Physical therapy interventions in children and adolescents with spina bifida: a scoping review
Creators: name: Ferreira, Lorena
name: Christovão, Isabella
name: Camargos, Ana
name: Leite, Hércules
name: Hull, Egmar
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Rehabilitation and Therapy
subject: Physiotherapy
subject: Medicine and Health Sciences
subject: physiotherapy
subject: Spina Bifida

description: This is a scoping review, which will be used to identify the extent of research evidence about all the physical therapy interventions in children and adolescents with spina bifida. In this study, the following steps will be applied: (1) identify the purpose of the review; (2) identify potential studies; (3) select the studies; (4) to plot data and (5) to order, synthesize and report the results. The review will follow the statement of Preferred Reporting Items for Prism Extension for Scoping Reviews (PRISMA-ScR). Identifying the aim of the review This scope review aims to (1) evaluate and review the literature regarding the physical therapy approach in children and adolescents up to 18 years of age with spina bifida; (2) evaluate the levels of evidences from articles, according to the Oxford Center for Evidence-Based Medicine (OCEBM). Identifying the potential studies - Search Strategy and terms The search strategies will be carried out on Medline, Embase, Cochrane, Scopus, Web of Science, PEDro, Lilacs and gray literature, researched on Google and Google Scholar. The descriptors that will be used in our research are related to "spina bifida", "rehabilitation", "physiotherapy", "children", "adolescents". We will also manually search the identified literature for possible additional studies in the area. Study Selection Inclusion and exclusion criteria The search strategy will be carried out in October 2022. This study will include systematic reviews, randomized trials, non-randomized control trials, n-of-1 trials, single-subject designs, case studies and case series/case reports that investigated physical therapy interventions in children and adolescents with spina bifida. Only full-text studies, published in English, Portuguese or Spanish, will be included in the study. The physical therapy interventions will be defined as any intervention using methods and techniques that aims to reduce body function and structure impairments, minimize activity limitations, improve functional skills, and encourage participation. Interventions exclusively related to the scope of other areas (for example orthopedic interventions) will not be included, except when combined with a physical therapy intervention. Studies that did not report the definition of the intervention and the instruments used in their methods will be excluded. Conference abstracts, research letters, editorials, opinions, letters to editors, notes or project evaluation reports, protocol studies, epidemiological studies, methodological research (for example, reliability and validity), exploratory studies (cohort studies, studies case-control, predictive, transversal, longitudinal research) and synthesis of knowledge (for example, narrative, systematic and scope reviews) will be excluded. Screening The screening of identified titles and abstracts and the evaluation of possible full texts using our eligibility criteria will be conducted by two independent reviewers, and when there are discrepancies a third reviewer will evaluate. To ensure reliability and consistency, the eligibility criteria will be tested by two researchers in the first 5 titles / abstracts. Any disagreement between the two surveys on the selected studies will be analyzed by a third reviewer. Data extraction The data extraction will include: year of publication, title, study design, level of evidence of the study design (OCEBM), objective, population and sample size, outcome measures, description of the physical therapy intervention used, domain explored in the intervention according to International Classification of Functioning, Disability and Health (ICF) and, main results. Levels of evidence All articles will be classified into levels of evidence based on the recommendations of the OCEBM. The OCEBM hierarchy consists of five levels of evidence, ranging from level 1 (strongest) to level 5 (weakest), as follows: level 1, systematic reviews/meta-analyses that critically summarize multiple studies and single-subject trials (n-of-1); level 2, randomized clinical trials; level 3, non-randomized studies that do not have strong bias control; level 4, studies with a relatively low level of evidence, including mostly descriptive studies such as case series/case reports; and level 5, studies based on mechanistic reasoning, in which evidence-based decisions are based on logical connections, including pathophysiological reasoning. Interventions characteristics The intervention components will be classified according to ICF domains into: body function and structure interventions (e.g., strength training or balance training interventions); activity interventions (e.g.,task specific training or gait training), participation interventions (e.g., community-based treatments) or enviromental interventions (e.g., context-focused therapy). The ICF domains will be extracted by the fifth author, with possible conflicts resolved by consensus. Results grouping, summary and reports: All authors will collectively discuss the mapped data to identify trends, breadth and gaps in the literature. The results are summarized both quantitatively and qualitatively.