Table 5 Longitudinal and Collective Effects of Serial Casting on the Lower Limb for Children with Cerebral Palsy
Outcome / Measure | Â | Effect of Serial Casting | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Inclusive of additional therapeutic interventions | Studies with pharmacological intervention (in all cases this was BTX-A) were removed from meta-analyses | ||||||||||
Ankle DF KPU | Timelines | Studies | Mean difference (MD or *SMD) | Confidence Interval | Hetero-geneity | Test for Overall Effect Z Score (p-value) | Studies | Mean difference (MD or *SMD) | Confidence Interval | Hetero-geneity | Test for Overall Effect Z Score (p-value) |
IP | 44, 11, 22, 16 | 15.15 | [11.74, 18.56] | I2 = 66% | NC | 44, 16 | 12.51 | [11.10, 13.92] | I2 = 0% | Z = 17.35 (p < 0.00001) | |
ST | 44, 11, 22, 58 | 8.74 | [5.76, 11.73] | I2 = 51% | NC | 44, 22 | 6.84 | [5.25, 8.43] | I2 = 0% | Z = 8.43 (p < 0.00001) | |
MT | 22, 53 | 8.54 | [5.78, 11.31] | I2 = 0% | Z = 6.06 (p < 0.00001) | 22 | 8.47 | [3.69, 13.25] | I2 = 0% | Z = 3.47 (p = 0.0005) | |
LT | 53 | 6.29 | [2.23, 10.35] | I2 = 0% | Z = 3.03 (p = 0.002) | – | – | – | – | – | |
Ankle DF KPF | IP | – | – | – | – | – | – | – | – | – | – |
ST | 45,46, 60, 39 | 6.50 | [3.21, 9.79] | I2 = 61% | NC | 45, 46, 39 | 6.31 | [0.84, 11.79] | I2 = 76% | NC | |
MT | – | – | – | – | – | 45, 46 | 5.92 | [1.76, 10.08] | I2 = 0% | Z = 2.79 (p = 0.005) | |
LT | – | – | – | – | – | – | – | – | – | – | |
Ankle DF KPE | IP | – | – | – | – | – | – | – | – | – | – |
ST | 45, 46, 31, 60, 39 | 7.42 | [3.44, 11.40] | I2 = 82% | NC | 45, 46, 31, 39 | 6.05 | [0.93, 11.18] | I2 = 80% | NC | |
MT | 45, 46 | 3.14 | [−3.24, 9.51] | I2 = 71% | NC | 45, 46 | 3.14 | [−3.24, 9.51] | I2 = 71% | NC | |
LT | – | – | – | – | – | – | – | – | – | – | |
Functional Gait (Objective Standardised Measures) | IP | – | – | – | – | – | – | – | – | – | – |
ST | 46, 11, 22 | * 0.83 | [0.43, 1.23] | I2 = 0% | Z = 4.11 (p < 0.0001) | 46, 22 | * 0.58 | [−0.06, 1.22] | I2 = 0% | Z = 1.79 (p = 0.07) | |
MT | 46, 22, 53 | * 0.88 | [0.41, 1.36] | I2 = 16% | Z = 3.63 (p = 0.0003) | 46, 22 | * 0.59 | [0.07, 1.11] | I2 = 0% | Z = 2.24 (p = 0.03) | |
LT | – | – | – | – | – | – | – | – | – | – | |
Neuro – Hypertonicity (MAS) PF | IP | 48, 11, 60 | * -2.13 | [−4.43, 0.18] | I2 = 96% | NC | – | – | – | – | – |
ST | 46, 48, 11, 22, 31, 60 | * -1.37 | [−1.97, −0.77] | I2 = 79% | NC | 46, 22, 31 | * -1.24 | [−1.73, −0.76] | I2 = 0% | Z = 5.01 (p < 0.00001) | |
MT | – | – | – | – | – | 46, 22 | * -0.49 | [− 1.02, 0.03] | I2 = 0% | Z = 1.86 (p = 0.06) | |
LT | – | – | – | – | – | – | – | – | – | – | |
Neuro – Spasticity (MTS) (R2-R1) | IP | – | – | – | – | – | – | – | – | – | – |
ST | 60 | * -1.61 | [−2.35, − 0.88] | I2 = 0% | Z = 4.30 (p < 0.0001) | – | – | – | – | – | |
MT | 53 | * -2.46 | [−5.71, 0.79] | I2 = 90% | NC | – | – | – | – | – | |
LT | 60, 53 | * -1.31 | [−3.09, 0.47] | I2 = 87% | NC | – | – | – | – | – | |
GMFM | IP | – | – | – | – | – | – | – | – | – | – |
ST | 48, 22, 31, 60, 58 | 5.49 | [−6.46, 17.45] | I2 = 95% | NC | 22, 31 | 0.80 | [−9.47, 11.08] | I2 = 0% | Z = 0.15 (p = 0.88) | |
MT | – | – | – | – | – | 22 | 8.03 | [−4.71, 20.76] | I2 = 0% | Z = 1.23 (p = 0.22) | |
LT | – | – | – | – | – | – | – | – | – | – | |