Study and participant characteristics
| Authors | Study type | Study design | Study design specified | N | Age | Gender (male), n (%) | Disease-specific characteristics | Parents’ characteristics |
| James et al23 (CA), 59 | F | Generic qualitative research design (part of large RCT). Interview study. | 10 | M: 11 years 4 months (SD 2 years 6 months) | 5 (50.0) | Spastic: 10 (100%)* Hemiplegia: 10 (100%) MACS: I: 3 (30.0%) II: 7 (70.0%)* | Gender: 1 male (10.0%)* | |
| McBurney et al61 | F | Qualitative study (embedded in an RCT). | 11 | M: 12 years 9 months (SD 2 years 10 months) | 4 (36.4)* | Spastic: 11 (100%)* Diplegia: 11 (100%)* GMFCS: I: 2 (18.2%) II: 2 (18.2%) III: 7 (63.6%)* | Gender: 3 male (23.1%)* | |
| Novak et al24 (CA), 11 | F | Qualitative study (embedded in an RCT). | 8 | Mdn: 6.5 years (range 5 years 5 months–12 years 8 months)* | 5 (62.5)* | Spastic: 6 (75.0%) Ataxic: 1 (12.5%) Athetosis: 1 (12.5%)* Hemiplegia: 1 (12.5%) Bilateral: 5 (62.5%) Unknown: 2 (25.0%)* | Gender: 2 male (20.0%)* | |
| Taylor et al70 | F | Qualitative research design using indepth interviews, embedded in an RCT. | 11 | M: 12.7 years (SD 2.8 years) | 4 (36.4)* | Spastic: 11 (100%)* Diplegia: 11 (100%)* GMFCS: I: 2 (18.2%) II: 2 (18.2%) III: 7 (63.6%)* | Gender: 3 male (23.1%)* | |
| Law and King15 | F | Feasibility study, embedded in a clinical trial. | 72 | Range 18 months–8 years | Spastic: 72 (100%)* | |||
| Lorentzen et al60 | F | Non-randomised controlled clinical study, including a feasibility component. | 46 | M: 11 years (SD 2.6 years)* | 30 (65.2)* | Spastic: 42 (91.3%) Ataxic: 4 (8.7%)* Hemiplegia: 38 (82.6%) Bilateral: 4 (8.7%) Unknown: 4 (8.7%)* MACS: I: 28 (60.9%) II: 18 (39.1%)* GMFCS: I: 44 (95.7%) II: 2 (4.3%)* | ||
| Psychouli and Kennedy65 | F | Uncontrolled clinical trial, using an A1-B-C-A2 design, with a feasibility component. | 9 | M: 6 years 9 months (range 5 years 1 months–11 years) | 6 (66.7)* | Spastic: 9 (100%)* Hemiplegia: 9 (100%)* | ||
| Ahl et al53 | F | Pilot study with feasibility component. | 14 | Mdn: 3 years 8 months (range 1 year 6 months–6 years)* | 11 (78.6)* | Spastic: 14 (100%) Diplegia: 12 (85.7%) Quadriplegia: 2 (14.3%)* GMFCS: II: 1 (7.1%) III: 8 (57.1%) IV: 3 (21.4%) V: 2 (14.3%)* | ||
| Novak et al14 | F | Pilot study (single-group, pretest–post-test design) with a feasibility component. | 20 | M: 3.8 years (range 2–7 years) | 16 (80)* | Spastic: 20 (100%)* | ||
| Bilde et al71 | F | Pilot study including feasibility components. | 9 | M: 10 years 3 months | 5 (55.6)* | Spastic: 9 (100%)* MACS: I: 4 (44.4%) II: 5 (55.6%)* GMFCS: I: 8 (88.9%) II: 1 (11.1%)* | ||
| Boyd et al25 (CA) | F | Pre–post pilot study including a feasibility component. | 9 | Range 9–13 years | Spastic: 9 (100%)* Hemiplegia: 9 (100%)* | |||
| McCoy et al29 (CA) | F | Pilot project. | 4 | Range 9–14 years | 3 (75)* | Spastic: 4 (100%)* Hemiplegia: 4 (100%)* MACS: I: 2 (50%) III: 2 (50%)* | ||
| Farr et al99 | F | Two-group, parallel feasibility trial. | 30 | |||||
| Shierk et al108 | F | Evaluated through a trial. | 65 | |||||
| Liu et al49 (CA) | F | Single-group, pre–post intervention trial. | 15 | M: 94.2 months (SD 27.5 months) | Hemiplegia: 15 (100%)* | |||
| Ferre et al22 (CA), 56 | F | Single-group design. | 11 | Mdn: 45 months (range 29–54 months)* | 6 (54.5) | Spastic: 11 (100%) Hemiplegia: 11 (100%) MACS: I: 2 (18.2%) II: 5 (45.5%) III: 3 (27.3%) IV: 1 (9.1%)* | ||
| Chiu et al98 | F | Single-group, pre–post intervention group. | 20 | M: 8.7 years (SD 2.4 years) | 11 (55)* | Hemiplegia: 8 (40%) Diplegia: 10 (50%) Quadriplegia: 2 (10%)* MACS: I and II: 17 (85%) III: 3 (15%)* GMFCS: I and II: 17 (85%) III: 3 (15%)* | ||
| Visser et al106 | F | Within-subjects, repeated-measures design. | 10 | Mdn: 14 years 3 months (range 6 years 2 months–16 years 6 months)* | Spastic: 9 (90%) Ataxic: 1 (10%)* Diplegia: 5 (50%) Triplegia: 3 (30%) Quadriplegia: 1 (10%) Unknown: 1 (10%)* MACS: I: 5 (50%) II: 4 (40%) III: 1 (10%)* GMFCS: II: 5 (50%) III: 5 (50%)* CFCS: I: 7 (70%) II: 1 (10%) III: 1 (10%) IV: 1 (10%)* | |||
| Fehlings et al27 (CA) | F | Prospective intervention study design (case series), including a feasibility component. | 15 | M: 8.8 years (SD 2.3 years) | Spastic: 15 (100%)* Hemiplegia: 15 (100%)* | |||
| Kenyon et al105 | F | Case series. | 3 | Mdn: 5 years 11 months (range 5 years 6 months–14 years 10 months)* | 3 (100) | Spastic: 3 (100%)* Diplegia: 1 (33.3%) Triplegia: 1 (33.3%) Quadriplegia: 1 (33.3%)* MACS: I: 1 (33.3%) III: 1 (33.3%) IV: 1 (33.3%)* GMFCS: III: 1 (33.3%) IV: 2 (66.6%)* CFCS: I: 1 (33.3%) IV: 2 (66.6%)* | ||
| Fergus et al55 | F | Case report with feasibility component. | 1 | 13 months | 1 female | Spastic: 1 (100%)* Hemiplegia: 1 (100%) | Educational level: postgraduate | |
| Reifenberg et al107 | F | Case report. | 1 | 5 years | 1 (100) | Spastic: 1 (100%) Hemiplegia: 1 (100%) | Gender: 1 female | |
| Hernandez Alvarado102 | F | Prospective case study with a single experimental group. | 5 | M: 15 years | 4 (80)* | MACS: I: 3 (60%) II: 2 (40%)* GMFCS: III: 5 (100%)* | ||
| Jaber et al47 (CA) | F | Mixed methods. | 15 | I: Mdn: 100 months* | 11 (73.3) | |||
| Basaran et al54 | F | Adherence survey study (cross-sectional). | 147 | Range 2.5–18.0 years | 83 (56.5)* | Spastic: 143 (97.3%) Unspecified: 4 (2.7%)* Hemiplegia: 39 (26.5%) Diplegia: 54 (36.7%) Quadriplegia: 50 (34%) Unspecified: 4 (2.7%)* GMFCS: I: 37 (25.2%) II: 21 (14.3%) III: 32 (21.8%) IV: 24 (16.3%) V: 33 (22.4%)* | Age: range 20–57 years Gender: 3 male (2.1%)* Educational level: Illiterate: 8 (5.4%) Literate: 3 (2.0%) Primary school: 68 (58.5%) Secondary school: 23 (15.6) High school: 23 (15.6%) University: 4 (2.7%)* | |
| Halvarsson et al57 | F | Qualitative study. | 15 | Range 3–19 years | GMFCS: II: 3 (30.0%) III: 3 (30.0%) IV: 4 (40.0%) | Gender: 5 male (33.3%)* | ||
| Hinojosa and Anderson58 | F | Qualitative study. | 9 | Mdn: 3 years (range 2–5 years)* | 5 (55.6) | Spastic: 8 (88.9%) Unspecified: 1 (11.1%) Hemiplegia: 1 (11.1%) Diplegia: 2 (22.2%) Quadriplegia: 5 (55.6%) Unspecified: 1 (11.1%) | Gender: 8 female | |
| Peplow and Carpenter62 | F | Qualitative research design (with constructivist approach). | 4 | Gender: 1 male (25%)* | ||||
| Piggot et al63 | F | Qualitative research project. | 7 | Range 2–10 years | Hemiplegia: 2 (28.6%) Quadriplegia: 5 (71.4%)* | Age: range mid-20s to late 30s Gender: 1 male (12.5%)* | ||
| Piggot et al64 | F | Grounded theory study. | ||||||
| Ross and Thomson66 | F | Questionnaire study. | 23 | M: 27.6 months | 11 (47.8)* | |||
| Sandlund et al67 | F | Qualitative study. | 15 | M: 11 years (range 6–16 years) | 8 (53.3)* | Gender: 6 male (31.6%)* | ||
| Gerhardy and Sandelance28 (CA) | F | A needs analysis was undertaken using semistructured interviews. | 17 | Range 2–7 years | ||||
| Finet101 | F | Qualitative, phenomenological methodological design. | 9 | Range 1–12 years | Age: range 32–53 years Gender: 1 male (11.1%)* Educational level: Some college: 1 (11.1%) High school: 2 (22.2%) Bachelor’s degree: 5 (55.5%) Associate’s degree: 1 (11.1%)* | |||
| Sel et al50 (CA) | F | Questionnaire study. | 118 | |||||
| Sandlund et al68 | F | 14 | M: 10 years 11 months (range 6–16 years) | 8 (57.1)* | Spastic: 12 (85.7%) Dyskinetic: 1 (7.1%) Ataxic: 1 (7.1%)* Hemiplegia: 7 (50.0%) Bilateral: 5 (35.7%) Unknown: 2 (14.3%)* MACS: I: 7 (50.0%) II: 5 (35.7%) III: 1 (7.1%) IV: 1 (7.1%)* GMFCS: I: 10 (71.4%) II: 2 (14.3%) III: 2 (14.3%)* | |||
| Sevick et al69 | F | 4 | Mdn: 13.5 years (range 8–17 years)* | 2 (50.0)* | Spastic: 4 (100%)* Hemiplegia: 4 (100%)* MACS: II: 4 (100%)* GMFCS: I: 4 (100%)* | |||
| Dizmek et al26 (CA) | F | |||||||
| Pasquet et al30 (CA) | F | 28 | M: 11.9 years (SD 2.7 years) | Spastic: 28 (100%)* Hemiplegia: 28 (100%)* | ||||
| Sisman Isik et al51 (CA) | F | 63 | 36 (57)* | GMFCS: I–III: 61.9% IV–V: 38.1% | ||||
| James et al31 (CA), 32 (CA), 76 | BEF | Large RCT (with narrow CI level I). | Matched-pairs waitlist control RCT. | 102 | I: M: 11 years 8 months (SD 2 years 4 months) | 51 (50.5)* | Spastic: 102 (100%) Hemiplegia: 102 (100%) MACS: I: 24 (23.8%) II: 76 (75.2%) III: 1 (1.0%)* GMFCS: I: 45 (44.6%) II: 56 (55.4%)* | |
| Hoare et al75 | BEF | Smaller RCT (with wider CI level II). | Randomised, controlled, evaluator-blinded trial. | 35 | M: 35.8 months (SD 15.8 months) | 20 (58.8)* | Spastic: 35 (100%) Hemiplegia: 35 (100%) | |
| Kirkpatrick et al77 | BEF | Smaller RCT (with wider CI level II). | Single-centre, single-blinded (outcomes assessor), parallel-group RCT with 1:1 allocation. | 70 | M: 5.6 years (SD 2.1 years) | 39 (55.7)* | Spastic: 70 (100%)* Hemiplegia: 70 (100%) | |
| Gordon et al85 | BEF | Smaller RCT (with wider CI level II). | RCT including a feasibility component. | 44 | I: M: 6 years 3 months (SD 2 years 2 months) | 20 (47.6)* | Spastic: 44 (100%)* Hemiplegia: 44 (100%) MACS: I: 5 (11.9%) II: 35 (83.3%) III: 2 (4.8%)* | |
| Wallen et al 33 (CA), 86 | BEF | Smaller RCT (with wider CI level II). | Pragmatic, randomised, assessor-blinded trial, including a feasibility component. | 50 | M: 48.6 months (SD 21.0 months) | 27 (54.0)* | Spastic: 50 (100%)* Hemiplegia: 50 (100%) MACS: I: 2 (4%) II: 37 (77%) III: 8 (17%) IV: 1 (2%) GMFCS: I: 33 (67%) II: 15 (31%) III: 1 (2%) | |
| Al-Oraibi and Eliasson72 | BEF | Smaller RCT (with wider CI level II). | 20 | I: M: 47 months (SD 19 months) | 10 (71.4)* | Spastic: 14 (100%)* Hemiplegia: 14 (100%) | Educational level: Diploma: 3 (21.4%) Below high school: 3 (21.4%) High school: 7 (50.0%) Bachelor: 1 (7.1%)* | |
| Eugster-Buesch et al73 | BEF | Smaller RCT (with wider CI level II). | Randomised, controlled, single-blinded pilot study including feasibility components. | 23 | I: M: 9.8 years (SD 3.5 years) | 12 (52.2)* | Spastic: 23 (100%)* Hemiplegia: 23 (100%) GMFCS: I: 20 (87.0%) II: 3 (13.0%)* | |
| Hsin et al74 | BEF | Smaller RCT (with wider CI level II). | 12 | I: M: 6.9 years (SD 0.6 years) | 10 (45.5)* | Spastic: 23 (100%) Hemiplegia: 23 (100%) | ||
| Klingels et al78 | BEF | Smaller RCT (with wider CI level II). | Randomised, controlled and evaluator-blinded trial including a feasibility component. | 51 | M: 8 years 9 months (SD 2 years 2 months) | 28 (54.9)* | Spastic: 51 (100%)* Hemiplegia: 51 (100%)* MACS: I: 4 (7.8%) II: 38 (74.5%) III: 9 (17.6%)* | |
| Lin et al79 | BEF | Smaller RCT (with wider CI level II). | RCT with feasibility component. | 22 | I: M: 76.7 months (SD 26.2 months) | 12 (57.1)* | Hemiplegia: 11 (52.4%) Quadriplegia: 10 (47.6%)* | |
| Novak et al81 | BEF | Smaller RCT (with wider CI level II). | Double-blind RCT with a feasibility component. | 36 | M: 7.75 years (SD 2.02 years) | 25 (69.4)* | Spastic: 30 (83.3%) Dyskinetic: 3 (8.3%) Ataxic: 1 (2.8%) Athetosis: 2 (5.6%)* Hemiplegia: 14 (38.9%) Diplegia: 14 (38.9%) Quadriplegia: 2 (5.6%) Unknown: 6 (16.7%)* MACS: I: 17 (47.2%) II: 9 (25.0%) III: 2 (5.6%) IV: 5 (13.9%) V: 3 (8.3%)* GMFCS: I: 17 (47.2%) II: 5 (13.9%) III: 6 (16.7%) IV: 2 (5.6%) V: 6 (16.7%)* | |
| Preston et al82 | BEF | Smaller RCT (with wider CI level II). | Pilot, single-blind, multicentre RCT, with a feasibility component. | 16 | M: 9 years 2 months (SD 2 years 5 months) | 9 (60.0)* | Hemiplegia: 14 (93.3%) Bilateral: 1 (6.7%)* MACS: II: 3 (20.0%) III: 5 (33.3%) IV: 7 (46.7%)* | |
| Sakzewski et al83 | BEF | Smaller RCT (with wider CI level II). | Pragmatic, single-blind, matched-pairs RCT. | 53 | M: 7 years 10 months (SD 2 years 4 months) | 32 (68.1)* | Spastic: 53 (100%)* Hemiplegia: 46 (97.9%) Unknown: 1 (2.1%)* MACS: I: 24 (51.1%) II: 23 (48.9%)* GMFCS: I: 34 (72.3%) II: 13 (27.7%)* | |
| Charles et al84 | BEF | Smaller RCT (with wider CI level II). | Single-blinded RCT, including a feasibility component. | 33 | M: 6 years 8 months (SD 1 year 4 months) | 14 (63.6)* | Spastic: 33 (100%)* Hemiplegia: 33 (100%) | |
| Chamudot et al44 (CA), 97 | BEF | Smaller RCT (with wider CI level II). | RCT including a feasibility component. | 36 | M corrected age 11.1 months (SD 2.2 months) | 19 (58)* | Spastic: 33 (100%)* Hemiplegia: 33 (100%)* | |
| Ferre et al100 110 | BEF | Smaller RCT (with wider CI level II). | Randomised trial including a feasibility component. | 40 | I: M: 5.2 years (SD 2.7 years) | 10 (41.7)* | Spastic: 24 (100%)* Hemiplegia: 24 (100%)* MACS: I: 5 (20.8%) II: 19 (79.2%)* | |
| Fischer et al45 (CA) | BEF | Smaller RCT (with wider CI level II). | Multisite RCT using a factorial design, including a feasibility component. | 55 | ||||
| Hobbs et al46 (CA) | BEF | Smaller RCT (with wider CI level II). | Pilot RCT. | 18 | M: 10 years 8 months (SD 3 years 4 months) | 12 (66.7)* | Hemiplegia: 13 (72.2%) Diplegia: 5 (27.8%)* MACS: I: 2 (11.1%) II: 10 (55.6%) III: 3 (16.7%) IV: 3 (16.7%)* | |
| Hughes et al103 | BEF | Smaller RCT (with wider CI level II). | Non-blinded, randomised intervention study. | 28 | Range 18–68 months | 17 (60.7)* | Educational level: 12 years of schooling or less | |
| Kassee et al104 | BEF | Smaller RCT (with wider CI level II). | Pilot study employing pretest, post-test experimental design. | 6 | Mdn: 9 years (range 7–12 years)* | 6 (100)* | Spastic: 6 (100%)* Hemiplegia: 6 (100%)* MACS: I: 2 (33.3%) II: 4 (66.7%)* | |
| Law et al109 | BEF | Smaller RCT (with wider CI level II). | Two-by-two factorial design. | 79 | 28 (39)* | Spastic: 72 (100%)* Hemiplegia: 28 (39%) Quadriplegia: 44 (61%)* | ||
| Liang et al48 (CA) | BEF | Smaller RCT (with wider CI level II). | Randomised trial. | 30 | ||||
| Hobbs et al52 (CA) | BEF | Smaller RCT (with wider CI level II). | RCT. | 18 | M: 10 years 8 months (SD 3 years 4 months) | 12 (66.7) | Hemiplegia: 13 (72.2%) Diplegia: 5 (27.8%)* MACS: I: 2 (11.1%) II: 10 (55.6%) III: 3 (16.7%) IV: 3 (16.7%)* | |
| Lowes et al80 | BEF | Pretest–post-test cohort design, with the participants serving as their own controls, including a feasibility component. | 7 | Mdn: 11.4 months (range 7.1–16.1 months)* | 3 (42.9)* | Spastic: 7 (100%)* Hemiplegia: 7 (100%)* | ||
| Facchin et al95 | E | Large RCT (with narrow CI level I). | Multicentre, prospective, cluster-randomised controlled clinical trial. | 105 | 53 (50.5)* | Spastic: 105 (100%)* Hemiplegia: 105 (100%) | ||
| Chen et al87 | E | Smaller RCT (with wider CI level II). | Single-blinded RCT. | 48 | I: M: 8.73 years (SD 1.9 years) | 21 (46.7)* | Spastic: 45 (100%) Hemiplegia: 45 (100%) | |
| Chiu et al34 (CA), 88 | E | Smaller RCT (with wider CI level II). | Prospective, single-blind, randomised trial. | 62 | I: M: 9.4 years (SD 1.9 years) | 28 (45.2)* | Spastic: 62 (100%) Hemiplegia: 62 (100%) MACS: I–III: 42 (67.7%) IV–V: 20 (32.3%)* GMFCS: I–III: 52 (83.9%) IV–V: 10 (16.1%)* | |
| Kim et al90 | E | Smaller RCT (with wider CI level II). | 19 | I: M: 9.1 years (SD 1.8 years) | 10 (52.6)* | Hemiplegia: 10 (52.6%) Quadriplegia: 9 (47.4%)* | ||
| Xu et al92 | E | Smaller RCT (with wider CI level II). | Single-blinded RCT. | 75 | I: M: 56.8 months (SD 34.0 months) | E: 25 (36.8)* | Spastic: 75 (100%)* Hemiplegia: 75 (100%)* MACS: I: 10 (14.7%) II: 49 (72.1%) III: 9 (13.2%) GMFCS: I: 60 (88.2%) II: 8 (11.8%) | |
| Abd El-Kafy et al93 | E | Smaller RCT (with wider CI level II). | 30 | I: M: 6.0 years (SD 1.7 years) | 12 (44.4)* | Spastic: 30 (100%)* Hemiplegia: 30 (100%) MACS: II: 11 (40.7%) III: 9 (33.3%) IV: 7 (25.9%)* | ||
| Bagley et al35 (CA) | E | Smaller RCT (with wider CI level II). | Prospective RCT with patient preference. | 38 | Range 5–15 years | Spastic: 38 (100%)* Hemiplegia: 38 (100%)* | ||
| Hoare et al36 37 (CA) | E | Smaller RCT (with wider CI level II). | Randomised, controlled, assessor-blinded trial. | 34 | M: 3 years (SD 1 year 4 months) | 20 (58.8)* | Spastic: 34 (100%)* Hemiplegia: 34 (100%)* | |
| Klingels et al38 (CA) | E | Smaller RCT (with wider CI level II). | 51 | M: 8 years 9 months | Spastic: 51 (100%)* Hemiplegia: 51 (100%)* | |||
| Koseotlu et al39 (CA) | E | Smaller RCT (with wider CI level II). | 32 | Spastic: 32 (100%)* Hemiplegia: 32 (100%)* | ||||
| Novak et al40 41 (CA) | E | Smaller RCT (with wider CI level II). | Double-blind RCT. | 36 | ||||
| Sakzewski et al42 43 (CA) | E | Smaller RCT (with wider CI level II). | Single-blind, matched-pairs, randomised comparison trial. | 48 | M: 7.9 years (SD 2.3 years) | 33 (68.8)* | Spastic: 48 (100%)* Hemiplegia: 48 (100%)* MACS: I: 25 (52.1%) II: 23 (47.9%)* | |
| Crocker et al89 | E | Single-subject design study (level IV). | Single-subject, ABA experimental design. | 2 | 2 years and 3 years | 1 male and 1 female | Spastic: 2 (100%)* Hemiplegia: 2 (100%) | |
| Naylor and Bower91 | E | Single-subject design study (level IV). | Single-case, A–B–A experimental design. | 9 | Mdn: 31 months (range 21–61 months)* | 6 (66.7)* | Spastic: 9 (100%)* Hemiplegia: 9 (100%)* | |
| Coker et al94 | E | Single-subject design study (level IV). | Single-subject ABAB design with a 6-month follow-up evaluation. | 1 | 5 months | 1 (100) | Spastic: 1 (100%)* Hemiplegia: 1 (100%) | |
| Gross et al96 | E | Single-subject design study (level III). | Multiple-baseline, across-subjects design (A-B + follow up). | 3 | Mdn: 3 years 8 months (range 2 years 9 months–3 years 8 months)* | 2 (66.7) | Spastic: 2 (66.7%) Mixed: 1 (33.0%)* Hemiplegia: 1 (33.3%) Quadriplegia: 1 (33.3%) Unspecified: 1 (33.3%)* |
*Numbers and percentages were calculated by the authors of this review.
BEF, both efficacy/effectiveness; CA, conference abstract; CFCS, Communication Function Classification System; E, efficacy/effectiveness study; F, feasibility study; GMFCS, Gross Motor Function Classification System; I, intervention group; M, mean; MACS, Manual Ability Classification System; Mdn, median; RCT, randomised controlled trial.