Table K.4.6Evidence profile for child-focused intervention compared with context-focused intervention in children with spasticity; joint movement assessment

Quality assessmentSummary of findings
No. of patientsEffectQuality
No. of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsChild-focused interventionContext-focused interventionRelative

(95% CI)
Absolute
Range of movement right hip abduction at 6 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.98 lower (5.56 lower to 3.6 higher)*Low
Range of movement right hip abduction at 9 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 1.3 higher (3.07 lower to 5.67 higher)*Low
Range of movement left hip abduction at 6 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 1.65 lower (6.08 lower to 2.78 higher)*Low
Range of movement left hip abduction at 9 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 1.42 higher (2.95 lower to 5.79 higher)*Low
Range of movement right hip extension at 6 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.39 higher (0.3 lower to 1.08 higher)*Low
Range of movement right hip extension at 9 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.16 higher (0.16 lower to 0.48 higher)*Low
Range of movement left hip extension at 6 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.62 higher (0.18 lower to 1.42 higher)*Low
Range of movement left hip extension at 9 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.03 lower (0.31 lower to 0.25 higher)*Low
Range of movement right popliteal angle at 6 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 1.48 higher (4.43 lower to 7.39 higher)*Low
Range of movement right popliteal angle at 9 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.29 lower (7.06 lower to 6.48 higher)*Low
Range of movement left popliteal angle at 6 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 3.54 higher (2.65 lower to 9.73 higher)*Low
Range of movement left popliteal angle at 9 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 2.67 higher (3.87 lower to 9.21 higher)*Low
Range of movement right ankle dorsiflexion at 6 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.58 lower (5.86 lower to 4.7 higher)*Low
Range of movement right ankle dorsiflexion at 9 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.78 higher (4.98 lower to 6.54 higher)*Low
Range of movement left ankle dorsiflexion at 6 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.32 lower (5.8 lower to 5.16 higher)*Low
Range of movement left ankle dorsiflexion at 9 months (final score) (Better indicated by higher values)
1 study (Law 2011)randomised trialsserious1no serious inconsistencyno serious indirectnessserious2none7157-MD 0.6 higher (4.83 lower to 6.03 higher)*Low

CI confidence interval, MD mean difference

*

Calculated by the NCC-WCH

1

Due to insufficient recruitment and loss to follow up this study was underpowered and the sizes of treatment groups were unbalanced

2

Total population less than 400

From: Appendix K, GRADE tables

Cover of Spasticity in Children and Young People with Non-Progressive Brain Disorders
Spasticity in Children and Young People with Non-Progressive Brain Disorders: Management of Spasticity and Co-Existing Motor Disorders and Their Early Musculoskeletal Complications.
NICE Clinical Guidelines, No. 145.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2012 Jul.
Copyright © 2012, National Collaborating Centre for Women's and Children's Health.

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