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. 2020 Dec 1;14(6):562-573.
doi: 10.1302/1863-2548.14.200139.

Patients' and parents' views about lower limb orthopaedic surgery for ambulant children and young people with cerebral palsy: a qualitative evidence synthesis

Hajar Almoajil  1   2 , Tim Theologis  1   3 , Helen Dawes  4   5 , Jackie Parsonage  4 , Jo Pierce  6 , Sally Hopewell  1 , Francine Toye  3
Affiliations

Patients' and parents' views about lower limb orthopaedic surgery for ambulant children and young people with cerebral palsy: a qualitative evidence synthesis

Hajar Almoajil et al. J Child Orthop. .

Abstract

Purpose: The article identifies the aspects of health and outcomes that are considered important from the perspective of ambulatory children with cerebral palsy (CP) and their parents regarding lower limb orthopaedic surgery and explores how they experience surgical interventions.

Methods: Four databases (Embase, MEDLINE (Ovid), CINAHL and PsycINFO) were searched from inception to 11 April 2020. Studies were included if they: 1) they involved children or young adults diagnosed with ambulant CP or their family, 2) participants had experience with lower limb orthopaedic surgery and 3) studies employed qualitative research methods. The Critical Appraisal Skills Programme was used to appraise identified studies. The 'Best-fit framework' synthesis approach was used by applying the International Classification of Functioning-Children and Youth (ICF-CY) linking rules and thematic synthesis. The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Six studies were included. Four themes were generated which were linked to the ICF-CY framework: Body function and structure, Activity and participation, Environmental factors, Personal factors, as well as non-ICF-CY themes including Emotional well-being and Goal setting. Important surgical outcomes identified were pain, fatigue, movement-related function, mobility, walking ability, community life, emotional well-being, and adequate provision of public and health services.

Conclusion: These findings are important for understanding patient-centred outcomes in lower limb ortho-paedics surgery and providing focus for future interventional studies aimed at improving outcomes of importance to children with CP. These findings highlight the importance of long-term support to help people negotiate the challenge of surgical regimes and to achieve good outcomes after orthopaedic surgery. The outcomes identified will contribute to the development of a core outcome set in this field.

Level of evidence: III.

Keywords: cerebral palsy; core outcome set; orthopaedic; qualitative evidence synthesis; surgery.

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Figures

Fig. 1
Fig. 1
Flowchart of the studies selection process.
See this image and copyright information in PMC

References

    1. Glinianaia SV, Best KE, Lingam R, Rankin J. Predicting the prevalence of cerebral palsy by severity level in children aged 3 to 15 years across England and Wales by 2020. Dev Med Child Neurol 2017;59:864-870. - PubMed
    1. Damiano DL, Leonard R. 2014 section on pediatrics knowledge translation lecture: clinicians and researchers on the same path toward facilitating family goals for mobility and participation. Pediatr Phys Ther 2015;27:105-112. - PMC - PubMed
    1. Rosenbaum, P, Paneth, N, Leviton, A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007. February;109:8-14. - PubMed
    1. WHO. International classification of functioning, disability and health: children and youth version: ICF-CY. Geneva: World Health Organization; 2007.
    1. Oeffinger DJ, Rogers SP, Bagley A, Gorton G, Tylkowski CM. Clinical applications of outcome tools in ambulatory children with cerebral palsy. Phys Med Rehabil Clin N Am 2009;20:549-565. - PubMed