【文献标题】Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis（康复干预改善脑瘫患儿步速的有效性:系统回顾和荟萃分析）
【文献来源】Physical Therapy 96(12) · June 2016
数据源 对于MEDLINE / PubMed，CINAHL，ERIC和PEDro从2014年4月的内容开始搜索。
数据合成 纳入了24个研究。确定了三类干预措施：步态训练（n = 8），阻力训练（n = 9）和杂项（n = 7）。 Meta分析显示，步态训练有效增加步态速度，标准化效应大小为0.92（95％置信区间= 0.19,1.66; P = 0.01），而阻力训练显示效果可以忽略不计= 0.06; 95％置信区间= -0.12,0.25; P = 0.51）。在杂项类别中效应大小从负向到大。
Purpose The purpose of this study was to determine the effectiveness of interventions for improving gait speed in ambulatory children with CP.
Data Sources MEDLINE/PubMed, CINAHL, ERIC, and PEDro were searched from inception through April 2014.
Study Selection The selected studies were randomized controlled trials or had experimental designs with a comparison group, included a physical therapy or rehabilitation intervention for children with CP, and reported gait speed as an outcome measure.
Data Extraction Methodological quality was assessed by PEDro scores. Means, standard deviations, and change scores for gait speed were extracted. General study information and dosing parameters (frequency, duration, intensity, and volume) of the intervention were recorded.
Data Synthesis Twenty-four studies were included. Three categories of interventions were identified: gait training (n=8), resistance training (n=9), and miscellaneous (n=7). Meta-analysis showed that gait training was effective in increasing gait speed, with a standardized effect size of 0.92 (95% confidence interval=0.19, 1.66; P=.01), whereas resistance training was shown to have a negligible effect (effect size=0.06; 95% confidence interval=−0.12, 0.25; P=.51). Effect sizes from negative to large were reported for studies in the miscellaneous category.
Limitations Gait speed was the only outcome measure analyzed.
Conclusions Gait training was the most effective intervention in improving gait speed for ambulatory children with CP. Strength training, even if properly dosed, was not shown to be effective in improving gait speed. Velocity training, electromyographic biofeedback training, and whole-body vibration were effective in improving gait speed in individual studies and warrant further investigation.