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Review
. 2024 Feb 16;11(2):257.
doi: 10.3390/children11020257.

Bone Deformities through the Prism of the International Classification of Functioning, Disability and Health in Ambulant Children with Cerebral Palsy: A Systematic Review

Rodolphe Bailly  1   2 , Christelle Pons  2   3   4 , Anne-Charlotte Haes  2   5 , Lisa Nguyen  2   5 , Matthias Thepaut  2   4   6 , Laëtitia Houx  1   2   3 , Mathieu Lempereur  2   3 , Sylvain Brochard  1   2   3   4
Affiliations
Review

Bone Deformities through the Prism of the International Classification of Functioning, Disability and Health in Ambulant Children with Cerebral Palsy: A Systematic Review

Rodolphe Bailly et al. Children (Basel). .

Abstract

(1) Aim: The aim of this study was to determine the relationship between lower limb bone deformities and body functions, activity, and participation in ambulant children with CP and whether changing bone morphology affects outcomes in these domains. (2) Methods: A systematic literature search (PROSPERO CRD42020208416) of studies reporting correlations between measures of lower limb bone deformities and measures of body function, activity or participation, or post-surgical outcomes in these domains was conducted from 1990 to 2023 in Medline, Scopus, and Cochrane Library. We assessed study quality with the Checklist for Case Series (CCS) and a quality assessment developed by Quebec University Hospital. Meta-analysis was not possible; therefore, descriptive synthesis was performed. (3) Results: A total of 12 of 3373 screened articles were included. No studies evaluated the relationships between bone deformities and activity or participation, or the effect of isolated bone surgery on these domains. Correlations between bone deformities and body functions were poor-to-moderate. Internal hip rotation during gait improved after femoral derotation osteotomy. (4) Conclusions: A shift in paradigm is urgently required for the research and management of bone deformities in children with CP to include the activity and participation domains of the ICF, as well as consider more psychological aspects such as self-image.

Keywords: ICF; bone deformity; cerebral palsy; children; gait.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Row diagram of the included articles. K = kappa coefficient of inter-rater reliability.
Figure 2
Figure 2
Correlations reported between lower limb bone morphology variable and body function, activity and participation for ambulant children with cerebral palsy. NSA: neck shaft angle; FT: femoral torsion; TT: tibial torsion, ＿ Significant relationship; ﹍ insignificant relationship; … no study.
Figure 3
Figure 3
results reported after isolated bone surgery of the lower limbs of ambulant children with cerebral palsy. In blue: hip region; in orange: femoral region; in velvet: tibial region; in pink: ankle region; ＿ Presence of results in the literature; ﹍ Absence of results in the literature; ⬈ Isolated bone surgery increases the variable; ⬊ Isolated bone surgery decreases the variable.
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