Evidence map›Paper›PMID 38512713›Full record

SynthesisEuropean journal of physical and rehabilitation medicine2024

Cognitive approaches in the rehabilitation of upper limbs function in children with cerebral palsy: a systematic review and meta-analysis.

Andrea Demeco, Anna Molinaro, Martina Ambroggi, Antonio Frizziero, Elisa Fazzi, Cosimo Costantino, Giovanni Buccino

Registry-linked trialOpen access · diamondAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in European journal of physical and rehabilitation medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07612371 (Investigation of the Effects of Motor Imagery and Action Observation Therapy on Gross Motor Function, Upper Extremity Functional Skills, Activity, and Participation in Children With Unilateral Cerebral Palsy), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07612371 narecruitingnot on this mapstarted 2026, after this paper: background citation

Investigation of the Effects of Motor Imagery and Action Observation Therapy on Gross Motor Function, Upper Extremity Functional Skills, Activity, and Participation in Children With Unilateral Cerebral Palsy

TypeinterventionalSponsorBahçeşehir UniversityRan2026 to 2026Enrolled48ConditionsCerebral Palsy (CP)Armsmotor imagery, Action observation therapy, Conventional physiotherapy group
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Andrea DemecoDepartment of Medicine and Surgery, University of Parma, Parma, Italy.
Anna MolinaroUnit of Child Neurology and Psychiatry, Department of Clinical and Experimental Sciences, University of Brescia ASST Ospedali Civili of Brescia, Brescia, Italy.
Martina AmbroggiDepartment of Medicine and Surgery, University of Parma, Parma, Italy.
Antonio FrizzieroDepartment of Medicine and Surgery, University of Parma, Parma, Italy.
Elisa FazziUnit of Child Neurology and Psychiatry, Department of Clinical and Experimental Sciences, University of Brescia ASST Ospedali Civili of Brescia, Brescia, Italy.
Cosimo CostantinoDepartment of Medicine and Surgery, University of Parma, Parma, Italy - cosimo.costantino@unipr.it.
Giovanni BuccinoIRCCS Istituto Scientifico San Raffaele, Milan, Italy.
University of Parma · ITUniversity of Brescia · ITIstituti di Ricovero e Cura a Carattere Scientifico · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCerebral palsy (CP) is the predominant cause of children disability. It is characterized by motor, sensory, and postural deficits due to a non-progressive injury to the developing central nervous system. In recent years, new rehabilitation techniques targeting the central representations of motor patterns have been introduced: the most used are action observation therapy (AOT), motor imagery (MI), and mirror therapy (MT). Aim of this study is to assess the effectiveness of these cognitive strategies on the recovery of upper limb motor functions in children with CP. EVIDENCE ACQUISITION: This study was designed as a systematic review and meta-analysis, registered in PROSPERO (CRD42023403794). For the report and methodological definitions of this study, the recommendations of the PRISMA protocol and the Cochrane collaboration, were followed. A total of 3 electronic databases (PubMed, Scopus, and Web of Science) were searched for relevant Randomized Control Trials (RCT) using the combinations of terms "cerebral palsy" AND "action observation" OR "motor imagery" OR "mirror therapy" OR "cognitive therapy." A meta-analysis was carried out to compare cognitive and conventional approaches and combine direct and indirect effects. A random-effects meta-analysis model was used to derive pooled effect estimates. EVIDENCE SYNTHESIS: Out of 328 records, 12 RCTs were analyzed in this systematic review published from 2012 to 2022, and included 375 children, of whom 195 received cognitive therapies, and 180 underwent conventional rehabilitation. AOT was the most investigated (RCTs N.=7), and showed significant results in the recovery of upper limb motor functions, albeit the meta-analysis demonstrated a non-significant difference in Melbourne Unilateral Upper limb Scale (MUUL) (95% CI: -7.34, 12); in Assisting Hand Assessment (AHA) (95% CI: -4.84, 10.74), and in AbilHand-Kids Questionnaire (95% CI: -1.12, 1.45). Five RCTs investigated MT showing significant improvements in grip and dexterity; none used MI as intervention therapy.

conclusionsCognitive therapies provided with encouraging results in the recovery of upper limb motor functions, although not a clinical effect in bimanual or unimanual performance; they could represent a valid therapeutic solution integrated to conventional rehabilitation in the treatment of upper limb motor impairment in children with CP.

Indexed as

Cerebral PalsyUpper ExtremityChildCognitive Behavioral TherapyHumansRecovery of Function

Identifiers

PMID38512713
PMCPMC11255880
OpenAlexW4393034685

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.