EVIDENCES OF CEREBRAL PALSY MANAGEMENT


EVIDENCES OF  CEREBRAL PALSY MANAGEMENT

Author of article:

DR. GAJANAN BHALERAO (PT), PhD Scholor, MPTH NEURO, Certified Adult NDT therapist. HOD Physiotherapy & Rehabilitation Dept in Sancheti Hospital Shivajinagar Pune

Associate Professor & HOD  PT in Neuro Rehabilitation  DEPT at Sancheti Institute College of Physiotherapy, Shivajinagar Pune

 

OBJECTIVES

  • What is evidence based practice?
  • What is the need for it?
  • What is Level of evidence?
  • How to read a evidence, interpret and apply in clinical practice?
  • What are the evidences in management of cerebral palsy?
  • Which are the of evidence requires more evidence & why?

Evidence Based Practice

  • Evidence-Based Practice (EBP) is a thoughtful integration of the best available evidence, coupled with clinical expertise.
  • An approach to decision making in which the clinician uses the best available evidence to decide which treatment option suits the patient.
  •  Addresses healthcare questions with an evaluative and quantitative approach.

LEVEL OF EVIDENCE

LEVEL DESCRIPTION
LEVEL I Randomized Control Trial (RCT)

Systematic Review (with homogeneity*) of RCTsLEVEL IICohort study /low

quality RCT

Systematic Review  (with homogeneity*) of cohortLEVEL IIICase-Control Study (CCT)

Systematic Review  (with homogeneity*) of case control StudiesLEVEL IVCase-series (and poor quality cohort

and case-control studies)LEVEL  VExpert opinion

INTRODUCTION

—For the child with CP the main aim of therapy should be to improve their quality of life with three general aims of:

1) Increasing or improving the skill repertoire

2) Maintaining functional level and general management

3) Minimization of musculoskeletal impairments contractures and deformities.

Common interventions usually address

  • —Reduction of the effects of abnormal muscle/postural tone,
  • —Musculoskeletal problems (muscle weakness and muscle length),
  • —Working for activity in a functional context
  • Providing opportunities for practice.
  • —Activity-based approaches aim to prevent secondary musculoskeletal impairments and maximise physical functioning, foster cognitive, social and emotional development of the child and develop, maintain and perhaps restore neural structures and pathways.

Topic to be covered in the article are

1.NDT

2.Strengthening

3.Treadmill training; 6 articles (all studies)

4.Balance training

5.Neuromuscular stimulation

6.Biofeedback

7.Casting

8.Stretching

9.Splinting

10.CIMT

11.Virtual reality

12.Frequency of physiotherapy; 4 articles (all studies)

13.Hydrotherapy

14.Hippotherapy

15.Conductive education

16.Medical managment

17.Orthotic management

for details please click here EVIDENCE BASED MANAGEMENT OF CP

also check these attachment

Motor control evidence based practice

TaskSpecificTraining week 2 motor control 1 (1)

 

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