Evidence-based Clinical Guidelines for Optimizing the Use of Standing Frame: A Systematic Review of Dosing Recommendations Among Cerebral Palsy

Evidence-based Clinical Guidelines for Optimizing the Use of Standing Frame: A Systematic Review of Dosing Recommendations Among Cerebral Palsy

Background: Standing frames are a common intervention for children with cerebral palsy (CP), yet there is a lack of standardized dosing recommendations, impeding the enhancement of treatment outcomes in this population. Objects: This paper aims to optimize dosing strategies for standing frame programs in children with CP. It evaluates effective durations and frequencies for using standing frames to improve gait, hip joint integrity, functional activities, joint range of motion, and muscle tone. The goal is to provide evidence-based clinical recommendations to guide practitioners in treating pediatric CP patients. Methods: A comprehensive research was conducted across seven databases, yielding 23 studies meeting inclusion criteria. Strength of evidence was assessed using established tools. Clinical recommendations were formulated based on the amalgamation of existing evidence. Results: The paucity of evidence-based dosing recommendations for children with CP supported standing device is highlighted in this review. Key findings suggest that standing frames implemented 5 days per week demonstrate positive effects on gait (45 minutes/day, 3 times/ week), hip joint integrity (60 minutes/day), functional activities (60 minutes/day in 30° to 60° of bilateral hip abduction), joint range of motion (60 minutes/day), and muscle tone (30 minutes/day). Conclusion: This systematic review of the treatment regimens for children with CP is providing useful insights to the dosing strategies of standing frames. The evidence supports a 30-60 minutes per day and 3-5 days a week intervention with specified durations for optimal outcomes. In enhancing the effectiveness of standing frames, as well as promoting evidencebased practices in the management of children with CP, these clinical recommendations offer guidance for practitioners.