Botulinum toxin type A injection for management of upper limb spasticity in children with cerebral palsy: a literature review Botulinum toxin type A injection for management of upper limb spasticity in children with cerebral palsy: a literature review Botulinum toxin type A injection for management of upper limb spasticity in children with cerebral palsy: a literature review Park E S, Rha D W CRD summary The authors concluded that high quality evidence was too limited and data too conflicting (...) for the efficacy of botulinum toxin type A for upper limb spasticity in children with cerebral palsy to be supported or refuted. This conclusion was supported by the evidence included in the review; but poor reporting of review methodology means that its reliability cannot be assessed. Authors' objectives To assess the outcome of botulinum toxin type A (BTX-A) for the management of upper limb spasticity in children with cerebral palsy (CP). Searching The databases MEDLINE and CINAHL were searched to June 2006

The effectiveness of passive stretching in children with cerebral palsy The effectiveness of passive stretching in children with cerebral palsy The effectiveness of passive stretching in children with cerebral palsy Pin T, Dyke P, Chan M CRD summary The authors concluded that there was limited evidence that manual stretching can increase range of motion, reduce spasticity and improve walking in children with cerebral palsy, and further research is required. Evidence for some outcomes was very (...) limited and a more cautious conclusion might have been more appropriate. Authors' objectives To evaluate the effectiveness of passive stretching in children with spastic cerebral palsy (CP). Searching MEDLINE, CINAHL, PsycINFO, EMBASE, the Cochrane Library and PEDro were searched from inception to April 2006; the search terms were reported. In addition, the reference lists from relevant studies and reviews were screened. Study selection Study designs of evaluations included in the review Studies

A systematic review of the evidence for hip surveillance in children with cerebral palsy A systematic review of the evidence for hip surveillance in children with cerebral palsy A systematic review of the evidence for hip surveillance in children with cerebral palsy Gordon G S, Simkiss D E CRD summary This review found that hip surveillance based on widely available radiological methods can identify children with cerebral palsy who are most at risk of subluxation. Limitations in the review (...) , especially the lack of detail about the included studies, make it difficult to comment on the reliability of these findings. Authors' objectives To determine the effectiveness of hip surveillance in children with cerebral palsy. Searching MEDLINE, EMBASE and CINAHL were searched from inception to April 2005. The Cochrane Controlled Trials Register, Cochrane Database of Systematic Reviews and DARE were also searched. Key journals were handsearched from 1998 to 2005, reference lists of retrieved studies

Effects of botulinum toxin type A on upper limb function in children with cerebral palsy: a systematic review Effects of botulinum toxin type A on upper limb function in children with cerebral palsy: a systematic review Effects of botulinum toxin type A on upper limb function in children with cerebral palsy: a systematic review Reeuwijk A, van Schie P E, Becher J G, Kwakkel G CRD summary This generally well-conducted review concluded that differences between studies, the use of unreliable (...) methods of measuring outcomes and small sample sizes meant that there was insufficient evidence for the effect of botulinum toxin type A injections in the upper limbs of children with cerebral palsy. This conclusion appears appropriate. Authors' objectives To assess the effectiveness of botulinum toxin type A injections in the upper limbs of children with cerebral palsy in terms of body functions, structures and activities. Searching PubMed, EMBASE, CINAHL, PiCarta, PEDro and the Cochrane Controlled

The effect of positioning for children with cerebral palsy on upper-extremity function: a review of the evidence The effect of positioning for children with cerebral palsy on upper-extremity function: a review of the evidence The effect of positioning for children with cerebral palsy on upper-extremity function: a review of the evidence Stavness C CRD summary The author concludes that an upright sitting position improves upper-extremity functioning in a child with cerebral palsy. Children (...) should be fitted for wheelchairs that place them in a functional sitting position (FSP) using the complete FSP package. Given the inadequate reporting of the review process and the poor quality of the available evidence, the author's conclusions should be treated with caution. Authors' objectives To determine the most appropriate seating position for children with cerebral palsy (CP) to promote energy conservation and optimal functional abilities. Searching MEDLINE, PubMed, CINAHL, AMED, HealthSTAR

Selected dorsal rhizotomy for cerebral palsy Selected dorsal rhizotomy for cerebral palsy Selected dorsal rhizotomy for cerebral palsy HAYES, Inc. Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Selected dorsal rhizotomy for cerebral palsy. Lansdale: HAYES, Inc.. Directory Publication. 2006 Authors' objectives Selective dorsal rhizotomy (SDR (...) ) involves the severing of spinal nerve rootlets selected by electromyographic techniques, with the goal of reducing or eliminating spasticity and facilitating the progress of normal movement patterns, and improving functional performance and daily care routines of patients with cerebral palsy (CP). Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Cerebral Palsy /therapy; Rhizotomy; Spinal Nerve Roots /surgery Language Published English Country

Selective dorsal rhizotomy for spasticity in cerebral palsy Selective dorsal rhizotomy for spasticity in cerebral palsy Selective dorsal rhizotomy for spasticity in cerebral palsy National Institute for Health and Clinical Excellence Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation National Institute for Health and Clinical Excellence. Selective dorsal rhizotomy (...) for spasticity in cerebral palsy. London: National Institute for Health and Clinical Excellence (NICE). Interventional Procedure Guidance 195. 2006 Authors' objectives This study aims to assess the current evidence on selective dorsal rhizotomy for spasticity in cerebral palsy. Authors' conclusions 1 Guidance 1.1 Current evidence on the safety of selective dorsal rhizotomy (SDR) for spasticity in cerebral palsy appears adequate; however, there is evidence of only limited efficacy. Therefore, the procedure

Surgical treatment for the thumb-in-palm deformity in patients with cerebral palsy. Thumb-in-palm deformity in patients with spastic cerebral palsy is a deformity that impairs the ability to use the thumb and thus severely limits hand function. From the variety of operative procedures that have been described, it may be clear that there is no consensus on the surgical treatment of thumb-in-palm deformity.To review the efficacy of surgical interventions for the thumb-in-palm deformity (...) in patients with spastic cerebral palsy; to review the selection criteria to surgically treat thumb-in-palm deformity in these patients; and to review the outcome assessment used in these studies.We identified studies for inclusion from searches of several electronic databases: the Cochrane Central Register of Controlled Trials (Issue 4, 2003), MEDLINE (1966 to December 2004), EMBASE (1980 to December 2004) and CINAHL (1982 to December 2004). We also cross-checked the reference lists of these studies

Intrathecal baclofen for cerebral palsy Intrathecal baclofen for cerebral palsy Intrathecal baclofen for cerebral palsy Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Intrathecal baclofen for cerebral palsy. Lansdale: HAYES, Inc.. Directory Publication. 2005 Authors' objectives Intrathecal administration of baclofen is used to reduce spasticity and spasm (...) frequency in patients with cerebral palsy who cannot be adequately treated with oral medications. If a screening trial involving a bolus dose of intrathecal baclofen indicates adequate response, an infusion pump is implanted to allow continuous intrathecal infusion of the drug. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Baclofen /administration& Cerebral Palsy /drug therapy; Injections, Spinal; dosage /therapeutic use Language Published

Dynamic lycra splinting for children with cerebral palsy Dynamic lycra splinting for children with cerebral palsy Dynamic lycra splinting for children with cerebral palsy NHS Quality Improvement Scotland Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation NHS Quality Improvement Scotland. Dynamic lycra splinting for children with cerebral (...) palsy. Glasgow: Quality Improvement Scotland (NHS QIS ). Evidence Note 11. 2005 Authors' conclusions Dynamic lycra splinting may improve functional abilities in the short term in some children with cerebral palsy. Suitability needs to be decided on a case by case basis. Further research is required to determine the long term effects of dynamic lycra splinting and which specific patient groups might benefit. No published evidence on the cost effectiveness of dynamic lycra splinting was identified

Botulinum toxin A as an adjunct to treatment in the management of the upper limb in children with spastic cerebral palsy. Cerebral palsy (CP) is a central nervous system deficit resulting from a non-progressive lesion in the developing brain. Although the brain lesions are static, the movement disorders that arise are not unchanging and are characterised by atypical muscle tone, posture and movement (Rang 1990). The spastic motor type is the most common form of CP and its conventional (...) groups. The study by Fehlings 2000 compared BtA with no intervention. When data were analysed no treatment effect was found for quality of upper limb function, passive range of motion, muscle tone, grip strength or self-care ability.This systematic review has not found sufficient evidence to support or refute the use of intramuscular injections of BtA as an adjunct to managing the upper limb in children with spastic cerebral palsy. Only one of the two identified RCTs reported some promising results

Cerebral palsy. Cerebral palsy, a range of non-progressive syndromes of posture and motor impairment, is a common cause of disability in childhood. The disorder results from various insults to different areas within the developing nervous system, which partly explains the variability of clinical findings. Management options include physiotherapy, occupational and speech therapy, orthotics, device-assisted modalities, pharmacological intervention, and orthopaedic and neurosurgical procedures (...) . Since 1980, modification of spasticity by means of orally administered drugs, intramuscular chemodenervation agents (alcohol, phenol, botulinum toxin A), intrathecally administered drugs (baclofen), and surgery (neurectomy, rhizotomy) has become more frequent. Family-directed use of holistic approaches for their children with cerebral palsy includes the widespread adoption of complementary and alternative therapies; however, the prevalence of their use and the cost of these options are unknown

Costs and consequences of botulinum toxin type A use: management of children with cerebral palsy in Germany Costs and consequences of botulinum toxin type A use: management of children with cerebral palsy in Germany Costs and consequences of botulinum toxin type A use: management of children with cerebral palsy in Germany Ruiz F J, Guest J F, Lehmann A, Davie A M, Guttler K, Schluter O, Dreiss G Record Status This is a critical abstract of an economic evaluation that meets the criteria (...) for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of botulinum toxin injections for the treatment of children with cerebral palsy was compared with no such injections. No further details of the medical treatment were provided. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population

Electrical stimulation in cerebral palsy: a review of effects on strength and motor function Electrical stimulation in cerebral palsy: a review of effects on strength and motor function Electrical stimulation in cerebral palsy: a review of effects on strength and motor function Kerr C, McDowell B, McDonough S CRD summary This review evaluated the efficacy of electrical stimulation in children with cerebral palsy. The authors concluded that the evidence is insufficient to provide conclusive (...) evidence for or against the use of neuromuscular electrical stimulation or threshold electrical stimulation. Despite limitations in the review methodology, the authors' conclusion is likely to reflect the evidence available in this field. Authors' objectives To assess the efficacy of electrical stimulation in strengthening or improving the motor function of children with cerebral palsy (CP). Searching MEDLINE (1966 to 2003), CINAHL (1982 to 2003), AMED (1985 to 2003) and PEDro (1966 to 2003) were

Interaction training for conversational partners of children with cerebral palsy: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

Chorioamnionitis and cerebral palsy in term and near-term infants. Half of all cases of cerebral palsy (CP) occur in term infants, for whom risk factors have not been clearly defined. Recent studies suggest a possible role of chorioamnionitis.To determine whether clinical chorioamnionitis increases the risk of CP in term and near-term infants.Case-control study nested within a cohort of 231 582 singleton infants born at 36 or more weeks' gestation between January 1, 1991, and December 31, 1998

Cerebral palsy and intrauterine growth in single births: European collaborative study. Cerebral palsy seems to be more common in term babies whose birthweight is low for their gestational age at delivery, but past analyses have been hampered by small datasets and Z-score calculation methods.We compared data from ten European registers for 4503 singleton children with cerebral palsy born between 1976 and 1990 with the number of births in each study population. Weight and gestation (...) of these children were compared with reference standards for the normal spread of gestation and weight-for-gestational age at birth.Babies of 32-42 weeks' gestation with a birthweight for gestational age below the 10th percentile (using fetal growth standards) were 4-6 times more likely to have cerebral palsy than were children in a reference band between the 25th and 75th percentiles. In children with a weight above the 97th percentile, the increased risk was smaller (from 1.6 to 3.1), but still significant

Hyperbaric oxygen therapy for brain injury, cerebral palsy, and stroke Hyperbaric oxygen therapy for brain injury, cerebral palsy, and stroke Hyperbaric oxygen therapy for brain injury, cerebral palsy, and stroke McDonagh M, Carson S, Ash J Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation McDonagh M, Carson S, Ash J. Hyperbaric oxygen (...) therapy for brain injury, cerebral palsy, and stroke. Rockville: Agency for Healthcare Research and Quality (AHRQ). Evidence Report/Technology Assessment No. 85. 2003 Authors' objectives The purpose of this report is to describe the methods, results, and conclusions of a literature review of the benefits and harms of hyperbaric oxygen therapy (HBOT) for brain injury, cerebral palsy, and stroke. Authors' conclusions Evidence from well-conducted clinical studies is limited. The balance of benefits

Hyperbaric oxygen therapy for brain injury, cerebral palsy, and stroke Hyperbaric oxygen therapy for brain injury, cerebral palsy, and stroke Hyperbaric oxygen therapy for brain injury, cerebral palsy, and stroke McDonagh M, Carson S, Ash J S, Russman B S, Stavri P Z, Krage K P, Helfand M CRD summary This review aimed to assess the benefits and harms of hyperbaric oxygen therapy (HBOT) for brain injury, cerebral palsy and stroke. The authors concluded that there was inadequate evidence (...) on the benefits and harms of HBOT for brain injury, cerebral palsy and stroke. This was a well-conducted review and the authors' conclusions are appropriate given the conflicting evidence reviewed. Authors' objectives To assess the benefits and harms of hyperbaric oxygen therapy (HBOT) for brain injury, cerebral palsy and stroke. Searching MEDLINE, Pre-MEDLINE, EMBASE, CINAHL, The Cochrane Library, Health Technology Assessment Database, HealthSTAR, AltHealthWatch and MANTIS were searched from inception

Effects of conductive education intervention for children with a diagnosis of cerebral palsy: an AACPDM evidence report Effects of conductive education intervention for children with a diagnosis of cerebral palsy: an AACPDM evidence report Effects of conductive education intervention for children with a diagnosis of cerebral palsy: an AACPDM evidence report Darrah J, Watkins B, Chen L, Bonin C CRD summary This review addressed the effects of conductive education in children with cerebral palsy (...) . The authors concluded that the quality of evidence was insufficient to determine whether conductive education is effective or not. Despite attempts to capture all study types, restricting studies to those published in English may have had a significant impact on the review's findings. The authors' conclusions are appropriately cautious. Authors' objectives To review the effects of conductive education (CE) in children diagnosed with cerebral palsy (CP). Searching The following electronic databases were