Assignment on Evidence Based Practice- Cerebral Palsy

Added on - 21 Apr 2020

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Running head: EVIDENCE BASED PRACTICEEvidence based practice- Cerebral PalsyName of the StudentName of the UniversityAuthor Note
1EVIDENCE BASED PRACTICECerebral palsy (CP) refers to the incidence of neurological disorders, caused due to non-progressive injury of the brain injury or malformations of the brain among children. It is usuallymanifested by the loss of motor functions, cognitive impairment, poor coordination,weak andstiff muscles, tremors and difficulty in swallowing, speaking and other sensations. CP can be ofdifferent types and completely hinder the ability of the patient to perform daily tasks and liveindependently. Thus, occupational therapy is practiced in order to reduce muscle stiffness,spasticity, improve muscle tone, and enhance coordination and balance among the patients.Evidence-based practice refers to integration of clinical expertise with best available researchand patient values while making decisions related to patient care. This report will criticallyevaluate 3 evidence-based practices on cerebral palsy. It will interpret the results to suggest theintervention that should be followed by occupational therapists.Article 1Title- The State of the Evidence for Intensive Upper Limb Therapy Approaches forChildren with Unilateral Cerebral PalsySummary- This article aimed to review the scientific rationale that underpinned thesetreatments that will assist in improving the upper limb outcomes of the patients. The reviewcompared 8 studies that focused on constraint-induced movement therapy, 1 on hand-armbimanual training, and 2 on hybrid therapy with control groups that received less therapy. Itrevealed that constraint-induced movement therapy was mainly used as an intervention amongstudents who were aged between 2-16 years. The comparison showed that the interventiondemonstrated significant and clinically beneficial effects on older children. However, nosignificant differences were observed in terms of health gains between different methods ofrestraint. The review showed that Short-length, high-duration therapies were carried out for aperiod of 2-4 weeks and the frequency ranged from 2-7 sessions per week. It suggested that theconstraint-induced therapy was applied primarily on school-aged children, and this led toindividualization of the program. The findings further suggested that there was a gain in upperlimb function on application of this therapy. On directly comparing, the home-based approachshowed greater gains among the sample at a time period of 3 months, post-intervention. Thus, itestablished that constraint-induced movement therapy was far superior to the usual care practicesin terms of improving quality and efficiency of impaired upper limb movement (Sakzewski,Gordon & Eliasson, 2014).Data showed that use of non-removable devices such as castings resulted in largerintensity of unstructured training, in addition to creating a burden on the child. Several adverseevents and discomfort among children were reported, related to the use of wearing a restraint bythe studies that had been evaluated. Further, the review provided evidences that HABITimproved the quality and amount of impairment in upper limb during bimanual tasks. In additionto retaining the intensive constraint induced practice, it engaged the child to a greater extent inbimanual activities. Direct comparison between the 2 approaches showed less significantdifferences between them in upper limb outcome improvement.Interpretation- Thus, it can be interpreted that although there was lack of knowledgerelated to the feasibility of the therapy in different environmental contexts, bimanual training andconstraint-induced movement therapy result in significant improvements in spatio-temporalcoordination. They increase goal identification by the caregivers and work best for children
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