Systematic Review of Clinical Guidelines Related to Care of Individuals With Cerebral Palsy as Part of the World Health Organization Efforts to Develop a Global Package of Interventions for Rehabilitation.
Diane L Damiano, Egmar Longo, Ana Carolina de Campos and 2 others
PMID 33453191WHAT IT FOUND
Existing cerebral palsy guidelines focus heavily on body functions and spasticity, with few recommendations for activity and participation.
Therapists should expect limited guidance on physical and occupational therapy interventions, noting that evidence for improving daily function often lags behind medical management.
Key findings
01The majority of intervention recommendations target body functions rather than activity and participation, with the largest group addressing neuromusculoskeletal and movement functions.
02No clinical practice guidelines were found that focused primarily on physical or occupational therapy, despite these being the most prevalent rehabilitation services.
03Evidence for spasticity treatments often shows effects on body functions but lacks support for improvements in activity and participation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The search was restricted to guidelines in English, potentially excluding relevant global resources. Many potential guidelines were excluded due to lack of conflict of interest disclosures or incomplete evidence grading, reducing the final pool to only 5. The review focused on guidelines, which may lag behind the most current systematic reviews of intervention efficacy. The analysis could not separate the contribution of individual components in multidisciplinary care programs.
Declared interests
The study was supported by the World Health Organization. The working group members were required to disclose conflicts of interest, and guidelines with commercial funding or undeclared conflicts were excluded.
The easy way to misread this
Do not interpret the lack of specific physical or occupational therapy guidelines as an absence of evidence for these interventions. The review highlights a gap in guideline development, not a lack of clinical efficacy, as separate systematic reviews have identified numerous effective therapy interventions.