Highlights
- •Perspectives on postural control in cerebral palsy (CP) were identified from clinicians and researchers.
- •Consensus was achieved on definitions for postural control in the context of CP.
- •Gaps in knowledge and practice were identified for frameworks, assessments, and interventions.
- •Future research priorities in postural control were identified for children with CP.
Abstract
Objective
To identify whether consensus can be achieved in how clinicians and researchers define,
describe, assess, and treat postural control dysfunction in children with cerebral
palsy (CP).
Design
Delphi study with 3 iterative rounds.
Setting
Electronic survey.
Participants
Researchers and/or clinicians (N=43) from 7 countries with a mean ± SD of 20±11 years
of experience working with children with CP participated. Participants included authors
of published works on postural control in CP (identified from a recent systematic
review), members of the Australasian Academy of CP and Developmental Medicine, and
2 major Australian rehabilitation providers.
Interventions
Not applicable.
Main Outcome Measures
The Delphi study consisted of 3 iterative rounds of surveys. In Round 1, respondents
answered open-ended questions regarding their views on (1) definition items for postural
control, (2) theoretical frameworks, (3) methods for assessment, and (4) interventions
for postural control dysfunction in children with CP. Rounds 2 and 3 were made up
of items generated by participants in Round 1 and combined with items identified from
the literature. Participants indicated their level of agreement for each item on a
7-point Likert scale. Threshold for consensus was ≥85% agreement.
Results
Of 306 items generated, 174 reached consensus by Round 3. Most postural control definition
items (90%) achieved consensus. Two theoretical frameworks (14%) reached consensus.
Less than half (42%) of assessment items reached consensus. More individual assessment
items (89%) reached consensus than multi-item tools (4%). Just over half (61%) of
the items generated for interventions reached consensus.
Conclusion
Consensus was achieved for a postural control definition. However, substantial research
is needed to establish a comprehensive, postural control–specific framework and suite
of assessments. These would provide a foundation to improve intervention selection
and dosage.
Keywords
List of abbreviations:
AusACPDM (Australasian Academy of Cerebral Palsy and Developmental Medicine), CP (cerebral palsy), CPL (Cerebral Palsy League), ICF (International Classification of Functioning, Disability and Health), NHMRC (National Health and Medical Research Council)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: August 25, 2016
Footnotes
Supported by a Career Development Grant awarded by the Research Foundation, Cerebral Palsy Alliance (grant no. PG4114) that allowed PhD funding support through the Children's Motor Control Research Collaboration.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
