"Medicine, Faculty of"@en . "Physical Therapy, Department of"@en . "DSpace"@en . "Dagenais, Lise"@en . "Lahay, Erin"@en . "Stueck, Kailey"@en . "White, Erin"@en . "Williams, Lindsay"@en . "Harris, Susan"@en . "2007-07-30T21:25:33Z"@en . "2007-07-30"@en . "MPT Systematic Reviews and Research Projects."@en . "https://circle.library.ubc.ca/rest/handle/2429/132?expand=metadata"@en . "35099655 bytes"@en . "1108906 bytes"@en . "application/octet-stream"@en . "application/pdf"@en . "Effects\u00C2\u00A0of\u00C2\u00A0Electrical\u00C2\u00A0Stimulation,\u00C2\u00A0 Exercise\u00C2\u00A0Training\u00C2\u00A0&\u00C2\u00A0Motor\u00C2\u00A0Skills\u00C2\u00A0 Training\u00C2\u00A0on\u00C2\u00A0Strength\u00C2\u00A0for\u00C2\u00A0Children\u00C2\u00A0 with\u00C2\u00A0Meningomyelocele: A\u00C2\u00A0Systematic\u00C2\u00A0Review Liese Dagenais \u00E2\u0080\u0090 Erin\u00C2\u00A0Lahay \u00E2\u0080\u0090 Kailey Stueck \u00E2\u0080\u0090 Erin\u00C2\u00A0White\u00C2\u00A0\u00E2\u0080\u0093 Lindsay\u00C2\u00A0Williams Supervisor\u00C2\u00A0\u00E2\u0080\u0090 Susan\u00C2\u00A0Harris Acknowledgements Susan\u00C2\u00A0Harris Supervisor\u00C2\u00A0and\u00C2\u00A0mentor Charlotte\u00C2\u00A0Beck Reference\u00C2\u00A0Librarian Outline \u00E2\u0080\u00A2 Introduction \u00E2\u0080\u00A2 Purpose \u00E2\u0080\u00A2 Methods \u00E2\u0080\u00A2 Results \u00E2\u0080\u00A2 Discussion\u00C2\u00A0 Introduction Spina\u00C2\u00A0bifida \u00E2\u0080\u00A2 Congenital\u00C2\u00A0abnormality \u00E2\u0080\u00A2 Incomplete\u00C2\u00A0closure\u00C2\u00A0of\u00C2\u00A0the\u00C2\u00A0spinal\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0 column1 \u00E2\u0080\u00A2 ~1/1000\u00C2\u00A0births\u00C2\u00A0annually2 \u00E2\u0080\u00A2 94%\u00C2\u00A0classified\u00C2\u00A0as\u00C2\u00A0meningomyelocele Spina\u00C2\u00A0bifida Meningomyelocele \u00E2\u0080\u00A2 Results\u00C2\u00A0in\u00C2\u00A0nerve\u00C2\u00A0damage\u00C2\u00A0below\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0 level\u00C2\u00A0of\u00C2\u00A0lesion1 \u00E2\u0080\u00A2 Common\u00C2\u00A0impairments1 \u00E2\u0080\u0093 Muscle\u00C2\u00A0weakness\u00C2\u00A0 \u00E2\u0080\u0093 Muscle\u00C2\u00A0paralysis \u00E2\u0080\u0093 Sensory\u00C2\u00A0impairments \u00E2\u0080\u0093 Bowel\u00C2\u00A0&\u00C2\u00A0bladder\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0 dysfunction Interventions \u00E2\u0080\u00A2 Multidisciplinary\u00C2\u00A0approach\u00C2\u00A0to\u00C2\u00A0 treatment\u00C2\u00A0is\u00C2\u00A0ideal \u00E2\u0080\u00A2 Physical\u00C2\u00A0therapy\u00C2\u00A0plays\u00C2\u00A0a\u00C2\u00A0key\u00C2\u00A0role1 \u00E2\u0080\u00A2 Interventions\u00C2\u00A0include1 \u00E2\u0080\u0093 Muscle\u00C2\u00A0strengthening \u00E2\u0080\u0093 Positioning \u00E2\u0080\u0093 Improving\u00C2\u00A0postural\u00C2\u00A0control \u00E2\u0080\u0093 Increasing\u00C2\u00A0independence\u00C2\u00A0 &\u00C2\u00A0mobility1 Existing\u00C2\u00A0Research \u00E2\u0080\u00A2 Limited\u00C2\u00A0evidence\u00C2\u00A0regarding\u00C2\u00A0efficacy\u00C2\u00A0 of\u00C2\u00A0physical\u00C2\u00A0therapy\u00C2\u00A0interventions\u00C2\u00A0for\u00C2\u00A0 children\u00C2\u00A0with\u00C2\u00A0meningomyelocele \u00E2\u0080\u00A2 Systematic\u00C2\u00A0review:\u00C2\u00A0Mazur\u00C2\u00A0JM\u00C2\u00A0&\u00C2\u00A0Kyle\u00C2\u00A0S,\u00C2\u00A0 20043 \u00E2\u0080\u0093 Inconsistent\u00C2\u00A0results \u00E2\u0080\u0093 No\u00C2\u00A0conclusive\u00C2\u00A0findings \u00E2\u0080\u0093 Further\u00C2\u00A0research\u00C2\u00A0necessary Cerebral\u00C2\u00A0Palsy\u00C2\u00A0Research \u00E2\u0080\u00A2 Current\u00C2\u00A0&\u00C2\u00A0high\u00C2\u00A0quality\u00C2\u00A0articles\u00C2\u00A0 available \u00E2\u0080\u00A2 Systematic\u00C2\u00A0review:\u00C2\u00A0Dodd\u00C2\u00A0KJ\u00C2\u00A0et\u00C2\u00A0al.,\u00C2\u00A0 20024 \u00E2\u0080\u0093 23\u00C2\u00A0relevant\u00C2\u00A0articles \u00E2\u0080\u0093 11\u00C2\u00A0high\u00C2\u00A0quality Purpose To\u00C2\u00A0provide\u00C2\u00A0an\u00C2\u00A0overview\u00C2\u00A0of\u00C2\u00A0the\u00C2\u00A0existing\u00C2\u00A0 research\u00C2\u00A0regarding\u00C2\u00A0the\u00C2\u00A0effects\u00C2\u00A0of\u00C2\u00A0 electrical\u00C2\u00A0stimulation,\u00C2\u00A0exercise\u00C2\u00A0training\u00C2\u00A0 and\u00C2\u00A0motor\u00C2\u00A0skills\u00C2\u00A0training\u00C2\u00A0on\u00C2\u00A0muscle\u00C2\u00A0 strengthening\u00C2\u00A0for\u00C2\u00A0children\u00C2\u00A0with\u00C2\u00A0 meningomyelocele Methods Literature\u00C2\u00A0Search \u00E2\u0080\u00A2Electronic\u00C2\u00A0databases Limits:\u00C2\u00A0English\u00C2\u00A0language \u00E2\u0080\u00A2Pubmed \u00E2\u0080\u00A2Embase \u00E2\u0080\u00A2Cinahl \u00E2\u0080\u00A2Medline \u00E2\u0080\u00A2PEDro \u00E2\u0080\u00A2CENTRAL\u00C2\u00A0 \u00E2\u0080\u00A2DARE \u00E2\u0080\u00A2CIRRIE \u00E2\u0080\u00A2Cochrane\u00C2\u00A0database \u00E2\u0080\u00A2Hand\u00C2\u00A0Search\u00C2\u00A0 Reference\u00C2\u00A0lists\u00C2\u00A0of\u00C2\u00A0selected\u00C2\u00A0articles Spina Bifida MeningomyeloceleSpinal Dysraphism Physical therapy Physical therapy modalitiesRehabilitation ExerciseElectrical stimulation Functional mobility Muscle strength Gait / Ambulation Search Terms Inclusion\u00C2\u00A0&\u00C2\u00A0Exclusion\u00C2\u00A0Criteria \u00E2\u0080\u00A2 Inclusion \u00E2\u0080\u0093 Participants\u00C2\u00A0diagnosed\u00C2\u00A0with\u00C2\u00A0 meningomyelocele \u00E2\u0080\u0093 Participants\u00C2\u00A021\u00C2\u00A0years\u00C2\u00A0of\u00C2\u00A0age\u00C2\u00A0and\u00C2\u00A0under \u00E2\u0080\u0093 Study\u00C2\u00A0involves\u00C2\u00A0physical\u00C2\u00A0therapy\u00C2\u00A0intervention\u00C2\u00A0\u00C2\u00A0 \u00E2\u0080\u00A2 Exclusions \u00E2\u0080\u0093 Book\u00C2\u00A0chapters\u00C2\u00A0 \u00E2\u0080\u0093 Duplicate\u00C2\u00A0publications \u00E2\u0080\u0093 Focus\u00C2\u00A0on\u00C2\u00A0surgical\u00C2\u00A0techniques,\u00C2\u00A0orthoses,\u00C2\u00A0bowel\u00C2\u00A0 &\u00C2\u00A0bladder\u00C2\u00A0function,\u00C2\u00A0cognition\u00C2\u00A0or\u00C2\u00A0scoliosis \u00E2\u0080\u00A2 Resulting\u00C2\u00A011\u00C2\u00A0studies\u00C2\u00A0extremely\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0 heterogeneous\u00C2\u00A0 \u00E2\u0080\u00A2 Therefore\u00E2\u0080\u00A6 STRENGTH\u00C2\u00A0\u00C2\u00A0was\u00C2\u00A0used\u00C2\u00A0as\u00C2\u00A0an\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0 outcome\u00C2\u00A0measure Inclusion\u00C2\u00A0&\u00C2\u00A0Exclusion\u00C2\u00A0Criteria PICO \u00E2\u0080\u00A2 Population:\u00C2\u00A0participants\u00C2\u00A021\u00C2\u00A0years\u00C2\u00A0of\u00C2\u00A0age\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0 and\u00C2\u00A0under\u00C2\u00A0with\u00C2\u00A0a\u00C2\u00A0diagnosis\u00C2\u00A0of\u00C2\u00A0 meningomyelocele \u00E2\u0080\u00A2 Intervention:\u00C2\u00A0Electrical\u00C2\u00A0stimulation,\u00C2\u00A0 exercise\u00C2\u00A0training\u00C2\u00A0&\u00C2\u00A0motor\u00C2\u00A0skills\u00C2\u00A0training \u00E2\u0080\u00A2 Comparison:\u00C2\u00A0N/A \u00E2\u0080\u00A2Outcome:\u00C2\u00A0Strength Studies\u00C2\u00A0included\u00C2\u00A0in\u00C2\u00A0Review\u00C2\u00A0 (N\u00C2\u00A0=6) Failed\u00C2\u00A0to\u00C2\u00A0meet\u00C2\u00A0full\u00C2\u00A0text\u00C2\u00A0inclusion/\u00C2\u00A0exclusion\u00C2\u00A0criteria\u00C2\u00A0 (N=9) Retrieved\u00C2\u00A0for\u00C2\u00A0Evaluation\u00C2\u00A0 (N\u00C2\u00A0=\u00C2\u00A020) Obtained\u00C2\u00A0by\u00C2\u00A0Hand\u00C2\u00A0Searching\u00C2\u00A0 (N\u00C2\u00A0=\u00C2\u00A02) After\u00C2\u00A0Screening\u00C2\u00A0Abstracts\u00C2\u00A0 (N\u00C2\u00A0=\u00C2\u00A018) Failed\u00C2\u00A0to\u00C2\u00A0meet\u00C2\u00A0abstract\u00C2\u00A0inclusion/\u00C2\u00A0exclusion\u00C2\u00A0criteria\u00C2\u00A0 (N=120) After\u00C2\u00A0Screening\u00C2\u00A0Titles\u00C2\u00A0 (N\u00C2\u00A0=\u00C2\u00A0138) Failed\u00C2\u00A0to\u00C2\u00A0meet\u00C2\u00A0title\u00C2\u00A0inclusion/\u00C2\u00A0exclusion\u00C2\u00A0criteria\u00C2\u00A0 (N=160) Did\u00C2\u00A0not\u00C2\u00A0use\u00C2\u00A0strength\u00C2\u00A0as\u00C2\u00A0an\u00C2\u00A0outcome\u00C2\u00A0measure\u00C2\u00A0 (N=5) After\u00C2\u00A0Screening\u00C2\u00A0Full\u00C2\u00A0Text\u00C2\u00A0 (N\u00C2\u00A0=\u00C2\u00A011) Potentially\u00C2\u00A0Relevant\u00C2\u00A0Citations\u00C2\u00A0 (N\u00C2\u00A0=\u00C2\u00A0298) Full\u00C2\u00A0Text\u00C2\u00A0Exclusions \u00E2\u0080\u00A2 5\u00C2\u00A0did\u00C2\u00A0not\u00C2\u00A0use\u00C2\u00A0\u00E2\u0080\u0098strength\u00E2\u0080\u0099 as\u00C2\u00A0outcome\u00C2\u00A0 measure \u00E2\u0080\u00A2 3\u00C2\u00A0duplicates\u00C2\u00A0 \u00E2\u0080\u00A2 2\u00C2\u00A0did\u00C2\u00A0not\u00C2\u00A0have\u00C2\u00A0a\u00C2\u00A0relevant\u00C2\u00A0physical\u00C2\u00A0therapy\u00C2\u00A0 intervention \u00E2\u0080\u00A2 1\u00C2\u00A0focused\u00C2\u00A0on\u00C2\u00A0scoliosis \u00E2\u0080\u00A2 1\u00C2\u00A0did\u00C2\u00A0not\u00C2\u00A0have\u00C2\u00A0a\u00C2\u00A0diagnosis\u00C2\u00A0of\u00C2\u00A0 meningomyelocele \u00E2\u0080\u00A2 1\u00C2\u00A0book\u00C2\u00A0chapter \u00E2\u0080\u00A2 1\u00C2\u00A0participants\u00C2\u00A0did\u00C2\u00A0not\u00C2\u00A0meet\u00C2\u00A0age\u00C2\u00A0 requirement Included\u00C2\u00A0Studies 6\u00C2\u00A0 Studies 2\u00C2\u00A0 Electrical\u00C2\u00A0 Stimulation 3 Exercise\u00C2\u00A0 Training 1\u00C2\u00A0 Motor\u00C2\u00A0Skills\u00C2\u00A0 Training AACPDM\u00C2\u00A0Levels\u00C2\u00A0of\u00C2\u00A0Evidence4 Level Intervention (Group) Studies I Systematic\u00C2\u00A0Review\u00C2\u00A0of\u00C2\u00A0randomized\u00C2\u00A0controlled\u00C2\u00A0trials\u00C2\u00A0(RCT\u00E2\u0080\u0099s) Large\u00C2\u00A0RCT\u00C2\u00A0(with\u00C2\u00A0narrow\u00C2\u00A0confidence\u00C2\u00A0intervals)\u00C2\u00A0(n>100)\u00C2\u00A0 II Smaller\u00C2\u00A0RCT\u00E2\u0080\u0099s (with\u00C2\u00A0wider\u00C2\u00A0confidence\u00C2\u00A0intervals)\u00C2\u00A0(n<100) Systematic\u00C2\u00A0Reviews\u00C2\u00A0of\u00C2\u00A0cohort\u00C2\u00A0studies \u00E2\u0080\u009COutcomes\u00C2\u00A0research\u00E2\u0080\u009D (very\u00C2\u00A0large\u00C2\u00A0ecologic\u00C2\u00A0studies) III Cohort\u00C2\u00A0studies\u00C2\u00A0(must\u00C2\u00A0have\u00C2\u00A0concurrent\u00C2\u00A0control\u00C2\u00A0group) Systematic\u00C2\u00A0Reviews\u00C2\u00A0of\u00C2\u00A0Case\u00C2\u00A0Control\u00C2\u00A0Studies IV Case\u00C2\u00A0series Cohort\u00C2\u00A0study\u00C2\u00A0without\u00C2\u00A0concurrent\u00C2\u00A0control\u00C2\u00A0group\u00C2\u00A0(e.g.\u00C2\u00A0with\u00C2\u00A0historical\u00C2\u00A0 control\u00C2\u00A0group) Case\u00E2\u0080\u0090control\u00C2\u00A0Study V Expert\u00C2\u00A0Opinion\u00C2\u00A0 Case\u00C2\u00A0Study\u00C2\u00A0or\u00C2\u00A0report Bench\u00C2\u00A0research\u00C2\u00A0 Expert\u00C2\u00A0opinion\u00C2\u00A0based\u00C2\u00A0on\u00C2\u00A0theory\u00C2\u00A0or\u00C2\u00A0physiologic\u00C2\u00A0research Common\u00C2\u00A0sense/anecdotes Level\u00C2\u00A0of\u00C2\u00A0Agreement\u00C2\u00A0=\u00C2\u00A0100% AACPDM\u00C2\u00A0Quality\u00C2\u00A0Assessment4 1. Was\u00C2\u00A0inclusion\u00C2\u00A0criteria\u00C2\u00A0well\u00C2\u00A0described\u00C2\u00A0&\u00C2\u00A0followed? 2.\u00C2\u00A0Were\u00C2\u00A0interventions\u00C2\u00A0well\u00C2\u00A0described\u00C2\u00A0&\u00C2\u00A0was\u00C2\u00A0there\u00C2\u00A0 adherence?\u00C2\u00A0 3.\u00C2\u00A0Were\u00C2\u00A0measures\u00C2\u00A0clearly\u00C2\u00A0described,\u00C2\u00A0valid\u00C2\u00A0&\u00C2\u00A0reliable? 4.\u00C2\u00A0Were\u00C2\u00A0there\u00C2\u00A0blind\u00C2\u00A0assessments? 5.\u00C2\u00A0Were\u00C2\u00A0appropriate\u00C2\u00A0statistical\u00C2\u00A0evaluations\u00C2\u00A0conducted\u00C2\u00A0&\u00C2\u00A0 reported? 6.\u00C2\u00A0Were\u00C2\u00A0dropouts\u00C2\u00A0reported\u00C2\u00A0and\u00C2\u00A0less\u00C2\u00A0than\u00C2\u00A020%?\u00C2\u00A0 7.\u00C2\u00A0Were\u00C2\u00A0appropriate\u00C2\u00A0methods\u00C2\u00A0for\u00C2\u00A0controlling\u00C2\u00A0 confounding\u00C2\u00A0variables\u00C2\u00A0&\u00C2\u00A0limiting\u00C2\u00A0potential\u00C2\u00A0biases\u00C2\u00A0 used?\u00C2\u00A0 Level\u00C2\u00A0II\u00C2\u00A0studies Case\u00C2\u00A0Study\u00C2\u00A0Quality\u00C2\u00A0Assessment5 Level\u00C2\u00A0IV\u00C2\u00A0&\u00C2\u00A0V\u00C2\u00A0studies 1.\u00C2\u00A0Was\u00C2\u00A0the\u00C2\u00A0purpose\u00C2\u00A0clearly\u00C2\u00A0stated? 2.\u00C2\u00A0Was\u00C2\u00A0the\u00C2\u00A0hypothesis\u00C2\u00A0clearly\u00C2\u00A0stated? 3.\u00C2\u00A0Were\u00C2\u00A0participants\u00C2\u00A0described\u00C2\u00A0in\u00C2\u00A0sufficient\u00C2\u00A0detail? 4.\u00C2\u00A0Were\u00C2\u00A0interventions\u00C2\u00A0&\u00C2\u00A0treatment\u00C2\u00A0settings\u00C2\u00A0described\u00C2\u00A0 in\u00C2\u00A0sufficient\u00C2\u00A0detail? 5.\u00C2\u00A0Were\u00C2\u00A0measures\u00C2\u00A0clearly\u00C2\u00A0described,\u00C2\u00A0valid\u00C2\u00A0&\u00C2\u00A0reliable? 6.\u00C2\u00A0Was\u00C2\u00A0the\u00C2\u00A0effect\u00C2\u00A0size\u00C2\u00A0clinically\u00C2\u00A0important? 7.\u00C2\u00A0Were\u00C2\u00A0limitations\u00C2\u00A0of\u00C2\u00A0the\u00C2\u00A0study\u00C2\u00A0identified\u00C2\u00A0&\u00C2\u00A0 discussed? Study\u00C2\u00A0Quality Study Level 1 2 3 4 5 6 7 Total AACPDM\u00C2\u00A0Quality\u00C2\u00A0Assessment4 Karmel\u00E2\u0080\u0090Ross\u00C2\u00A0et\u00C2\u00A0al.6 II \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A 4 Andrade\u00C2\u00A0et\u00C2\u00A0al.8 II \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A 5 Case\u00C2\u00A0Study\u00C2\u00A0Quality\u00C2\u00A0Assessment5 O\u00E2\u0080\u0099Connell\u00C2\u00A0&\u00C2\u00A0 Barnhart9 IV \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A 5 Mazliah et\u00C2\u00A0al.7 IV \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A 6 Rapport\u00C2\u00A0&\u00C2\u00A0Bailey10 V \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A 5 Manella &\u00C2\u00A0Varni11 V \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A \u00E2\u0088\u009A 4 Level\u00C2\u00A0of\u00C2\u00A0Agreement\u00C2\u00A0=\u00C2\u00A083%Strong\u00C2\u00A0=\u00C2\u00A0score\u00C2\u00A0of\u00C2\u00A06\u00E2\u0080\u00907 Moderate\u00C2\u00A0=\u00C2\u00A0score\u00C2\u00A0of\u00C2\u00A04\u00E2\u0080\u00905\u00C2\u00A0 Weak\u00C2\u00A0=\u00C2\u00A0score\u00C2\u00A0of\u00C2\u00A0\u00E2\u0089\u00A4 3 Data\u00C2\u00A0Extraction\u00C2\u00A0&\u00C2\u00A0Analysis \u00E2\u0080\u00A2 Standardized\u00C2\u00A0data\u00C2\u00A0extraction\u00C2\u00A0form \u00E2\u0080\u00A2 Summary\u00C2\u00A0tables \u00E2\u0080\u00A2 Descriptive\u00C2\u00A0synthesis\u00C2\u00A0method\u00C2\u00A0of\u00C2\u00A0data\u00C2\u00A0 analysis \u00E2\u0080\u0093 Evaluating\u00C2\u00A0participants,\u00C2\u00A0interventions,\u00C2\u00A0 outcomes \u00E2\u0080\u0093 Determine\u00C2\u00A0if\u00C2\u00A0findings\u00C2\u00A0can\u00C2\u00A0be\u00C2\u00A0generalized \u00E2\u0080\u0093 Limitations\u00C2\u00A0investigated Results Electrical\u00C2\u00A0Stimulation Authors Therapy\u00C2\u00A0 Interventions Karmel\u00E2\u0080\u0090Ross\u00C2\u00A0et\u00C2\u00A0 al.6 PRE\u00C2\u00A0TEST\u00C2\u00A0\u00E2\u0080\u0090 POST\u00C2\u00A0 TEST\u00C2\u00A0CONTROL Level\u00C2\u00A0II Quality\u00C2\u00A04/7 Applied\u00C2\u00A0to\u00C2\u00A0 quadriceps\u00C2\u00A0 femoris unilaterally \u00E2\u0080\u009030\u00C2\u00A0minute\u00C2\u00A0 sessions\u00C2\u00A06x/wk\u00C2\u00A0 for\u00C2\u00A08\u00C2\u00A0wks Applied\u00C2\u00A0to\u00C2\u00A0 quadriceps\u00C2\u00A0 femoris bilaterally \u00E2\u0080\u00901\u00E2\u0080\u00902\u00C2\u00A0hour\u00C2\u00A0sessions\u00C2\u00A0 daily\u00C2\u00A0for\u00C2\u00A06\u00C2\u00A0 months Mazliah et\u00C2\u00A0al.7 ONE\u00C2\u00A0GROUP\u00C2\u00A0PRE\u00C2\u00A0 TEST\u00C2\u00A0\u00E2\u0080\u0093 POST\u00C2\u00A0 TEST Level\u00C2\u00A0IV\u00C2\u00A0 Quality\u00C2\u00A06/7 Control\u00C2\u00A0 Intervention Sample Contralateral limb N=5\u00C2\u00A0(2\u00C2\u00A0males;\u00C2\u00A03\u00C2\u00A0 females) \u00E2\u0080\u0090Children\u00C2\u00A0with\u00C2\u00A0 Spina\u00C2\u00A0Bifida;\u00C2\u00A0lesion\u00C2\u00A0 at\u00C2\u00A0level\u00C2\u00A0L2\u00E2\u0080\u00903 \u00E2\u0080\u00905\u00E2\u0080\u009021\u00C2\u00A0years N/A N=3\u00C2\u00A0 \u00E2\u0080\u0090 Children\u00C2\u00A0with\u00C2\u00A0 lumbar\u00C2\u00A0MM\u00C2\u00A0 \u00E2\u0080\u0090Knee\u00C2\u00A0flexion\u00C2\u00A0 contractures\u00C2\u00A0>15\u00C2\u00A0\u00C2\u00B0 \u00E2\u0080\u0090 9\u00E2\u0080\u009012\u00C2\u00A0years Electrical\u00C2\u00A0Stimulation:\u00C2\u00A0Results Study Outcome\u00C2\u00A0of\u00C2\u00A0 Interest Measure Result Karmel Ross\u00C2\u00A0et\u00C2\u00A0 al.6 Quadriceps\u00C2\u00A0 femoris muscle\u00C2\u00A0 strength Maximum\u00C2\u00A0isometric\u00C2\u00A0 voluntary\u00C2\u00A0knee\u00C2\u00A0 extension\u00C2\u00A0torque 2/5\u00C2\u00A0statistically\u00C2\u00A0 significant\u00C2\u00A0 improvement Mazliah et\u00C2\u00A0al.7 Quadriceps\u00C2\u00A0 femoris muscle\u00C2\u00A0 strength Isometric\u00C2\u00A0Torque\u00C2\u00A0 measurements\u00C2\u00A0 2/3\u00C2\u00A0improved Exercise\u00C2\u00A0Training Authors Therapy\u00C2\u00A0 Intervention Control\u00C2\u00A0 Intervention Andrade\u00C2\u00A0et\u00C2\u00A0al.8 PRE\u00C2\u00A0TEST\u00C2\u00A0\u00E2\u0080\u0090 POST\u00C2\u00A0 TEST\u00C2\u00A0CONTROL Level\u00C2\u00A0II Quality\u00C2\u00A05/7 Children\u00C2\u00A0not\u00C2\u00A0 attending\u00C2\u00A0 exercise\u00C2\u00A0 program N/A N/A O\u00E2\u0080\u0099Connell\u00C2\u00A0&\u00C2\u00A0 Barnhart9 ONE\u00C2\u00A0GROUP\u00C2\u00A0PRE\u00C2\u00A0 TEST\u00C2\u00A0\u00E2\u0080\u0093 POST\u00C2\u00A0TEST Level\u00C2\u00A0IV Quality\u00C2\u00A05/7 UE\u00C2\u00A0strengthening \u00E2\u0080\u009030\u00C2\u00A0min\u00C2\u00A03x/wk\u00C2\u00A0for\u00C2\u00A09\u00C2\u00A0 wks N=6\u00C2\u00A0 \u00E2\u0080\u0090 MM\u00C2\u00A0(N=3);\u00C2\u00A0lesion\u00C2\u00A0 below\u00C2\u00A0T8\u00C2\u00A0 \u00E2\u0080\u0090 Children\u00C2\u00A0diagnosed\u00C2\u00A0 with\u00C2\u00A0CP\u00C2\u00A0(N=3)\u00C2\u00A0 \u00E2\u0080\u0090 4\u00E2\u0080\u009016\u00C2\u00A0years Rapport\u00C2\u00A0&\u00C2\u00A0 Bailey10 SINGLE\u00C2\u00A0SUBJECT Level\u00C2\u00A0V Quality\u00C2\u00A05/7 Fine/gross\u00C2\u00A0motor\u00C2\u00A0 \u00E2\u0080\u0090Clinic:\u00C2\u00A090\u00C2\u00A0min\u00C2\u00A0 1x/wk\u00C2\u00A0for\u00C2\u00A06\u00C2\u00A0wks \u00E2\u0080\u0090Home:\u00C2\u00A030\u00C2\u00A0min/day\u00C2\u00A0 5x/wk\u00C2\u00A0for\u00C2\u00A056\u00C2\u00A0wks N=1\u00C2\u00A0(male) \u00E2\u0080\u0090 Child\u00C2\u00A0with\u00C2\u00A0MM\u00C2\u00A0 \u00E2\u0080\u0090 8.5\u00C2\u00A0years\u00C2\u00A0 Sample Aerobic\u00C2\u00A0and\u00C2\u00A0UE\u00C2\u00A0 strengthening \u00E2\u0080\u00901\u00C2\u00A0hr/wk\u00C2\u00A0for\u00C2\u00A010\u00C2\u00A0wks N=13\u00C2\u00A0(7\u00C2\u00A0males;\u00C2\u00A06\u00C2\u00A0 females) \u00E2\u0080\u0090 MM;\u00C2\u00A0lesion\u00C2\u00A0below\u00C2\u00A0T6 \u00E2\u0080\u0090 8\u00E2\u0080\u009013\u00C2\u00A0years Exercise\u00C2\u00A0Training:\u00C2\u00A0Results Study Outcome\u00C2\u00A0of\u00C2\u00A0 Interest Measure Result Andrade\u00C2\u00A0 et\u00C2\u00A0al.8 Strength Isometric\u00C2\u00A0tests\u00C2\u00A0using\u00C2\u00A0 hand\u00C2\u00A0held\u00C2\u00A0 dynamometer Ss\u00C2\u00A0(p<0.01) O\u00E2\u0080\u0099Connell\u00C2\u00A0 &\u00C2\u00A0 Barnhart9 Wheelchair\u00C2\u00A0 propulsion 6\u00C2\u00A0repetition\u00C2\u00A0maximum\u00C2\u00A0 Ss\u00C2\u00A0(p=\u00C2\u00A0.018\u00E2\u0080\u0090 .031) Rapport\u00C2\u00A0&\u00C2\u00A0 Bailey10 UE\u00C2\u00A0fine\u00C2\u00A0motor UE\u00C2\u00A0gross\u00C2\u00A0motor OSCO\u00C2\u00A0Pinchmeter Dynamometer\u00C2\u00A0grip\u00C2\u00A0 strength All\u00C2\u00A0Improved\u00C2\u00A0 All\u00C2\u00A0Improved Motor\u00C2\u00A0Skills\u00C2\u00A0Training Authors Therapy\u00C2\u00A0Intervention Manella &\u00C2\u00A0 Varni11 SINGLE\u00C2\u00A0 SUBJECT Level\u00C2\u00A0V Quality\u00C2\u00A04/7 Functional\u00C2\u00A0activities\u00C2\u00A0 &\u00C2\u00A0behavioural\u00C2\u00A0 therapy \u00E2\u0080\u0090Clinic:\u00C2\u00A030\u00C2\u00A0min\u00C2\u00A04\u00C2\u00A0wks \u00E2\u0080\u0090Home:\u00C2\u00A030\u00C2\u00A0min\u00C2\u00A0daily \u00E2\u0080\u0090Follow\u00C2\u00A0up:\u00C2\u00A0 1x/month\u00C2\u00A0for\u00C2\u00A05\u00C2\u00A0 months N/A N=1\u00C2\u00A0(female) \u00E2\u0080\u0090Child\u00C2\u00A0with\u00C2\u00A0MM\u00C2\u00A0@\u00C2\u00A0L3 \u00E2\u0080\u0090 5\u00C2\u00A0years Control\u00C2\u00A0 Intervention Sample Motor\u00C2\u00A0Skills\u00C2\u00A0Training:\u00C2\u00A0Results Study Outcome\u00C2\u00A0of\u00C2\u00A0 Interest Measure Result Manella &\u00C2\u00A0 Varni11 Independence\u00C2\u00A0 in\u00C2\u00A0motor\u00C2\u00A0skills Quadriceps\u00C2\u00A0manual\u00C2\u00A0 muscle\u00C2\u00A0test\u00C2\u00A0 Improved\u00C2\u00A0grade\u00C2\u00A03\u00C2\u00A0 to\u00C2\u00A0grade\u00C2\u00A04\u00C2\u00A0 bilaterally Discussion This systematic review concludes there is a positive trend towards increasing muscle strength using electrical stimulation, exercise training and motor skills training for children with meningomyelocele. Electrical\u00C2\u00A0Stimulation Karmel\u00E2\u0080\u0090Ross\u00C2\u00A0et\u00C2\u00A0al.6 Mazliah et\u00C2\u00A0al.7 \u00E2\u0080\u00A2Level\u00C2\u00A0II \u00E2\u0080\u00A2Functional\u00C2\u00A0activities\u00C2\u00A0 during\u00C2\u00A0e\u00E2\u0080\u0090stim \u00E2\u0080\u00A2Improvements\u00C2\u00A0in\u00C2\u00A0gait \u00E2\u0080\u00A2Health\u00C2\u00A0&\u00C2\u00A0instructional issues \u00E2\u0080\u00A2Level\u00C2\u00A0IV \u00E2\u0080\u00A2Longer\u00C2\u00A0e\u00E2\u0080\u0090stim application\u00C2\u00A0 &\u00C2\u00A0study\u00C2\u00A0duration\u00C2\u00A0 \u00E2\u0080\u00A2Sedentary\u00C2\u00A0during\u00C2\u00A0e\u00E2\u0080\u0090stim \u00E2\u0080\u00A2No\u00C2\u00A0improvements\u00C2\u00A0in\u00C2\u00A0gait \u00E2\u0080\u00A2Possible\u00C2\u00A0low\u00C2\u00A0adherence\u00C2\u00A0or\u00C2\u00A0 ineffective\u00C2\u00A0application Exercise\u00C2\u00A0Training Andrade\u00C2\u00A0et\u00C2\u00A0al.8 O\u00E2\u0080\u0099Connell\u00C2\u00A0&\u00C2\u00A0 Barnhart9 Rapport\u00C2\u00A0&\u00C2\u00A0 Bailey10 \u00E2\u0080\u00A2Level\u00C2\u00A0II \u00E2\u0080\u00A210\u00C2\u00A0week\u00C2\u00A0program \u00E2\u0080\u00A2Resistance\u00C2\u00A0 training \u00E2\u0080\u00A2Level\u00C2\u00A0IV \u00E2\u0080\u00A29\u00C2\u00A0week\u00C2\u00A0program \u00E2\u0080\u00A2Resistance\u00C2\u00A0 training \u00E2\u0080\u00A2Level\u00C2\u00A0V \u00E2\u0080\u00A256\u00C2\u00A0week\u00C2\u00A0program \u00E2\u0080\u00A2Functional\u00C2\u00A0 activities Motor Skills Training Manella & Varni12 \u00E2\u0080\u00A2Task specific training \u00E2\u0080\u00A2Behavioral therapy Limitations \u00E2\u0080\u00A2 Limited\u00C2\u00A0search\u00C2\u00A0to\u00C2\u00A0English\u00C2\u00A0 \u00E2\u0080\u00A2 Limited\u00C2\u00A0search\u00C2\u00A0to\u00C2\u00A0published\u00C2\u00A0articles \u00E2\u0080\u00A2 Did\u00C2\u00A0not\u00C2\u00A0extensively\u00C2\u00A0search\u00C2\u00A0grey\u00C2\u00A0 literature \u00E2\u0080\u00A2 Descriptive\u00C2\u00A0synthesis\u00C2\u00A0vs.\u00C2\u00A0 meta\u00E2\u0080\u0090analysis \u00E2\u0080\u00A2 Small\u00C2\u00A0sample\u00C2\u00A0sizes \u00E2\u0080\u00A2 Dated\u00C2\u00A0studies \u00E2\u0080\u00A2 Lack\u00C2\u00A0of\u00C2\u00A0literature\u00C2\u00A0and\u00C2\u00A0low\u00C2\u00A0levels\u00C2\u00A0of\u00C2\u00A0 evidence Strengths\u00C2\u00A0of\u00C2\u00A0Review \u00E2\u0080\u00A2 Investigations\u00C2\u00A0of\u00C2\u00A0LE\u00C2\u00A0&\u00C2\u00A0UE \u00E2\u0080\u00A2 Relating\u00C2\u00A0strength\u00C2\u00A0gains\u00C2\u00A0to\u00C2\u00A0function \u00E2\u0080\u00A2 Extensive\u00C2\u00A0literature\u00C2\u00A0search \u00E2\u0080\u00A2 Monthly\u00C2\u00A0updates \u00E2\u0080\u00A2 5\u00C2\u00A0reviewers\u00C2\u00A0to\u00C2\u00A0limit\u00C2\u00A0bias \u00E2\u0080\u00A2 High\u00C2\u00A0inter\u00E2\u0080\u0090rater reliability\u00C2\u00A0 \u00E2\u0080\u00A2 Spina\u00C2\u00A0bifida\u00C2\u00A0expert\u00C2\u00A0 Future\u00C2\u00A0Research \u00E2\u0080\u00A2 Effects\u00C2\u00A0of\u00C2\u00A0electrical\u00C2\u00A0stimulation\u00C2\u00A0on\u00C2\u00A0 ambulation\u00C2\u00A0ability6 &\u00C2\u00A0knee\u00C2\u00A0flexion\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0 contractures7 \u00E2\u0080\u00A2 Effects\u00C2\u00A0of\u00C2\u00A0compliance,\u00C2\u00A0 motivation,\u00C2\u00A0education\u00C2\u00A0 &\u00C2\u00A0parental\u00C2\u00A0involvement\u00C2\u00A0 \u00E2\u0080\u00A2 Optimal\u00C2\u00A0treatment\u00C2\u00A0 protocols\u00C2\u00A0&\u00C2\u00A0duration Conclusion Although\u00C2\u00A0this\u00C2\u00A0review\u00C2\u00A0supports\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0\u00C2\u00A0 aspects\u00C2\u00A0of\u00C2\u00A0physical\u00C2\u00A0therapy\u00C2\u00A0 interventions,\u00C2\u00A0the\u00C2\u00A0literature\u00C2\u00A0is\u00C2\u00A0out\u00C2\u00A0of\u00C2\u00A0 date\u00C2\u00A0and\u00C2\u00A0scarce.\u00C2\u00A0\u00C2\u00A0 In\u00C2\u00A0order\u00C2\u00A0to\u00C2\u00A0ensure\u00C2\u00A0 physical\u00C2\u00A0therapy\u00C2\u00A0is\u00C2\u00A0 delivered\u00C2\u00A0in\u00C2\u00A0an\u00C2\u00A0 effective\u00C2\u00A0and\u00C2\u00A0efficient\u00C2\u00A0 manner,\u00C2\u00A0further\u00C2\u00A0 research\u00C2\u00A0is\u00C2\u00A0necessary http://www.youtube.com/watch?v=EnCx64 tyJHY&mode=related&search= References (1) Campbell S, Vander Linden D, Palisano R. Physical therapy for children. 3rd ed. Philadelphia: Saunders Elsevier Inc; 2006. (2) National Dissemination Center for Children with Disabilities. Spina Bifida Fact Sheet; 2004. [Cited 2007 May 18]. Available from: http://www.nichcy.org/pubs/factshe/ fs12txt.htm. (3) Mazur JM & Kyle S. Efficacy of bracing the lower limbs and ambulation training in children with myelomeningocele. Developmental Medicine & Child Neurology. 2004;46(5):352-356. (4) Dodd KJ, Taylor NF, Damiano DL. A systematic review of the effectiveness of strength-training programs for people with cerebral palsy. Arch Phys Med Rehabil. 2002 Aug;83(8):1157-64. (5) O\u00E2\u0080\u0099Donnel M., Darrah J, Adams R, Butler C, Roxborough L, Damiano D. AACPDM methodology to Develop Systematic Reviews of Treatment Interventions; 2004 [Cited 2007 April 17]. Available from: http://www.aacpdm.org/resources/systematicReviews Methodology.pdf. (6) Dean E, Arscott S, Desaulles P, Hughes K, Kotzo S, Preto R. The effect of manual therapy on range of motion following lateral ankle sprains: a systematic review. 2006. (7) Center for reviews and dissemination. CRD Report 4 (2nd edition); March 2001 [Cited 1007 April 17]. Available from: http://www.york.ac.uk/inst/crd/report4.htm. (8) Karmel-Ross K, Cooperman DR, Van Doren CL. The effect of electrical stimulation on quadriceps femoris muscle torque in children with spina bifida. Physical Therapy. 1992 Oct;72(10):723-730. (9) Mazliah J, Naumann S, White C, et al. Electrostimulation as a means of decreasing knee flexion contractures in children with spina bifida. Proceedings of the 6th annual conference on Rehabilitation Engineering 1983:63-65. (10) Andrade CK, Kramer J, Garber M, Longmuir P. Changes in self-concept, cardiovascular endurance and muscular strength of children with spina bifida aged 8 to 13 years in response to a 10-week physical-activity programme: a pilot study. Child Care Health Development 1991;17(3):183-196. (11) O'Connell DG, Barnhart R. Improvement in wheelchair propulsion in pediatric wheelchair users through resistance training: A pilot study. Archives of Physical Medicine & Rehabilitation 1995;76(4):368-372. (12) Rapport MD, Bailey JS. Behavioral physical therapy and spina bifida: a case study. J.Pediatr.Psychol. 1985 Mar;10(1):87-96. (13) Manella K, Varni J. Behavioral treatment of ambulatory function in a child with myelomeningocele: a case report. Physical Therapy 1984;64(10):1536- 1539. (14) Levels of evidence and grades of recommendation. [Cited 2007 July 18]. Available from: http://www.minervation.com/cebm2/docs/levels.html. (15) Falk B, Tenenbaum G. The effectiveness of resistance training in children. A meta-analysis. Sports Med. 1996;22:176\u00E2\u0080\u0093186. 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"Presentation"@en . "10.14288/1.0081226"@en . "eng"@en . "Unreviewed"@en . "Vancouver : University of British Columbia Library"@en . "Attribution-NonCommercial-NoDerivatives 4.0 International"@en . "http://creativecommons.org/licenses/by-nc-nd/4.0/"@en . "Graduate"@en . "University of British Columbia. RSPT 572"@en . "Physical therapy"@en . "Physiotherapy"@en . "Systematic reviews"@en . "Meningomyelocele"@en . "Exercise therapy"@en . "Electric stimulation therapy"@en . "Effects of Electrical Stimulation, Exercise Training & Motor Skills Training on Strength for Children with Meningomyelocele"@en . "Text"@en . "Sound"@en . "http://hdl.handle.net/2429/132"@en .