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    Rationale for prescription, and effectiveness of, upper limb orthotic intervention for children with cerebral palsy: a systematic review

    Access Status
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    Authors
    Garbellini, S.
    Robert, Y.
    Randall, M.
    Elliott, Catherine
    Imms, C.
    Date
    2018
    Type
    Journal Article
    
    Metadata
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    Citation
    Garbellini, S. and Robert, Y. and Randall, M. and Elliott, C. and Imms, C. 2018. Rationale for prescription, and effectiveness of, upper limb orthotic intervention for children with cerebral palsy: a systematic review. Disability and Rehabilitation. 40 (12): pp. 1361-1371.
    Source Title
    Disability and Rehabilitation
    DOI
    10.1080/09638288.2017.1297498
    ISSN
    0963-8288
    School
    School of Occ Therapy, Social Work and Speech Path
    URI
    http://hdl.handle.net/20.500.11937/67316
    Collection
    • Curtin Research Publications
    Abstract

    Purpose: To explore (i) reasons for upper limb orthosis prescription for children with cerebral palsy (CP), (ii) the link between reason and effect according to intended outcome and outcome measure utilized and (iii) to classify the prescribed orthoses using standard terminology. Method: A prospectively registered (center for reviews and dissemination: 42015022067) systematic review searched for experimental and observational studies investigating rigid/thermoplastic upper limb orthotic intervention for children aged 0–18 with CP. The Cochrane central register, MEDLINE, CINAHL, Embase, SCOPUS and Web of Science databases were searched. Included studies were assessed for risk of bias. Results: Sixteen studies met selection criteria. Two studies described a specific reason for orthosis prescription, six prescribed orthoses to manage a clinical symptom and eight did not describe a reason. Eight studies were analyzed for effect according to intended outcome with no clear connection found between reasons for prescription, outcome measures utilized and effect reported. Interpretation: The lack of evidence for upper limb orthotic intervention for children with CP leads to uncertainty when considering this treatment modality. Future research is needed to evaluate the effect of orthosis wear in relation to intended outcome utilizing robust methods and valid and reliable outcome measures. Implications for rehabilitation: Insufficient evidence exists about the reason for prescription of upper limb orthoses. The connection between reason for orthosis prescription, intended outcome, outcome measure utilized and observed effect is unclear. Recommend orthosis prescription to be accompanied by clear documentation of the aim of the orthosis and description using orthosis classification system terminology. Outcome measures consistent with the reason for orthosis prescription and intended outcome of the intervention are essential to measure effectiveness of the intervention.

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