Efficacy of intensive versus nonintensive physiotherapy in children with cerebral palsy: a meta-analysis
Efficacy of intensive versus nonintensive physiotherapy in children with cerebral palsy: a meta-analysis
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DOI：
10.1097/mrr.0b013e328332f617
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发表时间：
2010-06-01
影响因子：
1.7
通讯作者：
Curatolo, Paolo
中科院分区：
文献类型：
--
作者：
Arpino, Carla;Vescio, Maria Fenicia;Curatolo, Paolo
儿童脑性瘫痪的一种常用治疗方法是所谓的“传统疗法”，包括物理疗法或神经发育疗法。尽管更密集的康复治疗被认为比强度较小的干预更有效，但这一假设尚未得到证实。在这项研究中，我们比较了强化康复治疗和非强化康复治疗对脑瘫儿童的疗效。对1996年1月至2007年7月发表的研究进行了荟萃分析。纳入标准：婴幼儿/儿童/青少年(1-18岁)；使用粗大运动功能评分作为结果衡量标准的随机对照试验。排除标准：包括在所谓的常规治疗中通常不使用的治疗方法(即强制、捆绑)的研究。采用加权平均差值法综合治疗效果。进行固定效应和随机效应Meta分析，并对结果进行比较。异质性也进行了评估。对漏斗图进行了检验，并检验了小规模研究效应的存在。强化治疗往往比非强化治疗有更大的疗效(1.32；95%可信区间：0.55-2.10)。强化治疗对2岁儿童的效果更明显。我们的荟萃分析表明，在脑性瘫痪的儿童中，强化常规治疗可能会改善功能运动结果，但效果似乎不大。《国际康复研究杂志》33：134-141(C)2010 Wolters Kluwer Health|Lippincott Williams&Wilkins。
A commonly used treatment for cerebral palsy in children is so-called 'conventional therapy', which includes physiotherapy or the neurodevelopmental approach. Although more intensive rehabilitative treatment is thought to be more effective than less intensive interventions, this assumption has not been proven. In this study we compared the efficacy of intensive versus nonintensive rehabilitative treatment in children with cerebral palsy. A meta-analysis of the studies published between January 1996 and July 2007 was performed. Inclusion criteria: infants/children/adolescents (1-18 years old); randomized controlled trials using, as outcome measure, the Gross Motor Function Measure score. Exclusion criteria: studies that included therapies not generally used in 'so-called' conventional treatment (i.e. constraint, taping). Treatment effects were combined using the weighted mean difference method. Fixed and random effect meta-analyses were carried out and results were compared. Heterogeneity was also assessed. Funnel plots were examined and the presence of small-study effects was tested. Intensive therapy tended to have a greater effect than nonintensive therapy (1.32; 95% confidence interval: 0.55-2.10). The effect of intensive treatment tended to be apparently stronger for children 2 years of age. Our meta-analysis shows that, in children with cerebral palsy, intensive conventional therapy may improve the functional motor outcome, but the effect size seems to be modest. International Journal of Rehabilitation Research 33:134-141 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.