Telehealth and remote interventions for children with cerebral palsy: A scoping review.
Pagaki-Skaliora M., Morrow E., Theologis T.
BACKGROUND: Remote treatment, or telehealth, has shown promise for children with cerebral palsy (CP) prior to 2020; however, the beginning of the global COVID-19 pandemic limiting access to hospitals for face-to-face treatments has driven the requirements for telehealth and led to a surge in development. Due to the recent developments, there has been limited synthesis of the available evidence of telehealth for children with CP. OBJECTIVE: To analyse and summarise the existing evidence for telehealth interventions for the treatment of children with CP and identify any areas requiring further research. METHODS: A scoping review was performed. A systematic search of available literature in Medline and Pubmed was performed during July 2021. Inclusion criteria for articles were: primary research and systematic reviews, investigating telehealth, including children with CP, published between 2010-2021, and written in English. Exclusion criteria were: secondary research other than systematic reviews, intervention which did not meet the World Health Organisation definition of telehealth, all participants were over 18, children's results were not reported separately, or there were no results reported for children with CP. A scoping review was chosen due to the expected heterogeneity of the participants, as well as expected small sample sizes and inconsistency of measured outcomes; therefore narrative reporting of results was considered appropriate. RESULTS: Six papers were identified which included the results of nine studies. Two of the included articles were systematic reviews, which included results of three studies each. These studies, together with five primary research articles were included in this scoping review. The existing evidence is of low methodological quality, primarily consisting of case series. There is some evidence that requirements of telehealth differ depending on the children's developmental stage and functional level. Telehealth is reported to reduce caregiver burden. There is mixed evidence on children's compliance with telehealth. Overall, the results of telehealth interventions for the treatment of children with CP were positive, indicating either comparable or improved results compared with children receiving usual face-to-face care. CONCLUSIONS: The evidence base is lacking in breadth and methodological quality to provide robust clinical recommendations. Most studies investigated hand function only, indicating the limited scope of existing research. However, this review shows that telehealth has demonstrated potential to improve function for children with CP while making healthcare services more accessible and reducing carer burden. Areas requiring further research include telehealth interventions for the lower limb, postural management, pain control and the barriers to implementing telehealth. CLINICALTRIAL: