Sistemas de control postural durante el sueño para los niños con parálisis cerebral
Información
- DOI:
- https://doi.org/10.1002/14651858.CD009257.pub2Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 02 noviembre 2015see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Problemas de desarrollo, psicosociales y de aprendizaje
- Copyright:
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- Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Sharon F Blake co‐ordinated the review, undertook searches, screened search results, organised retrieval of papers, wrote to authors and manufacturers, screened and appraised papers, extracted data, entered data into RevMan software, and wrote the first draft.
Stuart Logan conceptualised the review, provided clinical and policy perspective, and contributed to writing of the review.
Ginny Humphreys conceptualised and designed the review, provided clinical perspective, and edited the draft.
Justin Matthews analysed the data and contributed to writing of the review.
Morwenna Rogers designed the search strategy, undertook searches, organised retrieval of papers, screened search results, extracted data, and edited the draft.
Joanna Thompson‐Coon provided methodological perspective, resolved disagreements during screening, and contributed to writing of the review.
Katrina Wyatt conceptualised, designed, and contributed to writing of the review.
Christopher Morris designed and managed the methodology and conduct of the review, screened search results, screened and appraised papers, extracted data, and contributed to writing of the review.
Sources of support
Internal sources
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No sources of support supplied
External sources
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National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon and Exeter NHS Foundation Trust (PenCLAHRC), UK.
Staff time and other resources for the review.
The views expressed are those of the authors and not necessarily those of the NIHR, National Health Service, or the Department of Health.
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Cerebra, UK.
Staff time and other resources for the review.
The views expressed are those of the authors and not necessarily those of Cerebra.
Declarations of interest
This review benefited from support from National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care of the South West Peninsula (PenCLAHRC) and the charity Cerebra. They had no influence on the conduct or reporting of the work. The views and opinions expressed in this paper are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health, or Cerebra.
Stuart Logan, Ginny Humphreys, Morwenna Rogers, Joanna Thompson‐Coon, Katrina Wyatt and Christopher Morris are or have been chief or co‐investigators on NIHR grants and/or grants from other funding agencies unrelated to this review, unless otherwise declared.
Sharon F Blake‐ none known.
Stuart Logan ‐ none known.
Ginny Humphreys is the author of an excluded study Humphreys 2012. She has not been involved in the assessment of eligibility, risk of bias, and data extraction for this review. Ginny Humphreys and Christopher Morris are co‐investigators for a pilot randomised controlled trial (RCT) evaluating sleep positioning systems for the same population UKCRN ID 10914 which is an ongoing study. Two independent authors, Sharon Blake and Morwenna Rogers, assessed the eligibility of this study and found that it would meet the criteria for inclusion. No data were available at the time of writing. When data become available, the author team will ensure that the 'Risk of bias' assessment and data extraction will be carried out by independent authors who have not been involved in this study.
Justin Matthews ‐ none known.
Morwenna Rogers ‐ none known.
Joanna Thompson‐Coon ‐ none known.
Katrina Wyatt ‐ none known.
Christopher Morris declares that none of his declared potential conflicts of interest have knowingly biased the work he has done on this Cochrane review.
Acknowledgements
This review benefited from support from National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care of the South West Peninsula (PenCLAHRC) and the charity Cerebra. The views and opinions expressed in this paper are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health, or Cerebra. We are grateful to parent carers from the PenCRU Family Faculty who advised this review (see Public Involvement section in Objectives), and also to Claire Lloyd, Camilla McHugh, Sally Parker, Donna Beswick, and Mark Beswick who authored the protocol for this review. We thank Astrid Janssens for translating two of the articles retrieved, and the editors and peer reviewers of the Cochrane Developmental, Psychosocial and Learning Problems Group for their guidance and support.
Version history
| Published | Title | Stage | Authors | Version |
| 2015 Nov 02 | Sleep positioning systems for children with cerebral palsy | Review | Sharon F Blake, Stuart Logan, Ginny Humphreys, Justin Matthews, Morwenna Rogers, Joanna Thompson‐Coon, Katrina Wyatt, Christopher Morris | |
| 2011 Jul 06 | Sleep positioning for children with cerebral palsy | Protocol | Claire Lloyd, Stuart Logan, Camilla McHugh, Ginny Humphreys, Sallie Parker, Donna Beswick, Mark Beswick, Morwenna Rogers, Joanna Thompson‐Coon, Christopher Morris, Katrina Wyatt | |
Differences between protocol and review
We updated our search strategy in 2014 to include different spellings of moonlite/moonlight and to include databases recommended by the Cochrane Review Group (trial registers, Conference Proceedings Citation Index and WorldCat Dissertations).
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Adolescent; Child; Child, Preschool; Humans;
PICO
Study flow diagram
Risk of bias summary: Review authors' judgements about each risk of bias item for each included study.
| Sleeping in a sleep positioning system compared with not sleeping in a sleep positioning system for children with cerebral palsy | |||
| Population: Children with cerebral palsy Settings: United Kingdom (at home or in paediatric research laboratory) Intervention: Sleeping in sleep positioning system Comparison: Not sleeping in sleep positioning system | |||
| Outcomes | Impact | Number of participants | Quality of the evidence |
| Reduce hip migration/hip problems | No RCTs measured effect of sleep positioning systems on hip migration/hip problems | ‐ | ‐ |
| Effect on sleep patterns and quality | Limited data. A small number of established users of sleep positioning systems showed no significant difference in sleep quality indicators | 21 | ⊕⊝⊝⊝ |
| Effect on quality of life of child and family | No RCTs measured effect of sleep positioning systems on child and family quality of life | ‐ | ‐ |
| Effect on pain | Limited data. A small number of established users of sleep positioning systems showed no significant difference in levels of pain | 10 (1 study) | ⊕⊝⊝⊝ |
| Effect on physical functioning | No RCTs measured effect of sleep positioning systems on physical functioning | ‐ | ‐ |
| Adverse effects | No RCTs measured harms or reported adverse events | ‐ | ‐ |
| GRADE Working Group grades of evidence | |||
| GRADE: Grades of Recommendation, Assessment, Development and Evaluation. | |||
| Outcome | Variable | Definition | Study ID | Number of participants | Sleeping in sleep positioning system Mean (SD) | Sleeping out of sleep positioning system Mean (SD) | Mean difference (95% CI) | Paired t‐test | |
| t value | P value | ||||||||
| Sleep patterns/sleep quality | Sleep latency | Time (in minutes) to fall asleep | 9* | 69.1† (52.6) | 32.9 (26.0) | 36.2 (‐1.12 to 73.45) | 2.24 | 0.06 | |
| 8£ | 64.1 (54.0) | 37.0 (24.5) | 27.1 (‐8.76 to 62.89) | 1.79 | 0.12 | ||||
| 9 | 68.8 (49.8) | 80.1 (48.1) | ‐11.3 (‐30.70 to 8.03) | ‐1.35 | 0.21 | ||||
| Sleep efficiency | % of time in bed actually asleep | 9 | 80.7 (15.4) | 83.1 (12.0) | ‐2.4 (‐11.77 to 7.04) | ‐0.58 | 0.58 | ||
| 10 | 76.2 (8.3) | 73.8 (11.1) | 2.4 (‐2.98 to 7.73) | 1.00 | 0.34 | ||||
| Pain | Pain | Paediatric Pain Profile (PPP) scale (parent‐reported scores) | 10 | 11.3 (12.1) | 13.0 (14.6) | ‐1.7 (‐4.88 to 0.15) | ‐1.68 | 0.13 | |
| CI: Confidence intervals; ID: Identifier; SD: Standard Deviation | |||||||||
| * Includes one participant who fell asleep before recording started (recorded as zero), as reported by Hill 2009. | |||||||||
| Study | Variable of sleep quality | Number of participants | Sleeping in sleep positioning systems Mean (SD) | Sleeping out of sleep positioning system Mean (SD) | Sleeping in sleep positioning system Median (IQR) | Sleeping out of sleep positioning system Median (IQR) |
| Total sleep time (in minutes)¹ | 10 | 517.1 (54.4) | 509.1 (72.5) | 511.5 (52.5) | 527.5 (117.5) | |
| Total sleep time (in minutes) | 9 | 349.9 (101.1) | 427.7 (55.0) | 412.5 (143.5)* | 421.0 (89.0)* | |
| Total sleep time that was S1^ (%) | 9 | 2.4 (2.2) | 3.2 (2.4) | 1.7 (1.1)* | 3.6 (3.5)* | |
| Total sleep time that was S4^ (%) | 9 | 33.3 (10.6) | 29.0 (10.6) | 29.2 (11.3) | 28.0 (7.5) | |
| Total sleep time that was S3^ (%) | 9 | 6.4 (1.7) | 6.2 (2.4) | 6.3 (2.2) | 5.5 (3.8) | |
| Total sleep time that was S2^ (%) | 9 | 46.4 (10.0) | 50.5 (11.0) | 48.7 (11.3) | 49.7 (10.8) | |
| REM onset latency (in minutes) | 9 | 159.0 (99.4) | 204.3 (122.4) | 190.0 (18.0) | 187.0 (65.0) | |
| Number of REM cycles | 9 | 3.3 (0.9) | 2.9 (1.1) | 4.0 (1.0)* | 2.0 (2.0) | |
| Total sleep time that was REM^ (%) | 9 | 11.5 (5.1) | 11.0 (4.6) | 10.7 (1.4) | 11.1 (3.9) | |
| Total arousal index | 9 | 11.5 (6.5) | 11.4 (5.0) | 8.5 (6.0)* | 10.8 (8.2)* | |
| Central Apnoea Index (CAI) | 9 | 3.0 (8.0) | 4.0 (9.9) | 0.4 (0.4)* | 0.6 (0.9)* | |
| Respiratory Arousal Index (RAI) | 9 | 2.2 (3.7) | 1.5 (2.5) | 1.4 (1.9)* | 0.6 (1.4)* | |
| Apnoea ‐ Hypopnoea Index (AHI) | 9 | 1.9 (1.8) | 0.9 (1.2) | 2.6 (3.0) | 0.4 (1.5)* | |
| Obstructive Apnoea Index (OAI) | 9 | 0.5 (0.6) | 0.4 (0.9) | 0.3 (0.8)* | 0.1 (0.3)* | |
| % total sleep time with SpO₂ > 95% | 9 | 80.5 (29.0) | 77.2 (28.1) | 98.0 (19.9)* | 87.8 (12.6)* | |
| Average (mean) SpO₂ over total time | 9 | 95.7 (0.9) | 96.2 (1.9) | 95.0 (1.0)* | 97.0 (2.0)* | |
| Minimum SpO₂ (Nidus value) | 9 | 92.7 (1.7) | 90.6 (3.0) | 92.0 (1.0)* | 91.0 (3.0)* | |
| IQR: Interquartile range; REM: Rapid eye movement; SD: Standard deviation; SpO₂: Peripheral capillary oxygen saturation | ||||||
| ¹ Originally reported in hours and minutes, here given as minutes to be comparable. ^S1, S2, S3, S4 refer to the different stages of sleep; stages one to four. All values in this table are calculated from data supplied by study authors. For results from Hill 2009, some discrepancies were found between our calculations and the original publication. These are highlighted with an asterisk (*). | ||||||
