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Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review

OBJECTIVE: To assess the feasibility and effectiveness of home-based occupational therapy and physiotherapy programmes in children with cerebral palsy (CP), focusing on the upper extremity and reporting on child-related and/or parent-related outcomes. DESIGN: Systematic review. DATA SOURCES: Electro...

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Autores principales: Beckers, Laura W M E, Geijen, Mellanie M E, Kleijnen, Jos, A A Rameckers, Eugene, L A P Schnackers, Marlous, J E M Smeets, Rob, Janssen-Potten, Yvonne J M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539606/
https://www.ncbi.nlm.nih.gov/pubmed/33028544
http://dx.doi.org/10.1136/bmjopen-2019-035454
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author Beckers, Laura W M E
Geijen, Mellanie M E
Kleijnen, Jos
A A Rameckers, Eugene
L A P Schnackers, Marlous
J E M Smeets, Rob
Janssen-Potten, Yvonne J M
author_facet Beckers, Laura W M E
Geijen, Mellanie M E
Kleijnen, Jos
A A Rameckers, Eugene
L A P Schnackers, Marlous
J E M Smeets, Rob
Janssen-Potten, Yvonne J M
author_sort Beckers, Laura W M E
collection PubMed
description OBJECTIVE: To assess the feasibility and effectiveness of home-based occupational therapy and physiotherapy programmes in children with cerebral palsy (CP), focusing on the upper extremity and reporting on child-related and/or parent-related outcomes. DESIGN: Systematic review. DATA SOURCES: Electronic searches were performed in MEDLINE, EMBASE, CINAHL, PsycINFO, OTseeker and PEDro, and in ICTRP and CENTRAL trial registers, from inception to 6 June 2019. ELIGIBLE CRITERIA: The review included all types of original studies concerning feasibility or effectiveness of home-based therapy in children aged <18 years with any type of CP. No language, publication status or publication date restrictions were applied. DATA EXTRACTION AND SYNTHESIS: Study and intervention characteristics and the demographics of participating children and their parents were extracted. Feasibility was assessed by outcomes related to acceptability, demand, implementation, practicality, adaptation, expansion or integration. Regarding effectiveness, child-related outcome measures related to any level of the International Classification of Functioning, Disability and Health, or parent-related outcomes were investigated. Two authors independently extracted the data. Risk of bias was assessed using the Downs and Black checklist and the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS: The search resulted in a total of 92 records: 61 studies and 31 conference abstracts. Feasibility studies reported mainly on acceptability and implementation. Overall compliance to home-based training programmes (implementation) was moderate to high, ranging from 56% to 99%. In the effectiveness studies, >40 different child-related outcome measures were found. Overall, an improvement in arm-hand performance within group across time was shown. Only two studies reported on a parent-related outcome measure. No increase in parental stress was found during the intervention. CONCLUSIONS: Based on the results of the included studies, home-based training programmes seem to be feasible. However, conclusions about the effectiveness of home programmes cannot be made due to the large variability in the study, patient and intervention characteristics, comparators, and outcome measures used in the included studies. PROSPERO REGISTRATION NUMBER: CRD42016043743.
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spelling pubmed-75396062020-10-19 Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review Beckers, Laura W M E Geijen, Mellanie M E Kleijnen, Jos A A Rameckers, Eugene L A P Schnackers, Marlous J E M Smeets, Rob Janssen-Potten, Yvonne J M BMJ Open Rehabilitation Medicine OBJECTIVE: To assess the feasibility and effectiveness of home-based occupational therapy and physiotherapy programmes in children with cerebral palsy (CP), focusing on the upper extremity and reporting on child-related and/or parent-related outcomes. DESIGN: Systematic review. DATA SOURCES: Electronic searches were performed in MEDLINE, EMBASE, CINAHL, PsycINFO, OTseeker and PEDro, and in ICTRP and CENTRAL trial registers, from inception to 6 June 2019. ELIGIBLE CRITERIA: The review included all types of original studies concerning feasibility or effectiveness of home-based therapy in children aged <18 years with any type of CP. No language, publication status or publication date restrictions were applied. DATA EXTRACTION AND SYNTHESIS: Study and intervention characteristics and the demographics of participating children and their parents were extracted. Feasibility was assessed by outcomes related to acceptability, demand, implementation, practicality, adaptation, expansion or integration. Regarding effectiveness, child-related outcome measures related to any level of the International Classification of Functioning, Disability and Health, or parent-related outcomes were investigated. Two authors independently extracted the data. Risk of bias was assessed using the Downs and Black checklist and the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS: The search resulted in a total of 92 records: 61 studies and 31 conference abstracts. Feasibility studies reported mainly on acceptability and implementation. Overall compliance to home-based training programmes (implementation) was moderate to high, ranging from 56% to 99%. In the effectiveness studies, >40 different child-related outcome measures were found. Overall, an improvement in arm-hand performance within group across time was shown. Only two studies reported on a parent-related outcome measure. No increase in parental stress was found during the intervention. CONCLUSIONS: Based on the results of the included studies, home-based training programmes seem to be feasible. However, conclusions about the effectiveness of home programmes cannot be made due to the large variability in the study, patient and intervention characteristics, comparators, and outcome measures used in the included studies. PROSPERO REGISTRATION NUMBER: CRD42016043743. BMJ Publishing Group 2020-10-06 /pmc/articles/PMC7539606/ /pubmed/33028544 http://dx.doi.org/10.1136/bmjopen-2019-035454 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Rehabilitation Medicine
Beckers, Laura W M E
Geijen, Mellanie M E
Kleijnen, Jos
A A Rameckers, Eugene
L A P Schnackers, Marlous
J E M Smeets, Rob
Janssen-Potten, Yvonne J M
Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review
title Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review
title_full Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review
title_fullStr Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review
title_full_unstemmed Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review
title_short Feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review
title_sort feasibility and effectiveness of home-based therapy programmes for children with cerebral palsy: a systematic review
topic Rehabilitation Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539606/
https://www.ncbi.nlm.nih.gov/pubmed/33028544
http://dx.doi.org/10.1136/bmjopen-2019-035454
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