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preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style"><div class="fm-sec bkr_bottom_sep"><div class="bkr_thumb"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng119er10-lrg.png" alt="Cover of Interventions that improve function and participation: vocational and independent living skills" /></a></div><div class="bkr_bib"><h1 id="_NBK578072_"><span itemprop="name">Interventions that improve function and participation: vocational and independent living skills</span></h1><div class="subtitle">Cerebral palsy in adults</div><p><b>Evidence review D1</b></p><p><i>NICE Guideline, No. 119</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Alliance (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2019 Jan</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3223-8</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div></div><div class="bkr_clear"></div></div><div id="chd1.s1"><h2 id="_chd1_s1_">Interventions that improve function and participation for adults aged 25 and over with cerebral palsy</h2><div id="chd1.s1.1"><h3>Review question</h3><p>D1 Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><div id="chd1.s1.1.1"><h4>Introduction</h4><p>Recreational, educational and vocational participation in society can be reduced in adults with cerebral palsy due to physical, cognitive and emotional disabilities that require interventions to optimise function. Barriers to participation can be environmental, financial, cultural, systemic and institutional. This review question seeks to look at what therapeutic interventions for the individual, based on their abilities and aspirations, improve participation.</p></div><div id="chd1.s1.1.2"><h4>PICO table</h4><p>Please see <a class="figpopup" href="/books/NBK578072/table/chd1.tab1/?report=objectonly" target="object" rid-figpopup="figchd1tab1" rid-ob="figobchd1tab1">Table 1</a> for a summary of the Population, Intervention, Comparison and Outcome (PICO) characteristics of this review.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figchd1tab1"><a href="/books/NBK578072/table/chd1.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figchd1tab1" rid-ob="figobchd1tab1"><img class="small-thumb" src="/books/NBK578072/table/chd1.tab1/?report=thumb" src-large="/books/NBK578072/table/chd1.tab1/?report=previmg" alt="Table 1. Summary of the protocol (PICO table)." /></a><div class="icnblk_cntnt"><h4 id="chd1.tab1"><a href="/books/NBK578072/table/chd1.tab1/?report=objectonly" target="object" rid-ob="figobchd1tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of the protocol (PICO table). </p></div></div><p>For full details see the review protocol in <a href="#chd1.appa">appendix A</a>.</p></div><div id="chd1.s1.1.3"><h4>Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual 2014</a>. Methods specific to this review question are described in the review protocol in <a href="#chd1.appa">appendix A</a> and for a full description of the methods see <a href="/books/n/niceng119erbm3/?report=reader" class="toc-item">supplementary document C</a>.</p><p>Declaration of interests were recorded according to NICE’s 2014 conflicts of interest policy from May 2016 until April 2018. From April 2018 onwards they were recorded according to NICE’s 2018 <a href="https://www.nice.org.uk/About/Who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">conflicts of interest policy</a>. Those interests declared until April 2018 were reclassified according to NICE’s 2018 conflicts of interest policy (see Interests Register).</p></div><div id="chd1.s1.1.4"><h4>Clinical evidence</h4><div id="chd1.s1.1.4.1"><h5>Included studies</h5><p>One cross-sectional study (number of participants, N=3162) was included in the review (<a class="bibr" href="#chd1.s1.ref1" rid="chd1.s1.ref1">Huang 2013</a>).</p><p><a class="bibr" href="#chd1.s1.ref1" rid="chd1.s1.ref1">Huang 2013</a> was a retrospective cross-sectional study using a United States vocational rehabilitation database to examine whether demographic, work disincentive variables and vocational rehabilitation services predicted employment outcomes in adults with cerebral palsy. The association of different types of rehabilitation services with employment was evaluated using multiple regression controlling for demographic and work disincentive variables.</p><p>The clinical studies included in this evidence review are summarised in <a class="figpopup" href="/books/NBK578072/table/chd1.tab2/?report=objectonly" target="object" rid-figpopup="figchd1tab2" rid-ob="figobchd1tab2">Table 2</a> and evidence from these are summarised in the clinical evidence profile below (<a class="figpopup" href="/books/NBK578072/table/chd1.tab3/?report=objectonly" target="object" rid-figpopup="figchd1tab3" rid-ob="figobchd1tab3">Table 3</a><a class="figpopup" href="/books/NBK578072/table/chd1.tab3/?report=objectonly" target="object" rid-figpopup="figchd1tab3" rid-ob="figobchd1tab3">Table 3</a>).</p><p>See also the literature search strategy in <a href="#chd1.appb">appendix B</a> study selection flow chart in <a href="#chd1.appc">appendix C</a>, study evidence tables in <a href="#chd1.appd">appendix D</a> and forest plots in <a href="#chd1.appe">appendix E</a>.</p></div><div id="chd1.s1.1.4.2"><h5>Excluded studies</h5><p>Studies excluded from this systematic review, with reasons for their exclusion, are provided in <a href="#chd1.appk">appendix K</a>.</p></div></div><div id="chd1.s1.1.5"><h4>Summary of clinical studies included in the evidence review</h4><p><a class="figpopup" href="/books/NBK578072/table/chd1.tab2/?report=objectonly" target="object" rid-figpopup="figchd1tab2" rid-ob="figobchd1tab2">Table 2</a> provides a brief summary of the included study.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figchd1tab2"><a href="/books/NBK578072/table/chd1.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figchd1tab2" rid-ob="figobchd1tab2"><img class="small-thumb" src="/books/NBK578072/table/chd1.tab2/?report=thumb" src-large="/books/NBK578072/table/chd1.tab2/?report=previmg" alt="Table 2. Summary of included studies." /></a><div class="icnblk_cntnt"><h4 id="chd1.tab2"><a href="/books/NBK578072/table/chd1.tab2/?report=objectonly" target="object" rid-ob="figobchd1tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of included studies. </p></div></div><p>See <a href="#chd1.appd">appendix D</a> for the full evidence table.</p></div><div id="chd1.s1.1.6"><h4>Quality assessment of clinical studies included in the evidence review</h4><p>The clinical evidence profile for this review question is presented in <a class="figpopup" href="/books/NBK578072/table/chd1.tab3/?report=objectonly" target="object" rid-figpopup="figchd1tab3" rid-ob="figobchd1tab3">Table 3</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figchd1tab3"><a href="/books/NBK578072/table/chd1.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figchd1tab3" rid-ob="figobchd1tab3"><img class="small-thumb" src="/books/NBK578072/table/chd1.tab3/?report=thumb" src-large="/books/NBK578072/table/chd1.tab3/?report=previmg" alt="Table 3. Summary clinical evidence profile: Comparison 1 vocational rehabilitation versus no vocational rehabilitation." /></a><div class="icnblk_cntnt"><h4 id="chd1.tab3"><a href="/books/NBK578072/table/chd1.tab3/?report=objectonly" target="object" rid-ob="figobchd1tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Summary clinical evidence profile: Comparison 1 vocational rehabilitation versus no vocational rehabilitation. </p></div></div><p>See <a href="#chd1.appf">appendix F</a> for the full GRADE tables.</p></div><div id="chd1.s1.1.7"><h4>Economic evidence</h4><div id="chd1.s1.1.7.1"><h5>Included studies</h5><p>A systematic review of the economic literature was conducted, but no studies were identified which were applicable to this review question.</p></div><div id="chd1.s1.1.7.2"><h5>Excluded studies</h5><p>No studies were identified which were applicable to this review question.</p></div></div><div id="chd1.s1.1.8"><h4>Summary of studies included in the economic evidence review</h4><p>No economic evaluations were included in this review.</p></div><div id="chd1.s1.1.9"><h4>Economic model</h4><p>This question was not prioritised for economic modelling as the committee considered that it was unlikely that any recommendation made would place additional costs on NHS or PSS budgets.</p></div><div id="chd1.s1.1.10"><h4>Resource impact</h4><p>No unit costs were presented to the committee as these were not prioritised for decision making purposes.</p></div><div id="chd1.s1.1.11"><h4>Evidence statements</h4><div id="chd1.s1.1.11.1"><h5>Comparison 1. Vocational rehabilitation versus no vocational rehabilitation</h5><div id="chd1.s1.1.11.1.1"><h5>Critical outcomes</h5><div id="chd1.s1.1.11.1.1.1"><h5>Participation</h5><ul id="l236"><li id="lt717" class="half_rhythm"><div>Low quality evidenced from 1 cross-sectional study including 3162 adults with cerebral palsy indicated that people who had received certain types of vocational rehabilitation including:
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<ul id="l237" class="circle"><li id="lt718" class="half_rhythm"><div>diagnostics and treatment,</div></li><li id="lt719" class="half_rhythm"><div>on-the-job training,</div></li><li id="lt720" class="half_rhythm"><div>job placement assistance,</div></li><li id="lt721" class="half_rhythm"><div>on-the-job support,</div></li><li id="lt722" class="half_rhythm"><div>maintenance,</div></li><li id="lt723" class="half_rhythm"><div>and rehabilitation technology,</div></li></ul>
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were more likely to be in competitive employment than those who had not received those interventions. It was not possible to infer causality, however, as this was an observational study.</div></li></ul></div><div id="chd1.s1.1.11.1.1.2"><h5>Independence</h5><ul id="l238"><li id="lt724" class="half_rhythm"><div>No evidence was found for this outcome.</div></li></ul></div><div id="chd1.s1.1.11.1.1.3"><h5>Health related quality of life</h5><ul id="l239"><li id="lt725" class="half_rhythm"><div>No evidence was found for this outcome.</div></li></ul></div></div><div id="chd1.s1.1.11.1.2"><h5>Important outcomes</h5><div id="chd1.s1.1.11.1.2.1"><h5>Function</h5><ul id="l240"><li id="lt726" class="half_rhythm"><div>No evidence was found for this outcome.</div></li></ul></div><div id="chd1.s1.1.11.1.2.2"><h5>Self-efficacy</h5><ul id="l241"><li id="lt727" class="half_rhythm"><div>No evidence was found for this outcome.</div></li></ul></div></div></div></div><div id="chd1.s1.1.12"><h4>The committee’s discussion of the evidence</h4><div id="chd1.s1.1.12.1"><h5>Interpreting the evidence</h5><div id="chd1.s1.1.12.1.1"><h5>The outcomes that matter most</h5><p>The critical outcomes for this question were participation and independence because of their role in enabling a person to take a full part in adult life. Health related quality of life was also a critical outcome because of the potential effects of participation in work and leisure on health and wellbeing. Important outcomes were function and self-efficacy.</p><p>Evidence was lacking for independence, health related quality of life and the other elements of participation beyond employment (such as vocational and leisure activities).</p></div><div id="chd1.s1.1.12.1.2"><h5>The quality of the evidence</h5><p>The quality of the evidence was low according to GRADE, due to the observational nature of the study there may have been important differences between those who did and did not receive vocational rehabilitation. The single included study, however, did attempt to control for group differences in relevant demographic and work disincentive variables including age, ethnic group, co-occurring disabilities, educational level, medical insurance and cash benefits by using multivariate logistic regression analysis. This lends weight to the study findings which indicated those who had received certain types of vocational rehabilitation were more likely to be in competitive employment. However, because of its observational design it was not possible to compare the relative effectiveness of such interventions.</p><p>The study was from the USA with a slightly different system of vocational rehabilitation which is not provided directly by the health service.</p><p>Evidence was lacking for independent living skills training and for the training of carers.</p></div><div id="chd1.s1.1.12.1.3"><h5>Benefits and harms</h5><p>The committee recognised that the <a href="http://www.legislation.gov.uk/ukpga/2010/15/contents" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Equality Act (2010)</a> protects the rights of people with disability and supports them to overcome barriers to reach their full potential. They noted that any recommendations need to be consistent with this legislation and also support the human rights of adults with cerebral palsy, as set out in the <a href="https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">UN Convention on the rights of persons with disabilities</a>, to independence, social and occupational integration, participation in the community, access to training and to engage in work. They did not explicitly state this as a recommendation but noted that their recommendations are drafted to fulfil NICE’s obligation to advance equality. However, the committee noted a number of potential environmental, social and institutional barriers to participation that should be minimised in line with governmental policy and legislation.</p><p>Based on their experience and expertise they decided to recommend referral to occupational therapy services to people with complex physical, cognitive, language or sensory needs. The committee agreed that such referrals would lead to tailored support in order to increase independence and quality of life.</p><p>There is potentially great benefit to be gained from increased independence, social and occupational integration, participation in the life of the community and access to work. The committee agreed, based on their experience that individualised information provision is key to identify which activities the adult with cerebral palsy would like to pursue. Furthermore they highlighted that this information about vocational and independent living skills needs to be tailored to the individual’s cognitive, communicative and functional abilities and be relevant to their needs and aspirations. The committee agreed best practice for the format of information provision and how to communicate with adults most effectively, is well described in the <a href="https://www.nice.org.uk/guidance/cg138" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE guideline on patient experience</a> and NICE’s guideline on <a href="https://www.nice.org.uk/guidance/ng86/chapter/Recommendations#information" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">people’s experience in adult social care service</a> to which they cross referred.</p><p>In the included study, higher educational attainment and fewer physical complications were associated with gaining paid employment. The committee agreed that this group of adults with cerebral palsy should be supported, but recognised that there are other adults with cerebral palsy who would like to work and/or live independently and should be offered referral to a professional with expertise in vocational and independent living skills, for example an occupational therapist. The benefits of this relate to the provision of information to enable adults to reach their full potential.</p><p>If problems in participation were highlighted by the adult with cerebral palsy the committee decided, based on their expertise and experience, that an assessment of physical and psychological factors followed by consideration of specialist input and possible to a professional with expertise in vocational and independent living skills (for example an occupational therapist). Examples of the relevant areas for assessment that the committee discussed included: employment support to include workplace training and job retention, leisure activities, statutory welfare benefits, vocational rehabilitation, voluntary work, job-seeking and access to work schemes, occupational health assessment or workplace assessment, supporting a planned exit from the workforce should it become too difficult to continue working. The committee acknowledged that many related recommendations in the NICE guideline on <a href="https://www.nice.org.uk/guidance/ng13" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Workplace health: management practices</a> (NG13) are also relevant and therefore cross-referenced to it.</p></div><div id="chd1.s1.1.12.1.4"><h5>Cost effectiveness and resource use</h5><p>The committee noted that no relevant published economic evaluations had been identified for this topic.</p><p>The committee recognised that if adults with cerebral palsy are not supported appropriately this can reduce their ability to participate and increase the costs associated with ill-health. The committee therefore prioritised a recommendation to assess someone’s physical and psychological health to reinforce current best practice. Estimating the costs to optimise physical and psychological health would go beyond the scope of this guideline, but the committee considered that such interventions would reduce future costs caused through lack of participation and delayed or inappropriate management.</p><p>The committee noted that access to risk assessments in the workplace are geographically variable, despite their relatively low cost to perform. This prevents any downstream costs associated with (avoidable) incidents such as strains and falls. Consequently, the committee considered that their recommendation to offer workplace assessment/occupational health assessment to individuals with cerebral palsy would be a cost effective. Even if these recommendations were not cost effective the committee noted that offering such assessments is government legislation and should legally be adhered to regardless of the resource use implications.</p><p>The committee agreed that the potential benefits in terms of securing employment and preventing problems associated with isolation would also positively impact on quality of life and participation. Overall, these recommendations are not expected to lead to a significant increase in resource use.</p></div></div></div></div><div id="rl.r11"><h3>References</h3><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="chd1.s1.ref1"><p id="p-123">
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<strong>Huang 2013</strong>
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</p>Huang, I.C., Holzbauer, J.J., Lee, E.J., Chronister, J., Chan, F., O’Neil, J., Vocational rehabilitation services and employment outcomes for adults with cerebral palsy in the United States, Developmental Medicine and Child Neurology, 55, 1000–1008, 2013 [<a href="https://pubmed.ncbi.nlm.nih.gov/23924262" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23924262</span></a>]</div></p></li></ul></div></div><div id="appendixes.appgroupd1"><h2 id="_appendixes_appgroupd1_">Appendices</h2><div id="chd1.appa"><h3>Appendix A. Review protocols</h3><p>Review protocol for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p id="chd1.appa.et1"><a href="/books/NBK578072/bin/chd1-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 4. Review protocol for interventions to promote participation and function</a><span class="small"> (PDF, 327K)</span></p></div><div id="chd1.appb"><h3>Appendix B. Literature search strategies</h3><p>Literature searches for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p>This appendix is a combined search strategy and will be the same for all the evidence reviews for the D review questions as listed below:
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<ul id="l242" class="simple-list"><li id="lt728" class="half_rhythm"><div>D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</div></li><li id="lt729" class="half_rhythm"><div>D2: Which interventions are effective for maintaining physical function and mobility in adults with cerebral palsy?
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<ul id="l243"><li id="lt730" class="half_rhythm"><div>Physical activity</div></li><li id="lt731" class="half_rhythm"><div>Strengthening programmes or training</div></li><li id="lt732" class="half_rhythm"><div>Orthotics</div></li><li id="lt733" class="half_rhythm"><div>Task-oriented upper limb training</div></li><li id="lt734" class="half_rhythm"><div>Orthopaedic surgery (including tendon lengthening and orthopaedic bone procedures in</div></li><li id="lt735" class="half_rhythm"><div>adulthood).</div></li></ul></div></li><li id="lt736" class="half_rhythm"><div>D3: What is the effectiveness of electronic assistive technology in promoting independence in adults with cerebral palsy?</div></li><li id="lt737" class="half_rhythm"><div>D4: Which interventions (for example augmentative and alternative communication systems) are effective in promoting communication for adults with cerebral palsy who have communication difficulties?</div></li></ul></p><div id="chd1.appb.s1"><h4>Database: Medlife & Embase (Multifile)</h4><p>Database(s): Embase 1974 to 2018 March 22, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to Present</p><p id="chd1.appb.tab1"><a href="/books/NBK578072/table/chd1.appb.tab1/?report=objectonly" target="object" rid-ob="figobchd1appbtab1" class="figpopup">Table 5. Last searched on 22 March 2018</a></p></div><div id="chd1.appb.s2"><h4>Database: Cochrane Library</h4><p id="chd1.appb.tab2"><a href="/books/NBK578072/table/chd1.appb.tab2/?report=objectonly" target="object" rid-ob="figobchd1appbtab2" class="figpopup">Table 6. Last searched on 22 March 2018</a></p></div><div id="chd1.appb.s3"><h4>Database: WEB OF SCIENCE</h4><p id="chd1.appb.tab3"><a href="/books/NBK578072/table/chd1.appb.tab3/?report=objectonly" target="object" rid-ob="figobchd1appbtab3" class="figpopup">Table 7. Last searched on 22 March 2018</a></p></div></div><div id="chd1.appc"><h3>Appendix C. Clinical evidence study selection</h3><p>Clinical evidence study selection for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p id="chd1.appc.fig1"><a href="/books/NBK578072/figure/chd1.appc.fig1/?report=objectonly" target="object" rid-ob="figobchd1appcfig1" class="figpopup">Figure 1. Flow diagram of clinical article selection for interventions to promote participation in adults with cerebral palsy review</a></p></div><div id="chd1.appd"><h3>Appendix D. Clinical evidence tables</h3><p>Clinical evidence tables for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p id="chd1.appd.et1"><a href="/books/NBK578072/bin/chd1-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 8. Studies included in the evidence review for interventions for participation</a><span class="small"> (PDF, 283K)</span></p></div><div id="chd1.appe"><h3>Appendix E. Forest plots</h3><p>Forest plots for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><div id="chd1.appe.s1"><h4>Comparison 1. vocational rehabilitation versus no vocational rehabilitation</h4><p id="chd1.appe.fig1"><a href="/books/NBK578072/figure/chd1.appe.fig1/?report=objectonly" target="object" rid-ob="figobchd1appefig1" class="figpopup">Figure 2. vocational rehabilitation versus no vocational rehabilitation</a></p></div></div><div id="chd1.appf"><h3>Appendix F. GRADE tables</h3><p>GRADE tables for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p id="chd1.appf.et1"><a href="/books/NBK578072/bin/chd1-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 9. Clinical evidence profile: Comparison 1: vocational rehabilitation versus no vocational rehabilitation</a><span class="small"> (PDF, 315K)</span></p></div><div id="chd1.appg"><h3>Appendix G. Economic evidence study selection</h3><p>Economic evidence study selection for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p>No economic evidence was identified for this review.</p></div><div id="chd1.apph"><h3>Appendix H. Economic evidence tables</h3><p>Economic evidence tables for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p>No economic evidence was identified for this review.</p></div><div id="chd1.appi"><h3>Appendix I. Health economic evidence profiles</h3><p>Health economic evidence profiles for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p>No economic evidence was identified for this review.</p></div><div id="chd1.appj"><h3>Appendix J. Health economic analysis</h3><p>Health economic analysis for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p>No economic evidence was included in this review.</p></div><div id="chd1.appk"><h3>Appendix K. Excluded studies</h3><p>Clinical and economic list of excluded studies for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><div id="chd1.appk.s1"><h4>Clinical studies</h4><p id="chd1.appk.et1"><a href="/books/NBK578072/bin/chd1-appk-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 10. Excluded clinical studies for vocational and independent living skills</a><span class="small"> (PDF, 294K)</span></p></div><div id="chd1.appk.s2"><h4>Economic studies</h4><p>No economic evidence was identified for this review.</p></div></div><div id="chd1.appl"><h3>Appendix L. Research recommendations</h3><p>Research recommendations for review question D1: Which interventions (for example, vocational and independent living skills training) promote participation in adults with cerebral palsy?</p><p>No research recommendation was made for this review.</p></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews</p><p>These evidence reviews were developed by the National Guideline Alliance, hosted by the Royal College of Obstetricians and Gynaecologists</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div><div class="small"><span class="label">Bookshelf ID: NBK578072</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35192272" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">35192272</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobchd1tab1"><div id="chd1.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the protocol (PICO table)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578072/table/chd1.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chd1.tab1_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_chd1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_chd1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Adults aged 25 and over with cerebral palsy</p>
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<p>(In included studies, all participants should be over 16 years old, but ideally over 25)</p>
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</td></tr><tr><th id="hd_b_chd1.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_chd1.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l228"><li id="lt692" class="half_rhythm"><div>Vocational training (for example: multidisciplinary vocational rehabilitation; work skills training; work readiness)</div></li><li id="lt693" class="half_rhythm"><div>Independent living skills training (for example: life skills training; relationships)</div></li><li id="lt694" class="half_rhythm"><div>Carer training</div></li></ul></td></tr><tr><th id="hd_b_chd1.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_chd1.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l229"><li id="lt695" class="half_rhythm"><div>Usual care</div></li><li id="lt696" class="half_rhythm"><div>Within intervention category comparison</div></li></ul></td></tr><tr><th id="hd_b_chd1.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</th><td headers="hd_b_chd1.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul id="l230"><li id="lt697" class="half_rhythm"><div>Participation
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<ul id="l231" class="circle"><li id="lt698" class="half_rhythm"><div>occupation</div></li><li id="lt699" class="half_rhythm"><div>employment</div></li><li id="lt700" class="half_rhythm"><div>vocational activity</div></li><li id="lt701" class="half_rhythm"><div>leisure</div></li><li id="lt702" class="half_rhythm"><div>(AUS)TOMS</div></li><li id="lt703" class="half_rhythm"><div>GAS</div></li></ul></div></li><li id="lt704" class="half_rhythm"><div>Independence</div></li><li id="lt705" class="half_rhythm"><div>Health related quality of life</div></li></ul>
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<b>Important</b>
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<ul id="l232"><li id="lt706" class="half_rhythm"><div>Function
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<ul id="l233" class="circle"><li id="lt707" class="half_rhythm"><div>COPM</div></li><li id="lt708" class="half_rhythm"><div>FIM or FAM</div></li></ul></div></li><li id="lt709" class="half_rhythm"><div>Self-efficacy / self-determination</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">(AUS)TOMS: (Australian) Therapy Outcome Measures; COPM: Canadian Occupational Performance Measure; FAM: Functional Assessment Measure; FIM: Functional Independence Measure; GAS: Goal Attainment Scale;</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobchd1tab2"><div id="chd1.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of included studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578072/table/chd1.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chd1.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_chd1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Study</th><th id="hd_h_chd1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Design</th><th id="hd_h_chd1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Participants</th><th id="hd_h_chd1.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Comparisons</th><th id="hd_h_chd1.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_chd1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<a class="bibr" href="#chd1.s1.ref1" rid="chd1.s1.ref1">Huang 2013</a>
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</td><td headers="hd_h_chd1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cross-sectional study</td><td headers="hd_h_chd1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=3162 adults with cerebral palsy aged 16 to 54 years</p>
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<p>United States of America</p>
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</td><td headers="hd_h_chd1.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="l234"><li id="lt710" class="half_rhythm"><div>vocational rehabilitation services compared with no rehabilitation services:
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<ul id="l235" class="circle"><li id="lt711" class="half_rhythm"><div>diagnostics and treatment</div></li><li id="lt712" class="half_rhythm"><div>on-the-job training</div></li><li id="lt713" class="half_rhythm"><div>job placement assistance</div></li><li id="lt714" class="half_rhythm"><div>on-the-job support</div></li><li id="lt715" class="half_rhythm"><div>maintenance</div></li><li id="lt716" class="half_rhythm"><div>rehabilitation technology</div></li></ul></div></li></ul></td><td headers="hd_h_chd1.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participation (employment)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">N: number of participants in study.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobchd1tab3"><div id="chd1.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Summary clinical evidence profile: Comparison 1 vocational rehabilitation versus no vocational rehabilitation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578072/table/chd1.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chd1.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_chd1.tab3_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_chd1.tab3_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_chd1.tab3_1_1_1_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Illustrative comparative risks* (95% CI)</th><th id="hd_h_chd1.tab3_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_chd1.tab3_1_1_1_3" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)<sup>1</sup></th><th id="hd_h_chd1.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_chd1.tab3_1_1_1_4" style="text-align:left;vertical-align:bottom;">No of Participants (studies)</th><th id="hd_h_chd1.tab3_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_chd1.tab3_1_1_1_5" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th></tr><tr><th headers="hd_h_chd1.tab3_1_1_1_2" id="hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Assumed risk without vocational rehabilitation<sup>2</sup></th><th headers="hd_h_chd1.tab3_1_1_1_2" id="hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Corresponding risk with vocational rehabilitation</th></tr></thead><tbody><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participation: employment (Diagnostics and treatment versus none)</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">500 per 1000</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>541 per 1000</p>
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<p>(500 to 582)</p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>OR 1.18</p>
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<p>(1 to 1.39)<sup>3</sup></p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>3162</p>
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<p>(1 study)</p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participation: employment (On-the-job training versus none)</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">500 per 1000</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>605 per 1000</p>
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<p>(510 to 692)</p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>OR 1.53</p>
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<p>(1.04 to 2.25)<sup>3</sup></p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>3162</p>
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<p>(1 study)</p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participation: employment (Job placement assistance versus none)</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">500 per 1000</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>737 per 1000</p>
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<p>(705 to 766)</p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>OR 2.8</p>
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<p>(2.39 to 3.28)<sup>3</sup></p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>3162</p>
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<p>(1 study)</p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participation: employment (On-the-job support versus none)</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">500 per 1000</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>700 per 1000</p>
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<p>(659 to 738)</p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>OR 2.33</p>
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<p>(1.93 to 2.81)<sup>3</sup></p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>3162</p>
|
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<p>(1 study)</p>
|
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</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participation: employment (Maintenance versus none)</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">500 per 1000</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>602 per 1000</p>
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<p>(548 to 653)</p>
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</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>OR 1.51</p>
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<p>(1.21 to 1.88)<sup>3</sup></p>
|
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</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>3162</p>
|
|
<p>(1 study)</p>
|
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</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participation: employment (Rehabilitation technology versus none)</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">500 per 1000</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>643 per 1000</p>
|
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<p>(597 to 687)</p>
|
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</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>OR 1.8</p>
|
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<p>(1.48 to 2.19)<sup>3</sup></p>
|
|
</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>3162</p>
|
|
<p>(1 study)</p>
|
|
</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td></tr><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Independence - not reported</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td></tr><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Health related quality of life - not reported</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td></tr><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Function - not reported</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td></tr><tr><td headers="hd_h_chd1.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Self-efficacy - not reported</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_2 hd_h_chd1.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td><td headers="hd_h_chd1.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">-</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">CI: Confidence interval; OR: Odds ratio; NR: not reported</p></div></dd></dl><dl class="bkr_refwrap"><dt>1</dt><dd><div id="chd1.tab3_1"><p class="no_margin">Univariate rates of employment were not reported according to types of vocational rehabilitation–odds ratios were derived from logistic regression</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="chd1.tab3_2"><p class="no_margin">Control risk is the overall employment rate in the study (50%)</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="chd1.tab3_3"><p class="no_margin">Odds ratios were adjusted for demographic and work disincentive variables</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobchd1appbtab1"><div id="chd1.appb.tab1" class="table"><h3><span class="label">Table 5</span><span class="title">Last searched on 22 March 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578072/table/chd1.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chd1.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Cerebral Palsy/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp cerebral palsy/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((cerebral or brain or central) adj2 (pal* or paralys#s or pares#s)).tw.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cerebral palsy.ti,ab.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">little? disease.tw.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemipleg* or dipleg* or tripleg* or quadripleg* or unilateral*) adj5 spastic*).tw.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemipleg* or dipleg* or tripleg* or quadripleg* or unilateral*) adj3 ataxi*).tw.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1–7</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 8 to english language</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 9 to (adult <18 to 64 years> or aged <65+ years>) use oemezd [Limit not valid in Ovid MEDLINE(R),Ovid MEDLINE(R) In-Process; records were retained]</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 9 to “all adult (19 plus years)” [Limit not valid in Embase; records were retained]</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11 use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/10,12</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Community Participation/ or exp Social Participation/ or exp “Activities of Daily Living”/ or exp Independent Living/ or exp Vocational Education/ or exp “Quality of Life”/ or exp Hearing Aids/ or exp Wheelchairs/ or exp Needs Assessment/ or exp Disability Evaluation/ or exp Self-Help Devices/ or exp Sickness Impact Profile/ or exp Sensory Aids/ or exp “Prostheses and Implants”/ or exp Orthotic Devices/ or exp Equipment Design/ or exp User-Computer Interface/ or exp communication aids for disabled/ or exp speech disorder/rh or exp Exercise/ or exp Rehabilitation/mt or exp Sports/ or exp Exercise Therapy/ or exp Orthopedic Procedures/ or exp Physical Therapy Modalities/</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14 use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">social behavior/ or exp social adaptation/ or exp social participation/ or exp social interaction/ or exp community integration/ or exp community living/ or exp daily life activity/ or exp independent living/ or exp vocational education/ or exp “quality of life”/ or exp hearing aid/ or exp wheelchair/ or exp needs assessment/ or exp disability/ or exp self help device/ or exp Sickness Impact Profile/ or exp sensory aid/ or exp “prostheses and orthoses”/ or exp orthosis/ or exp implant/ or exp equipment design/ or exp computer interface/ or exp exercise/ or exp rehabilitation/ or exp self help/ or exp assistive technology/ or exp vocational guidance/ or exp communication aid/ or exp facilitated communication/ or exp eye tracking/ or exp sport/ or exp kinesiotherapy/ or exp orthopedic surgery/ or exp physiotherapy/</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(participat* or (daily adj activit*) or (independen* adj5 liv*) or age* or aging or gender or motivat* or preference* or limitation* or restriction* or capacit* or performance* or (handl* adj5 object*) or assistive technolog* or (social adj5 interaction*) or employ* or vocation* or occupat* or educat* or profession* or isolat* or leisure activit* or mobil* or communicat* or eat* or dining or drink* or dress* or interact* or ((assistive or adaptive) adj5 (technolog* or device* or system*)) or home or school or work* or communit* or play* or eye tracking or sporting activit* or swim* or aqua* or upper limb training or bony procedure* or (neuro-developmental adj (treatment* or therap* or training)) or NDT or (muscle adj (tissue or tone)) or ((strength* or endurance) adj5 (program* or training*)) or ((tendon* or muscle*) adj (length* or stretch*)) or treadmill* or weight*).tw.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(augmentative or alternative communication or AAC or voice synthesizer* or accommodation* or sign language or gestur* or manual language board* or high?tech or touch screen* or speech?generating* or electronic keyboard* or phone* or iPad* or laptop* or computer* or modificat* or modify* or adapt* or custom* or tailor* or assist* or ((walking or hearing) adj aid*) or (communication adj (device* or system* or board*))).ti,ab.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 or 17 or 18 or 19</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13 and 20</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">conference abstract.pt. use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or LETTER/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Letter/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">EDITORIAL/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt. use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NEWS/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp HISTORICAL ARTICLE/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt. use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANECDOTES AS TOPIC/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">COMMENT/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CASE REPORT/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CASE REPORT/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CASE STUDY/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment* or abstracts).ti.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/22–35</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RANDOMIZED CONTROLLED TRIAL/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RANDOMIZED CONTROLLED TRIAL/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">random*.ti,ab.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/37–39</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36 not 40</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANIMALS/ not HUMANS/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANIMAL/ not HUMAN/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp ANIMALS, LABORATORY/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp ANIMAL EXPERIMENTATION/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp MODELS, ANIMAL/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp RODENTIA/ use prmz</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NONHUMAN/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp ANIMAL EXPERIMENT/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp EXPERIMENTAL ANIMAL/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANIMAL MODEL/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp RODENT/ use oemezd</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/41–53</td></tr><tr><td headers="hd_h_chd1.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_chd1.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21 not 54</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobchd1appbtab2"><div id="chd1.appb.tab2" class="table"><h3><span class="label">Table 6</span><span class="title">Last searched on 22 March 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578072/table/chd1.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chd1.appb.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Hits</th><th id="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Search</th></tr></thead><tbody><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Cerebral Palsy] explode all trees and with qualifier(s): [Physiopathology - PP, Rehabilitation - RH]</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((cerebral or brain or central) N2 (pal* or paralys?s or pare?s))</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemipleg* or dipleg* or tripleg* or quadripleg* or unilateral*) N5 spastic*)</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemipleg* or dipleg* or tripleg* or quadripleg* or unilateral*) N3 ataxi*)</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2 or #3 or #4</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Social Behavior] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Social Participation] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Interpersonal Relations] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Community Integration] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Independent Living] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Activities of Daily Living] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Vocational Education] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Quality of Life] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Hearing Aids] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Wheelchairs] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Needs Assessment] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Disability Evaluation] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Self-Help Devices] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Sickness Impact Profile] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Sensory Aids] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Prostheses and Implants] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Orthotic Devices] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#23</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Equipment Design] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#24</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [User-Computer Interface] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Exercise] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#26</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Rehabilitation] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#27</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Vocational Guidance] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#28</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Communication Aids for Disabled] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#29</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Eye Movements] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#30</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Sports] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#31</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Exercise Therapy] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#32</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Orthopedic Procedures] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#33</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Physical Therapy Modalities] explode all trees</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#34</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">sporting activit* or swim* or aqua* or upper limb training or bony procedures or Neuro-developmental near (Treatment* or therap* or training) or NDT or muscle tissue or muscle tone or strength* or endurance or length* or stretch* or treadmill* or weight*</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#35</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">participat* or independent liv* or age or aging or limitation* or restriction* or capacit* or performance* or Assistive technolog* or augmentative communication or alternative communication or AAC or employ* or vocation* or occupat* or educat* or profession* or leisure activit* or interaction* or home or school or work* or communit* or play* or accommodation* or sign language or gestur* or manual language board* or high?tech or touch screen* or speech?generating* or electronic keyboard* or phone* or iPad* or laptop* or computer or eye tracking or modif* or adapt* or custom* or tailor* or assist* or walking aid* or hearing aid*</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#36</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">{or #6–#35}</td></tr><tr><td headers="hd_h_chd1.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#37</td><td headers="hd_h_chd1.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5 and #36</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobchd1appbtab3"><div id="chd1.appb.tab3" class="table"><h3><span class="label">Table 7</span><span class="title">Last searched on 22 March 2018</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK578072/table/chd1.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chd1.appb.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_chd1.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#3</th><th id="hd_h_chd1.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#2 AND #1 AND LANGUAGE: (English)</th></tr></thead><tbody><tr><td headers="hd_h_chd1.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2</td><td headers="hd_h_chd1.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ts=Social Behavior or ts=Social Participation or ts=Interpersonal Relations or ts=Community Integration or ts=Independent Living or ts=Activities of Daily Living or ts=Vocational Education or ts=Quality of Life or ts=Hearing Aid* or ts=Wheelchair* or ts=Disability Evaluation or ts=Needs Assessment or ts=Self-Help Device* or ts=Sensory Aid* or ts=Prostheses or ts=Implant* or ts=Orthotic Device* or ts=Equipment Design or ts=User-Computer Interface or ts=Exercise* or ts=Rehabilitation or ts=Vocational Guidance or ts=Sport* or ts=Exercise Therap* or ts=Orthopedic Surgery or ts=Physiotherapy OR TS=Assistive technolog* or TS=augmentative communication or TS=alternative communication or TS=AAC OR TS=manual language board* or TS=high?tech or TS=touch screen* or TS=speech?generating* or TS=electronic keyboard* or TS=phone* or TS=iPad* or TS=laptop* or TS=eye tracking</td></tr><tr><td headers="hd_h_chd1.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1</td><td headers="hd_h_chd1.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ts=Cerebral Palsy</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobchd1appcfig1"><div id="chd1.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Flow%20diagram%20of%20clinical%20article%20selection%20for%20interventions%20to%20promote%20participation%20in%20adults%20with%20cerebral%20palsy%20review.&p=BOOKS&id=578072_chd1appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK578072/bin/chd1appcf1.jpg" alt="Figure 1. Flow diagram of clinical article selection for interventions to promote participation in adults with cerebral palsy review." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Flow diagram of clinical article selection for interventions to promote participation in adults with cerebral palsy review</span></h3></div></article><article data-type="fig" id="figobchd1appefig1"><div id="chd1.appe.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20vocational%20rehabilitation%20versus%20no%20vocational%20rehabilitation.&p=BOOKS&id=578072_chd1appef1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK578072/bin/chd1appef1.jpg" alt="Figure 2. vocational rehabilitation versus no vocational rehabilitation." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">vocational rehabilitation versus no vocational rehabilitation</span></h3><div class="caption"><p>CI: confidence interval; IV: inverse variance; SE: standard error; v(voc) rehab: vocational rehabilitation</p></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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