Perspectives on postural control dysfunction to inform future research: A Delphi study for children with cerebral palsy

Publication date: Available online 26 August 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Rosalee Dewar, Andrew P. Claus, Kylie Tucker, Leanne Marie Johnston
ObjectiveTo identify if consensus can be achieved in how clinicians and researchers define, describe, assess and treat postural control dysfunction in children with cerebral palsy (CP).DesignDelphi study with 3 iterative rounds.SettingElectronic surveyParticipants43 researchers and/or clinicians from 7 countries with a mean(SD) of 20(11) years experience working with children with cerebral palsy (CP) participated. Participants included authors of published works on postural control in CP (identified from a recent systematic review), members of the Australasian CP and Developmental Medicine Academy and two major Australian rehabilitation providers.InterventionNot applicable.Main Outcome measuresThe Delphi study consisted of 3 iterative rounds of surveys. In Round-I, respondents answered open-ended questions regarding their views on: i) definition items for postural control, ii) theoretical frameworks, iii) methods for assessment, and iv) interventions for postural control dysfunction in children with CP. Round II and III were made up of items generated by participants in Round-I and combined with items identified from the literature. Participants indicated their level of agreement for each item on a 7-point Likert scale. Threshold for consensus was ≥85% agreement.ResultsOf 306 items generated, 174 items reached consensus by Round-III. Most postural control Definition items (90%) achieved consensus. Two theoretical Frameworks reached consensus (14%). Less than half (42%) of Assessment items reached consensus. More individual assessment items (89%) reached consensus than multi-item tools (4%). Just over half (61%) of the items generated for interventions reached consensus.ConclusionConsensus was achieved for a postural control definition. However, substantial research is needed to establish a comprehensive, postural control specific framework and suite of assessments. These would provide a foundation to improve intervention selection and dosage.



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