Interventions to improve physical function for children and young people with cerebral palsy: international clinical practice guideline.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.