Context-focused interventions versus traditional motor therapies on occupational performance in children with cerebral palsy: a systematic review with meta-analysis
DOI:
https://doi.org/10.47197/retos.v76.117605Keywords:
Activity, participation, disability, childhood, rehabilitation, international classification of functioning, disability and health (ICF)Abstract
Introduction: Cerebral palsy (CP) is a chronic neurological condition that limits children’s functionality, particularly in the domains of activity and participation. Context-focused interventions have emerged as a complement to traditional motor therapies, prioritizing environmental modification to enhance functional outcomes.
Objective: To compare the effectiveness of context-focused interventions versus traditional motor approaches on outcomes related to activities and participation of the ICF in infants with CP.
Methods: A systematic review with meta-analysis of randomized controlled trials published between 2014 and 2024 was conducted. Search was conducted in five databases (OVID, EBSCO, PubMed, Web of Science, and Scopus). Studies assessing occupational performance, mobility, self-care, and quality of life in infants with CP were included. Risk of bias was evaluated using the RoB 2 tool, and analyses followed PRISMA guidelines.
Results: Nine studies with a total of 369 infants were included. The meta-analysis demonstrated a significant positive effect of context-focused interventions on perceived and satisfied occupational performance (SMD 1.07 and 0.89, respectively), with moderate heterogeneity. Effects on mobility, self-care, and quality of life were small or non-significant, with the certainty of evidence rated as low or very low according to GRADE.
Conclusion: Context-focused interventions show clinically relevant benefits in occupational performance among infants with CP, although effects on other functional domains remain uncertain. The low certainty of evidence underscores the need for more rigorous trials to confirm these findings and support clinical decision-making.
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