Table 1.
Characteristics of included studies
| Study | Study design | AACPDM LoE | CP n | Age range, mean and SD in years |
GMFCS levels/proportions | Task-specific training (T) | Comparison (C) or other task-specific training | Activity outcomes | Participation related outcomes (measure) | Other outcomes (ICF domain) | ||
| Gross motor function | Functional skills |
Gross motor skill performance |
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| Outcome measured used | ||||||||||||
|
1. Group research designs
a. Level II–III studies (task-specific vs comparison) | ||||||||||||
| Bar-Haim et al27 | RCT | II | Total=78 T=39 C=39 |
Range=5.5–12.2 Total=8.9± 1.7 T=8.8 ± 1.7 C=8.9 ± 1.7 |
T II=36%, III=64% C II=44% III=56% |
Motor learning coaching | Routine physiotherapy—NDT | GMFM | Parent survey | Mechanical efficiency (BSF) |
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| Bleyenheuft et al25 | Crossover RCT | II | Total=24* T=12 C=12 |
T=8.9± 1.7 C=8.5± 1.7 | T I=50% II=50% C I=42% II=58% |
Hand arm bimanual intensive training including lower extremity (HABIT-ILE) | Routine physiotherapy (in general had NDT while waiting for delayed HABIT-ILE) | PEDI (self-care domain only) | 6MWT ABILOCO Kids |
Social participation (Life-H Performan-ce and Satisfaction) | Body weight distribution (BSF) Mean step length (BSF) UL function (Act) Adverse events |
|
| Declerck et al26 | RCT | II | Total=14 T=7 C=7 |
Range=7–17 T=8.7± 3.4 C=11.8± 3.5 |
T I=14% II=86% C I=29% II=57% III=14% |
Swimming skills programme | Routine physiotherapy | WOTA-2† 1MWT |
Adherence/enjoyment | Pain (BSF) Fatigue (BSF) Adverse events |
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| Grecco et al28 | RCT | II | Total=36* T=17 C=18 |
T=6.8± 2.6 C=6.0± 1.5 |
T I=47% II=41% III=12% C I=31% II=50% GMFCS III=19% |
Overground walking | Treadmill training | GMFM | PEDI | 6MWT† TUG |
Balance (Act) | |
| Ketelaar et al33 | RCT | II | Total=55 T=28 C=27 |
Range (total)=2.0–7.25 T=4.5± 1.7 C=4.7± 1.7 |
T mild=79%, mod=21% C mild=77%, mod=23% |
Functional therapy | Routine physiotherapy—generally NDT or Votja method | GMFM | PEDI | |||
| Kumban et al29 | RCT | II | Total=21 T=10 C=11 |
T=12.3± 2.6 C=12.4± 2.4 |
T I–II=60%, III=40% C I–II=55% III=45% |
Regular PT + sit-to-stand task training | Routine physiotherapy | FTSST† | Balance ability (Act) Functional balance and lower limb strength (Act) |
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| Swe et al30 | RCT | II | Total=30* T=15 C=15 |
Total=13.2 +/- 3.4 T=13.0 +/- 3.6 C=13.4 +/- 3.3 |
T II=53% III=47% C II=67%, III=33% |
Overground walking | Partial weight support treadmill training | GMFM (standing and walking domains only) | 6MWT† 10MWT† |
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| Capio et al31 | Comparative study with concurrent controls | III | Total=24 T=12 C=12 |
T=6.92 +/- 3.04 C=7.98 +/- 1.74 |
T I=33% II=58% III=8% C I=25% II=58% III=17% |
Functional motor skills training | Routine physiotherapy or physical education | TGMD- 2 | Physical activity (accelerome-ter) | |||
| b. Level II–III (task-specific vs task-specific) | ||||||||||||
| Hemayattalab et al32 | RCT | II | Total=20 T1=10 T2=10 |
Total=11.6 +/- 1.5 T1=11.9 +/- 1.6 T2=11.3 +/- 1.4 |
I–III Proportions not stated |
Throwing task + self-control feedback | Throwing task + yoked feedback | Throwing accuracy† | ||||
| Hemayattalab and Rostami34 | Comparative study with concurrent controls | III | Total=24 T1=8 T2=8 T3=8 |
Range (total)=7–15 | I=100% | T1 = dart throwing task+50% KR T2 = dart throwing task+100% KR |
T3=dart throwing task+0% KR | Throwing accuracy† | ||||
| Löwing et al35 | Comparative study with concurrent controls | III | Total=44 T=22 C=22 |
Total=4.1 +/- 1.4 T=4.3 +/- 0.7 C=3.8 +/- 1.3 |
T I=45% II=23%, III=14% IV=18% C I=41% II=23%, III=22% IV=14% |
Activity focused individual therapy | Goal-directed functional group therapy | GMFM | PEDI | Goal attainment (GAS) in GDT group only | ||
| c. Level IV | ||||||||||||
| Sorsdahl et al36 | Repeated measures design | IV | T=22* | Range=2.8–9.25 Average age=5.5 |
T I=36% II=23%, III=27% IV–V=14% |
Functional family-centred goal directed therapy | GMFM GMPM |
Goal attainment (GAS) | Quality of fine motor movements (Act) | |||
| 2. Single-subject research designs | ||||||||||||
| Thorpe and Valvano14 | 13 x n=1 studies with random sampling to protocols (A, B or C) | I | N(total)=13 | Range=6.0–12.7 Age=8.6 +/- 1.89 |
III=100% | All protocols = task specific | Change in backward displacement† | |||||
| A=2 x no AI 1 x KP and 5 x KP+CS | B=3 x no AI, 2 x KP and 3 x KP+CS C=4 x no AI, 3 x KP and 1 x KP+CS |
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*Sample size justified with statistical consideration.
†Skill performance outcome is specific to skill being trained.
ABILOCO, measure of locomotion ability; Act, activity; AI, augmented information; BSF; body structures and functions; C, comparison; CS, cognitive strategies; GAS, Goal Attainment Scale, GMPM, Gross Motor Performance Measure; ICF, International Classification of Functioning, Disability and Health; GMFCS, Gross Motor Function Classification System; GMFM, Gross Motor Function Measure (-88 or -66); KP, knowledge of performance; KR, knowledge of results; LoE, level of evidence; Life-H, assessment of life habits; NDT, neurodevelopmental therapy; PEDI, Paediatric Evaluation of Disability Inventory; T, task-specific intervention; TGMD-2, Test of Gross Motor Development -2nd edition; WOTA-2, Water Orientation Test Alyn-2nd edition; 1MWT, 1 min walk test, 10MWT, 10 metre walk test; 6MWT, 6 min walk test.