title: The evidence-base for conceptual approaches and additional therapies targeting lower limb function in children with cerebral palsy: a systematic review using the ICF as a framework.
abstract: OBJECTIVE
  This systematic review provides an overview of the effectiveness of conceptual approaches and additional therapies used in lower limb physical therapy of children with cerebral palsy and supports the development of clinical guidelines.
  
  
  METHODS
  A literature search in 5 electronic databases was performed, extracting literature published between 1995 and 2009. Studies were evaluated using the framework recommended by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM), which classifies outcomes according to the International Classification of Functioning, Disability and Health (ICF).
  
  
  METHODS
  Three evaluators rated the strength of evidence of the effects according to the AACPDM levels of evidence classification, and the quality of the studies according to the AACPDM conduct score system.
  
  
  RESULTS
  A total of 37 studies used conceptual approaches (neurodevelopmental treatment (NDT), conductive education, Vojta therapy, sensory integration, functional training and goal-oriented therapy) and 21 studies focused on additional therapies (aquatic therapy and therapeutic horse-riding).
  
  
  CONCLUSIONS
  Level II evidence was found for the effectiveness of therapeutic horse-riding on posture and for NDT and functional training on gross motor function. Goal-oriented therapy and functional training were effective on the attainment of functional goals and participation. With level IV evidence, NDT was effective on all levels of the ICF.
authors.affiliation: Rehabilitation Sciences and Physiotherapy, Artevelde University College, Ghent University, Ghent, Belgium. inge.franki@ugent.be
authors.forename: Inge
authors.initials: I
authors.lastname: Franki
authors.forename: Kaat
authors.initials: K
authors.lastname: Desloovere
authors.forename: Josse
authors.initials: J
authors.lastname: De Cat
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
authors.forename: Guy
authors.initials: G
authors.lastname: Molenaers
authors.forename: Patrick
authors.initials: P
authors.lastname: Calders
authors.forename: Guy
authors.initials: G
authors.lastname: Vanderstraeten
authors.forename: Eveline
authors.initials: E
authors.lastname: Himpens
authors.forename: Christine
authors.initials: C
authors.lastname: Van Broeck
mesh_terms: D002547:Cerebral Palsy / Q000473:pathology / Q000534:rehabilitation*; D002648:Child; D002669:Child Welfare; D003210:Concept Formation; D004185:Disability Evaluation; D055317:Evidence-Based Practice; D006801:Humans; D038622:Internationality; D035002:Lower Extremity; D026741:Physical Therapy Modalities; D016896:Treatment Outcome