Artículos de revistas
Interventions to improve gross motor performance in children with neurodevelopmental disorders: A meta-analysis
Fecha
2016-11-29Registro en:
BMC Pediatrics, v. 16, n. 1, 2016.
1471-2431
10.1186/s12887-016-0731-6
2-s2.0-84999188110
2-s2.0-84999188110.pdf
Autor
Clinical School
University of Sydney
The University of Sydney
Physiotherapy Department
The Sydney Children's Hospital Networks (Westmead)
Curtin University
University of Sydney at Royal North Shore Hospital
Universidade Estadual Paulista (Unesp)
Division of Occupational Therapy
Division of Physical Therapy
Institución
Resumen
Background: 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. Methods: 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. Results: 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. Conclusion: 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.