Defining Functional Therapy in Research Involving Children with Cerebral Palsy: A Systematic Review

Area of Science:

• Pediatric Rehabilitation
• Developmental Disabilities
• Evidence-Based Practice

Background:

• Children with cerebral palsy (CP) often receive interventions described as 'functional'.
• The precise definitions and elements of these functional interventions are not consistently applied or understood.
• A lack of clarity may hinder the effectiveness and comparability of therapeutic approaches.

Purpose of the Study:

• To review definitions and elements of interventions labeled 'functional' for children with CP.
• To assess the alignment of these interventions with criteria for functional therapy outlined in the Dutch Guidelines.

Main Methods:

• Systematic review of intervention studies involving children with CP.
• Analysis of how 'functional' interventions were defined and described.
• Comparison of intervention elements against established functional therapy criteria.

Main Results:

• The most frequently cited criteria were 'based on the activities/participation level of the ICF-CY', 'goal-directed', and 'context-specific'.
• Descriptions for these criteria showed limited comparability to suggested definitions.
• Criteria like 'active involvement' and 'task-specific' were less frequent but had higher comparability to suggested definitions.

Conclusions:

• Interventions described as 'functional' in studies for children with CP generally do not adhere to established functional therapy criteria.
• Future research must provide detailed descriptions of intervention elements.
• Achieving consensus on the definition and components of functional therapy is crucial for advancing pediatric CP care.