title: Determination of interventions for upper extremity tactile impairment in children with cerebral palsy: a systematic review.
abstract: OBJECTIVE
  This study reviewed interventions suitable for treating tactile dysfunction in children with cerebral palsy (CP).
  
  
  METHODS
  A systematic review was conducted of six databases, searched for population: ('brain injury' OR 'cerebral palsy' OR 'stroke' OR 'cerebrovascular accident') and intervention: ('tactile' OR 'sensation'). Inclusion criteria were: (1) published after 1950 in English; (2) participants older than 4 years with brain injury; (3) upper limb intervention; and (4) examined tactile registration or perception.
  
  
  RESULTS
  Of 2938 studies identified, 30 met the inclusion criteria. Results from included studies indicated that tactile function improved in adults with stroke after transfer enhanced training (t[47]=2.75, p=0.004), stimulus specific training (p<0.001), ice therapy (F=5.71, p=0.028), mirror therapy (F=7.7, p=0.009), and functional deafferentation using an anaesthetic cream (t=3.76; p<0.01). No intervention reported improvement in tactile dysfunction for children with CP.
  
  
  CONCLUSIONS
  Research is required to develop tactile interventions for children with CP that integrate methodology from effective approaches for adults after stroke. Stimulus specific training, transfer enhanced training, and mirror therapy are promising. Other approaches are less suitable for children because of invasiveness (electrical stimulation), safety (ice therapy), or limitation of bimanual function (eutectic mixture of local anaesthetics, pneumatic cuff).
authors.affiliation: Cerebral Palsy League, Brisbane, QLD, Australia; School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Auld
authors.forename: Remo
authors.initials: R
authors.lastname: Russo
authors.forename: G Lorimer
authors.initials: GL
authors.lastname: Moseley
authors.forename: Leanne M
authors.initials: LM
authors.lastname: Johnston
mesh_terms: D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D006801:Humans; D012678:Sensation Disorders / Q000209:etiology* / Q000628:therapy*; D014110:Touch; D034941:Upper Extremity