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A Systematic Review of the Efficacy of Conservative Interventions on the Gait of Ambulant Adults with Cerebral Palsy

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Abstract

To identify, appraise and synthesize evidence regarding efficacy of conservative interventions (physiotherapeutic, pharmacological) to improve walking in ambulant adults with cerebral palsy (CP). Standard search and extraction methods were utilised. A descriptive synthesis was performed with additional limited meta-analysis where the same outcome measurements were used and clinical heterogeneity was low. Interventions were considered according to target domain (International Classification of Functioning, Disability and Health). From 1571 papers identified, 10 met inclusion criteria. Study exclusion was predominantly due to gait not being a target of the intervention, or non-adult age range. Five randomised controlled trials were identified. Interventions were diverse and included strength training, sensory cueing, neurodevelopmental training, whole body vibration and spasticity medication. A small between-group effect on gait speed was found, weighted mean difference 0.09 (95 % CI 0.03 to 0.16). Evidence to support efficacy of one physiotherapeutic or pharmacological intervention over another to improve gait in adults with CP is currently limited. Further research is required using standardised gait outcome measures, longer follow up periods and higher quality trial designs.

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Declaration of Interest

The authors report no declarations of interest.

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Authors and Affiliations

  1. Department of Physiotherapy, Monash University, McMahons Road, Frankston, VIC, 3199, Australia

    Prue E. Morgan

  2. Melbourne School of Health Sciences, The University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia

    Fiona L. Dobson & Jennifer L. McGinley

Authors
  1. Prue E. Morgan
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  2. Fiona L. Dobson
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  3. Jennifer L. McGinley
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Correspondence to Prue E. Morgan.

Appendix 1

Appendix 1

 

EMBASE SEARCH

 

Number

Searches

Results

1

Cerebral palsy.mp. or Cerebral Palsy/

28571

2

Exercise Therapy/or Physical therapy Modalities/or or physical therapy.mp.

80116

3

Rehabilitation

58106

4

Gait/or locomotion/

69916

5

2 or 3 or 4

201202

6

Muscle Relaxants, Central/or Baclofen/or intrathecal baclofen pump.mp.

17901

7

Botulinum toxin.mp. or Botulinum Toxins/

22708

8

Phenols/

34412

9

6 or 7 or 8

75021

10

5 or 9

244687

11

1 and 10

6025

12

Limit 11 to (English language and humans)

3781

13

Limit 12 to (adult <18 to 64 years > or aged <65+ years>)

782

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Morgan, P.E., Dobson, F.L. & McGinley, J.L. A Systematic Review of the Efficacy of Conservative Interventions on the Gait of Ambulant Adults with Cerebral Palsy. J Dev Phys Disabil 26, 633–654 (2014). https://doi.org/10.1007/s10882-014-9385-1

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  • DOI: https://doi.org/10.1007/s10882-014-9385-1

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