National Collaborating Centre for Women's and Children's Health
National Collaborating Centre for Women's and Children's Health
National Collaborating Centre for Women's and Children's Health
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Physical therapy (physiotherapy <strong>and</strong>/or occupational therapy)<br />
Number of<br />
studies<br />
Number of participants Effect Quality<br />
Active use<br />
therapy<br />
No active use<br />
therapy<br />
Relative<br />
(95% CI)<br />
Absolute<br />
(95% CI)<br />
PROM elbow extension at week 17 (better indicated by higher values)<br />
1 study (Aarts<br />
2011)<br />
28 22 - MD 3.6 higher<br />
(0.76 to 6.44<br />
higher)<br />
High<br />
AROM active range of movement, CI confidence interval, MD mean difference, PROM passive range of movement<br />
* Calculated by the NCC-WCH<br />
Three studies reported outcomes relevant to optimisation of function <strong>and</strong> movement (Aarts 2010;<br />
Katz-Leurer 2009; Novak 2009). The outcomes reported included Assisting H<strong>and</strong> Assessment (AHA),<br />
Goal Attainment Scaling (GAS; including GAS T-scores), Canadian Occupational Per<strong>for</strong>mance<br />
Measure (COPM; including domains relating to per<strong>for</strong>mance (COPM-P) <strong>and</strong> satisfaction (COPM-S).<br />
Table 4.2 Evidence profile <strong>for</strong> active use therapy compared with no active use therapy in children with unilateral<br />
or bilateral spasticity; functioning assessment<br />
Number of<br />
studies<br />
Number of participants Effect Quality<br />
Active use<br />
therapy<br />
No active use<br />
therapy<br />
Relative<br />
(95% CI)<br />
Absolute<br />
(95% CI)<br />
AHA score at week 9 (range 0 to 100, change from baseline, better indicated by higher values)<br />
1 study (Aarts<br />
2010) 28 a 22 b -<br />
MD 4.3 higher<br />
(0.28 to 8.32<br />
higher)*<br />
Moderate<br />
AHA score at week 17 (range 0 to 100, change from baseline, better indicated by higher values)<br />
1 study (Aarts<br />
2010) 28 c 22 d -<br />
MD 4.70 higher<br />
(1.58 to 7.82<br />
higher)*<br />
Moderate<br />
GAS score at week 9 (% children who showed an increase of 2 points or more compared to baseline)<br />
1 study (Aarts<br />
2010)<br />
23/28*<br />
(82%)<br />
5/22*<br />
(23%)<br />
RR 3.61<br />
(1.64 to 7.96)*<br />
59 more per 100<br />
(from 15 more<br />
to 100 more)*<br />
High<br />
GAS score at week 17 (% children who showed an increase of 2 points or more compared to baseline)<br />
1 study (Aarts<br />
2010)<br />
24/28*<br />
(86%)<br />
8/22*<br />
(36%)<br />
RR 2.36<br />
(1.33 to 4.18)*<br />
49 more per 100<br />
(from 12 more<br />
to 100 more)*<br />
High<br />
GAS T-score at week 8 in 4-week OTHP group (better indicated by higher values)<br />
1 study (Novak<br />
2009)<br />
11 12 - - e High<br />
GAS T-score at week 8 in 8-week OTHP group (better indicated by higher values)<br />
1 study (Novak<br />
2009)<br />
12 12 a - - f High<br />
GAS T-score at week 8 in 4-week versus 8-week OTHP groups (better indicated by higher values)<br />
1 study (Novak<br />
2009)<br />
11 12 g - - h Moderate<br />
49
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