Recent developments in the conceptualisation of disability (1), definition and classification of cerebral palsy (CP), treatment goals, and research on the effectiveness of interventions require synthesis for AHPs in clinical practice. A multidisciplinary consensus conference which included an international group of 24 clinicians and researchers was convened by the International Society for Prosthetics and Orthotics to consider research and contemporary thinking on the management of CP

Bowers, Roy

Ross, Karyn

English

University of Strathclyde Institutional Repository

Strathprints Institutional RepositoryRoss, Karyn and Bowers, R. (2010) Recent developments in healthcare for cerebral palsy. In:British Association of Prosthetists and Orthotists Annual Conference, 2010-03-05 - 2010-03-07,Bolton, UK.Strathprints is designed to allow users to access the research output of the University of Strathclyde.Copyright c© and Moral Rights for the papers on this site are retained by the individual authorsand/or other copyright owners. You may not engage in further distribution of the material for anyprofitmaking activities or any commercial gain. You may freely distribute both the url (http://strathprints.strath.ac.uk/) and the content of this paper for research or study, educational, ornot-for-profit purposes without prior permission or charge.Any correspondence concerning this service should be sent to Strathprints administrator:mailto:strathprints@strath.ac.ukhttp://strathprints.strath.ac.uk/  Ross, Karyn and Bowers, R. Recent developments in healthcare for cerebral palsy: implications and opportunities for orthotics. In: Allied Health Professions in Children and Young Persons.     http://strathprints.strath.ac.uk/16657/        Strathprints is designed to allow users to access the research output of the University of Strathclyde. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. You may not engage in further distribution of the material for any profitmaking activities or any commercial gain. You may freely distribute both the url (http://strathprints.strath.ac.uk) and the content of this paper for research or study, educational, or not-for-profit purposes without prior permission or charge. You may freely distribute the url (http://strathprints.strath.ac.uk) of the Strathprints website.  Any correspondence concerning this service should be sent to The Strathprints Administrator: eprints@cis.strath.ac.uk  Recent developments in the conceptualisation of disability (1), the definition and classification of cerebral palsy (CP), treatment goals, and research on the effectiveness of  a variety of  interventions require synthesis for allied health professionals in clinical practice.In  September 2008, a multidisciplinary consensus conference was convened by the International Society for Prosthetics and Orthotics (ISPO) to consider research and contemporary thinking on the management of cerebral palsy. An international group of 24 healthcare professionals and researchers participated in the conference, which was held at Wolfson College, Oxford. Before the conference, reviewers synthesised the best available published evidence and graded their findings using the Oxford Centre for Evidence-based Medicine Levels of Evidence. Reviews were presented on the definition and classification of CP, classification of gait in CP, physiotherapy, occupational therapy, medical management, orthopaedic management  and  orthotic management.Each review was considered and discussed in small groups and plenary sessions, following which conclusions and recommendations were drafted by the convenors and agreed by participants. The consensus conference report, together with the review papers provides a valuable educational resource (2). The conclusions and recommendations provide a nominal expert group consensus on the best available evidence on various aspects of the management of CP, including: • physiotherapy interventions  including frequency, duration, intensity and  timing of treatment• occupational therapy including the use of seating and positional devices, constraint-induced                               movement therapy and  virtual reality• medical management , including nutrition, spasticity management and weight-bearing programmes • orthopaedic surgery including single event multilevel surgery, and treatment of equinus, hip subluxation/dislocation, scoliosis and the upper limb• orthotic management of  the lower limb, the upper limb and spine, and  the use of Lycra garmentsHealthcare for people with CP requires the skills and input of a variety of healthcare professionals who must work efficiently and collaboratively with the family as a team to prioritise goals and to plan management regimes. The ultimate aim of healthcare provision in CP is to enable activities and participation by promoting efficient movement, limiting deformity, reducing pain, and employing cognitive and/or behavioural strategies. A ‘family-centred’ approach to delivering healthcare is likely to improve the wellbeing of children and their parents, with parental wellbeing believed to be associated with improved outcomes for the child. Classification of gross motor function using the Gross Motor Function Classification System (GMFCS) (3, 4) and manual abilities using the Manual Abilities Classification System (5)  of individuals with CP has enabled healthcare professionals to communicate with each other, and with parents, who appear to find these ‘levels’ of function both acceptable and useful in understanding their child’s status . The GMFCS is recommended as a framework for planning orthotic management of children and young people with CP .The full report  of the consensus conference can be downloaded free of charge from  www.ispoint.orgISPO UK is holding a multi-disciplinary meeting with an international faculty who will be reporting the conclusions andcontinuing the dialogue on the findings of the consensus conference on Thursday 14th and Friday 15th January 20 10, in TheCentre for Life, Newcastle Upon Tyne. Further information at www.cpconsensus.org.uk1.International classification of functioning, disability and health: ICF Geneva World Health Organisation: WHO; 2001.2.Recent developments in healthcare for cerebral palsy; implications and opportunities for orthotics, Morris C, Condie D, editors. Copenhagen: ISPO; 20093.Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997; 39: 214-223. 4.Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised gross motor function classification system. Dev Med Child Neurol. 2008; 50:7447505.Eliasson AC, Krumlinde Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall A-M, Rosenbaum P. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol 2006; 48: 549-554. Recent Developments in Healthcare for Cerebral Palsy: Implications and Opportunities for OrthoticsRoy Bowers, Karyn RossNational Centre for Prosthetics and Orthotics, University of StrathclydeKey words: Cerebral palsy, orthotics, multidisciplinary international consensus conference.Background                                                     Method                             Implications for practiceReferences  GMFCS levels I – V© Kerr Graham, Bill Reid &Adrienne Harvey, reproduced withpermissionFurther information 

Recent developments in healthcare for cerebral palsy

Bowers, R.

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Recent developments in healthcare for cerebral palsy

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