Thursday, 9 February 2017

'CE RESEARCH'

Some sound sense

Extracts from Appendix 8, 'External peer review – interpretation', of the recently published New Zealand research review –

The core conclusions, that CE is insufficiently supported by research evidence because of the negative findings of higher quality studies; the limited number of high quality studies, and the wide variation in the description of CE are well supported by the research evidence presented here. The consistency of finding of this and the previous ACC report, and the high quality published systematic reviews add weight to these conclusions. However, based on my wider clinical and research expertise, I would add a number of caveats to these conclusions in order to add context to them.

...while the evidence for CE is negative or untrustworthy in these studies, several of the studies describe components of best practice paediatric rehabilitation (or therapy), namely, child/parent education and tailored, context and task specific intervention as part of CE.... This description reflects what would be expected of any evidence-based rehabilitation service... I suggest that the studies on the effect of CE are interpreted in this context.

The greatest barrier in advancing research into CE is the absence of a clear description of it.

...If lack of generalisation [of CE studies] were a reason to not fund CE then this is equally true of any other intervention for this population I can think of.

... a criticism of a lack of follow up was made. I am not aware of any longitudinal study that evaluated the long term effects of a specific rehabilitation intervention... To not fund any intervention on the basis of the absence of this information is ethically questionable for a population that the information cannot be obtained for.

...the conclusion of this review that the lack of change in non-practiced tasks, is equally true of any paediatric rehabilitation intervention...

CE research has tended to target Impairments in motor functions, and discrete Activities rather than enhanced Participation in valued life roles, despite the dominant interest of consumers and families in the long term, being maximal participation in valued life roles...

It is the nature of such external peer reviews that they should be published anonymously. There is plenty for people in Conductive Education in general to consider here in making their eternal case against 'CE research' – and in wondering what studies of their own they might consider. As far specifically as those in New Zealand are concerned, it looks like they could find sound counsel close to home.

Previous posting on this review


Reference

Anon (2017) External peer review – interpretation, Appendix 8 of M. Barry. Evidence update: Conductive Education in children with cerebral palsy, pp. 39-40, Accident Compensation Corporation, August

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