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Overview of Cochrane systematic reviews for rehabilitation interventions in individuals with cerebral palsy: A mapping synthesis

Aim This overview of Cochrane systematic reviews (CSRs) reports on current evidence on the effectiveness of rehabilitation interventions for individuals with cerebral palsy (CP) and the quality of the evidence. Method Following the inclusion criteria defined by the World Health Organization, all CSR...

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Published in:Developmental medicine and child neurology 2023-10, Vol.65 (10), p.1280-1291
Main Authors: Liguori, Sara, Young, Vanessa M., Arienti, Chiara, Pollini, Elisa, Patrini, Michele, Gimigliano, Francesca, Negrini, Stefano, Kiekens, Carlotte
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container_end_page 1291
container_issue 10
container_start_page 1280
container_title Developmental medicine and child neurology
container_volume 65
creator Liguori, Sara
Young, Vanessa M.
Arienti, Chiara
Pollini, Elisa
Patrini, Michele
Gimigliano, Francesca
Negrini, Stefano
Kiekens, Carlotte
description Aim This overview of Cochrane systematic reviews (CSRs) reports on current evidence on the effectiveness of rehabilitation interventions for individuals with cerebral palsy (CP) and the quality of the evidence. Method Following the inclusion criteria defined by the World Health Organization, all CSRs tagged in the Cochrane Rehabilitation database that were relevant for individuals with CP were included. A mapping synthesis was used to group outcomes and comparisons of included CSRs indicating the effect of rehabilitation interventions and the certainty of evidence. Results A total of eight CSRs were included in the evidence map. The effect of interventions varied across comparisons and the certainty of evidence was inconsistent, ranging from high to very low. The best evidence was found for botulinum neurotoxin A (BoNT‐A) combined with occupational therapy in the management of spasticity. However, the effect of BoNT‐A on drooling and salivation remains unclear. A paucity of randomized controlled trials studying treatments for both dystonia and postural deformities was noted. Interpretation This review emphasizes the need to further investigate the effectiveness and cost–benefit of rehabilitation interventions for individuals with CP. What this paper adds The quality and quantity of evidence on rehabilitation interventions for cerebral palsy is limited worldwide. Botulinum neurotoxin A plus occupational therapy showed robust efficacy for the management of upper‐limb spasticity. Evidence on sleep‐positioning systems for hip migration and trihexyphenidyl for dystonia is scarce. What this paper adds The quality and quantity of evidence on rehabilitation interventions for cerebral palsy is limited worldwide. Botulinum neurotoxin A plus occupational therapy showed robust efficacy for the management of upper‐limb spasticity. Evidence on sleep‐positioning systems for hip migration and trihexyphenidyl for dystonia is scarce.
doi_str_mv 10.1111/dmcn.15572
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Method Following the inclusion criteria defined by the World Health Organization, all CSRs tagged in the Cochrane Rehabilitation database that were relevant for individuals with CP were included. A mapping synthesis was used to group outcomes and comparisons of included CSRs indicating the effect of rehabilitation interventions and the certainty of evidence. Results A total of eight CSRs were included in the evidence map. The effect of interventions varied across comparisons and the certainty of evidence was inconsistent, ranging from high to very low. The best evidence was found for botulinum neurotoxin A (BoNT‐A) combined with occupational therapy in the management of spasticity. However, the effect of BoNT‐A on drooling and salivation remains unclear. A paucity of randomized controlled trials studying treatments for both dystonia and postural deformities was noted. Interpretation This review emphasizes the need to further investigate the effectiveness and cost–benefit of rehabilitation interventions for individuals with CP. What this paper adds The quality and quantity of evidence on rehabilitation interventions for cerebral palsy is limited worldwide. Botulinum neurotoxin A plus occupational therapy showed robust efficacy for the management of upper‐limb spasticity. Evidence on sleep‐positioning systems for hip migration and trihexyphenidyl for dystonia is scarce. What this paper adds The quality and quantity of evidence on rehabilitation interventions for cerebral palsy is limited worldwide. Botulinum neurotoxin A plus occupational therapy showed robust efficacy for the management of upper‐limb spasticity. Evidence on sleep‐positioning systems for hip migration and trihexyphenidyl for dystonia is scarce.</description><identifier>ISSN: 0012-1622</identifier><identifier>EISSN: 1469-8749</identifier><identifier>DOI: 10.1111/dmcn.15572</identifier><identifier>PMID: 36908077</identifier><language>eng</language><publisher>England</publisher><ispartof>Developmental medicine and child neurology, 2023-10, Vol.65 (10), p.1280-1291</ispartof><rights>2023 The Authors. published by John Wiley &amp; Sons Ltd on behalf of Mac Keith Press.</rights><rights>2023 The Authors. 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Method Following the inclusion criteria defined by the World Health Organization, all CSRs tagged in the Cochrane Rehabilitation database that were relevant for individuals with CP were included. A mapping synthesis was used to group outcomes and comparisons of included CSRs indicating the effect of rehabilitation interventions and the certainty of evidence. Results A total of eight CSRs were included in the evidence map. The effect of interventions varied across comparisons and the certainty of evidence was inconsistent, ranging from high to very low. The best evidence was found for botulinum neurotoxin A (BoNT‐A) combined with occupational therapy in the management of spasticity. However, the effect of BoNT‐A on drooling and salivation remains unclear. A paucity of randomized controlled trials studying treatments for both dystonia and postural deformities was noted. Interpretation This review emphasizes the need to further investigate the effectiveness and cost–benefit of rehabilitation interventions for individuals with CP. What this paper adds The quality and quantity of evidence on rehabilitation interventions for cerebral palsy is limited worldwide. Botulinum neurotoxin A plus occupational therapy showed robust efficacy for the management of upper‐limb spasticity. Evidence on sleep‐positioning systems for hip migration and trihexyphenidyl for dystonia is scarce. What this paper adds The quality and quantity of evidence on rehabilitation interventions for cerebral palsy is limited worldwide. Botulinum neurotoxin A plus occupational therapy showed robust efficacy for the management of upper‐limb spasticity. 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title Overview of Cochrane systematic reviews for rehabilitation interventions in individuals with cerebral palsy: A mapping synthesis
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