Effectiveness of therapeutic interventions on participation in children with cerebral palsy: A systematic review and meta-analysis

IF 1.8 4区医学 Q2 PEDIATRICS Child Care Health and Development Pub Date : 2024-07-03 DOI:10.1111/cch.13301

Rigas Dimakopoulos, Theodora Vakalaki, Arietta Spinou, Ioannis Michopoulos, Μarianna Papadopoulou

{"title":"Effectiveness of therapeutic interventions on participation in children with cerebral palsy: A systematic review and meta-analysis","authors":"Rigas Dimakopoulos, Theodora Vakalaki, Arietta Spinou, Ioannis Michopoulos, Μarianna Papadopoulou","doi":"10.1111/cch.13301","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Participation in life activities is an integral part of health and a main outcome of rehabilitation services for children and adolescents with disabilities. However, there is still no consensus on the most effective way to improve participation. The aim of this systematic review is to determine the effectiveness of therapeutic interventions on participation outcomes of children with cerebral palsy (CP).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A systematic review was conducted, searching the databases PubMed, Cochrane Library, Science Direct, Web of Science and Scopus for randomized controlled trials (RCTs), between 2001 and 2023. Studies were eligible for inclusion if they evaluated children with CP undergoing any intervention and using any tool measuring participation as an outcome measure. A meta-analysis of treatment effect was conducted. A sensitivity analysis was conducted to identify the effect on participation when intervention targeted different International Classification of Functioning (ICF) domains.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 1572 records were identified. Eight RCTs including 384 children (195 in the intervention group and 189 in the control group) were included in the systematic review and in the meta-analysis. A sensitivity analysis showed that interventions focusing on participation significantly improved participation; standardized mean difference (1.83; 95% CI: 1.33–2.32; Z = 7.21; <i>P</i> < 0.00001). When other types of interventions, that is, focusing on body functions and structures or activities, were used, then participation was not favourably affected.</p>\n </section>\n \n <section>\n \n <h3> Interpretation</h3>\n \n <p>Interventions primarily targeting barriers to participation across several ICF domains have a greater influence on enhancing participation. Interventions aimed at enhancing specific motor skills, including gross and fine motor function or strength, do not necessarily have a positive impact on participation.</p>\n </section>\n </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"50 4","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.13301","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Child Care Health and Development","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cch.13301","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Participation in life activities is an integral part of health and a main outcome of rehabilitation services for children and adolescents with disabilities. However, there is still no consensus on the most effective way to improve participation. The aim of this systematic review is to determine the effectiveness of therapeutic interventions on participation outcomes of children with cerebral palsy (CP).

Methods

A systematic review was conducted, searching the databases PubMed, Cochrane Library, Science Direct, Web of Science and Scopus for randomized controlled trials (RCTs), between 2001 and 2023. Studies were eligible for inclusion if they evaluated children with CP undergoing any intervention and using any tool measuring participation as an outcome measure. A meta-analysis of treatment effect was conducted. A sensitivity analysis was conducted to identify the effect on participation when intervention targeted different International Classification of Functioning (ICF) domains.

Results

A total of 1572 records were identified. Eight RCTs including 384 children (195 in the intervention group and 189 in the control group) were included in the systematic review and in the meta-analysis. A sensitivity analysis showed that interventions focusing on participation significantly improved participation; standardized mean difference (1.83; 95% CI: 1.33–2.32; Z = 7.21; P < 0.00001). When other types of interventions, that is, focusing on body functions and structures or activities, were used, then participation was not favourably affected.

Interpretation

Interventions primarily targeting barriers to participation across several ICF domains have a greater influence on enhancing participation. Interventions aimed at enhancing specific motor skills, including gross and fine motor function or strength, do not necessarily have a positive impact on participation.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

治疗干预对脑瘫儿童参与的有效性：系统回顾和荟萃分析。

背景：参与生活活动是健康的组成部分，也是残疾儿童和青少年康复服务的主要成果。然而，对于提高参与度的最有效方法仍未达成共识。本系统综述旨在确定治疗干预对脑瘫（CP）儿童参与结果的有效性：方法：我们在 PubMed、Cochrane Library、Science Direct、Web of Science 和 Scopus 等数据库中搜索了 2001 年至 2023 年间的随机对照试验 (RCT)，并进行了系统性综述。如果研究对接受任何干预措施的 CP 儿童进行了评估，并使用任何测量参与度的工具作为结果测量指标，则符合纳入条件。对治疗效果进行了荟萃分析。还进行了一项敏感性分析，以确定针对不同国际功能分类（ICF）领域的干预对参与的影响：共找到 1572 条记录。系统综述和荟萃分析共纳入了 8 项研究性试验，其中包括 384 名儿童（干预组 195 人，对照组 189 人）。敏感性分析表明，以参与为重点的干预措施显著提高了参与度；标准化平均差（1.83；95% CI：1.33-2.32；Z = 7.21；P 解释：主要针对多个 ICF 领域的参与障碍的干预措施对提高参与度的影响更大。旨在提高特定运动技能（包括粗大和精细运动功能或力量）的干预措施并不一定会对参与产生积极影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Child Care Health and Development 医学-小儿科

CiteScore

3.40

自引率

5.30%

发文量

136

审稿时长

4-8 weeks

期刊介绍： Child: care, health and development is an international, peer-reviewed journal which publishes papers dealing with all aspects of the health and development of children and young people. We aim to attract quantitative and qualitative research papers relevant to people from all disciplines working in child health. We welcome studies which examine the effects of social and environmental factors on health and development as well as those dealing with clinical issues, the organization of services and health policy. We particularly encourage the submission of studies related to those who are disadvantaged by physical, developmental, emotional and social problems. The journal also aims to collate important research findings and to provide a forum for discussion of global child health issues.