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Dev Med Child Neurol ; 59(11): 1130-1138, 2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-28574172

RESUMEN

AIM: To conduct a systematic review and evaluate the quality of evidence for interventions to prevent hip displacement in children with cerebral palsy (CP). METHOD: A systematic review was performed using American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Searches were completed in seven electronic databases. Studies were included if participants had CP and the effectiveness of the intervention was reported using a radiological measure. Results of orthopaedic surgical interventions were excluded. RESULTS: Twenty-four studies fulfilled the inclusion criteria (4 botulinum neurotoxin A; 2 botulinum neurotoxin A and bracing; 1 complementary and alternative medicine; 1 intrathecal baclofen; 1 obturator nerve block; 8 positioning; 7 selective dorsal rhizotomy). There was significant variability in treatment dosages, participant characteristics, and duration of follow-up among the studies. Overall, the level of evidence was low. No intervention in this review demonstrated a large treatment effect on hip displacement. INTERPRETATION: The level and quality of evidence for all interventions aimed at slowing or preventing hip displacement is low. There is currently insufficient evidence to support or refute the use of the identified interventions to prevent hip displacement or dislocation in children and young people with CP. WHAT THIS PAPER ADDS: High-quality evidence on prevention of hip displacement is lacking. No recommendations can be made for preventing hip displacement in children with cerebral palsy because of poor-quality evidence. High-quality, prospective, longitudinal studies investigating the impact of interventions on hip displacement are required.


Asunto(s)
Parálisis Cerebral/complicaciones , Luxación de la Cadera/etiología , Luxación de la Cadera/prevención & control , Toxinas Botulínicas Tipo A/uso terapéutico , Tirantes , Niño , Terapias Complementarias , Bases de Datos Factuales/estadística & datos numéricos , Humanos , Bloqueo Nervioso , Fármacos Neuromusculares/uso terapéutico , Evaluación de Resultado en la Atención de Salud , Rizotomía
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