Show simple item record

dc.contributor.authorImms, C.
dc.contributor.authorWallen, M.
dc.contributor.authorElliott, Catherine
dc.contributor.authorHoare, B.
dc.contributor.authorRandall, M.
dc.contributor.authorGreaves, S.
dc.contributor.authorAdair, B.
dc.contributor.authorBradshaw, E.
dc.contributor.authorCarter, R.
dc.contributor.authorOrsini, F.
dc.contributor.authorShih, S.
dc.contributor.authorReddihough, D.
dc.date.accessioned2017-01-30T13:40:29Z
dc.date.available2017-01-30T13:40:29Z
dc.date.created2016-06-14T19:30:13Z
dc.date.issued2016
dc.identifier.citationImms, C. and Wallen, M. and Elliott, C. and Hoare, B. and Randall, M. and Greaves, S. and Adair, B. et al. 2016. Minimising impairment: Protocol for a multicentre randomised controlled trial of upper limb orthoses for children with cerebral palsy. BMC Pediatrics. 16 (1): 70.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/33970
dc.identifier.doi10.1186/s12887-016-0608-8
dc.description.abstract

BACKGROUND: Upper limb orthoses are frequently prescribed for children with cerebral palsy (CP) who have muscle overactivity predominantly due to spasticity, with little evidence of long-term effectiveness. Clinical consensus is that orthoses help to preserve range of movement: nevertheless, they can be complex to construct, expensive, uncomfortable and require commitment from parents and children to wear. This protocol paper describes a randomised controlled trial to evaluate whether long-term use of rigid wrist/hand orthoses (WHO) in children with CP, combined with usual multidisciplinary care, can prevent or reduce musculoskeletal impairments, including muscle stiffness/tone and loss of movement range, compared to usual multidisciplinary care alone. METHODS/DESIGN: This pragmatic, multicentre, assessor-blinded randomised controlled trial with economic analysis will recruit 194 children with CP, aged 5-15 years, who present with flexor muscle stiffness of the wrist and/or fingers/thumb (Modified Ashworth Scale score =1). Children, recruited from treatment centres in Victoria, New South Wales and Western Australia, will be randomised to groups (1:1 allocation) using concealed procedures. All children will receive care typically provided by their treating organisation. The treatment group will receive a custom-made serially adjustable rigid WHO, prescribed for 6 h nightly (or daily) to wear for 3 years. An application developed for mobile devices will monitor WHO wearing time and adverse events. The control group will not receive a WHO, and will cease wearing one if previously prescribed. Outcomes will be measured 6 monthly over a period of 3 years. The primary outcome is passive range of wrist extension, measured with fingers extended using a goniometer at 3 years. Secondary outcomes include muscle stiffness, spasticity, pain, grip strength and hand deformity. Activity, participation, quality of life, cost and cost-effectiveness will also be assessed. DISCUSSION: This study will provide evidence to inform clinicians, services, funding agencies and parents/carers of children with CP whether the provision of a rigid WHO to reduce upper limb impairment, in combination with usual multidisciplinary care, is worth the effort and costs. TRIAL REGISTRATION: ANZ Clinical Trials Registry: U1111-1164-0572 .

dc.publisherBioMed Central
dc.titleMinimising impairment: Protocol for a multicentre randomised controlled trial of upper limb orthoses for children with cerebral palsy.
dc.typeJournal Article
dcterms.source.volume16
dcterms.source.number1
dcterms.source.startPage70
dcterms.source.endPage70
dcterms.source.issn1471-2431
dcterms.source.titleBMC Pediatrics
curtin.note

This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by/4.0/

curtin.departmentSchool of Occupational Therapy and Social Work
curtin.accessStatusOpen access


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record