a Centre for Disability and Development Research , Australian Catholic University , Melbourne , VIC , Australia.
b Department of Pediatric Rehabilitation , Princess Margaret Hospital , Perth , WA , Australia.
Disabil Rehabil. 2018 Jun;40(12):1361-1371. doi: 10.1080/09638288.2017.1297498. Epub 2017 Mar 12.
To explore (i) reasons for upper limb orthosis prescription for children with cerebral palsy (CP), (ii) the link between reason and effect according to intended outcome and outcome measure utilized and (iii) to classify the prescribed orthoses using standard terminology.
A prospectively registered (center for reviews and dissemination: 42015022067) systematic review searched for experimental and observational studies investigating rigid/thermoplastic upper limb orthotic intervention for children aged 0-18 with CP. The Cochrane central register, MEDLINE, CINAHL, Embase, SCOPUS and Web of Science databases were searched. Included studies were assessed for risk of bias.
Sixteen studies met selection criteria. Two studies described a specific reason for orthosis prescription, six prescribed orthoses to manage a clinical symptom and eight did not describe a reason. Eight studies were analyzed for effect according to intended outcome with no clear connection found between reasons for prescription, outcome measures utilized and effect reported.
The lack of evidence for upper limb orthotic intervention for children with CP leads to uncertainty when considering this treatment modality. Future research is needed to evaluate the effect of orthosis wear in relation to intended outcome utilizing robust methods and valid and reliable outcome measures. Implications for rehabilitation: Insufficient evidence exists about the reason for prescription of upper limb orthoses. The connection between reason for orthosis prescription, intended outcome, outcome measure utilized and observed effect is unclear. Recommend orthosis prescription to be accompanied by clear documentation of the aim of the orthosis and description using orthosis classification system terminology. Outcome measures consistent with the reason for orthosis prescription and intended outcome of the intervention are essential to measure effectiveness of the intervention.
探讨（i）为脑瘫儿童开具上肢矫形器的原因，（ii）根据预期结果和使用的结果测量指标，原因与效果之间的联系，以及（iii）使用标准术语对规定的矫形器进行分类。
一项前瞻性注册（中心评论和传播：42015022067）系统评价搜索了针对年龄在 0-18 岁脑瘫儿童的刚性/热塑上肢矫形干预的实验和观察性研究。检索了 Cochrane 中央注册库、MEDLINE、CINAHL、Embase、SCOPUS 和 Web of Science 数据库。纳入的研究进行了偏倚风险评估。
符合选择标准的研究有 16 项。两项研究描述了矫形器处方的具体原因，六项研究规定矫形器用于治疗临床症状，八项研究未描述原因。有八项研究根据预期结果分析了效果，没有发现处方原因、使用的结果测量指标和报告的效果之间有明确的联系。
脑瘫儿童上肢矫形干预的证据不足，导致在考虑这种治疗方式时存在不确定性。需要进一步研究，利用可靠的方法和有效且可靠的结果测量指标，评估矫形器佩戴对预期结果的影响。
关于上肢矫形器的处方原因，证据不足。矫形器处方的原因、预期结果、使用的结果测量指标和观察到的效果之间的联系尚不清楚。建议在开具矫形器处方时，应明确记录矫形器的目的，并使用矫形器分类系统术语进行描述。与矫形器处方的原因和干预的预期结果一致的结果测量指标对于测量干预的效果至关重要。
