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Meta-Analysis
. 2024 Jul;50(4):e13301.
doi: 10.1111/cch.13301.

Effectiveness of therapeutic interventions on participation in children with cerebral palsy: A systematic review and meta-analysis

Rigas Dimakopoulos  1 , Theodora Vakalaki  1 , Arietta Spinou  2 , Ioannis Michopoulos  3 , Μarianna Papadopoulou  1
Affiliations
Meta-Analysis

Effectiveness of therapeutic interventions on participation in children with cerebral palsy: A systematic review and meta-analysis

Rigas Dimakopoulos et al. Child Care Health Dev. 2024 Jul.

Abstract

Background: Participation in life activities is an integral part of health and a main outcome of rehabilitation services for children and adolescents with disabilities. However, there is still no consensus on the most effective way to improve participation. The aim of this systematic review is to determine the effectiveness of therapeutic interventions on participation outcomes of children with cerebral palsy (CP).

Methods: A systematic review was conducted, searching the databases PubMed, Cochrane Library, Science Direct, Web of Science and Scopus for randomized controlled trials (RCTs), between 2001 and 2023. Studies were eligible for inclusion if they evaluated children with CP undergoing any intervention and using any tool measuring participation as an outcome measure. A meta-analysis of treatment effect was conducted. A sensitivity analysis was conducted to identify the effect on participation when intervention targeted different International Classification of Functioning (ICF) domains.

Results: A total of 1572 records were identified. Eight RCTs including 384 children (195 in the intervention group and 189 in the control group) were included in the systematic review and in the meta-analysis. A sensitivity analysis showed that interventions focusing on participation significantly improved participation; standardized mean difference (1.83; 95% CI: 1.33-2.32; Z = 7.21; P < 0.00001). When other types of interventions, that is, focusing on body functions and structures or activities, were used, then participation was not favourably affected.

Interpretation: Interventions primarily targeting barriers to participation across several ICF domains have a greater influence on enhancing participation. Interventions aimed at enhancing specific motor skills, including gross and fine motor function or strength, do not necessarily have a positive impact on participation.

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References

REFERENCES

    1. Adair, B., Ullenhag, A., Keen, D., Granlund, M., & Imms, C. (2015). The effect of interventions aimed at improving participation outcomes for children with disabilities: A systematic review. Developmental Medicine and Child Neurology, 57, 1093–1104. https://doi.org/10.1111/dmcn.12809
    1. Ades, A. E., Lu, G., & Higgins, J. P. T. (2005). The interpretation of random‐effects meta‐analysis in decision models. Medical Decision Making, 25, 646–654. https://doi.org/10.1177/0272989X05282643
    1. Anaby, D., Hand, C., Bradley, L., DiRezze, B., Forhan, M., DiGiacomo, A., & Law, M. (2013). The effect of the environment on participation of children and youth with disabilities: A scoping review. Disability and Rehabilitation, 35, 1589–1598. https://doi.org/10.3109/09638288.2012.748840
    1. Anaby, D. R., Law, M., Feldman, D., Majnemer, A., & Avery, L. (2018). The effectiveness of the pathways and resources for engagement and participation (PREP) intervention: Improving participation of adolescents with physical disabilities. Developmental Medicine and Child Neurology, 60, 513–519. https://doi.org/10.1111/dmcn.13682
    1. Armijo‐Olivo, S., da Costa, B. R., Cummings, G. G., Ha, C., Fuentes, J., Saltaji, H., & Egger, M. (2015). PEDro or Cochrane to assess the quality of clinical trials? A meta‐epidemiological study. PLoS ONE, 10, e0132634. https://doi.org/10.1371/journal.pone.0132634