Efficacy and Safety of Interventions for Cerebral Palsy: An Umbrella Review of 35 Meta-analyses
Main Article Content
Abstract
Background; At present, there is a shortage of strength and credibility of evidence regarding the efficacy and safety of intervention methods for individuals with cerebral palsy (CP).
Aim; To systematically evaluate the efficacy and safety of various intervention strategies for CP across physical, pharmacological, and biological domains through an umbrella review of meta-analyses.
Methods; PubMed, Web of Science, and Embase were systematically searched to identify peer-reviewed articles published prior to December 31, 2023. The study involved a meta-analysis of randomized controlled trials (RCTs) focusing on individuals diagnosed with CP who received interventions spanning physical (e.g., motor and stimulation therapies), pharmacological (e.g., botulinum toxin type A), and biological (e.g., stem cell therapy) domains. Two reviewers independently extracted data and assessed the quality of included studies using the AMSTAR tool. The GRADE system was used to evaluate the strength of evidence. The primary exclusion criteria were the absence of outcome measures related to efficacy and safety.
Results; This review encompasses 35 studies covering physical, biological, and pharmaceutical interventions, yielding a total of 31 outcome measures. The findings indicate that assistive technologies such as robot-assisted gait training, virtual-reality exercises, and hippotherapy, along with physical stimulation methods and stem cell therapy, positively influence multiple aspects of body functions and structures. Nevertheless, more comprehensive and stringent research is imperative to establish standardized therapeutic regimens. Type A botulinum toxin has proven effective in enhancing gait, albeit with safety concerns.
Conclusions; Our findings compared the effectiveness of multiple intervention methods for addressing various issues, yet further research is required to adopt more standardized approaches for evaluating the outcome measurements of these treatment plans. Future research should prioritize large-scale RCTs to validate these interventions and integrate multidisciplinary approaches to optimize functional outcomes in clinical practice.