Malone Ailish, Tanner Giorgia, French Helen P
School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
School of Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
Dev Med Child Neurol. 2025 Apr;67(4):450-462. doi: 10.1111/dmcn.16175. Epub 2024 Nov 21.
To identify, describe, and synthesize available evidence on the longitudinal relationship between hip displacement and hip function, using the International Classification of Functioning, Disability and Health (ICF) framework, in children and adolescents with cerebral palsy (CP) aged up to 18 years.
Five databases were searched systematically from inception to May 2022. Study and sample characteristics, and hip displacement and hip function measures, mapped to the ICF domains, were extracted for narrative synthesis.
Twenty-nine studies were included: four longitudinal registry-based studies; 12 prospective studies; 12 retrospective studies; and one randomized controlled trial. Sample size ranged from 11 to 267. Twenty-seven (93%) studies entailed an intervention: surgery (n = 16); rehabilitation (n = 2); nerve block or botulinum neurotoxin A injection (n = 4); and combined surgery and injection (n = 2). Twenty-six studies (90%) reported outcomes at the body structure and function and impairment domain of the ICF; 17 (59%) reported outcomes in the activity domain; and three (10%) included participation measures. The most common hip displacement measure was Reimers' migration percentage (79%).
Because of the inclusion of interventions in most studies, and the preponderance of retrospective studies, the relationship between hip displacement and hip function in CP is unclear. More high-quality prospective evidence on the natural history of hip displacement, and its effect on function, is needed to improve population-wide screening of children with CP.
采用国际功能、残疾和健康分类（ICF）框架，识别、描述并综合18岁及以下脑瘫（CP）儿童和青少年中髋关节移位与髋关节功能纵向关系的现有证据。
对五个数据库从创建至2022年5月进行系统检索。提取研究和样本特征以及映射到ICF领域的髋关节移位和髋关节功能测量指标，进行叙述性综合分析。
纳入29项研究：4项基于纵向登记处的研究；12项前瞻性研究；12项回顾性研究；以及1项随机对照试验。样本量从11至267不等。27项（93%）研究涉及干预措施：手术（n = 16）；康复（n = 2）；神经阻滞或肉毒杆菌神经毒素A注射（n = 4）；以及手术与注射联合（n = 2）。26项研究（90%）报告了ICF身体结构与功能及损伤领域的结果；17项（59%）报告了活动领域的结果；3项（10%）纳入了参与度测量指标。最常用的髋关节移位测量指标是赖默斯移位百分比（79%）。
由于大多数研究纳入了干预措施，且回顾性研究占主导，CP中髋关节移位与髋关节功能之间的关系尚不清楚。需要更多关于髋关节移位自然史及其对功能影响的高质量前瞻性证据，以改善对CP儿童的全人群筛查。
