An overview of systematic reviews of adaptive seating interventions for children with cerebral palsy: where do we go from here?

Abstract

Purpose: This article provides an overview and assessment of systematic reviews of adaptive seating outcomes in children with cerebral palsy (CP) and proposes strategies to advance and improve the clinical utility of future research evidence. Methods: A comprehensive search for systematic reviews was performed to locate and evaluate the functional effects of adaptive seating in children with CP. Relevant electronic databases were searched to identify reviews published between January 1990 and December 2010. Results: The search yielded five reviews of adaptive seating interventions that found generally positive, but inconclusive evidence of effectiveness for postural control and management, seated posture, upper extremity function, and overall clinical outcomes. Review authors consistently reported that they were unable to combine data from original research studies to make sound clinical recommendations due to the low quality of studies, the lack of appropriate outcome indicators, and the heterogeneity and lack of clarity in population characteristics and adaptive seating interventions. Conclusions: Strategies to improve the quality and clinical relevance of new research evidence for adaptive seating interventions include the adoption of an expanded view of child functioning, a child motor function classification and development approach, and contemporary frameworks for the measurement and evaluation of assistive technology outcomes.

Implications for Rehabilitation

• Assistive technology practitioners recommend adaptive seating devices to improve child functioning.

• Past systematic reviews of adaptive seating outcomes in children with cerebral palsy provide limited empirical support.

• Current thinking about child health and assistive technology outcomes provides direction to inform research and clinical practice.

Keywords::

• Assistive technology
• childhood disability
• outcomes
• postural support

Acknowledgements

The author gratefully acknowledges the sound advice provided by Drs. Paul Helders, Colin Macarthur, Patricia Rigby, and Jan Andrysek during the development of this article.

Declaration of interest

The author declares no conflicts of interest.