Article

The aim of this study was to describe systematically the best available
intervention evidence for children with cerebral palsy (CP). METHOD: This study
was a systematic review of systematic reviews. The following databases were
searched: CINAHL, Cochrane Library, DARE, EMBASE,
Google Scholar MEDLINE,
OTSeeker, PEDro, PsycBITE, PsycINFO, and speechBITE.
Two independent reviewers
determined whether studies met the inclusion criteria. These were that (1) the
study was a systematic review or the next best available; (2) it was a
medical/allied health intervention; and (3) that more than 25% of participants
were children with CP. Interventions were coded using the Oxford Levels of
Evidence; GRADE; Evidence Alert Traffic Light; and the International
Classification of Function, Disability and Health. RESULTS: Overall, 166 articles
met the inclusion criteria (74% systematic reviews) across 64 discrete
interventions seeking 131 outcomes. Of the outcomes assessed, 16% (21 out of 131)
were graded 'do it' (green go); 58% (76 out of 131) 'probably do it' (yellow
measure); 20% (26 out of 131) 'probably do not do it' (yellow measure); and 6% (8
out of 131) 'do not do it' (red stop). Green interventions included
anticonvulsants, bimanual training, botulinum toxin, bisphosphonates, casting,
constraint-induced movement therapy, context-focused therapy, diazepam, fitness
training, goal-directed training, hip surveillance, home programmes, occupational
therapy after botulinum toxin, pressure care, and selective dorsal rhizotomy.
Most (70%) evidence for intervention was lower level (yellow) while 6% was
ineffective (red). INTERPRETATION: Evidence supports 15 green light
interventions. All yellow light interventions should be accompanied by a
sensitive outcome measure to monitor progress and red light interventions should
be discontinued since alternatives exist.
CI - (c) 2013 Mac Keith Press.

Langue : ANGLAIS