Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis

Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis

Authors
Lucas, B. R. Elliott, E. J. Coggan, S. Pinto, R. Z. Jirikowic, T. McCoy, S. W. Latimer, J.
Year
2016
Journal
Bmc Pediatrics
Volume
16
Pages
193
BACKGROUND: Gross motor skills are fundamental to childhood development. The effectiveness of current physical therapy options for children with mild to moderate gross motor disorders is unknown. The aim of this study was to systematically review the literature to investigate the effectiveness of conservative interventions to improve gross motor performance in children with a range of neurodevelopmental disorders. METHODS: A systematic review with meta-analysis was conducted. MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PEDro, Cochrane Collaboration, Google Scholar databases and clinical trial registries were searched. Published randomised controlled trials including children 3 to <18 years with (i) Developmental Coordination Disorder (DCD) or Cerebral Palsy (CP) (Gross Motor Function Classification System Level 1) or Developmental Delay or Minimal Acquired Brain Injury or Prematurity (<30 weeks gestational age) or Fetal Alcohol Spectrum Disorders; and (ii) receiving non-pharmacological or non-surgical interventions from a health professional and (iii) gross motor outcomes obtained using a standardised assessment tool. Meta-analysis was performed to determine the pooled effect of intervention on gross motor function. Methodological quality and strength of meta-analysis recommendations were evaluated using PEDro and the GRADE approach respectively. RESULTS: Of 2513 papers, 9 met inclusion criteria including children with CP (n=2) or DCD (n=7) receiving 11 different interventions. Only two of 9 trials showed an effect for treatment. Using the least conservative trial outcomes a large beneficial effect of intervention was shown (SMD:-0.8; 95% CI:-1.1 to -0.5) with "very low quality" GRADE ratings. Using the most conservative trial outcomes there is no treatment effect (SMD:-0.1; 95% CI:-0.3 to 0.2) with "low quality" GRADE ratings. Study limitations included the small number and poor quality of the available trials. CONCLUSION: Although we found that some interventions with a task-orientated framework can improve gross motor outcomes in children with DCD or CP, these findings are limited by the very low quality of the available evidence. High quality intervention trials are urgently needed.

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Type of intervention

Treatment and Child Welfare Interventions

Topic

Development and Life Coping Skills

Motor development

Biological Risk Factors, Diseases and Symptoms

Preterm Birth

Mental/Physical Impairment

Intervention

The organization of interventions

E-health interventions

Age group

School Aged Children (6-12 years)

Adolescents (13-18 years)

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