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Physical therapy in children with cerebral palsy in Brazil: a scoping review
Michelle A S Furtado1,2, Kênnea M A Ayupe3, Isabella S Christovão2
1Graduate Program in Rehabilitation and Functional Performance, Physical Therapy Department, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.
Insights
Physical therapy for children with cerebral palsy (CP) in Brazil often focuses on impairments and activity limitations. More research is needed on participation and environmental factors to improve evidence-based care.
Area of Science:
- Rehabilitation Medicine
- Pediatric Physical Therapy
- Cerebral Palsy Research
Background:
- Cerebral palsy (CP) is a prevalent condition affecting children and adolescents.
- Physical therapy plays a crucial role in managing CP.
- The International Classification of Functioning, Disability and Health (ICF) provides a framework for assessing disability and functioning.
Purpose of the Study:
- To systematically review and evaluate published physical therapy studies for Brazilian children and adolescents with CP.
- To analyze these studies through the lens of the ICF framework.
- To identify gaps in the current research landscape.
Main Methods:
- A comprehensive literature search was conducted in English and Portuguese databases until October 2020.
- Studies were analyzed for characteristics, journal metrics, sample details, and ICF domains.
- Evidence levels were assessed using the Oxford Centre for Evidence-Based Medicine hierarchy.
Main Results:
- Ninety-four studies were included, predominantly focusing on spastic CP with motor limitations.
- A significant majority (67%) had low evidence levels and were published in non-impact factor journals.
- Common interventions included neurodevelopmental treatment, suit therapy, and transcranial direct current stimulation.
- Interventions primarily targeted body functions/structures and activity, with minimal focus on environmental factors or participation.
- Outcomes measured mostly addressed activity and body functions/structures, neglecting environmental aspects and underrepresenting participation.
Conclusions:
- Current physical therapy research for pediatric CP in Brazil emphasizes reducing impairments and activity limitations.
- There is a critical need for studies with higher evidence levels.
- Future research should broaden its scope to include participation and environmental factors for a more holistic approach to CP management.
Aim:
To identify and assess published studies concerning physical therapy in Brazilian children and adolescents with cerebral palsy (CP) using the International Classification of Functioning, Disability and Health (ICF) framework.
Method:
Articles in English and Portuguese published until October 2020, with no date restrictions, were searched in several different databases. Study characteristics, journal metrics, sample characteristics, and ICF domains explored intervention components and outcomes were extracted. Studies were classified according to the Oxford Centre for Evidence-Based Medicine hierarchy levels to characterize the evidence.
Results:
Ninety-four studies were included. Spastic CP with fewer limitations in gross motor abilities was the most reported; 67% of the studies had low levels of evidence and were published in journals without an impact factor. The three most frequent interventions were neurodevelopmental treatment, suit therapy, and transcranial direct current stimulation. Intervention components explored body functions and structures (73.4%), activity (59.6%), environment (2.1%). They did not explore participation (0%). The outcomes investigated addressed activity (79.8%), body functions and structures (67.0%), and participation (1.1%), but not environment (0%).
Interpretation:
Studies of physical therapy for Brazilian children and adolescents with CP focused on reducing impairments and activity limitations. Studies with higher levels of evidence and an expanded focus on participation and environmental factors are necessary.
