Friday, August 14, 2015

Measuring Upper Extremity Function - Systematically

Systematic Review

Upper limb function evaluation scales for individuals with cerebral palsy: A systematic review

Journal of Physical Therapy Science 27:1617 – 1620, 2015.

Santos, C. A., Franco de Moura, R. C., Lazzari, R. D., Dumont, A. J., Braun, L. A. & Oliveira, C. S.

Link to full text: www.ncbi.nlm.nih.gov/pmc/articles/PMC448345

Objective: What is the state of the evidence for scales and methods used to evaluate upper extremity function in cerebral palsy?

Method: Two reviewers independently assessed randomized controlled (RCT) trial articles published between 2006 and 2014. The Physiotherapy Evidence Database (PEDRO) scale was used to evaluate studies to see if there is sufficient accompanying information for (internal) validity and for the reader to interpret and reproduce results.

Findings: Five studies achieved 6/10 “good” or higher on PEDRO (1 – 9/10, 1 – 8/10, 2 – 7/10, 1 – 6/10). The various studies analyzed:

  • Quality Upper Extremity Skill Test and the Besta scale (Fedrizzi et al.)
  • Upper Extremity Functional Test and Peabody Developmental Motor Scales-2 (PDMS-2), Xu et al.
  • PDMS-2, Bruninks-Oseretsky Test of Motor Proficiency and Pediatric Motor Activity Log, Lin et al.
  • Melbourne Assessment of Unilateral Upper Limb Function, Koman et al.
  • Redman et al. used the Pediatric Quality of Life Scale.

"…no consensus has been reached on the most appropriate scale or which has ideal clinical applicability to this population".

References
PEDRO www.pedro.org.au/

Fedrizzi E, Rosa-Rizzotto M, Turconi AC, et al. : GIPCI Study Group: Unimanual and bimanual intensive training in children with hemiplegic cerebral palsy and persistence in time of hand function improvement: 6-month follow-up results of a multisite clinical trial. J Child Neurol, 2013, 28: 161–175. [PubMed]

Xu K, Wang L, Mai J, et al. : Efficacy of constraint-induced movement therapy and electrical stimulation on hand function of children with hemiplegic cerebral palsy: a controlled clinical trial. Disabil Rehabil, 2012, 34: 337–346. [PubMed]

Lin KC, Wang TN, Wu CY, et al. : Effects of home-based constraint-induced therapy versus dose-matched control intervention on functional outcomes and caregiver well-being in children with cerebral palsy. Res Dev Disabil, 2011, 32: 1483–1491. [PubMed]

Koman LA, Smith BP, Williams R, et al. : Upper extremity spasticity in children with cerebral palsy: a randomized, double-blind, placebo-controlled study of the short-term outcomes of treatment with botulinum A toxin. J Hand Surg Am, 2013, 38: 435–46.e1. [PubMed]

Redman TA, Finn JC, Bremner AP, et al. : Effect of upper limb botulinum toxin-A therapy on health-related quality of life in children with hemiplegic cerebral palsy. J Paediatr Child Health, 2008, 44: 409–414.[PubMed]