Assessments and Interventions for Spasticity in Infants With or at High Risk for Cerebral Palsy: A Systematic Review

被引:13
作者
Ayala, Lauren [1 ]
Winter, Sarah [1 ]
Byrne, Rachel [2 ]
Fehlings, Darcy [3 ,4 ]
Gehred, Alison [5 ]
Letzkus, Lisa [6 ]
Noritz, Garey [7 ]
Paton, Madison C. B. [8 ]
Pietruszewski, Lindsay [9 ]
Rosenberg, Nathan [7 ]
Tanner, Kelly [10 ]
Vargus-Adams, Jilda [11 ]
Novak, Iona [7 ]
Maitre, Nathalie L. [8 ]
机构
[1] Univ Utah, Sch Med, Dept Pediat, 295 Chipeta Way, Salt Lake City, UT 84108 USA
[2] Cerebral Palsy Fdn, New York, NY USA
[3] Holland Bloorview Kids Rehabil Hosp, Toronto, ON, Canada
[4] Univ Toronto, Dept Pediat, Toronto, ON, Canada
[5] Nationwide Childrens Hosp, Grant Morrow III Lib, Columbus, OH USA
[6] Univ Virginia, Sch Med, Dept Pediat, Charlottesville, VA 22908 USA
[7] Nationwide Childrens Hosp, Dept Pediat, Columbus, OH USA
[8] Univ Sydney, Fac Med & Hlth, Discipline Child & Adolescent Hlth, Cerebral Palsy Alliance Res Inst, Sydney, NSW, Australia
[9] Nationwide Childrens Hosp, Ctr Perinatal Res, Columbus, OH USA
[10] Nationwide Childrens Hosp, Dept Clin Therapies, Columbus, OH USA
[11] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH USA
关键词
Cerebral palsy; Systematic review; Spasticity; Infant; Children; Child; Assessment; Intervention; EXTRACORPOREAL SHOCK-WAVE; YOUNG-CHILDREN; SURFACE EMG; THERAPY; RELIABILITY; MANAGEMENT; DIAGNOSIS; SCALE;
D O I
10.1016/j.pediatrneurol.2020.10.014
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: The majority of children with cerebral palsy develop spasticity, which interferes with motor development, function, and participation. This systematic review appraised current evidence regarding assessments and interventions for spasticity in children aged less than two years with or at high risk for cerebral palsy and integrated findings with parent preferences. Methods: Five databases (CINAHL, EMBASE, OVID/Medline, SCOPUS, and PsycINFO) were searched. Included articles were screened using PRISMA guidelines. Quality of the evidence was reviewed by two independent reviewers using Quality Assessment of Diagnostic Accuracy Studies, second edition (QUADAS-2), the RTI Item Bank on Risk of Bias and Precision of Observational Studies (RTI), or The Cochrane Collaboration's tool for assessing risk of bias in randomized trials (RoB). An online survey was conducted regarding parent preferences through social media channels. Results: Twelve articles met inclusion criteria. No high-quality assessment tool emerged for this population. Six interventions (botulinum toxin-A, orthotic use, radial extracorporeal shock wave therapy, erythropoietic stimulating agents, medical cannabis, and homeopathy) were identified. There was low-quality evidence for the use of botulinum toxin-A and radial extracorporeal shock wave therapy to improve short-term outcomes. Survey respondents indicated that spasticity assessments and interventions are highly valued, with nonpharmacologic interventions ranked most preferably. Conclusions: Further research is needed to validate assessments for spasticity in children younger than two years. Conditional recommendations can be made for botulinum toxin-A and radial extracorporeal shock wave therapy based on low level of evidence to reduce spasticity in children aged less than two years. (C) 2020 The Authors. Published by Elsevier Inc.
引用
收藏
页码:72 / 90
页数:19
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