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Occupational therapy for children with cerebral palsy: a systematic review
Esther M J Steultjens1, Joost Dekker, Lex M Bouter
1Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands. e.steultjens@nivel.nl
Insights
This systematic review found insufficient evidence that occupational therapy (OT) improves outcomes for children with cerebral palsy (CP). More high-quality research is needed to determine OT
Area of Science:
- Pediatric Rehabilitation
- Occupational Therapy Research
- Cerebral Palsy Interventions
Background:
- Occupational therapy (OT) is crucial for developing daily living skills in children with cerebral palsy (CP).
- The effectiveness of OT interventions for children with CP requires rigorous evaluation.
Purpose of the Study:
- To systematically review and synthesize evidence on the efficacy of occupational therapy interventions for children with cerebral palsy.
- To assess the impact of OT on functional outcomes in pediatric CP populations.
Main Methods:
- Conducted an extensive literature search across multiple databases (MEDLINE, CINAHL, EMBASE, AMED, SCISEARCH).
- Included studies with controlled and uncontrolled designs, analyzing six intervention categories.
- Employed a best-evidence synthesis approach, considering study design, quality, outcome measures, and statistical significance.
Main Results:
- Seventeen studies, including seven randomized controlled trials (RCTs), were analyzed.
- Only one RCT demonstrated high methodological quality.
- Insufficient evidence was found for the efficacy of OT across all intervention categories due to low study quality and non-significant results.
Conclusions:
- The current evidence base is limited, yielding inconclusive findings on OT efficacy for children with CP.
- Difficulties in conducting high-quality efficacy research in pediatric OT for CP may explain these results.
- Future research must address methodological challenges to better evaluate OT interventions for children with CP.
Objective:
Occupational therapy (OT) for cerebral palsy focuses on the development of skills necessary for the performance of activities of daily living. The aim of this systematic review was to determine whether OT interventions improve outcome for children with cerebral palsy (CP).
Methods:
An extensive search in MEDLINE, CINAHL, EMBASE, AMED and SCISEARCH was performed. Studies with controlled and uncontrolled designs were included. Six intervention categories were distinguished and individually analysed using a best-evidence synthesis. This synthesis is based on the type of design, the methodological quality, the type of outcome measures and the statistical significance of the findings.
Results:
Seventeen studies were included in this review, seven of which were randomized controlled trials (RCTs). One RCT had a high methodological quality. The analyses resulted in insufficient evidence of the efficacy of occupational therapy in all intervention categories, due to the low methodological quality of studies presenting statistically nonsignificant results.
Conclusion:
Despite the reasonable number of studies identified, the inconclusive findings regarding the efficacy of occupational therapy for children with cerebral palsy may be a reflection of the difficulties in efficacy research in OT for children with CP. Future research should critically reflect on methodological issues.