Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis.
Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis.
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DOI：
10.1186/s12887-016-0731-6
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发表时间：
2016-11-29
期刊：
影响因子：
2.4
通讯作者：
Latimer J
中科院分区：
文献类型：
--
作者：
Lucas BR;Elliott EJ;Coggan S;Pinto RZ;Jirikowic T;McCoy SW;Latimer J
大运动技能是儿童发展的基础。目前物理治疗对轻度至中度粗大运动障碍儿童的有效性尚不清楚。本研究的目的是系统地回顾文献，以调查保守干预措施对改善一系列神经发育障碍儿童的粗大运动表现的有效性。进行了一项系统综述和荟萃分析。检索了MEDLINE、EMBASE、AMED、CINAHL、PsycINFO、PEDro、科克伦协作网、Google Scholar数据库和临床试验登记系统。已发表的随机对照试验，包括3至≤18岁的（i）发育协调障碍（DCD）或脑瘫（CP）儿童（粗大运动功能分类系统1级）或发育迟缓或轻微获得性脑损伤或早产（<30周胎龄）或胎儿酒精谱系障碍;和（ii）接受来自健康专业人员的非药物或非手术干预和（iii）使用标准化评估工具获得的粗大运动结果。进行荟萃分析，以确定干预对粗大运动功能的汇总效应。分别使用PEDro和GRADE方法评价荟萃分析建议的方法学质量和强度。在2513篇论文中，9篇符合纳入标准，包括接受11种不同干预的CP（n = 2）或DCD（n = 7）儿童。9项试验中只有2项显示了治疗效果。使用最不保守的试验结果，显示了干预的巨大有益效果（SMD：-0.8; 95% CI：-1.1至0.5），GRADE评级为“非常低质量”。使用最保守的试验结局，没有治疗效果（SMD：-0.1; 95% CI：-0.3至0.2），等级为“低质量”。研究的局限性包括现有试验的数量少和质量差。虽然我们发现一些任务导向框架的干预措施可以改善患有DCD或CP的儿童的粗大运动结果，但这些发现受到现有证据质量非常低的限制。迫切需要高质量的干预试验。本文的在线版本（doi：10.1186/s12887-016-0731-6）包含补充材料，可供授权用户使用。
Gross motor skills are fundamental to childhood development. The effectiveness of current physical therapy options for children with mild to moderate gross motor disorders is unknown. The aim of this study was to systematically review the literature to investigate the effectiveness of conservative interventions to improve gross motor performance in children with a range of neurodevelopmental disorders. A systematic review with meta-analysis was conducted. MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PEDro, Cochrane Collaboration, Google Scholar databases and clinical trial registries were searched. Published randomised controlled trials including children 3 to ≤18 years with (i) Developmental Coordination Disorder (DCD) or Cerebral Palsy (CP) (Gross Motor Function Classification System Level 1) or Developmental Delay or Minimal Acquired Brain Injury or Prematurity (<30 weeks gestational age) or Fetal Alcohol Spectrum Disorders; and (ii) receiving non-pharmacological or non-surgical interventions from a health professional and (iii) gross motor outcomes obtained using a standardised assessment tool. Meta-analysis was performed to determine the pooled effect of intervention on gross motor function. Methodological quality and strength of meta-analysis recommendations were evaluated using PEDro and the GRADE approach respectively. Of 2513 papers, 9 met inclusion criteria including children with CP (n = 2) or DCD (n = 7) receiving 11 different interventions. Only two of 9 trials showed an effect for treatment. Using the least conservative trial outcomes a large beneficial effect of intervention was shown (SMD:-0.8; 95% CI:-1.1 to −0.5) with “very low quality” GRADE ratings. Using the most conservative trial outcomes there is no treatment effect (SMD:-0.1; 95% CI:-0.3 to 0.2) with “low quality” GRADE ratings. Study limitations included the small number and poor quality of the available trials. Although we found that some interventions with a task-orientated framework can improve gross motor outcomes in children with DCD or CP, these findings are limited by the very low quality of the available evidence. High quality intervention trials are urgently needed. The online version of this article (doi:10.1186/s12887-016-0731-6) contains supplementary material, which is available to authorized users.
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影响因子：
1.1
作者：
Ledebt, A;Becher, J;Savelsbergh, GJP
通讯作者：
Savelsbergh, GJP
影响因子：
3.1
作者：
Green, Dido;Lingam, Raghu;Emond, Alan
通讯作者：
Emond, Alan
DOI：
10.1111/j.1530-0277.2011.01726.x
发表时间：
2012-07-01
影响因子：
3.2
作者：
Hamilton, Gillian F.;Boschen, Karen E.;Klintsova, Anna Y.
通讯作者：
Klintsova, Anna Y.
影响因子：
105.7
作者：
Higgins, JPT;Thompson, SG;Altman, DG
通讯作者：
Altman, DG
DOI：
10.1097/phm.0b013e3182643eba
发表时间：
2012-09-01
影响因子：
3
作者：
Chrysagis, Nikolaos;Skordilis, Emmanouil K.;Koutsouki, Dimitra
通讯作者：
Koutsouki, Dimitra