Moving together is better: a systematic review with meta-analysis of sports-focused interventions aiming to improve physical activity participation in children and adolescents with cerebral palsy

Ricardo Rodrigues de Sousa Junior, Deisiane Oliveira Souto, Ana Cristina Resende Camargos, Georgina L Clutterbuck, Hércules Ribeiro Leite

Abstract

Purpose: To analyze the effectiveness of sports-focused interventions on the participation of children and adolescents with cerebral palsy (CP).

Methods: Study searches were conducted on EMBASE, PubMed, Scielo, PEDro, CINAHL, SPORTDiscuss in June 2022. We included randomized controlled trials that investigated the effectiveness of sports-focused interventions in children and adolescents with CP in comparison with control. Risk of bias was assessed with PEDro scale and evidence certainty with GRADE approach. Data were pooled in random-effects meta-analyses and results were presented as standardized mean differences.

Results: Ten RCTs were selected with different modalities, mostly for ambulant children and adolescents. Significant pooled effects on participation in leisure-time physical activity were seen only in group interventions (modified sports, gross motor training, and fitness training), in comparison with control [SMD(95% CI) = 0.32(0.01-0.73) p = 0.04]. No pooled effects were seen in participation in other life areas in comparison with control (p > 0.05). Current certainty of evidence of all sports-focused interventions included was moderate due to imprecision.

Conclusion: Positive results on leisure-time participation were seen at short-term follow-up for group interventions. Sports-focused interventions did not improve participation in other life areas, reinforcing the importance of specificity when conducting participation interventions. Studies investigating sports-focused interventions including non-ambulatory individuals are still necessary. IMPLICATIONS FOR REHABILITATIONSports-focused interventions target leisure-time physical activity participation. They present moderate evidence of their effectiveness to improve physical activity participation in individuals with cerebral palsy. Group interventions are effective in improving leisure-time physical activity participation.Sports-focused interventions did not improve participation in other life areas.