The objective, best practice information presented on the CP-Engine website is based on a series of systematic reviews carried out to weigh the strength of the scientific evidence supporting commonly used interventions in the rehabilitation of cerebral palsy.
Three steps were taken to arrive at the conclusions reached on the strength of the evidence on each of the topics under review.
1. Data Collection
a. Journal articles were collected in a systematic process:
An extensive search of these databases was done: CINAHL, CIRRIE, the Cochrane Library, EMBASE, ERIC, HealthSTAR, Health and Psychosocial Instruments, MEDLINE, OTSeeker, PEDro, PsycINFO, RehabData.
b. Inclusion/ Exclusion Criteria
Study type: Case descriptions were excluded from the study.
Participant diagnosis: No particular diagnoses of cerebral palsy were excluded.
Age of participants: The age range for inclusion was 0 to 21 years.
Types of Intervention: Any method of applying a particular intervention was included.
Outcome Measures: Purely observational (no standardized scaling) measures were excluded.
2. Individual studies were ranked according to their type and level of scientific rigor
Study Type: Articles meeting the inclusion criteria were sorted into two groups. The first group was made of random clinical trials (RCT) while the latter group was made of non-RCT studies. To be considered a RCT, experimenters must have randomized subjects into at least two groupings (experimental or control).
i. Random Clinical Trials:
The quality of evidence of the RCTs was assessed by the PEDro Scale which evaluates the internal validity of a study .
A study’s PEDro Scale score, ranging between 0 and 10, was used to classify the RCT:
PEDro Scale: RCT quality ranking
High >6
Fair: 4-5
Poor: <3
ii. Non-RCT Studies:
The quality of evidence presented in non-RCT studies was assessed using the McMaster Critical Review Form (Law et al, 1999)
3. Overall Evidence Ranking:
Once individual studies were assessed and ranked according to their scientific integrity, the Sackett Scale was used to give an overall ranking of the evidence based on the quality of research done to date. Conclusions were based on the best, reliable evidence available.
