There were too few studies to enable us to perform these analyses. Children with CP constitute a relatively small but challenging group of patients. sitioning systems to reduce or prevent hip migration for chil-, ies) found no differences in sleep quality or pain b, tioning systems. USA.gov. Ten parents/carers completed serial QOL questionnaires. and pain. In December 2014, we searched CENTRAL, Ovid MEDLINE, Embase, and 13 other databases. The level and quality of evidence for all interventions aimed at slowing or preventing hip displacement is low. Any negative effect of sleep positioning systems on hip migration will be considered within this objective.Secondary objectives were to determine the effect of sleep positioning systems on: (1) number or frequency of hip problems; (2) sleep patterns and quality; (3) quality of life of the child and family; (4) pain; and (5) physical functioning. Clipboard, Search History, and several other advanced features are temporarily unavailable. cerebral palsy using night-time postural equipment: systems on sleep-wake patterns and pain levels in non-. Cochrane database of systematic reviews (Online). These were cross-over trials (see Cochrane Glossary). Textbook of neurological Cochrane reviews, Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children, Adjuvant corticosteroids for reducing death in neonatal bacterial meningitis. A systematic review and meta-analysis of the prevalence of sleep problems in children with cerebral palsy: how do children with cerebral palsy differ from each other and from typically developing children? Study authors were asked for additional information in the case of missing data. The search strategy combined terms for cerebral palsy with generic, search strategies for each database are reported in, In addition, we searched the reference lists of, retrieved to identify studies missed by the e, contacted the manufacturers of sleep positioning, thors of relevant papers to ask if they were aware of any published, and unpublished research. neonatal units). Search methods: For more infor-, mation on methods to overcome unit of analysis issues archived, Study authors provided the raw data from their studies to enable, reanalysis. Age range 9 months to, tioning systems. Selection criteria: Poor sleep and inability ABSTRACT Aims To explore the views of children on using a sleep system, the role of their parents and therapists in its use, and the quality of sleep achieved as a result. • The Posture and Postural Ability Scale may be considered for use in the management of body shape in adults with CP. The authors report on the findings of a national postal survey of Paediatric Chartered Physiotherapists regarding their experiences of the benefits and limitations of five commercially available night time postural management equipment systems. Get the latest research from NIH: https://www.nih.gov/coronavirus. Anthropmetric measures, gastroeintestinal symptoms, Children's sleep habits questionnaire (CSHQ) Arabic version, polysomnography, Chalfont epilepsy severity score, and EEG were done at enrollment and after the 3-months. The following data were extracted, intervention characteristics (duration, frequency, training received by parents in the use of the sleep positioning. Participants in both trials were children (12 boys, 9 girls, in total) with cerebral palsy, graded as Levels III to V according, to the GMFCS; aged 5 to 16 years; and established users of sleep, scribed as a pilot, was conducted in a laboratory (one night with. spastic, ataxic, dyskinetic/athetoid); severity of cerebral palsy (as classified by the Gross Motor Function, age (e.g. Between January 2010 and December 2016, 21 patients (median age 11.1 (range 1.7–16.1) years) with CP were initiated on NIV at Great Ormond Street Hospital for Children following diagnosis of moderate to severe SDB on cardiorespiratory polygraphy. Reflux problmes, sleeping disorders (such as sleep apnea), and seizures are among a few of the many medical conditions that children with cerebral palsy may face, an in turn, sleep is greatly affected. All trials were included irrespective of blinding, numbers of participants randomly assigned and language of the article. These were cross-over trials (see Cochrane Glossary). The evidence for postural management to prevent or reduce hip migration in children with cerebral palsy is limited by the lack of high-quality studies. We collected the numbers of participants for whom no, outcome data were obtained and reported this information in the, archived for future updates of this review, please see, Where a study met the inclusion criteria, we examined th.  |  58 ). and drinking ability and weight centiles. Both were judged, to have a high risk of bias and inadequate power related to small, samples and substantial individual variability in the outcomes as-, sessed. Search methods: Additional analgesic interventions may be less likely with TENS (odds ratio 0.57; 95% CI 0.34-0.96), number-needed-to-treat 14 (95% CI 7.3-119). A case series of ch, positioning systems identified that while most children adapted to, using the equipment, some children were unable to sleep in the, survey indicated that many families encountered pr, the equipment and needed support and education, particularly, with developmental disabilities are much more co, The evidence for postural management programmes appears lim-, ited and it is thought that further research is needed (, sitioning systems, the prescription of this equipment is becoming, increasingly widespread. physical functioning scores), we plan to calculate standardised, mean differences (SMD) with 95% confidence intervals (CIs). hip problems (dislocation, dysplasia) and pelvic obliquity. May LH. There is currently insufficient evidence to support or refute the use of the identified interventions to prevent hip displacement or dislocation in children and young people with CP. The order in which they either used or did not use the equipment was randomised. The aim of this review was to look for robust evidence from randomised controlled trials evaluating the effectiveness of sleep positioning systems for children with cerebral palsy. While, blinding of the delivery of this intervention was not possible in, the included studies, a lack of blinding may have impacted, subjective outcomes that were not measured by technology (scores. Authors' conclusions: Clinicians, and families need to know if sleep positioning, Sleep positioning systems are commercially-available, individu-, alised, lying support systems that may contain one or more com-, ferent sizes and are made from a variety of materials, including, special foams that conform to body shape or a series of straps that, hold the body in a neutral and symmetrical position. vant data onto a data extraction form based on examples of forms, used by National Institute for Health Research (NIHR) Collabo-, ration for Leadership in Applied Health Research and Care, South, review authors were not blinded to the study authors or journal, when extracting the data. Standards for the reporting of new, Cochrane Intervention Reviews. In order to enable comparison, the results, Neither study found a statistically significant, Both included studies also measured the percentag, child was actually asleep in bed (efficiency). Six studies were included with a total of 458 patients. Intrathecal baclofen for treating spasticity in children with cerebral palsy. Therapists should remain cautious when presenting the benefits to families. Where a study had a large number of variables, we identified a, limited set of key variables for each outcome in advance of statisti-, the rate of false positive results and avoid use of adjustments, multiple comparisons, which make statistical tests more conser-, vative. Occupational therapists have a distinct role in the assessment and provision of night-time positioning equipment and need to be both skilled in assessment and knowledgeable about postural management and the equipment available. the outcome assessment were blinded to group assignment. In 1994 a cerebral palsy (CP) register and healthcare programme was established in southern Sweden with the primary aim of preventing dislocation of the hip in these children. may include the use of support in seating and standing. Consensus statement on hip surveillance for, References to other published versions of this review, Lloyd C, Logan S, McHugh C, Humphreys G, Parker, velopes. We defined the key variables we thought, most closely fit the objectives of this review and, Both included studies measured the time it took, fell asleep before the intervention commenced (bedtime). Although cerebral palsy (CP) is the most common cause of motor deficiency in young children, it occurs in only a to 3 per 1000 live births. 39/52 children completed th, Age-range unclear but includes children under 5 years of age, Aim to recruit 50 children, aged 3 to 16 years with cerebral palsy (GMFCS Levels IV to V), who are not, walking independently and are not using sleep positioning systems, Children with other conditions which may affect their musculoskeletal, * Includes one participant who fell asleep before recording started (recorded as zero), as r. ¹ Originally reported in hours and minutes, here given as minutes to be comparable. The difference in pain scores of children sleeping in sleep, positioning systems compared to those sleeping without was not, No studies meeting the inclusion criteria explored the impact of. bit.ly/1yLdZY4 (accessed 21 January 2015). Families and health professionals need information about whether sleep positioning systems work in this way, to help them make decisions about their use. We checked references and contacted manufacturers and authors for potentially relevant literature, and searched the internet using Google. The evidence is current to December 2014. Assessment of risk of bias in included studies, Review authors assessed the methodological quality of each trial, which met the inclusion criteria using the ’Risk of bias’ tool de-, each study independently and resolved disagreements by discus-, sion with each other. Hip migration (where the top of the thigh bone gradually moves away from the pelvis) affects a substantial number of children with cerebral palsy and is often associated with pain. Newborn infants regularly undergo minor invasive procedures for which analgesics are not, To review the effectiveness and safety of transcutaneous electrical nerve stimulation (TENS) for labour pain. One of the studies took place in a sleep laboratory and the other study took place in the children's homes. In December 2014, we searched CENTRAL, Ovid MEDLINE, Embase, and 13 other databases. Disability organisations, manufacturers and colleagues worldwide were also contacted. United Kingdom (at home or in paediatric research laboratory), Further research is very unlikely to change. Morwenna Rogers designed the search strategy, Joanna Thompson-Coon provided methodological perspective, resolved disagreements during screening, and contributed to writing. severe motor disorders using night-time postural equipment.