title: Effectiveness of upper and lower limb casting and orthoses in children with cerebral palsy: an overview of review articles.
abstract: The objective of this overview is to summarize from systematic reviews the evidence on the effectiveness of using upper and lower limb casting or orthoses in children with cerebral palsy. We used computerized bibliographic databases to search for systematic reviews without any language restrictions. Identification, selection, quality assessment, and data extraction were performed independently by two investigators. Of the 40 identified reviews, 23 were selected for closer consideration, and five reviews met the inclusion criteria. The quality of existing systematic reviews and original studies included in our reviews varied widely. The following evidence was found: (1) casting of lower limbs has a short-term effect on passive range of movement; (2) orthoses that restrict ankle plantar flexion have a favorable effect on an equinus walk, but the long-term clinical significance is unclear; (3) evidence on managing upper limb problems with casting or splinting in children with cerebral palsy is inconclusive. Our conclusion is that there is a paucity of evidence from primary studies on the use of orthoses in children with cerebral palsy. More original, well-designed research is needed.
authors.affiliation: FinOHTA (Finnish Office for Health Technology Assessment)/STAKES (National Research and Development Centre for Welfare and Health), Helsinki, Finland.
authors.forename: Ilona
authors.initials: I
authors.lastname: Autti-Rämö
authors.forename: Jutta
authors.initials: J
authors.lastname: Suoranta
authors.forename: Heidi
authors.initials: H
authors.lastname: Anttila
authors.forename: Antti
authors.initials: A
authors.lastname: Malmivaara
authors.forename: Marjukka
authors.initials: M
authors.lastname: Mäkelä
mesh_terms: D000203:Activities of Daily Living; D002370:Casts, Surgical; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D005121:Extremities; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D009048:Motor Skills; D009989:Orthotic Devices; D016059:Range of Motion, Articular; D016896:Treatment Outcome