RESUMEN
OBJECTIVES: To identify evidence evaluating the effectiveness of physiotherapy in adolescents (>16 years of age) and adults with cerebral palsy. DATA SOURCES: Systematic literature search from the earliest available time until March 2009. Additional studies were identified through reference and citation tracking. REVIEW METHODS: Two reviewers independently agreed on eligibility, methodological quality and quality of evidence assessment. Standard methods were used for quality assessments. RESULTS: Included were 13 studies, two of which were randomized controlled trials. No article met the criteria for high methodological quality. Evidence of moderate quality was found on gait after strength training. Evidence of low quality was found on balance after strength training and workstation interventions. Low-quality evidence was also found on functionality after strength training in four studies evaluating gross motor capacity. There was very low-quality evidence on increased muscle strength and in outcome measures used to evaluate range of motion. CONCLUSION: Evidence for the effect of physiotherapy on adolescents and adults with cerebral palsy is sparse, and therefore there is an urgent need for well-designed physiotherapeutic trials for these people.
Asunto(s)
Parálisis Cerebral/rehabilitación , Práctica Clínica Basada en la Evidencia , Entrenamiento de Fuerza , Adolescente , Adulto , Humanos , Adulto JovenRESUMEN
AIM: The motor performance of 165 very low birthweight (VLBW) infants was assessed prospectively at 5, 10, 18 mo and 5.5 y. The aim of the study was to evaluate longitudinal stability of motor development and its association with birthweight (BW), gestational age at birth, intraventricular haemorrhage (IVH), periventricular leucomalacia (PVL) and retinopathy of prematurity (ROP). Furthermore, at 5.5 y the motor behaviour of the VLBW population was compared with that of 124 children born at term. METHODS: The results of each examination were ranked into four levels and the stability of motor development was evaluated on the basis of this ranking. At 5.5 y, VLBW children and controls were compared according to percentiles in the Movement ABC. RESULTS: Fifty-three percent of the VLBW infants displayed a stable motor development. Only PVL and BW contributed significantly to the variability in their motor performance. Forty-seven percent of the infants exhibited an unstable motor development with no association to risk factors. In the entire group only IVH and severe ROP were related to poor motor performance. The majority of the VLBW children performed within the normal range at 5.5 y but their performances were inferior to those of control children. CONCLUSION: VLBW infants with poor early motor performance and/or severe IVH/PVL and ROP should be recruited into individualized follow-up programmes, whereas regular ongoing monitoring by follow-up may be sufficient for those with normal early motor performance and normal ultrasound findings.