Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Department of Physical Therapy, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Dev Med Child Neurol. 2020 Oct;62(10):1138-1146. doi: 10.1111/dmcn.14599. Epub 2020 Jun 22.
To determine the reported outcome domains and measures used to assess lower limb orthopaedic surgery of ambulant children and young people with cerebral palsy (CP) and map these outcomes to the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY) framework.
This updated scoping review included studies published between January 2016 and July 2019 in five databases: MEDLINE, PubMed, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials. Studies were included if participants were ambulant individuals with CP aged between 0 and 20 years who had undergone lower limb orthopaedic surgery. Health outcome domains and measures were identified and classified using the ICF-CY framework.
Forty-four eligible studies were identified with a total of 40 different outcome domains recorded. Among eligible studies, 44 (100%) measured body function and structural impairment and seven (16%) measured activity limitation and participation restriction. The most frequently reported outcome was gait pattern (n=37, 84%). Few studies reported adverse effects of surgery (n=13, 30%). Twenty-nine different outcome measures were identified. Patient-reported outcomes measures were used in 10 studies (23%).
The review highlights a heterogeneity in the reported outcome domains and measures used in CP studies. The majority of the reported outcomes focus on the ICF-CY domain of body function and structure. The review also highlights a notable shift towards patient-reported outcomes in recent years. Development of a core outcome set for lower limb orthopaedic surgery would guide researchers to use more consistent and complete measurement sets.
确定用于评估能走动的脑瘫儿童和青少年下肢矫形手术的报告结局领域和测量方法，并将这些结局映射到国际功能、残疾和健康分类-儿童和青少年（ICF-CY）框架。
本更新的范围综述包括 2016 年 1 月至 2019 年 7 月期间在 5 个数据库（MEDLINE、PubMed、EMBASE、CINAHL 和 Cochrane 对照试验中心注册库）发表的研究。如果参与者为年龄在 0 至 20 岁之间、能走动的脑瘫患者，且接受过下肢矫形手术，则纳入研究。使用 ICF-CY 框架识别和分类健康结局领域和测量方法。
确定了 44 项符合条件的研究，共记录了 40 个不同的结局领域。在符合条件的研究中，有 44 项（100%）测量了身体功能和结构损伤，有 7 项（16%）测量了活动受限和参与受限。报告最多的结局是步态模式（n=37，84%）。很少有研究报告手术的不良影响（n=13，30%）。确定了 29 种不同的结局测量方法。10 项研究（23%）使用了患者报告结局测量方法。
该综述突出了脑瘫研究中报告的结局领域和测量方法的异质性。报告的大部分结局都集中在 ICF-CY 的身体功能和结构领域。该综述还突出了近年来向患者报告结局的显著转变。下肢矫形手术的核心结局集的制定将指导研究人员使用更一致和完整的测量集。
