Methodological Considerations to Investigate Dosage Parameters of Intensive Upper Limb Rehabilitation in Children with Unilateral Spastic Cerebral Palsy: A Scoping Review of RCTs.

Lucas Ravault, Nelly Darbois, Nicolas Pinsault
Author Information
  1. Lucas Ravault: Grenoble Alps University Hospital , Grenoble, France. ORCID
  2. Nelly Darbois: Grenoble Alps University , Grenoble, France.
  3. Nicolas Pinsault: Grenoble Alps University Hospital , Grenoble, France.

Abstract

PURPOSES: To identify and synthesize RCTs on the isolated effect of dosage parameters of upper limb Intensive Motor Rehabilitation Treatments (IMRT) of children with Unilateral Spastic Cerebral Palsy (USCP); to identify the most frequent methodological weaknesses.
METHODS: Searches were conducted until September 2018 in gray and published literature databases and supplemented by exploring the identified studies' references. Inclusion criteria applied: RCT; children aged 1.5 to 19 years with USCP; upper limb IMRT differing only from ���1/4 dosage parameters between groups. Literature analyses conducted: qualitative and descriptive.
RESULTS: We identified 461 studies. Seventeen were included: three presented a rehabilitation dosage distinction between groups in Frequency-Time, four in Intensity-Progressivity, three in Intensity-Restraint, two in Intensity-Environment and five presented ���3 distinctions above.
CONCLUSIONS: Inconsistencies were noted between USCP lifelong issues, and the short follow-ups and lack of participation assessments. Confounding factors and misstatements in Intent To Treat (ITT) analyses were identified. A meta-analysis was considered irrelevant.
ABBREVIATIONS: USCP, CP: Unilateral Spastic Cerebral Palsy, Cerebral Palsy; RCT: Randomized Controlled Trial; IMRT: Intensive Motor Rehabilitation Treatment.

Keywords

MeSH Term

Adolescent
Cerebral Palsy
Child
Child, Preschool
Humans
Randomized Controlled Trials as Topic
Treatment Outcome
Upper Extremity

Word Cloud

Created with Highcharts 10.0.0CerebraldosageUSCPIntensiveRehabilitationUnilateralSpasticPalsyidentifiedidentifyRCTsparametersupperlimbMotorIMRTchildrengroupsanalysesthreepresentedrehabilitationPURPOSES:synthesizeisolatedeffectTreatmentsfrequentmethodologicalweaknessesMETHODS:SearchesconductedSeptember2018graypublishedliteraturedatabasessupplementedexploringstudies'referencesInclusioncriteriaapplied:RCTaged1519yearsdiffering���1/4Literatureconducted:qualitativedescriptiveRESULTS:461studiesSeventeenincluded:distinctionFrequency-TimefourIntensity-ProgressivityIntensity-RestrainttwoIntensity-Environmentfive���3distinctionsaboveCONCLUSIONS:Inconsistenciesnotedlifelongissuesshortfollow-upslackparticipationassessmentsConfoundingfactorsmisstatementsIntentTreatITTmeta-analysisconsideredirrelevantABBREVIATIONS:CP:RCT:RandomizedControlledTrialIMRT:TreatmentMethodologicalConsiderationsInvestigateDosageParametersUpperLimbChildrenPalsy:ScopingReviewpalsycriticalthinkingparameterintensivemotorpediatrics

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