Reported outcomes of lower limb orthopaedic surgery in children and adolescents with cerebral palsy: a mapping review

• Published in: Developmental medicine and child neurology Vol. 56; no. 9; pp. 808 - 814
• Main Authors: Wilson, Nichola C, Chong, Jimmy, Mackey, Anna H, Stott, Ngaire S
• Format: Journal Article
• Language: English
• Published: England 01-09-2014
• Subjects: Adolescent; Cerebral Palsy - surgery; Child; Child, Preschool; Humans; Infant; Lower Extremity - surgery; Orthopedic Procedures; Treatment Outcome; Young Adult
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/dmcn.12431

Aim
Lower limb surgery is often performed in ambulatory children with cerebral palsy (CP) to improve walking ability. This mapping review reports on outcome measures used in the published literature to assess surgical results, determine range and frequency of use, and map each measure to the International Classification of Functioning, Disability and Health.
Method
A mapped review of literature published between 1990 and 2011 was carried out to identify papers reporting the outcomes of lower limb orthopaedic surgery in ambulatory children with CP, aged 0 to 20 years.
Results
A total of 229 published papers met the inclusion criteria. Thirty‐two outcome measures with known psychometric properties were reported in the 229 papers. Twenty measures assess impairments in body structure and function and were used in 91% of studies. Ten measures assess restrictions in activity and participation and were used in 9% of papers. Two measures assessed quality of life. Since 1997, 29% of papers have used the Gross Motor Function Classification System to describe participants.
Interpretation
The body of literature evaluating outcomes of lower limb orthopaedic surgery in CP is small but increasing. There is a need to develop a suite of outcome measures that better reflect outcomes across the International Classification of Functioning, Disability and Health, including activity and participation.
What this paper adds
Less than half of recently published studies use the GMFCS to classify participants.
The activity and participation domain of the ICF is not well represented in current studies of orthopaedic surgical outcomes.
Further work is needed to define a minimum data set to adequately capture the outcomes of lower limb orthopaedic surgery in CP.