Effect of different intensive training on upper limb motor function in children with cerebral palsy:a network me-ta-analysis
Objective To systematically review the effect of upper extremity intensive training on upper limb motor function in chil-dren with cerebral palsy.Methods The PICO framework was constructed.PubMed,Embase,Cochrane Library,Scopus,Web of Science,CNKI,CBM,VIP and Wanfang data were retrieved for randomized controlled trials on the improvement of upper limb motor function in children with cerebral palsy by upper extremity intensive training from January,2010 to March,2024.The quality of the included researches was evaluated using the Cochrane System Evaluation Manu-al and Physiotherapy Evidence Database scale.Two reviewers independently screened literature,extracted data and assessed the risk of bias.Network meta-analysis was conducted using RevMan 5.4 and Stata 17.0.Results A total of 27 randomized controlled trials were selected,including 1 173 cases,involving three kinds of upper extremity intensive training.Constraint-induced movement therapy,modified constraint-induced movement thera-py and hand-arm bimanual intensive therapy improved Assistive Hand Assessment score and Peabody Develop-mental Motor Scale-Fine Motor score;constraint-induced movement therapy and modified constraint-induced movement therapy improved the Quality of Upper Extremity Skills Test score;hand-arm bimanual intensive ther-apy improved Pediatric Evaluation of Disability Inventory score.Constraint-induced movement therapy was the best in improving the Assistive Hand Assessment score,Quality of Upper Extremity Skills Test score and Pea-body Developmental Motor Scale-Fine Motor score,while hand-arm bimanual intensive therapy was the best in improving the Pediatric Evaluation of Disability Inventory score.Conclusion Upper extremity intensive training can significantly improve upper limb motor function,fine motor function and activities of daily living in children with cerebral palsy.Constraint-induced movement therapy is the best in improving upper limb function and fine motor function,and hand-arm bimanual intensive therapy is the best in improving the activities of daily living.
cerebral palsyupper extremityintensive trainingconstraint-induced movement therapymotor functionnetwork meta-analysis
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