Article

AIM: To conduct a systematic review and evaluate the quality of evidence for
interventions to prevent hip displacement in children with cerebral palsy (CP).
METHOD: A systematic review was performed using American Academy of Cerebral
Palsy and Developmental Medicine (AACPDM) and Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) methodology. Searches were
completed in seven electronic databases. Studies were included if participants
had CP and the effectiveness of the intervention was reported using a
radiological measure. Results of orthopaedic surgical interventions were
excluded. RESULTS: Twenty-four studies fulfilled the inclusion criteria (4
botulinum neurotoxin A; 2 botulinum neurotoxin A and bracing; 1 complementary and
alternative medicine; 1 intrathecal baclofen; 1 obturator nerve block; 8
positioning; 7 selective dorsal rhizotomy). There was significant variability in
treatment dosages, participant characteristics, and duration of follow-up among
the studies. Overall, the level of evidence was low. No intervention in this
review demonstrated a large treatment effect on hip displacement. INTERPRETATION:
The level and quality of evidence for all interventions aimed at slowing or
preventing hip displacement is low. There is currently insufficient evidence to
support or refute the use of the identified interventions to prevent hip
displacement or dislocation in children and young people with CP. WHAT THIS PAPER
ADDS: High-quality evidence on prevention of hip displacement is lacking. No
recommendations can be made for preventing hip displacement in children with
cerebral palsy because of poor-quality evidence. High-quality, prospective,
longitudinal studies investigating the impact of interventions on hip
displacement are required.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS