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A systematic review of interventions for children with cerebral palsy: state of the evidence.

Abstract：

AIM:The aim of this study was to describe systematically the best available intervention evidence for children with cerebral palsy (CP). METHOD:This study was a systematic review of systematic reviews. The following databases were searched: CINAHL, Cochrane Library, DARE, EMBASE, Google Scholar MEDLINE, OTSeeker, PEDro, PsycBITE, PsycINFO, and speechBITE. Two independent reviewers determined whether studies met the inclusion criteria. These were that (1) the study was a systematic review or the next best available; (2) it was a medical/allied health intervention; and (3) that more than 25% of participants were children with CP. Interventions were coded using the Oxford Levels of Evidence; GRADE; Evidence Alert Traffic Light; and the International Classification of Function, Disability and Health. RESULTS:Overall, 166 articles met the inclusion criteria (74% systematic reviews) across 64 discrete interventions seeking 131 outcomes. Of the outcomes assessed, 16% (21 out of 131) were graded 'do it' (green go); 58% (76 out of 131) 'probably do it' (yellow measure); 20% (26 out of 131) 'probably do not do it' (yellow measure); and 6% (8 out of 131) 'do not do it' (red stop). Green interventions included anticonvulsants, bimanual training, botulinum toxin, bisphosphonates, casting, constraint-induced movement therapy, context-focused therapy, diazepam, fitness training, goal-directed training, hip surveillance, home programmes, occupational therapy after botulinum toxin, pressure care, and selective dorsal rhizotomy. Most (70%) evidence for intervention was lower level (yellow) while 6% was ineffective (red). INTERPRETATION:Evidence supports 15 green light interventions. All yellow light interventions should be accompanied by a sensitive outcome measure to monitor progress and red light interventions should be discontinued since alternatives exist.

journal_name

Dev Med Child Neurol

journal_title

Developmental medicine and child neurology

authors

Novak I,McIntyre S,Morgan C,Campbell L,Dark L,Morton N,Stumbles E,Wilson SA,Goldsmith S

doi

10.1111/dmcn.12246

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

885-910

issue

eissn

0012-1622

issn

1469-8749

journal_volume

pub_type

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A systematic review of interventions for children with cerebral palsy: state of the evidence.