Objective: This systematic review and meta-analysis investigates the effects of strength training program in children and adolescents with cerebral palsy to improve function, activity, and participation. Data sources: Five electronic databases (MEDLINE-Pubmed, Cochrane Library, PEDro, CINAHL, and SPORTDiscus) were systematically searched for full-text articles published from inception to 30 June 2021. Review methods: Randomized controlled trials were included, who compared: (i) child population with spastic cerebral palsy population between 0 and 22 years; (ii) studies in which a muscle strength training program was performed and included dosing information; (iii) studies comparing strength training with other physical therapy technique(s) or untreated control group. Studies with similar outcomes were pooled by calculating standardized mean differences. Risk of bias was assessed with Cochrane Collaboration’s tool for assessing the risk of bias and PROSPERO’s registration number ID: CRD42020193535. Results: Twenty-seven studies, comprising 847 participants with spastic cerebral palsy. The meta-analyses demonstrated significant standardized mean differences in favor of strength training program compared to other physical therapy technique(s) or untreated control group(s) for muscle strength at the knee flexors, at the knee extensor, at the plantarflexors, maximum resistance, balance, gait speed, GMFM (global, D and E dimension) and spasticity. Conclusion: A strength training program has positive functional and activity effects on muscle strength, balance, gait speed, or gross motor function without increasing spasticity for children and adolescents with cerebral palsy in Gross Motor Function Classification System levels I, II, and III when adequate dosage and specific principles are utilized.

Background: Accumulation of bilirubin above normal levels is considered a neurological risk factor for both premature and full‐term newborns. This systematic review aimed to determine the effect of neonatal hyperbilirubinemia on neurodevelopment in preterm and full‐term newborns.Methods: PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Scopus and Lilacs databases were searched for articles published until 1 June 2022. The quality of cohort and case–control studies was assessed with the Newcastle–Ottawa Scale, and the MINCir scale was used to evaluate the methodological quality of therapy studies or the therapeutic procedures. Premature neonates without neurological conditions and those born at term with hyperbilirubinemia as the sole risk factor were included. Studies reporting one or more neurodevelopmental outcomes were included with an inter‐group comparison of a hyperbilirubinemia group versus a non‐hyperbilirubinemia or non‐pathological hyperbilirubinemia group. The main outcomes were auditory function, visual function, cognitive function, motor function, behavior, global development and neurological risk.Results: The search identified 951 studies, 19 of which (n = 2210 newborns) were finally included. Fifteen of the cohort and case–control studies presented low risk of bias, and six studies showed high methodological quality. Within the preterm population, hyperbilirubinemia as the sole risk factor was not shown to affect neurodevelopment. Auditory, neurological and motor development alterations were found in the population of full‐term newborns with hyperbilirubinemia, which were more evident during the first year of life.Conclusions: Elevated bilirubin levels may be a trigger for the onset of neurodevelopmental disorders in full‐term infants during the first year of life. More studies are warranted in the preterm population with hyperbilirubinemia to draw conclusions about its impact on their neurodevelopment.

Cerebral palsy results in the progressive loss of motor functions, with a negative impact on daily activities and participation. Despite the well described benefits of aquatic therapy in children, little is known about the effects of the same in school settings. This study aimed to describe the experience of children and youth with cerebral palsy participating in an aquatic therapy program within a special education school considering their educational and therapeutic perspectives. A qualitative descriptive case study with embedded units was developed, comprising 27 participants. This study employed purposeful sampling to include children and youth with cerebral palsy from the Asociación Ayuda a la Paralisis Cerebral (APACE) special education school, together with their parents, the special education teachers, and health care professionals. Data were collected via non-participant observation, semi-structured and informal interviews, focus groups, and researcher field notes. A thematic analysis was conducted, revealing the following themes: (a) the connection with the environment; (b) postural improvements and mobility; (c) the opportunity to perform tasks; (d) learning and transfer. A motivating environment leads to physical, cognitive and social benefits, both at school and in the home. Aquatic therapy was viewed as a means for learning and participation. These findings may enhance understanding regarding the potential benefits of implementing multidisciplinary aquatic therapy programs in specialist school settings.

Background: While constraint‐induced movement therapy is strongly recommended as an intervention for infants with unilateral cerebral palsy, the optimal dosage remains undefined. This systematic review aims to identify the most effective level of intensity of constraint‐induced movement therapy to enhance manual function in infants at high risk of asymmetric brain lesions or unilateral cerebral palsy diagnosis.Methods: This systematic review with meta‐analysis encompassed a comprehensive search across four electronic databases to identify articles that met the following criteria: randomised controlled trials, children aged 0–6 with at high risk or with unilateral cerebral palsy, and treatment involving constraint‐induced movement therapy for upper limb function. Studies with similar outcomes were pooled by calculating the standardised mean difference score for each subgroup, and subgroups were stratified every 30 h of total intervention dosage (30–60, 61–90, >90 h). Risk of bias was assessed with Cochrane Collaboration's tool.Results: Seventeen studies were included. Meta‐analyses revealed significant differences among subgroups. The 30–60 h subgroup showed a weak effect for spontaneous use of the affected upper limb during bimanual performance, grasp function, and parents' perception of how often children use their affected upper limb. Additionally, this subgroup demonstrated a moderate effect for the parents' perception of how effectively children use their affected upper limb.Conclusions: Using a dosage ranging from 30 to 60 h when applying a constraint‐induced movement therapy protocol holds promise as the most age‐appropriate and cost‐effectiveness approach for improving upper limb functional outcomes and parent's perception.

Background and Purpose: Carpal tunnel syndrome is the most common peripheral neuropathy of the upper extremities and kinesio taping is one of the tools used as a complementary tool within the conventional treatment of carpal tunnel syndrome. To investigate the short‐term effects of kinesio taping on pain, functionality, strength, and nerve conduction in subjects suffering from carpal tunnel syndrome.Methods: Systematic review with meta‐analysis. Seven electronic databases (MEDLINE‐Pubmed, Web of Science, Scopus, Cochrane Library, PEDro, CINAHL, and SPORTDiscus) were searched for full‐text articles published from inception to March 1^st, 2023. Studies had to meet the following inclusion criteria: randomised clinical trials, including patients of legal age with mild, moderate, or severe symptoms of carpal tunnel syndrome without associated pathologies, and treating the studied body area with kinesio taping, whether or not in combination with other therapies. The DerSimonian and Laird method was employed using random effects models to calculate the pooled estimate of the effect size with confidence intervals of 95%. The risk of bias was assessed with the Cochrane Collaboration's tool and the Grading of Recommendations Assessment, Development and Evaluation approach was used to judge the certainty of the evidence for all outcomes.Results: Thirteen studies were included, comprising 665 participants with carpal tunnel syndrome. This meta‐analysis revealed a strong effect of kinesio taping on distal sensory latency and a weak effect on functionality and pain, while no significantly superior effects were found on the symptom severity, strength, or neurophysiological outcomes (distal motor latency and sensory conduction velocity) compared to other physical therapy techniques or untreated control group in the short term, with moderate‐certainty evidence.Discussion: Kinesio taping is a complementary tool to the conventional treatment of carpal tunnel syndrome that improves functionality, pain, and distal sensory latency in the short term.

Purpose. This study aimed to: (a) translate and cross-culturally adapt the Hammersmith Infant Neurological Examination (HINE) into Spanish; (b) evaluate its intra- and inter-examiner reliability; (c) support a knowledge translation and tool implementation program in early intervention; and (d) evaluate its reliability and implementation for professionals one year after receiving training. Materials and methods. The translation followed the World Health Organization’s recommendations. Reliability was assessed in 25 infants aged between 3 and 15 months with identifiable risks of cerebral palsy (CP). The implementation was also evaluated by analyzing the reliability of professionals without previous experience of the tool by using a pre-survey and a follow-up survey one year after training. The survey covered aspects related to the use of early detection tools of CP and the use of HINE, including attitudes, opinions, and perceptions. Results. An excellent intra- and inter-examiner agreement was obtained for the total score of the HINE intra-class correlation coefficient (ICC = 0.98 in both indices). One year after training, the professionals also showed excellent reliability values (ICC = 0.99), as well as an increase in sensitization and skills in evidence-based practices for the early detection of “high risk” of CP. Conclusions. The Spanish version of HINE is a reliable measure for the neurological evaluation of “high risk” of CP and can be administered after standardized training and without costs to acquire the evaluation. This allows its accessible and widespread implementation in the clinical context.