Article

As research on the efficacy or effectiveness of interventions to improve motor
functioning in cerebral palsy (CP) has accumulated and been incorporated into
systematic reviews, the foundation for evidence-based practice in CP is growing.
To determine whether an intervention is effective, clinical trials report mean
group differences. However, even if a statistically significant mean group effect
is found, this does not imply that this intervention was effective for each study
participant or ensure positive outcomes for all with CP. A personalized approach
to medical care is currently being advocated based primarily on increasingly
recognized genetic variations in individual responses to medications and other
therapies. A similar approach is also warranted, and perhaps more justifiable, in
CP which includes a heterogeneous group of disorders. Even interventions deemed
highly effective in CP demonstrate a range of individual responses along a
continuum from a negative or negligible response to a strong positive effect, the
bases for which remain incompletely understood. This narrative review recommends
that the next critical step in advancing evidence-based practice is to implement
research strategies to identify patient factors that predict treatment responses
so we can not only answer the question 'what works', but also 'what works best,
for whom'.
CI - Published 2014. This article is a U.S. Government work and is in the public
domain in the USA.

Langue : ANGLAIS