Affiliations: [a] Cerebra Research Unit and PenCLAHRC, Peninsula Medical School, University of Exeter, Exeter, UK | [b] Honorary Principal Orthotist, Nuffield Orthopaedic Centre, Oxford, UK | [c] National Centre for Prosthetics and Orthotics, University of Strathclyde, UK | [d] Hanger Prosthetics and Orthotics Inc, Salt Lake City, UT, USA | [e] Orthotic Innovations, Melbourne, Victoria, Australia | Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Australia
Correspondence:
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Corresponding author: Chris Morris, Cerebra Research Unit and PenCLARHC, Child Health Group, Veysey Building, Salmon Pool Lane, University of Exeter, Exeter, Devon EX2 4SG, UK. Tel.: +44 1392 262980; Fax: +44 1392 262964; E-mail: [email protected]
Abstract: An international multidisciplinary group of healthcare professionals and researchers participated in a consensus conference on the management of cerebral palsy, convened by the International Society for Prosthetics and Orthotics. Participants reviewed the evidence and considered contemporary thinking on a range of treatment options including physical and occupational therapy, and medical, surgical and orthotic interventions. The quality of many of the reviewed papers was compromised by inadequate reporting and lack of transparency, in particular regarding the types of patients and the design of the interventions being evaluated. Substantial evidence suggests that ankle-foot orthoses (AFOs) that control the foot and ankle in stance and swing phases can improve gait efficiency in ambulant children (GMFCS levels I-III). By contrast, little high quality evidence exists to support the use of orthoses for the hip, spine or upper limb. Where the evidence for orthosis use was not compelling consensus was reached on recommendations for orthotic intervention. Subsequent group discussions identified recommendations for future research. The evidence to support using orthoses is generally limited by the brevity of follow-up periods in research studies; hence the extent to which orthoses may prevent deformities developing over time remains unclear. The full report of the conference can be accessed free of charge at www.ispoint.org.
