A review of the efficacy of lower-limb orthoses used for cerebral palsy

CRD COMMENTARY: The aims of the review were stated and the inclusion criteria were defined in terms of the intervention, study design, participants and outcome. Many relevant sources of trials were searched and attempts were made to locate unpublished material. It was not stated whether any language restrictions were applied and the methods used to select the studies were not reported. Validity was not formally assessed, although some aspects of validity were discussed in the text. Some relevant data were extracted and tabulated, but the methods used to extract the data were not described and the results were not presented with values or levels of statistical significance. A narrative review was appropriate given the clinical heterogeneity among the studies. The critical appraisal of the evidence on specific orthoses was lacking. In addition, it was not mentioned whether the studies were adequately powered to detect a difference between the treatments and, given that only 10 studies included more than 16 patients, this could seriously affect the validity of the results. Conclusions were based on limited evidence from poor quality studies with small sample sizes and may not be reliable. The authors' conclusions about the need for further research were supported by the evidence presented.