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Interventions to improve physical function for children and young people with cerebral palsy: international clinical practice guideline.

Developmental medicine and child neurology
May 1, 2022
Michelle Jackman et al. (10 authors)
Journal ArticlePractice GuidelineHuman StudyClinical
Study Details

Study Goal

To provide recommendations for interventions, including walking, to improve physical function for children and young people with cerebral palsy.

Results Summary

Overground walking is recommended to improve walking ability and can be supplemented with treadmill training; interventions should include client-chosen goals and whole-task practice in real-life settings.

Population

Children and young people with cerebral palsy.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
intervention includes client-chosen goals, whole-task practice within real-life settings, support to empower families, and a team approach
increase
functional goals
children and young people with cerebral palsy
-
recommended
#1
overground walking
increase
walking ability
children and young people with cerebral palsy
-
recommended
#2
treadmill training
increase
walking ability
children and young people with cerebral palsy
-
can be supplemented
#3
bimanual therapy, constraint-induced movement therapy, goal-directed training, and cognitive approaches
increase
hand use goals
children and young people with cerebral palsy
-
can facilitate
#4
whole-task practice combined with assistive devices
increase
independence
children and young people with cerebral palsy
-
can increase
#5
whole-task practice combined with assistive devices
decrease
caregiver burden
children and young people with cerebral palsy
-
can reduce
#6
whole-task practice with strategies to address environmental, personal, and social barriers
increase
participation in leisure goals
children and young people with cerebral palsy
-
can combine
#7
Abstract

AIM: To provide recommendations for interventions to improve physical function for children and young people with cerebral palsy. METHOD: An expert panel prioritized questions and patient-important outcomes. Using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods, the panel assessed the certainty of evidence and made recommendations, with international expert and consumer consultation. RESULTS: The guideline comprises 13 recommendations (informed by three systematic reviews, 30 randomized trials, and five before-after studies). To achieve functional goals, it is recommended that intervention includes client-chosen goals, whole-task practice within real-life settings, support to empower families, and a team approach. Age, ability, and child/family preferences need to be considered. To improve walking ability, overground walking is recommended and can be supplemented with treadmill training. Various approaches can facilitate hand use goals: bimanual therapy, constraint-induced movement therapy, goal-directed training, and cognitive approaches. For self-care, whole-task practice combined with assistive devices can increase independence and reduce caregiver burden. Participation in leisure goals can combine whole-task practice with strategies to address environmental, personal, and social barriers. INTERPRETATION: Intervention to improve function for children and young people with cerebral palsy needs to include client-chosen goals and whole-task practice of goals. Clinicians should consider child/family preferences, age, and ability when selecting specific interventions.

Medical Subject Headings (MeSH)
AdolescentCerebral PalsyChildHumansPhysical Therapy ModalitiesUpper ExtremityWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations130
Citations/Year43.3
Relative Citation Ratio33.45
NIH Percentile99.8%
Research Impact Scores
APT Score0.95
Weight Score3.41
Normalized Score0.72
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