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

Thomason, Pam; Graham, H. Kerr

doi:10.1111/dmcn.12417

Cited by 19 publications

(24 citation statements)

References 9 publications

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“…Several recent systematic reviews have advocated for an increased focus on the child's environment and social interactions for this population (Case-Smith, Clark, & Schlabach, 2013;Novak et al, 2013). Recommendations from these systematic reviews parallel growing evidence that the effectiveness of early intervention for children with developmental delays, more broadly than cerebral palsy, is related to the ability of parents to read their child's cues and respond sensitively rather than the amount or intensity of therapy (Atkins-Burnett & Allen-Meares, 2000; Karaaslan, Diken, & Mahoney, 2013).…”

mentioning

confidence: 99%

Parent‐child interactions and children with cerebral palsy: An exploratory study investigating emotional availability, functional ability, and parent distress

Barfoot

Meredith

Ziviani

et al. 2017

Child

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Findings from this study are consistent with the wider literature showing a link between parental depression and the parent-child relationship and extend this link to the cerebral palsy population. The importance of routine screening for parental mental health problems in early childhood intervention is highlighted by these findings. In addition, this study emphasizes the need to better understand how therapists support parents to implement therapeutic strategies to minimize negative impact on the developing parent-child relationship.

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mentioning

confidence: 99%

Parent‐child interactions and children with cerebral palsy: An exploratory study investigating emotional availability, functional ability, and parent distress

Barfoot

Meredith

Ziviani

et al. 2017

Child

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“…To our knowledge, this is the first randomised controlled trial investigating the effectiveness of an individually tailored interdisciplinary intervention addressing impairments identified by IGA compared with ‘care as usual’ in children diagnosed with CP. Such a trial is warranted because IGA is widely used for orthopaedic surgical planning [ 11 , 14 , 15 ] and has been shown to affect the decision-making in the planning of orthopaedic surgery [ 18 ]. However, its effectiveness regarding gait pathology, walking performance and patient-reported outcomes of functional mobility, overall health, pain and participation in normal daily activities as well as health-related quality of life have never been investigated.…”

Section: Discussionmentioning

confidence: 99%

“…The use of IGA in combination with clinical examinations and standardised measures provide quantifiable information for clinical decisions regarding individually tailored interventions, in contrast to the current practice (‘care as usual’) where only clinical examinations and standardised measures are used. In the last two decades, pre-operative IGA has developed to the point where it has become an important investigation in ambulant children with CP [ 11 , 14 , 15 ]. Studies have shown that IGA can significantly affect the decisions regarding orthopaedic surgical interventions [ 16 – 18 ], and that there is good agreement between recommendations based on IGA and the surgery performed [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

The use of instrumented gait analysis for individually tailored interdisciplinary interventions in children with cerebral palsy: a randomised controlled trial protocol

et al. 2015

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BackgroundChildren with cerebral palsy (CP) often have an altered gait. Orthopaedic surgery, spasticity management, physical therapy and orthotics are used to improve the gait. Interventions are individually tailored and are planned on the basis of clinical examinations and standardised measurements to assess walking (‘care as usual’). However, these measurements do not describe features in the gait that reflect underlying neuro-musculoskeletal impairments. This can be done with 3-dimensional instrumented gait analysis (IGA). The aim of this study is to test the hypothesis that improvements in gait following individually tailored interventions when IGA is used are superior to those following ‘care as usual’.Methods/DesignA prospective, single blind, randomised, parallel group study will be conducted. Children aged 5 to 8 years with spastic CP, classified at Gross Motor Function Classification System levels I or II, will be included. The interventions under investigation are: 1) individually tailored interdisciplinary interventions based on the use of IGA, and 2) ‘care as usual’. The primary outcome is gait measured by the Gait Deviation Index. Secondary outcome measures are: walking performance (1-min walk test) and patient-reported outcomes of functional mobility (Pediatric Evaluation of Disability Inventory), health-related quality of life (The Pediatric Quality of Life Inventory Cerebral Palsy Module) and overall health, pain and participation (The Pediatric Outcome Data Collection Instrument). The primary endpoint for assessing the outcome of the two interventions will be 52 weeks after start of intervention. A follow up will also be performed at 26 weeks; however, exclusively for the patient-reported outcomes.DiscussionTo our knowledge, this is the first randomised controlled trial comparing the effects of an individually tailored interdisciplinary intervention based on the use of IGA versus ‘care as usual’ in children with CP. Consequently, the study will provide novel evidence for the use of IGA.Trial registrationTrial registration: ClinicalTrials.gov NCT02160457. Registered June 2, 2014.

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“…18 Similar to our view, several groups indicated their preference for prospective cohort studies to understand factors associated with children's outcomes. 16,18,19 Our research has used comprehensive rehabilitation outcomes research 20 which is structured around the World Health…”

Section: Difficulties In Applying Knowledge From Intervention Studiesmentioning

confidence: 99%

A Collaborative Approach to Decision Making Through Developmental Monitoring to Provide Individualized Services for Children With Cerebral Palsy

et al. 2018

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In this perspective paper, we explore the challenge that physical and occupational therapists face when attempting to use evidence of effectiveness of interventions to support people with heterogeneous health conditions, such as cerebral palsy (CP). We define CP and describe how variable children with this diagnosis are. We then selectively review published literature that highlights difficulties in using information from randomized controlled trials (RCTs) and systematic reviews to inform service planning for children with CP. We propose an evidence-based alternative using prospective cohort studies that produce knowledge of determinants of outcomes important to children and families and methods for developmental monitoring using longitudinal and reference percentile curves to inform individualized care. We provide guidelines to explore how this evidence can be used to plan family-centred, collaborative, strengths-based services to support development and function. Cerebral Palsy and Heterogeneity Cerebral palsy (CP) describes a group of permanent disorders of the development of movement and posture ….. often accompanied by disturbances of sensation, perception, cognition, communication, and behaviour, by epilepsy, and by secondary musculoskeletal problems. 1, pg9 Traditionally, children with CP have been described by type of motor disorder or distribution of involvement. Recently, functional classification systems have been identified to be more useful and reliable than systems based on impairments. 2 The Gross Motor Function Classification System (GMFCS), 3,4 the Manual Ability Classification System (MACS), 5 and the Communication Function Classification System (CFCS) 6 are 5-level ordinal classification systems to categorize usual performance in gross motor, hand, and communication function in everyday life with evidence supporting their reliability and validity. In all systems, level I represents the highest function and level V the lowest. Together, these systems contribute significantly in understanding the variable manifestation of CP. They also provide enhanced

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

Cited by 19 publications

References 9 publications

Parent‐child interactions and children with cerebral palsy: An exploratory study investigating emotional availability, functional ability, and parent distress

Parent‐child interactions and children with cerebral palsy: An exploratory study investigating emotional availability, functional ability, and parent distress

The use of instrumented gait analysis for individually tailored interdisciplinary interventions in children with cerebral palsy: a randomised controlled trial protocol

A Collaborative Approach to Decision Making Through Developmental Monitoring to Provide Individualized Services for Children With Cerebral Palsy

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