Sunday, November 10, 2013

ESSENTIAL article for anyone with Cerebral Palsy - A Systematic Review of Treatments

Developmental Medicine & Child Neurology


 As a longtime member American Academy of Cerebral Palsy and  Developmental  Medicine with 13 years devoted to functional treatment of children and adults with CP,  I am very excited to see this systematic review of cerebral palsy treatments.   Of the recorded treatments, only 16% met the criteria  for the green light recommendations.  Only 24% of the listed interventions are proven to be effective.   - JR


A systematic review of interventions 

for children with cerebral palsy - 

state of the evidence.



Green Light - GO-  interventions for Cerebral Palsy

In the papers retrieved, the following CP interventions were shown to be effective: 
(1) botulinum toxin (BoNT), diazepam, and selective dorsal rhizotomy for reducing muscle spasticity; 
(2) casting for improving and maintaining ankle range of motion; 
(3) hip surveillance for maintaining hip joint integrity; 
(4) constraint-induced movement therapy, bimanual training, context-focused therapy, goal-directed/functional training, occupational therapy following BoNT, and home programmes for improving motor activity performance and/or self-care; 
(5) fitness training for improving fitness; 
(6) bisphosphonates for improving bone density; 
(7) pressure care for reducing the risk of pressure ulcers; and 
(8) anticonvulsants for managing seizures (despite no CP-specific anticonvulsant evidence existing, the panel rated the strength of the recommendation as strong plus (do it) because good-quality evidence supports anticonvulsants in non-CP populations,and serious harm, even death, can arise from no treatment).



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