Table G.1What is the effectiveness of physical therapy (physiotherapy and occupational therapy) interventions in children with spasticity with or without other motor disorders (dystonia, muscle weakness and choreoathetosis) caused by a non progressive brain disorder?

Bibliographic informationReason for exclusion
Ackman,J.D., Russman,B.S., Thomas,S.S., Buckon,C.E., Sussman,M.D., Masso,P., Sanders,J., D'Astous,J., Aiona,M.D., Shriners Hospitals,B.T.X., Comparing botulinum toxin A with casting for treatment of dynamic equinus in children with cerebral palsy, Developmental Medicine and Child Neurology, 47, 620-627, 2005Comparison not relevant to review protocol: BoNT+casting versus BoNT+AFO
Bertoti,D.B., Effect of short leg casting on ambulation in children with cerebral palsy, Physical Therapy, 66, 1522-1529, 1986No relevant outcomes reported. A better quality paper on this intervention already included in review (McNee 2007)
Bottos,M., Benedetti,M.G., Salucci,P., Gasparroni,V., Giannini,S., Botulinum toxin with and without casting in ambulant children with spastic diplegia: a clinical and functional assessment, Developmental Medicine and Child Neurology, 45, 758-762, 2003Comparison not relevant to review protocol: BoNT+PT+casting versus BoNT+PT+AFO
Botulinum toxin type A and dynamic equinus in children with cerebral palsy: new indication. Better than repeat casts, Prescrire International, 10, 12-14, 2001Evidence summary paper on BoNT, not on therapy
Bower,E., Michell,D., Burnett,M., Campbell,M.J., McLellan,D.L., Randomized controlled trial of physiotherapy in 56 children with cerebral palsy followed for 18 months, Developmental Medicine and Child Neurology, 43, 4-15, 2001The therapists used a mixture of interventions - not controlling was done for one therapy against another
Boyd,R., Sakzewski,L., Ziviani,J., Abbott,D.F., Badawy,R., Gilmore,R., Provan,K., Tournier,J.D., Macdonell,R.A., Jackson,G.D., INCITE: A randomised trial comparing constraint induced movement therapy and bimanual training in children with congenital hemiplegia, BMC Neurology, 10, 4-, 2010Study protocol. An article reporting results of this study has been included (Sakzewski 2011)
Boyd,R.N., Morris,M.E., Graham,H.K., Management of upper limb dysfunction in children with cerebral palsy: a systematic review. [96 refs], European Journal of Neurology, 8 Suppl 5, 150-166, 2001It only included 4 randomised studies on interventions not relevant to the review: BoNT and NDT
Bryanton,C., Bosse,J., Brien,M., McLean,J., McCormick,A., Sveistrup,H., Feasibility, motivation, and selective motor control: virtual reality compared to conventional home exercise in children with cerebral palsy, Cyberpsychology and Behavior, 9, 123-128, 2006Not an RCT.
Dodd,K.J., Foley,S., Partial body-weight-supported treadmill training can improve walking in children with cerebral palsy: a clinical controlled trial, Developmental Medicine and Child Neurology, 49, 101-105, 2007Not an RCT.
Dodd,K.J., Taylor,N.F., Damiano,D.L., A systematic review of the effectiveness of strength-training programs for people with cerebral palsy. [40 refs], Archives of Physical Medicine and Rehabilitation, 83, 1157-1164, 2002Only one of the included studies was an RCT and it reported outcomes not relevant to our review: rate of torque development and movement time
Engsberg,J.R., Ross,S.A., Collins,D.R., Increasing ankle strength to improve gait and function in children with cerebral palsy: a pilot study, Pediatric Physical Therapy, 18, 266-275, 2006Comparison of outcomes across treatment groups is not presented
Gilmore,R., Ziviani,J., Sakzewski,L., Shields,N., Boyd,R. , A balancing act: children's experience of modified constraint-induced movement therapy, Developmental neurorehabilitation, 2010 2 p.88-94No results available for a comparison group (children in the bimanual therapy group were not asked about their experiences).
Hadders-Algra,M., van der Heide,J.C., Fock,J.M., Stremmelaar,E., van Eykern,L.A., Otten,B., Effect of seat surface inclination on postural control during reaching in preterm children with cerebral palsy, Physical Therapy, 87, 861-871, 2007Not an RCT.
Hahn,M.E., Simkins,S.L., Gardner,J.K., Kaushik,G., A dynamic seating for children with cerebral palsy, Journal of Musculoskeletal Research, 12, 21-30, 2009Methodologically inadequate: 50% drop out from the control arm of RCT.
Hankinson,J., Morton,R.E., Use of a lying hip abduction system in children with bilateral cerebral palsy: A pilot study, Developmental Medicine and Child Neurology, 44, 177-180, 2002Not an RCT
Hellweg,S., Johannes,S., Physiotherapy after traumatic brain injury: A systematic review of the literature, Brain Injury, 22, 365-373, 2008Explicitly excluded children and younger people <12 years. References checked.
Hill,J., The effects of casting on upper extremity motor disorders after brain injury, American Journal of Occupational Therapy, 48, 219-224, 1994Mainly adults. One group (mean age 24.9, range 9 to 44) and another group all adults
Hoare,Brian J., Wasiak,Jason, Imms,Christine, Carey,Leeanne, Constraint-induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy, Cochrane Database of Systematic Reviews, -, 2009It only included 3 trials: one of them was not randomised and the other two included outcomes not relevant to the review: Box and Blocks test, Erhardt Developmental Prehension Assessment, WeeFIM, PMAL, EBS, CAUT and QUEST
Ketelaar,M., Vermeer,A., Hart,H., van Petegem-van,Beek E., Helders,P.J., Effects of a functional therapy program on motor abilities of children with cerebral palsy, Physical Therapy, 81, 1534-1545, 2001Excluded as review as it included non-comparative studies. Relevant RCTs already retrieved as individual papers
Lannin,N.A., Novak,I., Cusick,A., A systematic review of upper extremity casting for children and adults with central nervous system motor disorders. [49 refs], Clinical Rehabilitation, 21, 963-976, 2007Included studies in adults, non-RCTs and 2 RCTs in children but comparison excluded as per protocol (NDT + casting versus traditional therapy and versus NDT alone respectively)
Leyendecker,C., Electrical stimulation therapy and its effects on the general activity of motor impaired cerebral palsied children; a comparative study of the Bobath physiotherapy and its combination with the Hufschmidt electrical stimulation therapy (author's transl), Rehabilitation, 14, 150-159, 1975Paper not published in English
Makela,P., Hammerbeck,U., Rushton,D.N., Rehabilitation of the younger adult stroke patient, Therapy, 3, 273-289, 2006Review paper. No references to children found
Marshall,S., Teasell,R., Bayona,N., Lippert,C., Chundamala,J., Villamere,J., Mackie,D., Cullen,N., Bayley,M., Motor impairment rehabilitation post acquired brain injury. [70 refs], Brain Injury, 21, 133-160, 2007Systematic review that included only studies in adults or in interventions not relevant to review protocol
McNamara,L., Casey,J., Seat inclinations affect the function of children with cerebral palsy: a review of the effect of different seat inclines. [28 refs], Disability and Rehabilitation Assistive Technology, 2, 309-318, 2007Systematic review. References checked. Included case series and studies comparing children with cerebral palsy with children without any neurological impairment
Miedaner,J.A., Renander,J., The effectiveness of classroom passive stretching programs for increasing or maintaining passive range of motion in non-ambulatory children: An evaluation of frequency, Physical and Occupational Therapy in Pediatrics, 7, 35-43, 1987On top of the passive stretching programme at school evaluated in the study, children received concurrently passive stretching at home, as well as positioning and bracing and these were not adequately controlled for.
Noronha,J., Bundy,A., Groll,J., The effect of positioning on the hand function of boys with cerebral palsy, American Journal of Occupational Therapy, 43, 507-512, 1989Outcomes not relevant to review: Jebsen-Taylor Hand Function Test and modified Hohlstein's classification
Nwaobi,O.M., Seating orientations and upper extremity function in children with cerebral palsy, Physical Therapy, 67, 1209-1212, 1987Not an RCT.
O'Brien,M., Tsurumi,K., The effect of two body positions on head righting in severely disabled individuals with cerebral palsy, American Journal of Occupational Therapy, 37, 673-680, 1983Not an RCT. Outcomes not relevant to the review protocol: frequency and duration of head righting during a feeding task by means of a mercury switch system
Odman,P., Krevers,B., Oberg,B., Parents' perceptions of the quality of two intensive training programmes for children with cerebral palsy, Developmental Medicine and Child Neurology, 49, 93-100, 2007Interventions included not relevant to review protocol: eclectic approach and conductive education (adapted to Swedish circumstances)
Park,E.S., Rha,D.W., Botulinum toxin type A injection for management of upper limb spasticity in children with cerebral palsy: a literature review. [45 refs], Yonsei Medical Journal, 47, 589-603, 2006Intervention not relevant: review is on BoNT, not on therapy
Park,E.S., Rha,D.W., Lee,J.D., Yoo,J.K., Chang,W.H., The short-term effects of combined modified constraint-induced movement therapy and botulinum toxin injection for children with spastic hemiplegic cerebral palsy, Neuropediatrics, 40, 269-274, 2009Not an RCT. Comparison not relevant for review protocol (BoNT + CIMT versus BoNT)
Pin,T., Dyke,P., Chan,M., The effectiveness of passive stretching in children with cerebral palsy, Developmental Medicine and Child Neurology, 48, 855-862, 2006Excluded as a review as it included non-comparative studies and studies reporting outcomes not relevant to this review
Pin,T.W., Effectiveness of static weight-bearing exercises in children with cerebral palsy. [34 refs][Erratum appears in Pediatr Phys Ther. 2007 Summer;19(2):172-8], Pediatric Physical Therapy, 19, 62-73, 2007Excluded as a review as it included non-comparative studies, studies with very small sample size and/or reporting outcomes not relevant to this review
Reid,D.T., The effects of the saddle seat on seated postural control and upper-extremity movement in children with cerebral palsy, Developmental Medicine and Child Neurology, 38, 805-815, 1996Not an RCT
Reid,S., Hamer,P., Alderson,J., Lloyd,D., Neuromuscular adaptations to eccentric strength training in children and adolescents with cerebral palsy, Developmental Medicine and Child Neurology, 52, 358-363, 2010Outcomes are not relevant to this review : peak torque and work rates and EMG data
Rogers,A., Furler,B.L., Brinks,S., Darrah,J., A systematic review of the effectiveness of aerobic exercise interventions for children with cerebral palsy: an AACPDM evidence report. [22 refs], Developmental Medicine and Child Neurology, 50, 808-814, 2008Excluded as review as it included non comparative studies and interventions not relevant to our review. References checked
Scholtes,V.A., Becher,J.G., Comuth,A., Dekkers,H., Van,Dijk L., Dallmeijer,A.J., Effectiveness of functional progressive resistance exercise strength training on muscle strength and mobility in children with cerebral palsy: a randomized controlled trial, Developmental Medicine and Child Neurology, 52, e107-e113, 2010Excluded as per protocol: conventional physical therapy programme in the control group not described. Better trials already included for this type of intervention
Scholtes,V.A., Dallmeijer,A.J., Rameckers,E.A., Verschuren,O., Tempelaars,E., Hensen,M., Becher,J.G., Lower limb strength training in children with cerebral palsy--a randomized controlled trial protocol for functional strength training based on progressive resistance exercise principles, BMC Pediatrics, 8, 41-, 2008Study protocol only
Scianni,A., Butler,J.M., Ada,L., Teixeira-Salmela,L.F., Muscle strengthening is not effective in children and adolescents with cerebral palsy: a systematic review. [35 refs], Australian Journal of Physiotherapy, 55, 81-87, 2009Excluded as a review as it included studies on interventions not relevant (electrical stimulation). Relevant RCTs already retrieved as individual papers
Shamsoddini,A.R., Hollisaz,M.T., Effect of sensory integration therapy on gross motor function in children with cerebral palsy, Iranian Journal of Child Neurology, 3, 43-48, 2009Intervention not included in review protocol
Tremblay,F., Malouin,F., Richards,C.L., Dumas,F., Effects of prolonged muscle stretch on reflex and voluntary muscle activations in children with spastic cerebral palsy, Scandinavian Journal of Rehabilitation Medicine, 22, 171-180, 1990Outcomes reported not relevant to review: torque and EMG outcomes
Van den Berg-Emons RJ, Van Baak,M.A., Speth,L., Saris,W.H., Physical training of school children with spastic cerebral palsy: effects on daily activity, fat mass and fitness, International Journal of Rehabilitation Research, 21, 179-194, 1998Intervention included a mix of activities not relevant to review protocol. Outcomes reported not relevant to review either (Anthropometry, level of daily PA, and physical fitness)
Verschuren,O., Ketelaar,M., Takken,T., Helders,P.J.M., Gorter,J.W., Exercise programs for children with cerebral palsy: A systematic review of the literature, American Journal of Physical Medicine and Rehabilitation, 87, 404-417, 2008Excluded as review as it included non-comparative studies. Relevant RCTs already retrieved as individual papers
Volman,M.J.M., Wijnroks,A., Vermeer,A., Effect of task context on reaching performance in children with spastic hemiparesis, Clinical Rehabilitation, 16, 684-692, 2002Not an RCT.
Wallen,M., O'Flaherty,S.J., Waugh,M.C., Functional outcomes of intramuscular botulinum toxin type a and occupational therapy in the upper limbs of children with cerebral palsy: a randomized controlled trial, Archives of Physical Medicine and Rehabilitation, 88, 1-10, 2007Comparison not relevant to review protocol: BoNT + therapy versus therapy alone. One of the remaining comparisons already included in the BoNT review.
Weindling,A.M., Cunningham,C.C., Glenn,S.M., Edwards,R.T., Reeves,D.J., Additional therapy for young children with spastic cerebral palsy: A randomised controlled trial, Health Technology Assessment, 11, iii-55, 2007Study protocol only
Weindling,A.M., Intervention after brain injury to reduce disability. [31 refs], Seminars in Neonatology, 5, 53-60, 2000Excluded as review as it mostly included papers on not relevant interventions (NDT) and other reporting non relevant outcomes. References checked.
Wiart,L., Darrah,J., Kembhavi,G., Stretching with children with cerebral palsy: What do we know and where are we going?, Pediatric Physical Therapy, #20, 173-178, 2008Excluded as a review as it included non-comparative studies. References checked
Williams,H., Pountney,T., Effects of a static bicycling programme on the functional ability of young people with cerebral palsy who are non-ambulant, Developmental Medicine and Child Neurology, 49, 522-527, 2007Not an RCT.

From: Appendix H, Excluded studies

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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