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Prognostic predictors for ambulation in children with cerebral palsy: a systematic review and meta-analysis of
Orawan Keeratisiroj1,2, Nuanlaor Thawinchai3, Wantana Siritaratiwat4
1a Clinical Epidemiology Program, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand.
Insights
Key predictors for ambulation in children with cerebral palsy (CP) include sitting independently by age 2, and the absence of visual impairment, intellectual disability, and seizures. These factors guide rehabilitation goals for improved mobility.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) is a group of movement disorders affecting muscle tone and posture.
- Identifying prognostic predictors for ambulation is crucial for effective therapeutic planning in children with CP.
Purpose of the Study:
- To conduct a meta-analysis of observational studies to identify prognostic predictors for ambulation in children with cerebral palsy.
- To synthesize evidence on factors influencing walking ability in pediatric CP populations.
Main Methods:
- Systematic electronic searches of multiple databases (PubMed, SCOPUS, CINAHL, etc.) up to December 2015.
- Qualitative synthesis of 12 studies and meta-analysis of 8 studies to identify significant predictors.
Main Results:
- Qualitative synthesis identified potential predictors: CP type, motor milestones, reflexes, absence of visual impairment, intellectual disability, epilepsy, and self-feeding ability.
- Meta-analysis confirmed four significant prognostic predictors for ambulation: independent sitting by 2 years, absence of visual impairment, absence of intellectual disability, and absence of epilepsy or seizure.
Conclusions:
- Independent sitting by age 2, absence of visual impairment, absence of intellectual disability, and absence of epilepsy are strong positive predictors for ambulation in children with CP.
- These identified prognostic predictors are vital for tailoring therapeutic plans and rehabilitation goals, particularly emphasizing early sitting milestones.
Purpose:
The purpose of this study is to investigate the prognostic predictors for ambulation in children with cerebral palsy using meta-analysis of observational studies.
Method:
Electronic searches were conducted in PubMed, SCOPUS, CINAHL, ProQuest, Ovid, Wiley InterScience, and ScienceDirect databases from their start dates to December 2015.
Results:
Of the 1123 identified articles, 12 met the inclusion criteria for qualitative synthesis, eight of which were deemed appropriate for meta-analysis. Qualitative synthesis found that the type of cerebral palsy, early motor milestones, primitive reflexes and postural reactions, absence of visual impairment, absence of intellectual disability, absence of epilepsy or seizure, and ability to feed self were indicated as potential predictors for ambulation. Meta-analysis detected four significant prognostic predictors for ambulation: sitting independently at 2 years, absence of visual impairment, absence of intellectual disability, and absence of epilepsy or seizure.
Conclusion:
These prognostic predictors should be taken into consideration in therapeutic plans and rehabilitation goals, especially sitting independently before the age of 2 years. Implications for rehabilitation The meta-analysis supports strong evidence that sitting independently at 2 years of age, absence of visual impairment, absence of intellectual disability, and absence of epilepsy or seizure are positive predictors for ambulation in children with cerebral palsy. The therapeutic plans and rehabilitation goals should be considered cautiously for these predictors, especially sitting independently before the age of two years.
