Prevalence and goal attainment with spinal orthoses for children with cerebral palsy.
Katina Pettersson, Elisabet Rodby-Bousquet
PMID 31227670WHAT IT FOUND
Only 251 of 2800 children with CP used spinal orthoses, mostly for function.
Functional goals were often attained, but 37% of children with severe scoliosis who had that goal attained deformity prevention.
Key findings
01Spinal orthoses were used by 251 of 2800 children with CP, and use was only reported at GMFCS levels III to V, reaching 38% at level V.
02Functional goals were common among orthosis users and were often reported as attained: 209 of 241 stability goals, 99 of 127 head-control goals, and 77 of 96 arm/hand-function goals.
03Deformity prevention was reported for 83 of 251 orthosis users, and goal attainment was 71% in mild scoliosis and 37% in severe scoliosis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Goal attainment was a judgment made by the physiotherapist with the child and family about everyday life, not an objective test. The study was cross-sectional, so it could not show whether an orthosis caused change or how function changed over time. There was no comparison group, so reported attainment cannot be separated from usual therapy, growth, seating, or natural change. Only a small number of children at GMFCS level III used spinal orthoses, so findings for that group are thin. The registry did not record orthosis type, material, or whether it was prefabricated or individually molded. The study was done in Sweden, where health care and orthotic services are freely available; use and outcomes may differ elsewhere. Information about scoliosis presence was missing for two children and severity for nine children. The spinal examination was clinical, not radiographic, although the paper reports good validity for detecting curvature.
The easy way to misread this
Do not read the high functional goal attainment rates as proof that spinal orthoses improve function. This was a cross-sectional registry report with no comparison group, and attainment was a therapist and family judgment about daily life.