Network Meta-analysis of the effect of different rehabilitation therapies on improving motor dysfunction in children with spastic cerebral palsy
Objective To systematically evaluate the effects of various rehabilitation therapies,including hydrotherapy,rehabilitation robot,core stability training(CST),whole-body vibration training(WBV),repetitive transcranial magnetic stimulation(rTMS),sling exercise training(SET),task-oriented training(TOT)and virtual reality(VR),on motor dysfunction in children with spastic cerebral palsy,so as to provide a reference for the scientific selection of rehabilitation programs for children.Methods Randomized controlled trials(RCTs)of the 8 rehabilitation therapies in the treatment of motor dysfunction in children with spastic cerebral palsy were searched from various databases,including PubMed,The Cochrane Library,Web of Science,EmBase,CNKI,CBM,VIP,and WanFang Database,from database inception to December 2022.Two researchers independently conducted literature screening,data extraction,and literature quality evaluation.Network Meta-analysis was performed using ADDIS 1.16.6 software,and Stata 16.0 software was used for graphic representation.Results A total of 43 RCTs involving 2 722 children with spastic cerebral palsy were included in the analysis.The results of the network Meta-analysis indicated that WBV had the most significant effect in improving the GMFM-88 score(MD=18.56,95％CI:34.91-2.45,P＜0.05).Rehabilitation robot had the most significant effect in improving dimensions D(MD=6.30,95％CI:8.44-4.41,P＜0.05)and E(MD=10.03,95％CI:15.03-4.84,P＜0.05)of the GMFM-88 score.Additionally,hydrotherapy showed the most significant effect in improving the BBS score(MD=11.24,95％CI:22.26-0.20,P＜0.05).Conclusions For children with spastic cerebral palsy,WBV is the most effective rehabilitation therapy to improve gross motor function,rehabilitation robot is the most effective therapy for improving standing and walking function,and hydrotherapy is the most effective therapy for improving balance.
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