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Phys Occup Ther Pediatr. 2019 Sep 26:1-16. doi: 10.1080/01942638.2019.1664703. [Epub ahead of print]

Defining Functional Therapy in Research Involving Children with Cerebral Palsy: A Systematic Review.

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Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University , Maastricht , The Netherlands.
Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands.
De Hoogstraat Rehabilitation , Utrecht , The Netherlands.
d Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland , Brisbane , QLD , Australia.
e Department of Physical Therapy and Rehabilitation Sciences, Drexel University , Philadelphia , PA , USA.
f Centre of Expertise in Rehabilitation and Audiology , Hoensbroek , The Netherlands.
g Department of Pediatric Physical Therapy, Hasselt University , Biomed , Hasselt , Belgium.


Aim: To review definitions and elements of interventions in studies, which used the word "functional" to describe their intervention for children with cerebral palsy (CP), and to determine whether definitions and elements are similar to criteria of functional therapy described in the Dutch Guidelines. Methods: Systematic review of intervention studies, which used the word "functional" to describe interventions for children with CP. We described criteria of functional therapy that were used to describe the intervention, and whether criteria were described similarly to the descriptions used in the Dutch Guidelines. Results: Of the 27 included studies, criteria "based on the activities/participation level of the ICF-CY", "goal-directed" and "context-specific" were referred to the most (40-59.3%). Descriptions of these criteria were less comparable to the suggested definition (43.8-69.2%). The remaining three criteria ("active involvement", "task-specific", and "focused on functionality instead of normality") were referred to less frequently (18.5-33.3%). The descriptions reported for these criteria were, however, the most comparable with the suggested definitions (80-100%). Conclusions: The included studies, in general have not used criteria of functional therapy. Future studies have to describe the elements of interventions in detail. Moreover, it is important to reach consensus on the definition and elements of functional therapy.


Active involvement; ICF-CY; activity; cerebral palsy; context-specific; functional therapy; functionality; goal-directed; participation; task-specific

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