Upper limb manual training for children with cerebral palsy: A systematic review and network meta-analysis of randomized controlled trials

Author:

Yang Fu-An1,Lee Ting-Hsuan2,Huang Shih-Wei34ORCID,Liou Tsan-Hon34ORCID,Escorpizo Reuben56,Chen Hung-Chou347ORCID

Affiliation:

1. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

2. Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

3. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan

4. Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

5. Department of Rehabilitation and Movement Science, University of Vermont, College of Nursing and Health Sciences, Burlington, VT, USA

6. Swiss Paraplegic Research, Nottwil, Switzerland

7. Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, Taiwan

Abstract

Objective There are different upper limb manual training protocols, namely constraint-induced movement therapy, modified constraint-induced movement therapy, hand–arm bimanual intensive training, hand–arm bimanual intensive training including lower extremity, action observation training, and mirror therapy, available for improving functional outcomes in children with cerebral palsy. However, the effect and priority of these strategies remain unclear. Data sources We searched the PubMed, Cochrane Library, and Embase databases for relevant articles from inception to October 12, 2022. Review methods To assess the effect and priority of different strategies of upper limb manual training protocols through a systematic review and network meta-analysis of randomized controlled trials. Results We included 22 randomized controlled trials in this network meta-analysis. The ranking probability and standard mean differences with 95% credible intervals of the comparison between placebo and other forms of upper limb manual training were as follows: mirror therapy = 2.83 (1.78, 3.88), hand–arm bimanual intensive training including the lower extremity = 0.53 (0.09, 0.96), constraint-induced movement therapy = 0.44 (0.18, 0.71), hand–arm bimanual intensive training = 0.41 (0.15, 0.67), modified constraint-induced movement therapy = 0.39 (0.03, 0.74), and action observation training = 0.18 ( − 0.29, 0.65). No significant inconsistency was noted between the results of direct and indirect comparisons. Conclusion We suggest that mirror therapy could be the upper limb manual training protocol of choice for improving functional outcomes in patients with cerebral palsy.

Publisher

SAGE Publications

Subject

Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. UK research priority setting for childhood neurological conditions;Developmental Medicine & Child Neurology;2024-07-16

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