Report: Treatment Decisions in Cerebral Palsy

Report: Treatment Decisions in Cerebral Palsy

November 12-13, 2014
National Institutes of Health, Rockville, MD
Sponsors: National Institute of Neurological Disorders and Stroke, Eunice Kennedy Shriver National Institute of Child Health and Human Development, American Academy for Cerebral Palsy and Developmental Medicine, the Cerebral Palsy International Research Foundation, and Reaching for the Stars. 

The “State of the Science and Treatment Decisions in Cerebral Palsy” workshop brought over 100 scientists, clinicians, advocates, and other stakeholders in cerebral palsy (CP) together to discuss therapeutic interventions, research methodologies, and the needs of patients and families. One of the major goals of the workshop was to identify the current gaps in the evidence base for therapeutics and interventions and potential strategies to address those gaps. The workshop included 15 talks and panel discussions on topics ranging from research to clinical care.

The workshop started with an overview of prevention and treatment strategies and the current state of the evidence base. Speakers highlighted the diversity in clinical practices for CP, in terms of the types, timing, intensity and frequency of treatments and interventions. They also noted the heterogeneity of CP: even patients with the same brain abnormality may present with different symptoms and response to treatment, and motor impairments and functional abilities may change throughout stages of development. Thus, individualized therapy is essential, and evidence to develop best practices for each age group is needed.

Additional speakers provided overviews of: current practices in diagnosing CP and assessing the types of impairments; current state of international and US regional registries as well as surveillance activities; and types of research designs used to evaluate treatment efficacy. A panel discussion on family perspectives emphasized the challenges of getting access to medical care and the particular needs of adults with CP, including social development, employment assistance, and mental health care.

Over the course of the workshop, speakers and discussants identified gaps in research and priorities for advancing progress on effective treatments. Comparative effectiveness research, in parallel with registries, was highlighted as an optimal method to build the evidence base for treatments that are already in use. The group discussed in the importance of basic and translational research in addressing new types of treatments, particularly in the areas of enhancing neuroplasticity and neuromodulation approaches. In addition, participants discussed the importance of encouraging young scientists to enter the CP research field.

A video cast of the workshop is available here:

Day 1

Day 2