Karadağ-Saygı Evrim, Giray Esra
Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, İstanbul, Turkey.
Turk J Phys Med Rehabil. 2019 Feb 14;65(1):93-110. doi: 10.5606/tftrd.2019.3431. eCollection 2019 Mar.
The aim of this review to evaluate the clinical aspects and effectiveness of suit therapy for patients with cerebral palsy (CP).
A literature search was performed in the PubMed, SCOPUS, Web of Science, and PEDro databases within the period from the establishment of the relevant database to July 2018. The articles were categorized according to their study design. We included studies published in peer-review journals focusing on the efficacy of suit therapies for CP and excluded review articles, duplications, non-related articles. A narrative synthesis approach was used, as it was not possible to classify extracted and analyzed data, and the overall effect size was unable to be calculated. Data regarding study subjects (number, age, CP type, Gross Motor Function Classification System [GMFCS] level), suit type, intervention including dose of suit therapy, outcome measurements, outcomes, adverse effects, and funding were extracted. The method introduced by Furlan, Pennick, Bombardier, and van Tulder was used to evaluate the risk of bias for the assessment of methodological quality of randomized-controlled trials (RCTs).
A total of 29 studies were included of which 10 were Class I, eight were Class II-III, and 11 were Class IV studies. Studies were heterogenous in design, sample size, study population, and outcomes measured. The methodological quality score of RCTs varied between 4 and 10. The results of the high-quality RCTs showed that wearing the suit along with conventional therapy improved proximal stability, gross motor function, and gait. The Class II-III and IV studies supported the findings of the Class I studies.
The major improvements from the RCTs were seen in proximal stability, gross motor function and gait, although grading was unable to be done due to the heterogeneity of included studies. In order to obtain gains in the function, it is important to carefully consider intended use, patient selection criteria, and suit type.
本综述旨在评估针对脑瘫（CP）患者的套装疗法的临床情况及有效性。
在PubMed、SCOPUS、科学网和PEDro数据库中，于各相关数据库建立至2018年7月期间进行文献检索。文章根据其研究设计进行分类。我们纳入发表在同行评审期刊上、聚焦于套装疗法对CP疗效的研究，排除综述文章、重复文章及不相关文章。采用叙述性综合分析方法，因为无法对提取和分析的数据进行分类，且无法计算总体效应量。提取有关研究对象的数据（数量、年龄、CP类型、粗大运动功能分类系统[GMFCS]水平）、套装类型、干预措施（包括套装疗法剂量）、结局测量指标、结果、不良反应及资金情况。采用Furlan、Pennick、Bombardier和van Tulder介绍的方法评估随机对照试验（RCT）方法学质量评估中的偏倚风险。
共纳入29项研究，其中10项为I类研究，8项为II - III类研究，11项为IV类研究。各项研究在设计、样本量、研究人群及测量结局方面存在异质性。RCT的方法学质量评分在4至10分之间。高质量RCT的结果表明，与传统疗法一起穿着套装可改善近端稳定性、粗大运动功能和步态。II - III类和IV类研究支持I类研究的结果。
尽管由于纳入研究的异质性无法进行分级，但RCT的主要改善体现在近端稳定性、粗大运动功能和步态方面。为了在功能上取得进展，仔细考虑预期用途、患者选择标准和套装类型非常重要。
