Iona Novak1, Catherine Morgan2, Michael Fahey3,4, Megan Finch-Edmondson2, Claire Galea2,5, Ashleigh Hines2, Katherine Langdon6, Maria Mc Namara2, Madison Cb Paton2, Himanshu Popat2,5, Benjamin Shore7, Amanda Khamis2, Emma Stanton2, Olivia P Finemore2, Alice Tricks2, Anna Te Velde2, Leigha Dark8, Natalie Morton8,9, Nadia Badawi2,5. 1. Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia. inovak@cerebralpalsy.org.au. 2. Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia. 3. Department of Paediatric Neurology, Monash Health, Clayton, Victoria, Australia. 4. Department of Paediatrics, Monash University, Clayton, Victoria, Australia. 5. Grace Centre for Newborn Care, Children's Hospital at Westmead, Westmead, New South Wales, Australia. 6. Department of Paediatric Rehabilitation, Kids Rehab WA, Perth Children's Hospital, Perth, Australia. 7. Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. 8. Allied and Public Helath, Faculty of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia. 9. School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia.
Abstract
PURPOSE OF REVIEW: Cerebral palsy is the most common physical disability of childhood, but the rate is falling, and severity is lessening. We conducted a systematic overview of best available evidence (2012-2019), appraising evidence using GRADE and the Evidence Alert Traffic Light System and then aggregated the new findings with our previous 2013 findings. This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019. RECENT FINDINGS: Effective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pressure care, stepping stones triple P, strength training, task-specific training, treadmill training, partial body weight support treadmill training, and weight-bearing. Effective medical and surgical interventions include anti-convulsants, bisphosphonates, botulinum toxin, botulinum toxin plus occupational therapy, botulinum toxin plus casting, diazepam, dentistry, hip surveillance, intrathecal baclofen, scoliosis correction, selective dorsal rhizotomy, and umbilical cord blood cell therapy. We have provided guidance about what works and what does not to inform decision-making, and highlighted areas for more research.
PURPOSE OF REVIEW: Cerebral palsy is the most common physical disability of childhood, but the rate is falling, and severity is lessening. We conducted a systematic overview of best available evidence (2012-2019), appraising evidence using GRADE and the Evidence Alert Traffic Light System and then aggregated the new findings with our previous 2013 findings. This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019. RECENT FINDINGS: Effective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pressure care, stepping stones triple P, strength training, task-specific training, treadmill training, partial body weight support treadmill training, and weight-bearing. Effective medical and surgical interventions include anti-convulsants, bisphosphonates, botulinum toxin, botulinum toxin plus occupational therapy, botulinum toxin plus casting, diazepam, dentistry, hip surveillance, intrathecal baclofen, scoliosis correction, selective dorsal rhizotomy, and umbilical cord blood cell therapy. We have provided guidance about what works and what does not to inform decision-making, and highlighted areas for more research.
Authors: Diego Longo; Marco Lombardi; Paolo Lippi; Daniela Melchiorre; Maria Angela Bagni; Francesco Ferrarello Journal: J Rehabil Med Clin Commun Date: 2021-06-17