parameter for very different evidence-based therapy approaches. 

Link to website discussed:

https://cpresource.org/topic/treatment-options/considering-alternatives-guide-decision-making-cerebral-palsy-treatments