Translating Research Into Practice

Summary

Current Projects

  • About Cerebral Palsy: Public website for Knowledge Translation
  • Cochrane Review Update: Constraint-induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy

Completed projects

  • A systematic review of interventions for children with cerebral palsy: state of the evidence
  • Prioritisation of cerebral palsy research: a Delphi study
  • What does our future hold? Prognosis of cerebral palsy systematic literature review
  • Accelerating our understanding of the causal pathways to cerebral palsy with a computer supported discovery system

Current Projects

About Cerebral Palsy – Public website for Knowledge Translation

Cerebral Palsy Alliance Investigator: Margaret Wallen

This project involves developing and maintaining a publicly available web-based resource containing research-based information for people with CP and their families, clinicians, service providers and funding agencies. It is intended to provide information to facilitate discussions and decision making between these stakeholders regarding effective interventions and assessments.

Information will include:

  1. Interventions – information about interventions and the resources required, as well as appraised evidence to inform about intervention effectiveness. It includes the evidence Alert System, a pictographic “traffic light system” to enable users to see, at a glance, whether an intervention is effective.
  2. Assessments – include information about key classification, goal setting and outcome measurement tools

In 2015, more topics were added and an evaluation by staff and consumers was completed.


Cochrane Review Update: Constraint-induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy.

Cerebral Palsy Alliance Investigator: Margaret Wallen
Co-Investigators: Brian Hoare (Monash Children’s Hospital), Christine Imms (Australian Catholic University), Leeanne Carey (Florey Neuroscience Institutes), Michelle Jackman (John Hunter Children’s Hospital), Megan Thorley (Queensland Cerebral Palsy Health Service)

Cochrane systematic reviews appraise and synthesise findings from randomised controlled trials to provide the highest level of research evidence informing stakeholders about interventions.
Constraint-induced movement therapy (CIMT) is a treatment approach for use with children with hemiplegic cerebral palsy which aims to increase spontaneous use of the affected upper limb and ability to use the upper limb to complete daily activities. CIMT is based on two fundamental principles: constraint of the non-affected limb, and massed practice of therapeutic tasks with the affected limb. This project is updating a previous Cochrane systematic review published in 2007 when the evidence base was beginning to emerge. The review included only 3 studies and concluded that CIMT was a promising intervention which required more research. The update will contain over 20 studies and provide stronger and more definitive evidence supporting CIMT as an effective intervention for children with hemiplegic cerebral palsy.


Completed Projects

A systematic review of interventions for children with cerebral palsy: state of the evidence

Primary investigators: Iona Novak (Cerebral Palsy Alliance), Sarah McIntyre (Cerebral Palsy Alliance), Cathy Morgan (Cerebral Palsy Alliance), Leigha Dark (Cerebral Palsy Alliance), Natalie Morton (Cerebral Palsy Alliance), Elise Stumbles (Cerebral Palsy Alliance), Salli-Ann Craik (Cerebral Palsy Alliance), Shona Goldsmith (Cerebral Palsy Alliance)

This study systematically describes the best available intervention evidence for children with cerebral palsy (CP). Two independent reviewers determined whether studies met the inclusion criteria: (1) the study was a systematic review or the next best available; (2) it was a medical/allied health intervention; and (3) that more than 25% of participants were children with CP. Interventions were coded using the Oxford Levels of Evidence; GRADE; Evidence Alert Traffic Light; and the International Classification of Function, Disability and Health. Overall, 166 articles met the inclusion criteria (74% systematic reviews) across 64 discrete interventions seeking 131 outcomes. Evidence supports 15 green light interventions. All yellow light interventions should be accompanied by a sensitive outcome measure to monitor progress and red light interventions should be discontinued since alternatives exist.

Novak, I., S. McIntyre, et al. (2013). “A systematic review of interventions for children with cerebral palsy: state of the evidence.” Dev Med Child Neurol 55(10): 885-910.


Prioritisation of cerebral palsy research: a Delphi study

Primary investigators: Sarah McIntyre (Cerebral Palsy Alliance), Iona Novak (Cerebral Palsy Alliance), Anne Cusick (University of Western Sydney)

Research funds for cerebral palsy are scarce and competition for them is strong. This study identified questions for future research that were agreed to be a high priority. An expert panel of consumers, researchers, and clinicians was assembled (n=127) and surveyed using a Delphi survey comprising three rounds. Consumers identified questions in the themes of prevention/cure, quality of life/community participation, and service provision/intervention. Intervention researchers/clinicians identified questions in the themes of effective outcomes and effective research/services. Aetiology and prevention researchers identified questions in the themes of infection/inflammation, focus on timing, haematology, research tools, neuroregeneration, and genetics. Fifty per cent of the consumers’ priorities were also identified by professionals. Research priorities change as evidence is established.

McIntyre, S., Novak, I., Cusick, A. (2010). Consensus research priorities for cerebral palsy: a Delphi survey of consumers, researchers, and clinicians. Developmental Medicine and Child Neurology, 52(3), 270-5 (doi: 10.1111/j.1469-8749.2009.03358.x).
http://www.ncbi.nlm.nih.gov/pubmed/19694780


What does our future hold? Prognosis of cerebral palsy systematic literature review

Primary investigator: Iona Novak (Cerebral Palsy Alliance), Shona Goldsmith (Cerebral Palsy Alliance), Monique Hines (Cerebral Palsy Alliance), Richard Barclay (Cerebral Palsy Alliance)

Families of children with CP want to know about prognosis to help them with planning family-centred services. This project systematically reviewed the published evidence regarding the rates of associated impairments in CP, the likelihood of future unwanted events occurring, and the associations between risk factors and outcomes.

Novak, I., M. Hines, et al. (2012). “Clinical prognostic messages from a systematic review on cerebral palsy.” Pediatrics 130(5): e1285-1312.


Accelerating our understanding of the causal pathways to cerebral palsy with a computer supported discovery system

Primary investigators: Enrico Coiera (University of New South Wales), Stephen Anthony (University of New South Wales), Sarah McIntyre (Cerebral Palsy Alliance), Katherine Swinburn (Cerebral Palsy Alliance), Iona Novak (Cerebral Palsy Alliance), Monique Hines (Cerebral Palsy Alliance)

Research and knowledge is expanding rapidly regarding cerebral palsy and it is thought that a computer supported discovery environment may be able to accelerate the way in which we understand causal pathways to cerebral palsy. This project developed software tools that search the published scientific literature and assist in exploring, partially answering and developing new hypotheses for the aetiology of cerebral palsy.