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Sundaramurthi JC, Bagley AM, Blau H, Carmody L, Crandall A, Danis D, Gargano MA, Gustafson AG, Raney EM, Shingle M, Davids JR, Robinson PN. De novo TRPM3 missense variant associated with neurodevelopmental delay and manifestations of cerebral palsy. Cold Spring Harb Mol Case Stud 2023; 9:a006293. [PMID: 37684057 PMCID: PMC10815282 DOI: 10.1101/mcs.a006293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
We identified a de novo heterozygous transient receptor potential cation channel subfamily M (melastatin) member 3 (TRPM3) missense variant, p.(Asn1126Asp), in a patient with developmental delay and manifestations of cerebral palsy (CP) using phenotype-driven prioritization analysis of whole-genome sequencing data with Exomiser. The variant is localized in the functionally important ion transport domain of the TRPM3 protein and predicted to impact the protein structure. Our report adds TRPM3 to the list of Mendelian disease-associated genes that can be associated with CP and provides further evidence for the pathogenicity of the variant p.(Asn1126Asp).
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Affiliation(s)
| | - Anita M Bagley
- Shriners Children's Northern California, Sacramento, California 95817, USA
| | - Hannah Blau
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06032, USA
| | - Leigh Carmody
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06032, USA
| | - Amy Crandall
- Shriners Children's, Portland, Oregon 97239, USA
| | - Daniel Danis
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06032, USA
| | - Michael A Gargano
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06032, USA
| | | | | | - Mallory Shingle
- Shriners Children's Northern California, Sacramento, California 95817, USA
| | - Jon R Davids
- Shriners Children's Northern California, Sacramento, California 95817, USA
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, California 95817, USA
| | - Peter N Robinson
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06032, USA;
- Institute for Systems Genomics, University of Connecticut, Farmington, Connecticut 06032, USA
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52
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Khair AM, McIlvain G, McGarry MDJ, Kandula V, Yue X, Kaur G, Averill LW, Choudhary AK, Johnson CL, Nikam RM. Clinical application of magnetic resonance elastography in pediatric neurological disorders. Pediatr Radiol 2023; 53:2712-2722. [PMID: 37794174 PMCID: PMC11086054 DOI: 10.1007/s00247-023-05779-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
Magnetic resonance elastography is a relatively new, rapidly evolving quantitative magnetic resonance imaging technique which can be used for mapping the viscoelastic mechanical properties of soft tissues. MR elastography measurements are akin to manual palpation but with the advantages of both being quantitative and being useful for regions which are not available for palpation, such as the human brain. MR elastography is noninvasive, well tolerated, and complements standard radiological and histopathological studies by providing in vivo measurements that reflect tissue microstructural integrity. While brain MR elastography studies in adults are becoming frequent, published studies on the utility of MR elastography in children are sparse. In this review, we have summarized the major scientific principles and recent clinical applications of brain MR elastography in diagnostic neuroscience and discuss avenues for impact in assessing the pediatric brain.
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Affiliation(s)
| | - Grace McIlvain
- Department of Biomedical Engineering, University of Delaware, Newark, DE, USA
| | | | - Vinay Kandula
- Department of Radiology, Nemours Children's Hospital, Wilmington, DE, USA
| | - Xuyi Yue
- Department of Radiology, Nemours Children's Hospital, Wilmington, DE, USA
- Department of Biomedical Research, Nemours Children's Hospital, Wilmington, DE, USA
| | - Gurcharanjeet Kaur
- Department of Neurology, New York-Presbyterian / Columbia University Irving Medical Center, New York, NY, USA
| | - Lauren W Averill
- Department of Radiology, Nemours Children's Hospital, Wilmington, DE, USA
| | - Arabinda K Choudhary
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Curtis L Johnson
- Department of Biomedical Engineering, University of Delaware, Newark, DE, USA
- Department of Biomedical Research, Nemours Children's Hospital, Wilmington, DE, USA
| | - Rahul M Nikam
- Department of Radiology, Nemours Children's Hospital, Wilmington, DE, USA.
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53
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Menezes KKP, Avelino PR, Nascimento LR. Addition of backward walking training to forward walking training improves walking speed in children with cerebral palsy: a systematic review with meta-analysis. Int J Rehabil Res 2023; 46:300-307. [PMID: 37581293 DOI: 10.1097/mrr.0000000000000598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
The objective was to examine the effects of backward walking training for improving walking speed and balance in children with cerebral palsy. A systematic review of randomized trials was conducted. Trials had to include children with cerebral palsy, with a Gross Motor Function Classification System, between I and III, that delivered backward walking training as a solo intervention or in combination with forward walking training. The outcomes of interest were walking speed and balance. The methodological quality of included trials was assessed by the PEDro scale, and the quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation. Eight papers, involving 156 participants, were included. Using random-effects meta-analysis, we estimated that backward walking training improved walking speed by 0.10 m/s [95% confidence interval (CI) 0.05-0.16] and by 2 points on the Pediatric Balance Scale (0-56) (95% CI 1.5-2.2) more than forward walking training. We also estimated that the addition of backward walking training increased walking speed by 0.20 m/s (95% CI 0.07-0.34) and reduced the angular excursion of the center of gravity by 0.5 degrees (95% CI -0.7 to -0.3). The quality of the evidence was classified as low to moderate. In conclusion, overall, backward walking training appears to be as effective or slightly superior to forward walking training for improving walking speed in children with CP. The addition of backward walking training statistically significantly and clinically important enhanced benefits on walking speed.
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Affiliation(s)
- Kênia K P Menezes
- NeuroGroup, Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais
| | - Patrick R Avelino
- NeuroGroup, Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais
| | - Lucas R Nascimento
- NeuroGroup, Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais
- Center of Health Sciences, Department of Physiotherapy, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
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Khanna S, Arunmozhi R, Goyal C. Neurodevelopmental Treatment in Children With Cerebral Palsy: A Review of the Literature. Cureus 2023; 15:e50389. [PMID: 38213384 PMCID: PMC10783202 DOI: 10.7759/cureus.50389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
This review aimed to explore the current literature on neurodevelopmental treatment (NDT) in children with cerebral palsy (CP). It also sought to determine what outcome measures are used to analyze the effect of NDT and whether these parameters are in line with the components of the International Classification of Functioning, Disability and Health (ICF). The studies published in the English language between 2000 and 2023 were included based on a search of the databases PEDro, PubMed, and Google Scholar. Studies that examined the effect of NDT on children with CP were included. We found a total of 54 studies describing the effect of NDT in children with CP and these were included in this literature review. NDT in children with CP was found to have positive outcomes in 41 studies, while 13 studies had contradictory conclusions. Based on our findings, NDT is widely used for the rehabilitation of children with CP globally. The parameters used to assess the improvement mostly included gross motor function, balance, and postural control. The outcome measures used in studies are usually linked to body structure and function or activities domain of the ICF model by the World Health Organization (WHO). However, there is a scarcity of studies on the effect of NDT on participation, which should be the outcome of any rehabilitation program. There is scope for future research to demonstrate the effect of NDT on the participation of children with CP. Further studies with larger sample sizes and homogenous groups are recommended.
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Affiliation(s)
- Sandeep Khanna
- Physiotherapy, PhD Program, Sardar Bhagwan Singh University, Dehradun, IND
- Physiotherapy, Latika Roy Memorial Foundation, Dehradun, IND
| | | | - Chanan Goyal
- Physiotherapy, Government Physiotherapy College, Raipur, IND
- Neuro Physiotherapy, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Murni W, Umar TP, Tandarto K, Simatupang A, Hasugian AR, Purwoko RY, Idaiani S, Stevanny B, Oktarina C, Jonlean R, Tango T, Kusuma KS, Sugiyono SP, Putra A. Efficacy and safety of medical cannabinoids in children with cerebral palsy: a systematic review. EINSTEIN-SAO PAULO 2023; 21:eRW0387. [PMID: 37991091 PMCID: PMC10691312 DOI: 10.31744/einstein_journal/2023rw0387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/19/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION The increasing popularity of cannabinoids for treating numerous neurological disorders has been reported in various countries. Although it reduces tetrahydrocannabinol psychoactivity, it helps patients tolerate higher doses and complements the anti-spasmodic effects of tetrahydrocannabinol. One of the most important potential of cannabinoids are related to its potential to help children with cerebral palsy, a contributor of lifelong disability. Therefore, this systematic review aimed to assess the efficacy and safety of medical cannabinoids in children with cerebral palsy. METHODS This review adhered to The Preferred Reporting Items for Systematic Reviews and Meta-analysis 2020 guidelines. Seven databases, namely, Scopus, PubMed, EBSCO Host, ProQuest, Google Scholar, Semantic Scholar, and JSTOR, were used to identify relevant studies. Studies examining pediatric patients with cerebral palsy and reporting the efficacy and safety of medical cannabinoids through clinical trials, observational cross-sectional studies, or cohort designs were included. The outcomes of the studies included the efficacy of medical cannabinoids administered for spasticity, motor components, pain control, sleep difficulties, adverse effects, and seizure control. RESULTS Of 803 identified articles, only three met the inclusion criteria for data synthesis. One study exhibited a moderate risk-of-bias. A total of 133 respondents, mainly from Europe, were investigated. Overall effectiveness and safety were considered good. However, the results are inconsistent, especially regarding spasticity treatment variables. CONCLUSION The anti-spasticity, anti-inflammatory, and anti-seizure properties of cannabinoids might be beneficial for patients with cerebral palsy, although their effectiveness has not been widely studied. Further studies with larger sample sizes and various ethnicities are warranted. Prospero database registration: (www.crd.york.ac.uk/prospero) under ID CRD42022358383.
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Affiliation(s)
- Widya Murni
- Jakarta Anti-Aging Center ClinicJakartaIndonesia Jakarta Anti-Aging Center Clinic , Jakarta , Indonesia .
| | - Tungki Pratama Umar
- Faculty of MedicineSriwijaya UniversityPalembangIndonesia Faculty of Medicine , Sriwijaya University , Palembang , Indonesia .
| | - Kevin Tandarto
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia Faculty of Medicine and Health Sciences , Atma Jaya Catholic University of Indonesia , Jakarta , Indonesia .
| | - Abraham Simatupang
- Department of Pharmacology and TherapyFaculty of MedicineUniversitas Kristen IndonesiaJakartaIndonesia Department of Pharmacology and Therapy , Faculty of Medicine , Universitas Kristen Indonesia , Jakarta , Indonesia .
| | - Armedy Ronny Hasugian
- Indonesia National Research and Innovation AgencyJakartaIndonesia Indonesia National Research and Innovation Agency , Jakarta , Indonesia .
| | - Reza Yuridian Purwoko
- Indonesia National Research and Innovation AgencyJakartaIndonesia Indonesia National Research and Innovation Agency , Jakarta , Indonesia .
| | - Sri Idaiani
- Indonesia National Research and Innovation AgencyJakartaIndonesia Indonesia National Research and Innovation Agency , Jakarta , Indonesia .
| | - Bella Stevanny
- Faculty of MedicineSriwijaya UniversityPalembangIndonesia Faculty of Medicine , Sriwijaya University , Palembang , Indonesia .
| | - Caroline Oktarina
- Faculty of MedicineUniversity of IndonesiaJakartaIndonesia Faculty of Medicine , University of Indonesia , Jakarta , Indonesia .
| | - Reganedgary Jonlean
- Faculty of MedicineUniversity of IndonesiaJakartaIndonesia Faculty of Medicine , University of Indonesia , Jakarta , Indonesia .
| | - Tamara Tango
- Faculty of MedicineUniversity of IndonesiaJakartaIndonesia Faculty of Medicine , University of Indonesia , Jakarta , Indonesia .
| | - Kevin Surya Kusuma
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia Faculty of Medicine and Health Sciences , Atma Jaya Catholic University of Indonesia , Jakarta , Indonesia .
| | - Sagita Pratiwi Sugiyono
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia Faculty of Medicine and Health Sciences , Atma Jaya Catholic University of Indonesia , Jakarta , Indonesia .
| | - Aditya Putra
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia Faculty of Medicine and Health Sciences , Atma Jaya Catholic University of Indonesia , Jakarta , Indonesia .
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Guillotte A, Alkiswani AR, Keeler KA, Partington MD. Symptomatic spinal arachnoid cyst with spastic diplegia secondary to cerebral palsy: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 6:CASE23478. [PMID: 37956422 PMCID: PMC10651389 DOI: 10.3171/case23478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/17/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Selective dorsal rhizotomy (SDR) can improve the spastic gait of carefully selected patients with cerebral palsy. Spinal arachnoid cysts are a rare pathology that can also cause spastic gait secondary to spinal cord compression. OBSERVATIONS The authors present an interesting case of a child with cerebral palsy and spastic diplegia. He was evaluated by a multidisciplinary team and determined to be a good candidate for SDR. Preoperative evaluation included magnetic resonance imaging (MRI) of the spine, which identified an arachnoid cyst causing spinal cord compression. The cyst was surgically fenestrated, which provided some gait improvement. After recovering from cyst fenestration surgery, the patient underwent SDR providing further gait improvement. LESSONS SDR can be beneficial for some patients with spastic diplegia. Most guidelines do not include spinal MRI in the preoperative evaluation for SDR. However, spinal MRI can be beneficial for surgical planning by localizing the level of the conus. It may also identify additional spinal pathology that is contributing to the patient's spasticity. In rare cases, such as this one, patients may benefit from staged surgery to address structural causes of spastic gait prior to proceeding with SDR.
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Affiliation(s)
- Andrew Guillotte
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Abdul-Rahman Alkiswani
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Kathryn A Keeler
- Department of Orthopedics, Children’s Mercy Hospital, Kansas City, Missouri; and
| | - Michael D Partington
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, Kansas
- Division of Pediatric Neurosurgery, Children’s Mercy Hospital, Kansas City, Missouri
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Malesevic N, Svensson I, Hägglund G, Antfolk C. An Integrated Approach for Real-Time Monitoring of Knee Dynamics with IMUs and Multichannel EMG. SENSORS (BASEL, SWITZERLAND) 2023; 23:8955. [PMID: 37960654 PMCID: PMC10649777 DOI: 10.3390/s23218955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
Measuring human joint dynamics is crucial for understanding how our bodies move and function, providing valuable insights into biomechanics and motor control. Cerebral palsy (CP) is a neurological disorder affecting motor control and posture, leading to diverse gait abnormalities, including altered knee angles. The accurate measurement and analysis of knee angles in individuals with CP are crucial for understanding their gait patterns, assessing treatment outcomes, and guiding interventions. This paper presents a novel multimodal approach that combines inertial measurement unit (IMU) sensors and electromyography (EMG) to measure knee angles in individuals with CP during gait and other daily activities. We discuss the performance of this integrated approach, highlighting the accuracy of IMU sensors in capturing knee joint movements when compared with an optical motion-tracking system and the complementary insights offered by EMG in assessing muscle activation patterns. Moreover, we delve into the technical aspects of the developed device. The presented results show that the angle measurement error falls within the reported values of the state-of-the-art IMU-based knee joint angle measurement devices while enabling a high-quality EMG recording over prolonged periods of time. While the device was designed and developed primarily for measuring knee activity in individuals with CP, its usability extends beyond this specific use-case scenario, making it suitable for applications that involve human joint evaluation.
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Affiliation(s)
- Nebojsa Malesevic
- Department of Biomedical Engineering, Faculty of Engineering, 223 63 Lund, Sweden; (I.S.); (C.A.)
| | - Ingrid Svensson
- Department of Biomedical Engineering, Faculty of Engineering, 223 63 Lund, Sweden; (I.S.); (C.A.)
| | - Gunnar Hägglund
- Orthopedics, Department of Clinical Sciences, Lund University, 223 65 Lund, Sweden;
- Department of Orthopedics, Skane University Hospital, 223 65 Lund, Sweden
| | - Christian Antfolk
- Department of Biomedical Engineering, Faculty of Engineering, 223 63 Lund, Sweden; (I.S.); (C.A.)
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Dlamini MD, Chang YJ, Nguyen TTB. Caregivers' experiences of having a child with cerebral palsy. A meta-synthesis. J Pediatr Nurs 2023; 73:157-168. [PMID: 37690430 DOI: 10.1016/j.pedn.2023.08.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/27/2023] [Accepted: 08/27/2023] [Indexed: 09/12/2023]
Abstract
AIM To synthesize qualitative research findings of caregiver experiences and challenges in caring for and raising a child with cerebral palsy. DESIGN A systematic review and meta-synthesis. METHODS Four electronic databases: CINAHL, Embase, OVID Medline, and Cochrane, were systematically searched for qualitative research papers published before December 2022. Two independent reviewers assessed eligibility and further appraised the quality of methodology using the Critical Appraisal Skills Program (CASP) tool for qualitative research. A content thematic analysis approach was used to synthesize the qualitative research findings, construct core subthemes, and synthesize themes. RESULTS Sixty-seven findings were extracted from the 12 included studies. The findings were grouped into eleven sub-themes and then into five synthesized themes. The synthesized themes are 1. Need for convenient healthcare facilities, therapeutic services, and accessible public places, 2. Need for healthcare information and financial aid, 3. Psychological, and physical constraints, 4. Societal rejection and stigma, and 5. Overwhelming caring burden. CONCLUSION Caregivers face many challenges in adjusting their lifestyles to meet the needs of the child with cerebral palsy. Some adjustments reported included giving up full-time jobs and businesses to be full-time caregivers, giving up leisure activities, and confinement to one place.
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Affiliation(s)
- Maggie Dumsile Dlamini
- Department of Nursing, College of Medicine, National Cheng Kung University, No1 University Road, Tainan 70101, Taiwan; Department of Nursing, Eswatini Christian Medical University, Lomkiri Portion 69 of Farm 73, Zone 4, Mbabane, Hhohho, Swaziland
| | - Ying-Ju Chang
- Professor, Institute of Allied Health Sciences & Department of Nursing, College of Medicine, National Cheng Kung University, No 1 University Road, Tainan 70101, Taiwan; Director, Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Tram Thi Bich Nguyen
- Department of Nursing, College of Medicine, National Cheng Kung University, No1 University Road, Tainan 70101, Taiwan; Medical Simultaion Center, Duy Tan University, 254 Nguyen Van Linh, Da Nang, Viet Nam.
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Wang X, Pang F, Du XG. Analysis of Traditional Chinese Medicine Symptoms in Children with Spastic Cerebral Palsy, a Protocol for Data Mining. J Multidiscip Healthc 2023; 16:3143-3149. [PMID: 37905184 PMCID: PMC10613444 DOI: 10.2147/jmdh.s426969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
Background Cerebral palsy (CP) is characterized by abnormal pronunciation, posture, and movement. Clinically, CP can be categorized into various motor syndromes, including spastic hemiplegia, diplegia, quadriplegia, involuntary movement, ataxia, and mixed types. Among these, spastic CP represents over 70-80% of all CP cases. The primary objective of our study is to identify the top and core Traditional Chinese Medicine (TCM) symptoms and analysis their association rules in children with spastic cerebral palsy, thereby enhancing the theoretical foundations of TCM treatment on spastic CP. Methods The study will be conducted on children aged 4 to 14 years with spastic CP who are undergoing treatment at Xi'an Encephalopathy Hospital Affiliated to Shaanxi University of Chinese Medicine. Basic information about the patients and their TCM symptoms will be collected on the first day of admission. This information will include age, gender, birth history, family history, disease classification, and TCM symptoms (including symptoms, tongue, and pulse). Once the data is collected, it will be exported from the electronic medical record system for further analysis. Descriptive statistics will be performed using Excel 2019, while exploratory factor analysis and cluster analysis will be conducted using SPSS Statistics 22. Additionally, association rule analysis will be carried out using SPSS Modeler 18. Results This study will investigate the most top TCM symptoms in children with spastic CP and explore the association rules between these symptoms, mapping the presentation of spastic CP onto symptoms identified within TCM. Conclusion Our findings will provide the distinctive characteristics of TCM symptoms in children with spastic CP, furnishing evidence-based support to clinicians and patients in making well-informed decisions collaboratively.
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Affiliation(s)
- Xing Wang
- M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
- Famous TCM Expert Heritage Studio, Xi’an Encephalopathy Hospital Affiliated to Shaanxi University of Chinese Medicine, Xi’an, Shaanxi, People’s Republic of China
| | - Fang Pang
- Institute of Sports Biology, Shaanxi Normal University, Xi’an, Shaanxi, People’s Republic of China
| | - Xiao-Gang Du
- Famous TCM Expert Heritage Studio, Xi’an Encephalopathy Hospital Affiliated to Shaanxi University of Chinese Medicine, Xi’an, Shaanxi, People’s Republic of China
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冯 叶. [Recent research on the long-term neurodevelopmental outcomes of very preterm infants]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:1066-1071. [PMID: 37905765 PMCID: PMC10621061 DOI: 10.7499/j.issn.1008-8830.2305072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/16/2023] [Indexed: 11/02/2023]
Abstract
With the increase in the survival rate of very preterm infants, the long-term neurodevelopmental outcomes of such infants have attracted more and more attention. Very preterm infants tend to develop movement disorders and psychological and behavioral problems, including cerebral palsy, developmental coordination disorders, autism spectrum disorders, attention deficit hyperactivity disorders, specific learning disorders, and intellectual developmental disorders. It is of vital importance to improve the long-term prognosis of very preterm infants, and early comprehensive intervention measures can minimize disability and achieve optimal parenting outcomes. This article provides a review of the research progress on the long-term neurodevelopmental outcomes in extremely preterm infants.
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Javvaji CK, Vagha JD, Meshram RJ, Taksande A. Assessment Scales in Cerebral Palsy: A Comprehensive Review of Tools and Applications. Cureus 2023; 15:e47939. [PMID: 38034189 PMCID: PMC10685081 DOI: 10.7759/cureus.47939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/28/2023] [Indexed: 12/02/2023] Open
Abstract
Cerebral palsy (CP) is a complex neurological condition characterized by motor dysfunction affecting millions worldwide. This comprehensive review delves into the critical role of assessment in managing CP. Beginning with exploring its definition and background, we elucidate the diverse objectives of CP assessment, ranging from diagnosis and goal setting to research and epidemiology. We examine standard assessment scales and tools, discuss the challenges inherent in CP assessment, and highlight emerging trends, including integrating technology, personalized medicine, and neuroimaging. The applications of CP assessment in clinical diagnosis, treatment planning, research, and education are underscored. Recommendations for the future encompass standardization, interdisciplinary collaboration, research priorities, and professional training. In conclusion, we emphasize the importance of assessment as a compass guiding the care of individuals with CP, issuing a call to action for improved assessment practices to shape a brighter future for those affected by this condition.
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Affiliation(s)
- Chaitanya Kumar Javvaji
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jayant D Vagha
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Revat J Meshram
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amar Taksande
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Megremis P, Megremis O. Surgical Treatment of Thumb-in-Palm Deformity: A Case Report. JBJS Case Connect 2023; 13:01709767-202312000-00029. [PMID: 37943972 DOI: 10.2106/jbjs.cc.23.00330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
CASE A 13-year-old adolescent boy with spastic triplegia was referred to our institution with a thumb-in-palm deformity. An intramuscular slide of the flexor pollicis longus and augmentation of the weak abductor pollicis longus, extensor pollicis longus, and extensor pollicis brevis by tendon transfer were performed. Two years later, the result of the surgery was evaluated as excellent. CONCLUSION There are several factors that will play a decisive role in the final outcome and effectiveness of hand surgery, such as the severity of the neuromuscular disorder, the extent of the deformity, the quality of voluntary muscle control, hand sensibility, and the age and intelligence of the patient.
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Affiliation(s)
- Panos Megremis
- Orthopaedic Department, Athens General Children's Hospital "P. & A. Kyriakou," Athens, Greece
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Wang X, Teh SH, Du XG, Wang XH. Acupuncture and Tuina Treatment for Gross Motor Function in Children with Spastic Cerebral Palsy: A Monocentric Clinical Study. Neuropsychiatr Dis Treat 2023; 19:1875-1886. [PMID: 37667737 PMCID: PMC10475301 DOI: 10.2147/ndt.s424102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Abstract
Objective Cerebral palsy (CP) is a condition characterized by abnormal pronunciation, posture, and movement, particularly spastic CP, which involves Gross motor dysfunction due to increased muscle tone and stiffness. This monocentric clinical study aims to evaluate the effectiveness of acupuncture and tuina (AT) in improving gross motor function and alleviating associated symptoms in children diagnosed with spastic CP. Methods A total of 83 eligible patients received AT treatment, while 85 patients received conventional rehabilitation treatment. Both groups underwent a 12-week treatment period following the research protocol. Pre- and post-treatment assessments included the Modified Ashworth Muscle Tension Scale (MAS), Gross Motor Function Measure (GMFM-D and GMFM-E), 6-min walking distance measurement (6MWD), and Modified Children's Functional Independence Rating Scale (WeeFIM). Results After 12 weeks of treatment, when compared with baseline, the scores of MAS in both AT group and control group are decreased (p<0.01, p<0.01), the scores of GMFM-D, GMFME, 6MWD, WeeFIM in both group are increased (p<0.01 in all indicators). When compared with control group, AT group had significantly lower MAS scores compared to the control group (p<0.01), indicating reduced muscle tension. Moreover, AT group showed significantly higher scores in GMFM-D, GMFM-E, 6MWD, and WeeFIM compared to the control group (p<0.01 in all indicators), indicating improved gross motor function and functional independence. The study also revealed an inverse correlation between the children's age and treatment efficacy (r= -0.496, p<0.01 in AT group, r=-0.540, p<0.01 in control group), highlighting the importance of early intervention in the management of CP in children. Conclusion These findings suggest that AT may effectively enhance gross motor function and alleviate associated symptoms in children diagnosed with spastic CP. Moreover, early initiation of treatment is crucial to maximize therapeutic efficacy in children with spastic CP. Trial Registration Chinese Clinical Trial Registry, ChiCTR2200059823. Registered on 12 May 2022.
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Affiliation(s)
- Xing Wang
- M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, SGR, Malaysia
- Famous TCM Expert Heritage Studio, Xi’an Encephalopathy Hospital Affiliated to Shaanxi University of Chinese Medicine, Xi’an, Shaanxi, People’s Republic of China
| | - Siew Hoon Teh
- M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, SGR, Malaysia
| | - Xiao-Gang Du
- Famous TCM Expert Heritage Studio, Xi’an Encephalopathy Hospital Affiliated to Shaanxi University of Chinese Medicine, Xi’an, Shaanxi, People’s Republic of China
| | - Xing-Hua Wang
- M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, SGR, Malaysia
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Supramaniam N, Zanudin A, Azmi NA. Body Mass Index, Physical Activity, Cardiorespiratory Endurance and Quality of Life among Children with Physical Disabilities. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1465. [PMID: 37761426 PMCID: PMC10527673 DOI: 10.3390/children10091465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/01/2023] [Accepted: 07/05/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Children with physical disabilities (PD) have reduced levels of physical activity (PA) compared to typically developing children, which increases their risk of becoming overweight and obese, which leads to numerous adverse health consequences. This study aimed to determine the differences between groups classified by body mass index (BMI) percentile in terms of PA levels, cardiorespiratory endurance and quality of life (QoL), and also to evaluate the relationship between BMI percentile and PA levels, cardiorespiratory endurance and QoL in children and adolescents with physical disabilities. METHODS A total of 172 children and adolescents with PD aged between 5 and 17 years from Hospital Tunku Azizah were included in this cross-sectional study. The BMI percentile was calculated to determine the weight status. PA levels were assessed with the Physical Activity Questionnaire for Older Children (PAQ-C), cardiorespiratory endurance was measured by the Six-Minute Walk Test (6MWT) and QoL was measured by the Paediatric Quality of Life Inventory version 2.0 (PedsQL 2.0). RESULTS According to the BMI percentile, 70.3% had a healthy BMI percentile (50th to 84th percentile), 11.6% were overweight (50th to 84th percentile), 11% were underweight (0-49th percentile) and 7.0% were obese (95th percentile and above). Most children reported a healthy weight, and the rates of being overweight and obese were higher in children who could ambulate without aids (6.4% and 3.5%, respectively) compared to those who used walking aids (5.2% and 3.5%, respectively). Significant differences were found in the PAQ-C, 6MWT and PedsQL 2.0 scores between different BMI percentile groups (p < 0.05). There were also significant correlations between the BMI percentile and the PAQ-C (r = 0.209, p < 0.001), 6MWT (r = 0.217, p < 0.001) and PedsQL 2.0 (r = 0.189, p < 0.001). CONCLUSION The rate of being overweight and obese is greater among children who ambulate without aids than among those with aids. An increase in the BMI percentile can reduce the QoL in different ways. This study suggests that children with PD who can walk without aids are at a greater risk of being overweight and obese. Hence, the engagement of this population in PA is crucial for their weight management.
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Affiliation(s)
- Nimale Supramaniam
- Physiotherapy Program, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia; (N.S.); (A.Z.)
- Physiotherapy Unit, Hospital Tuanku Ampuan Najihah Kuala Pilah, Kuala Pilah 72000, Negeri Sembilan, Malaysia
| | - Asfarina Zanudin
- Physiotherapy Program, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia; (N.S.); (A.Z.)
| | - Nor Azura Azmi
- Physiotherapy Program, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia; (N.S.); (A.Z.)
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Abdelhalim SM, Shoukry KE, Alsharnoubi J. Effect of low-level laser therapy on quadriceps and foot muscle fatigue in children with spastic diplegia: a randomized controlled study. Lasers Med Sci 2023; 38:182. [PMID: 37572215 PMCID: PMC10423123 DOI: 10.1007/s10103-023-03841-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/25/2023] [Indexed: 08/14/2023]
Abstract
Spastic diplegia is the most common form of cerebral palsy; children with spastic diplegia are suffering from muscle fatigue and spasticity which lead to decreasing power of muscles, impaired motor control, and many functional abilities. The effect of low-level laser (LLL) has a good result as it improves muscles pain and spasticity and in decreasing lactate levels. Forty children were selected with spastic diplegia and were divided into two groups: A and B. Group A received low-level laser treatment (LLLT) with physiotherapy treatment. Group B got physiotherapy sessions. Pain intensity was assessed by the visual analog scale (VAS) of pain which is reliable from age 5, before treatment and after 1-month follow-up. Muscle fatigue and power were assessed by maximum voluntary isometric contraction (MVIC) before treatment and after 1-month follow-up. Also, we tested blood lactate level in both groups; all evaluations were done before treatment and after 1-month follow-up. We found a significant difference between the two groups in VAS and MVIC and blood lactate level test regarding low-level therapy after 1-month follow-up. There is a good effect of low-level laser in increasing muscle power, decreasing blood lactate level, and improving pain.
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Affiliation(s)
| | - Kamal Elsayed Shoukry
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Jehan Alsharnoubi
- Pediatrics Department, National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt.
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66
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Al-Rumaih MH, Camp MW, Narayanan UG. Current Concept and Management of Spastic Hip in Children: A Narrative Review. Cureus 2023; 15:e43347. [PMID: 37577278 PMCID: PMC10421643 DOI: 10.7759/cureus.43347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 08/15/2023] Open
Abstract
Cerebral palsy (CP) is a non-progressive motor condition that hinders the development of movement and posture. One of the common problems faced in CP is spastic hips, which can cause discomfort, deformity, and functional restrictions. This review article seeks to offer a thorough summary of the most recent methods for treating spastic hips in cerebral palsy patients. Additionally, it describes the success and potential risks of various conservative and surgical procedures. It also looks at new treatments and potential avenues for managing this complicated ailment.
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Affiliation(s)
- Mohammed H Al-Rumaih
- Department of Orthopaedic Surgery, Prince Sultan Military Medical City, Riyadh, SAU
- Scientific Research Center (SRC), Prince Sultan Military Medical City, Riyadh, SAU
| | - Mark W Camp
- Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, CAN
- Department of Surgery, University of Toronto, Toronto, CAN
| | - Unni G Narayanan
- Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, CAN
- Department of Surgery, University of Toronto, Toronto, CAN
- Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, CAN
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, CAN
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67
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Mwinbam MM, Suglo JN, Agyeman YN, Kukeba MW. Family caregivers' experience of care with a child with cerebral palsy: the lived experiences and challenges of caregivers in a resource-limited setting in northern Ghana. BMJ Paediatr Open 2023; 7:e001807. [PMID: 37407248 PMCID: PMC10335558 DOI: 10.1136/bmjpo-2022-001807] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 06/22/2023] [Indexed: 07/07/2023] Open
Abstract
INTRODUCTION Caring for a child with cerebral palsy may be more emotionally and physically exhausting than caring for a typical growing child. The family caregivers' perspective of this phenomenon needs exploring to facilitate the development of services. Our study explored the challenges family caregivers face with children with cerebral palsy in a resource-limited context in northern Ghana. METHODS We conducted a qualitative study underpinned by phenomenological principles where it is believed that the reality of a phenomenon is tied to caregivers' perspectives of their own experiences. In this study, we unearthed caregivers' experiences/challenges from their own perspectives. The method of data analysis used was to allow the issues to emerge from the data (inductive process) using the content analysis approach. We recruited 13 caregivers of children with cerebral palsy from the physiotherapy unit at Tamale Teaching Hospital, and conducted individual in-depth interviews supported by an open-ended topic guide. Interviews were audio recorded, transcribed, and translated and coded inductively before conducting a content analysis of the data when grouped into themes. RESULTS We have identified barriers to managing a child with cerebral palsy, including sociocultural barriers (values, attitudes and belief systems within society), economic challenges and immediate physical care burdens. Specific barriers included discrimination and isolation, lack of family and societal support, with poor access to health information and formal education. Others were lack of information on the cause and course of cerebral palsy, caregivers' loss of jobs, increased healthcare expenditure and struggles in lifting and moving children, which resonate with evidence-based multidimensional model of caregiving process and caregiver burden. CONCLUSION Caregivers have the arduous task of caring for a child with cerebral palsy. Social support interventions and policy initiatives that seek to ameliorate caregivers' finances and make formal education accessible to this marginalised child population may be beneficial in this context.
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Affiliation(s)
- Mavis Mallory Mwinbam
- Department of Nursing, Nadowli District Hospital, Upper West Region, Nadowli, Ghana
- Faculty of Paediatric Nursing, Ghana College of Nurses and Midwives (GCNM), Accra, Ghana
| | - Joseph Ngmenesegre Suglo
- Department of Nursing and Midwifery, Presbyterian University College, Abetifi, Ghana
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Yaa Nyarko Agyeman
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Margaret Wekem Kukeba
- Department of Nursing, C K Tedam University of Technology and Applied Sciences, Navrongo, Ghana
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Homlong EG, Kumar RP, Elle OJ, Wiig O. Automated structuring of gait data for analysis purposes - A deep learning pilot example. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-5. [PMID: 38083029 DOI: 10.1109/embc40787.2023.10340938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Clinical gait analysis can help diagnose ambulatory children with cerebral palsy and provide treatment recommendations. This group represents the largest group of children with gait problems. Currently, the workflow for 3D gait analysis involves a complex process of collecting motion capture data and other types of data, analyzing the collected data, and creating an expert knowledge-based assessment. With this in mind, a data pipeline is essential for efficiently and effectively structuring data and reducing the time and effort required for data annotation and organization.A novel data pipeline has been developed to help structure, anonymize and automate parts of the annotation process of the data. In this sense, a pilot experiment was conducted using a simple convolutional neural network to classify between hemi-plegic and diplegic gait. This experiment included preprocessing the data, training the model and testing it.The data pipeline was used to create a semi-automated annotated data set. The neural network was trained on the data set and achieved an accuracy of 0.78 and a median of 1.0 on a holdout test set.
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Constance D, Subbiah R, Sukumaran A, Madankumar PD. Barriers in maintaining oral health among the children with cerebral palsy - Parent/caregiver's perspective. J Indian Soc Pedod Prev Dent 2023; 41:234-238. [PMID: 37861638 DOI: 10.4103/jisppd.jisppd_360_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Background Cerebral palsy (CP) is primarily a neuromotor disorder that affects the development of movement, muscle tone, and posture. Objective This qualitative study explores the underlying barriers in maintaining oral health from the perspective of the caregivers or parents. Materials and Methods Focus group discussion was conducted with the parents or caregivers in the National Institute for Empowerment of Persons with Multiple Disabilities (NIEPMD), Muttukadu, Chennai. Data were collected from seven participants. Thematic analysis identified key themes using NVivo software. Results The discussion on barriers to maintain oral health faced by parents of children with CP identified a collation of three key themes: behavioral challenges, inhibited social and communication skills, and parental dependence. Conclusion Oral health professionals should aim to raise awareness among health-care professionals to work toward reducing the barriers to oral health care that these populations currently experience.
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Affiliation(s)
- Diana Constance
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Rohini Subbiah
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Aparna Sukumaran
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
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van Tittelboom V, Heyrman L, De Cat J, Algoet P, Peeters N, Alemdaroğlu-Gürbüz I, Plasschaert F, Van Herpe K, Molenaers G, De Bruyn N, Deschepper E, Desloovere K, Calders P, Feys H, Van den Broeck C. Intensive Therapy of the Lower Limbs and the Trunk in Children with Bilateral Spastic Cerebral Palsy: Comparing a Qualitative Functional and a Functional Approach. J Clin Med 2023; 12:4078. [PMID: 37373771 DOI: 10.3390/jcm12124078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Few studies have examined the effect of intensive therapy on gross motor function and trunk control in children with cerebral palsy (CP). This study evaluated the effects of an intensive burst of therapy on the lower limbs and trunk by comparing qualitative functional and functional approaches. This study was designed as a quasi-randomized, controlled, and evaluator-blinded trial. Thirty-six children with bilateral spastic CP (mean age = 8 y 9 mo; Gross Motor Function Classification II and III) were randomized into functional (n = 12) and qualitative functional (n = 24) groups. The main outcome measures were the Gross Motor Function Measure (GMFM), the Quality Function Measure (QFM), and the Trunk Control Measurement Scale (TCMS). The results revealed significant time-by-approach interaction effects for all QFM attributes and the GMFM's standing dimension and total score. Post hoc tests showed immediate post-intervention gains with the qualitative functional approach for all QFM attributes, the GMFM's standing and walking/running/jumping dimension and total score, and the total TCMS score. The qualitative functional approach shows promising results with improvements in movement quality and gross motor function.
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Affiliation(s)
- Vanessa van Tittelboom
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, 9000 Ghent, Belgium
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Lieve Heyrman
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, 9000 Ghent, Belgium
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Josse De Cat
- Belgian Bobath Association (ABBV), 1082 Brussels, Belgium
| | - Patrick Algoet
- Belgian Bobath Association (ABBV), 1082 Brussels, Belgium
| | - Nicky Peeters
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
| | | | - Frank Plasschaert
- Department of Orthopedic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Katrin Van Herpe
- Rehabilitation Centre for Children and Youth, 2242 Pulderbos, Belgium
| | - Guy Molenaers
- Pediatric Orthopedics, Department of Orthopedics, University Hospital Leuven, 3000 Leuven, Belgium
| | - Nele De Bruyn
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, 9000 Ghent, Belgium
| | - Ellen Deschepper
- Biostatistics Unit, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, 9000 Ghent, Belgium
| | - Hilde Feys
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
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Aldharman SS, Alhamad FS, Alharbi RM, Almutairi YS, Alhomsi MWM, Alzahrani SA, Alayyaf AS, Alabdullatif NH, Bin Saeedu SS, Alnaaim SA. Risk Factors for Mortality in Patients With Cerebral Palsy: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e39327. [PMID: 37378195 PMCID: PMC10292172 DOI: 10.7759/cureus.39327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Cerebral palsy (CP) is a developmental and physical disorder with different degrees of severity. Since CP manifests itself in early childhood, numerous research studies have concentrated on children with CP. Patients with CP encounter different severity of motor impairments attributed to the damage or disturbance to the fetal or infant developing brain, which begins in early childhood and persists through adulthood. Patients with CP are more prone to mortality compared to the general population. This systematic review and meta-analysis aimed to assess the risk factors that predict and influence mortality in patients with CP. Systematic search for studies assessing the risk factors for mortality in CP patients that were conducted from 2000 to 2023 in Google Scholar, PubMed, and Cochrane Library was performed. R-One Group Proportion was used for statistical analysis and Newcastle-Ottawa Quality Assessment Scale (NOS) for quality appraisal. Of the 1791 total database searches, nine studies were included. Based on the NOS tool for quality appraisal, seven studies were of moderate quality, and two studies were rated as of high quality. The risk factors included pneumonia and other respiratory infections, neurological disorders, circulatory diseases, gastrointestinal infections, and accidents. Pneumonia (OR = 0.40, 95% CI = 0.31 - 0.51), neurological disorders (OR = 0.11, 95% CI = 0.08 - 0.16), respiratory infections (OR = 0.36, 95% CI = 0.31 - 0.51), cardiovascular and circulatory diseases (OR = 0.11, 95% CI = 0.04 - 0.27), gastrointestinal and metabolic causes (OR = 0.12, 95% CI = 0.06 - 0.22), and accidents (OR = 0.05, 95% CI = 0.04 - 0.07) were the risk factors assessed. It was concluded that multiple factors predict the risk of mortality in patients with CP. Pneumonia and other respiratory infections are associated with a high risk of mortality. Cardiovascular and circulatory diseases, gastrointestinal and metabolic disorders, and accidents are strongly linked to mortality in CP patients.
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Affiliation(s)
- Sarah S Aldharman
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Fahad S Alhamad
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | - Yousef S Almutairi
- College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj, SAU
| | | | | | | | | | | | - Saud A Alnaaim
- Department of Clinical Neurosciences, King Faisal University, Al-Ahsa, SAU
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Lim SY, Shin SH, Yang HJ, Park SG, Kim EK, Kim HS, Jun JK. Neonatal and developmental outcomes of very preterm twins according to the chorionicity and weight discordance. Sci Rep 2023; 13:6784. [PMID: 37100892 PMCID: PMC10133444 DOI: 10.1038/s41598-023-33428-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
Perinatal outcomes of twin pregnancies are determined by several factors, such as gestational age (GA), chorionicity, and discordance at birth. This retrospective study aimed to investigate the association of chorionicity and discordance with neonatal and neurodevelopmental outcomes in preterm twin infants from uncomplicated pregnancy. Data of very preterm twin infants who were both live-born between 2014 and 2019 on the chorionicity of the twin, diagnosis of the twin-to-twin syndrome (TTTS), weight discordance at birth, and neonatal and neurodevelopmental outcomes at 24 months of corrected age (CA) were collected. Of the 204 twin infants analyzed, 136 were dichorionic (DC) and 68 were monochorionic (MC), including 15 pairs with TTTS. After adjusting for GA, brain injury, including severe intraventricular hemorrhage and periventricular leukomalacia, was mostly found in the MC with TTTS group, with a higher incidence of cerebral palsy and motor delay at CA 24 months. After excluding TTTS, multivariable analysis showed no association between chorionicity and neonatal and developmental outcomes, whereas small infants among co-twins (adjusted odds ratio (aOR) 3.33, 95% confidence interval 1.03-10.74) and greater discordance (%) of weight at birth (aOR 1.04, 1.00-1.07) were associated with neurodevelopmental impairment. Monochorionicity might not determine adverse outcomes among very preterm twins from uncomplicated pregnancy.
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Affiliation(s)
- Soo Yeon Lim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seung Han Shin
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea.
- Department of Pediatrics, Seoul National University College of Medicine, 101, Daehak-Ro, Jongno-Gu, Seoul, Republic of Korea.
| | - Hyo Ju Yang
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seul Gi Park
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea
- Department of Pediatrics, Seoul National University College of Medicine, 101, Daehak-Ro, Jongno-Gu, Seoul, Republic of Korea
| | - Ee-Kyung Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea
- Department of Pediatrics, Seoul National University College of Medicine, 101, Daehak-Ro, Jongno-Gu, Seoul, Republic of Korea
| | - Han-Suk Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea
- Department of Pediatrics, Seoul National University College of Medicine, 101, Daehak-Ro, Jongno-Gu, Seoul, Republic of Korea
| | - Jong Kwan Jun
- Department of Obstetrics & Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
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Zhakupova M, Nurbakyt A, Ospanova D, Chuyenbekova A, Kozhekenova Z, Dauletova G, Aitmanbetova A, Abdikadir M, Padaiga Z, Izmailovich M, Glushkova N, Semenova Y. Epidemiology of cerebral palsy in the Republic of Kazakhstan: Incidence and risk factors. Heliyon 2023; 9:e14849. [PMID: 37025867 PMCID: PMC10070905 DOI: 10.1016/j.heliyon.2023.e14849] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Background There is a paucity of robust data on the incidence and causes of cerebral palsy (CP) in Central Asian countries, while this information is important for planning local healthcare services. This epidemiological study was designed to clear the gap in knowledge on both the incidence of CP and the underlying risk factors in the Republic of Kazakhstan. Methods This was a retrospective study that comprised two stages. At the first stage, a cross-sectional analysis of CP frequencies was performed on the basis of official statistics obtained from the Republican Center for Health Development. A study with age- and sex-matched controls was carried out at the second stage to elucidate the maternal and neonatal risk factors associated with CP. Results Mild variability in national CP incidence was observed, ranging from 68.7 to 83.3 per 100,000 population. A number of maternal risk factors were significantly associated with CP, including arterial hypertension, thrombocytopenia, diabetes mellitus, pathology of fetal membranes, premature rupture of membranes, and acute respiratory illness during pregnancy. Low Apgar score, gestational age, birth weight, and presence of intraventricular hemorrhage or periventricular leukomalacia were among the important neonatal risk factors. Conclusion There is a need for a more comprehensive prospective study to document the extent of the CP problem in Kazakhstan. In addition, a national CP registry must be envisaged to overcome the lack of essential data.
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de Lima Crispim TR, Neto MG, Crispim TRL, Dias RB, de Albuquerque MDM, Saquetto MB, Magalhães PAF. Addition of respiratory exercises to conventional rehabilitation for children and adolescents with cerebral palsy: a systematic review and meta-analysis. World J Pediatr 2023; 19:340-355. [PMID: 36376558 PMCID: PMC9663285 DOI: 10.1007/s12519-022-00642-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/16/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Respiratory dysfunctions are an important cause of morbidity and death in cerebral palsy (CP) populations. Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respiratory status in CP patients. The objective of this systematic review and meta-analysis was to verify the effects of the addition of respiratory exercises to conventional rehabilitation on pulmonary function, functional capacity, respiratory muscle strength, gross motor function and quality of life in children and adolescents with CP. METHODS We searched for randomized controlled clinical trials in PubMed/Medline, Lilacs, SciELO, EMBASE and Physiotheraphy Evidence (PEDro) from their inception until July 2022 without language restrictions. Studies that included respiratory exercises (breathing exercise program; feedback respiratory training; incentive spirometer exercise; inspiratory muscle training; and combination of respiratory exercises + incentive spirometer exercise) in combination with conventional rehabilitation for children and adolescents with CP were evaluated by two independent reviewers. The mean difference (MD) and 95% confidence interval (CI) were estimated by random effect models. RESULTS Ten studies met the eligibility criteria, including 324 children aged from 6 to 16 years. The meta-analysis showed an improvement in inspiratory muscle strength of 22.96 cmH2O (18.63-27.27, n = 55) and pulmonary function of 0.60 (0.38-0.82, n = 98) for forced vital capacity (L); 0.22 (0.06-0.39, n = 98) for forced expiratory volume at 1 second (L); and 0.50 (0.05-0.04, n = 98) for peak expiratory flow (L/min). Functional skills in daily living activities improved in the intervention group. Caregivers' assistance of daily living activities, functional capacity, gross motor function and expiratory muscle strength showed a nonsignificant improvement. Social well-being and acceptance and functioning domains improved in only one study. CONCLUSIONS Emerging data show significant enhancements in inspiratory muscle strength and pulmonary function in CP patients after respiratory training in addition to conventional rehabilitation. There is no consensus on the frequency, type or intensity of respiratory exercises for children with and adolescents with CP.
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Affiliation(s)
- Thálita Raysa de Lima Crispim
- Research Group of Neonatal and Pediatric Physical Therapy, Baby GrUPE, Petrolina, Pernambuco, Brazil.
- Postgraduate Program in Rehabilitation and Functional Performance, PPGRDF, Universidade de Pernambuco, Rodovia BR 203, Km 2 S/N. Vila Eduardo, Petrolina, Pernambuco, 56328-900, Brazil.
| | - Mansueto Gomes Neto
- Research Group of Physiotherapy, Department of Physical Therapy, Universidade Federal da Bahia, Salvador, Brazil
- Posgraduate Program in Medicine and Health, Salvador, Bahia, Brazil
| | | | - Renivaldo Batista Dias
- Research Group of Neonatal and Pediatric Physical Therapy, Baby GrUPE, Petrolina, Pernambuco, Brazil
| | | | - Micheli Bernardone Saquetto
- Research Group of Physiotherapy, Department of Physical Therapy, Universidade Federal da Bahia, Salvador, Brazil
- Posgraduate Program in Medicine and Health, Salvador, Bahia, Brazil
| | - Paulo André Freire Magalhães
- Research Group of Neonatal and Pediatric Physical Therapy, Baby GrUPE, Petrolina, Pernambuco, Brazil
- Postgraduate Program in Rehabilitation and Functional Performance, PPGRDF, Universidade de Pernambuco, Rodovia BR 203, Km 2 S/N. Vila Eduardo, Petrolina, Pernambuco, 56328-900, Brazil
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75
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Yang FA, Lee TH, Huang SW, Liou TH, Escorpizo R, Chen HC. Upper limb manual training for children with cerebral palsy: A systematic review and network meta-analysis of randomized controlled trials. Clin Rehabil 2023; 37:516-533. [PMID: 36330696 DOI: 10.1177/02692155221137698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE There are different upper limb manual training protocols, namely constraint-induced movement therapy, modified constraint-induced movement therapy, hand-arm bimanual intensive training, hand-arm bimanual intensive training including lower extremity, action observation training, and mirror therapy, available for improving functional outcomes in children with cerebral palsy. However, the effect and priority of these strategies remain unclear. DATA SOURCES We searched the PubMed, Cochrane Library, and Embase databases for relevant articles from inception to October 12, 2022. REVIEW METHODS To assess the effect and priority of different strategies of upper limb manual training protocols through a systematic review and network meta-analysis of randomized controlled trials. RESULTS We included 22 randomized controlled trials in this network meta-analysis. The ranking probability and standard mean differences with 95% credible intervals of the comparison between placebo and other forms of upper limb manual training were as follows: mirror therapy = 2.83 (1.78, 3.88), hand-arm bimanual intensive training including the lower extremity = 0.53 (0.09, 0.96), constraint-induced movement therapy = 0.44 (0.18, 0.71), hand-arm bimanual intensive training = 0.41 (0.15, 0.67), modified constraint-induced movement therapy = 0.39 (0.03, 0.74), and action observation training = 0.18 ( - 0.29, 0.65). No significant inconsistency was noted between the results of direct and indirect comparisons. CONCLUSION We suggest that mirror therapy could be the upper limb manual training protocol of choice for improving functional outcomes in patients with cerebral palsy.
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Affiliation(s)
- Fu-An Yang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ting-Hsuan Lee
- Department of Family Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan.,Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan.,Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, University of Vermont, College of Nursing and Health Sciences, Burlington, VT, USA.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City, Taiwan.,Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, Taiwan
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76
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Claassen DO, Riordan HR, Dure LS, Battini R, Cortez A, Gordon MF, O'Connor M, Jackson K, Foster A, Kosinski M. Content Validation of the Movement Disorder-Childhood Rating Scale (MD-CRS) for Dyskinetic Cerebral Palsy. Pediatr Neurol 2023; 141:65-71. [PMID: 36774682 DOI: 10.1016/j.pediatrneurol.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/09/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Dyskinetic cerebral palsy (DCP), a lifelong neurological disorder beginning in early childhood, manifests with hyperkinetic movements and dystonia. The Movement Disorder-Childhood Rating Scale (MD-CRS) is a clinician-reported outcome measure assessing the intensity of movement disorders and their effect on daily life in pediatric patients. Content validity of clinical outcome assessments is key to accurately capturing patient perspective. Evidence demonstrating content validity of the MD-CRS in patients with DCP is needed. This study captures input from patients with DCP and their caregivers regarding the content validity of the MD-CRS. METHODS This qualitative, noninterventional, cross-sectional study included interviews with children/adolescents (aged six to 18 years) with DCP and caregivers of children with DCP. Participants were asked to describe body regions and daily functions affected by DCP. Caregivers also reviewed MD-CRS Part I to evaluate the relevance of the items and corresponding response options. Descriptions of DCP were coded and mapped to MD-CRS items and response options. Caregiver feedback on MD-CRS Part I was analyzed using inductive content analysis. RESULTS Eight patients and 12 caregivers were interviewed. Participants confirmed that the body regions and activities listed in the MD-CRS were affected by DCP and that involuntary movements interfered with all motor, oral/verbal, self-care, and video protocol activities. Caregivers endorsed the response options for 12 of 15 items in MD-CRS Part I and suggested clarifications for others. CONCLUSIONS Participants confirmed that affected body regions and activities listed in the MD-CRS were relevant to their experience with DCP, demonstrating the content validity of this tool in children/adolescents with DCP.
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Affiliation(s)
| | | | - Leon S Dure
- Heersink School of Medicine, Birmingham, Alabama
| | - Roberta Battini
- IRCCS Fondazione Stella Maris, Viale de Tirreno, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Lungarno Antonio Pacinotti, Pisa, Italy
| | - Alma Cortez
- Teva Branded Pharmaceutical Products R&D, Inc., West Chester, Pennsylvania
| | | | | | | | - April Foster
- QualityMetric Incorporated, LLC, Johnston, Rhode Island
| | - Mark Kosinski
- QualityMetric Incorporated, LLC, Johnston, Rhode Island
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Kumar D, Kumar R, Mudgal SK, Ranjan P, Kumar S. The Effects of Botulinum Toxin and Casting in Spastic Children With Cerebral Palsy: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e36851. [PMID: 37123757 PMCID: PMC10142340 DOI: 10.7759/cureus.36851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
Cerebral palsy (CP) is a neurological disorder that affects muscle tone, movement, and motor skills in children. One of the most common symptoms of cerebral palsy is spasticity, which is characterised by involuntary muscle contractions and stiffness. Both botulinum toxin and casting have been used as standalone treatments for spasticity in cerebral palsy, but which is better is still unclear. The aim of the present meta-analysis was to compare the effects on spasticity of serial casting and/or botulinum toxin type A (BoNT-A) in conjunction with or as independent therapies. Studies up to February 2022 were identified in four separate databases. The inclusion criteria were randomised controlled trials (RCTs) that compared different therapies (Botulinum toxin A, or BoNT-A, and casting) and assessed spasticity improvement in children with spastic cerebral palsy who were younger than 18 years old and were published in English. With a 95% confidence interval (CI), the standardised mean difference (SMD) was utilised to calculate treatment effects. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist was followed to undertake the current study. The search for relevant literature in four databases generated 147 results. After the abstract and full-text screening, five publications with a total of 190 cerebral palsy patients were included in this systematic review and meta-analysis. In patients with cerebral palsy, both methods - botulinum toxin and casting- apply globally; our systematic review tries to find out the most effective treatment between the two but does not show any significant difference in these methods. As we know, botulinum toxin is expensive, and the casting method is time-consuming and poorly accepted by patients. There is a need for an excellent study to examine the impact of casting and botulinum toxin type A.
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78
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Ferreira de Andrade A, dos Santos Guimarães GK, Ferreira da Silva J, Moura de Sousa BM, Honorato MM, de Carvalho Cremaschi RM, Santos Coelho FM. Neurodegeneration with brain iron accumulation: a differential diagnosis of cerebral palsy. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2023. [DOI: 10.1186/s41983-023-00639-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Abstract
Background
Brain iron accumulation neurodegeneration (NBIA) comprises a group of rare diseases characterized by deposits of this metal in brain structures. It presents a great variability of progression, which can be fast enough to lead the patient to death in the first years of life, or slow enough to be confused with non-progressive diseases.
Case presentation
Female, 19-year-old patient, cesarean delivery at 38 weeks of gestation. History of multiple sclerosis in a second-degree paternal aunt. Normal neuropsychomotor growth and development up to 11 months, when changes in gait began. After that, it got worse, with decreased muscle strength and falls, but it progressed so slowly that she was diagnosed with cerebral palsy, a non-progressive condition. At the age of 16, she underwent molecular analysis by exome sequencing, being diagnosed with the NBIA Phospholipase A2 (PLAN) variant. Currently doing physical therapy, hydrotherapy, occupational therapy and sertraline.
Conclusions
The report draws attention to the variability of the disease and the possibility of confusion with other diagnoses, which may delay proper management.
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79
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Cabezas-López M. How Is Cerebral Palsy Different from Other Childhood Neurological Disorders? JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2023. [DOI: 10.1007/s40817-023-00140-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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80
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Adaikina A, Derraik JGB, Taylor J, O'Grady GL, Hofman PL, Gusso S. Vibration Therapy as an Early Intervention for Children Aged 2-4 Years with Cerebral Palsy: A Feasibility Study. Phys Occup Ther Pediatr 2023; 43:564-581. [PMID: 36872600 DOI: 10.1080/01942638.2023.2181723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 03/07/2023]
Abstract
Aims: To evaluate the feasibility and acceptability of vibration therapy (VT) in preschool children with cerebral palsy (CP) and obtain preliminary data on its potential effectiveness.Methods: Nine children aged 2.5-4.8 years (4 boys) with CP GMFCS levels I-III participated in a single-group feasibility study, undergoing a 12-week control period without intervention, followed by 12 weeks of home-based VT (four times/week, 9 min/day, frequency 20 Hz). We assessed adherence to VT protocol, adverse events, and family acceptability of VT. Clinical assessments included motor function (GMFM-66), body composition (DXA), mobility (10-meter walk/run test), and health-related quality of life (PedsQL).Results: VT was well tolerated and acceptable to families, with high adherence levels reported (mean = 93%). There were no observed between-period differences (ΔControl vs ΔVT) except for an improvement in the PedsQL "Movement & Balance" dimension with VT (p = 0.044). Nonetheless, changes after the VT but not the Control period were suggestive of potential treatment benefits for mobility, gross motor function, and body composition (lean mass and legs bone mineral density).Conclusion: Home-based VT is feasible and acceptable for preschool children with CP. Our preliminary data suggest potential health benefits from VT for these children, supporting larger randomized trials to assess its effectiveness properly. Clinical trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN12618002027291).
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Affiliation(s)
- Alena Adaikina
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Thailand
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Janice Taylor
- Child Development Unit and Newborn Services, Starship Children's Hospital, Auckland, New Zealand
| | - Gina L O'Grady
- Paediatric Neurology Department, Starship Children's Hospital, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Silmara Gusso
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Exercise Sciences Department, University of Auckland, Auckland, New Zealand
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81
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Maiti KS. Non-Invasive Disease Specific Biomarker Detection Using Infrared Spectroscopy: A Review. Molecules 2023; 28:2320. [PMID: 36903576 PMCID: PMC10005715 DOI: 10.3390/molecules28052320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
Many life-threatening diseases remain obscure in their early disease stages. Symptoms appear only at the advanced stage when the survival rate is poor. A non-invasive diagnostic tool may be able to identify disease even at the asymptotic stage and save lives. Volatile metabolites-based diagnostics hold a lot of promise to fulfil this demand. Many experimental techniques are being developed to establish a reliable non-invasive diagnostic tool; however, none of them are yet able to fulfil clinicians' demands. Infrared spectroscopy-based gaseous biofluid analysis demonstrated promising results to fulfil clinicians' expectations. The recent development of the standard operating procedure (SOP), sample measurement, and data analysis techniques for infrared spectroscopy are summarized in this review article. It has also outlined the applicability of infrared spectroscopy to identify the specific biomarkers for diseases such as diabetes, acute gastritis caused by bacterial infection, cerebral palsy, and prostate cancer.
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Affiliation(s)
- Kiran Sankar Maiti
- Max–Planck–Institut für Quantenoptik, Hans-Kopfermann-Straße 1, 85748 Garching, Germany; ; Tel.: +49-289-14054
- Lehrstuhl für Experimental Physik, Ludwig-Maximilians-Universität München, Am Coulombwall 1, 85748 Garching, Germany
- Laser-Forschungslabor, Klinikum der Universität München, Fraunhoferstrasse 20, 82152 Planegg, Germany
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82
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Pennington J, Contini S, Brown M, Goel N, Chen T. Efficacy of intrathecal morphine administration in pediatric patients undergoing selective dorsal rhizotomy. J Pediatr Rehabil Med 2023; 16:109-114. [PMID: 36806525 DOI: 10.3233/prm-220048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the effectiveness of intrathecal morphine following selective dorsal rhizotomy in pediatric patients previously diagnosed with cerebral palsy. METHODS This was a retrospective, cohort analysis over the course of four years. The analysis consisted of a treatment group which received intrathecal morphine (5 mcg/kg) injection and a control group that did not receive the injection prior to dural closure. All patients underwent multilevel laminectomies for selective dorsal rhizotomy at Akron Children's Hospital. The effectiveness of the treatment was measured by total dose of hydromorphone administered on patient-controlled analgesia (PCA), number of days on oral narcotics, and cumulative dose of oral narcotic. RESULTS Of the analyzed 15 pediatric patients, seven patients received intrathecal morphine injection while the other eight did not receive the treatment prior to dural closure. There was a difference of 1135 mcg in total PCA dose between the study group (3243 mcg) and the control group (4378 mcg). The total PCA dose based on weight was lower in the study group (163 mcg/kg) than in the control group (171 mcg/kg). CONCLUSION Based on these findings, the administration of intrathecal morphine clinically reduces the opiate need in the first 96 hours post-operatively.
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Affiliation(s)
| | | | | | - Nupur Goel
- Northeast Ohio Medical University, Rootstown, OH, USA
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83
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Grodon C, Bassett P, Shannon H. The 'heROIC' trial: Does the use of a robotic rehabilitation trainer change quality of life, range of movement and function in children with cerebral palsy? Child Care Health Dev 2023. [PMID: 36788457 DOI: 10.1111/cch.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/25/2023] [Accepted: 02/05/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Children with severe cerebral palsy (CP) (GMFCS IV/V) can find it difficult to access equipment that allows them to exercise effectively, potentially impacting their quality of life. Physiotherapists working within special schools are well placed to facilitate increased physical activity as part of the school day. This study explored whether the Innowalk Pro, a robotic rehabilitation trainer, could influence quality of life (measured by the CPCHILD questionnaire), in children with CP, alongside, joint range of movement, spasticity and functional goals of the lower limbs, measured by goniometry, modified Tardieu scale and goal attainment scoring, GAS, respectively. METHODS A prospective single-arm, pre-post trial was undertaken. The Innowalk Pro was used four times a week for 30 min alongside usual physiotherapy care in a school setting over a 6-week period. Outcomes were evaluated immediately pre/post intervention and at 6 weeks and 3 months post intervention. Analysis also explored differences between primary and secondary age participants. RESULTS Twenty-seven participants aged 5-18 years with a diagnosis of CP GMFCS IV/V (10 female, 17 male, mean age 12 years) were included from a convenience sample in a special school. Quality of life improved in 36% of participants, the majority of these being secondary aged. Knee extension reduced significantly 3 months post intervention. There were no meaningful changes in spasticity. GAS goals improved in 88% of participants after using the Innowalk Pro. GAS goals tended to decline after a break from using the equipment, with 21% declining by two or more units at 3 months post intervention. CONCLUSION A 6-week course of the Innowalk Pro can improve quality of life and functional goals for children with CP aged 5-18 years. After a break of 6-12 weeks, functional goals tend to return to baseline. Further research is needed to explore different prescriptions of the Innowalk Pro, to see if increasing the time used/increasing the frequency or number of weeks it is used for can provide longer lasting benefits.
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Affiliation(s)
| | | | - Harriet Shannon
- UCL Great Ormond Street Institute of Child Health, London, UK
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84
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Dijkstra JN, Boon E, Kruijt N, Brusse E, Ramdas S, Jungbluth H, van Engelen BGM, Walters J, Voermans NC. Muscle cramps and contractures: causes and treatment. Pract Neurol 2023; 23:23-34. [PMID: 36522175 DOI: 10.1136/pn-2022-003574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 12/23/2022]
Abstract
Muscle cramps are painful, sudden, involuntary muscle contractions that are generally self-limiting. They are often part of the spectrum of normal human physiology and can be associated with a wide range of acquired and inherited causes. Cramps are only infrequently due to progressive systemic or neuromuscular diseases. Contractures can mimic cramps and are defined as shortenings of the muscle resulting in an inability of the muscle to relax normally, and are generally myogenic. General practitioners and neurologists frequently encounter patients with muscle cramps but more rarely those with contractures. The main questions for clinicians are: (1) Is this a muscle cramp, a contracture or a mimic? (2) Are the cramps exercise induced, idiopathic or symptomatic? (3) What is/are the presumed cause(s) of symptomatic muscle cramps or contractures? (4) What should be the diagnostic approach? and (5) How should we advise and treat patients with muscle cramps or contractures? We consider these questions and present a practical approach to muscle cramps and contractures, including their causes, pathophysiology and treatment options.
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Affiliation(s)
- Jildou N Dijkstra
- Department of Neurology, Radboud Universiteit, Nijmegen, The Netherlands
| | - Eline Boon
- Department of Neurology, Radboud Universiteit, Nijmegen, The Netherlands
| | - Nick Kruijt
- Department of Neurology, Radboud Universiteit, Nijmegen, The Netherlands
| | - Esther Brusse
- Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Sithara Ramdas
- MDUK Neuromuscular Centre, Department of Paediatrics, University of Oxford, Oxford, UK.,Department of Paediatric Neurology, John Radcliffe Hospital, Oxford, UK
| | - Heinz Jungbluth
- Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's and St Thomas' Hospitals NHS Trust, London, UK.,Randall Centre for Cell and Molecular Biophysics, Muscle Signalling Section, Faculty of Life Sciences and Medicine (FoLSM), King's College London, London, UK
| | | | - Jon Walters
- Department of Neurology, Morriston Hospital, Swansea, UK
| | - Nicol C Voermans
- Department of Neurology, Radboud Universiteit, Nijmegen, The Netherlands
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85
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Mimouni-Bloch A, Shaklai S, Levin M, Ingber M, Karolitsky T, Grunbaum S, Friedman J. Developmental and acquired brain injury have opposite effects on finger coordination in children. Front Hum Neurosci 2023; 17:1083304. [PMID: 36755895 PMCID: PMC9899809 DOI: 10.3389/fnhum.2023.1083304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/02/2023] [Indexed: 01/24/2023] Open
Abstract
The ability to coordinate finger forces to dexterously perform tasks develops in children as they grow older. Following brain injury, either developmental (as in cerebral palsy-CP) or acquired (as in traumatic brain injury-TBI), this developmental trajectory will likely be impaired. In this study, we compared finger coordination in a group of children aged 4-12 with CP and TBI to a group of typically developing children using an isometric pressing task. As expected, deficits were observed in functional tests (Jebsen Taylor test of hand function, Box and Block test) for both groups, and children in both groups performed the pressing task less well than the control group. However, differing results were observed between the CP and TBI groups when using the uncontrolled manifold hypothesis to look at the synergy index. This index measures the relative amount of "good" (does not affect the outcome measure) and "bad" (does affect the outcome measure) variability, where in this case the outcome measure is the total force produced by the fingers. While children with CP were more variable in their performance, their synergy index was not significantly different from typically developing children, suggesting the development of compensatory strategies. In contrast, the children following TBI showed performance that got worse as a function of age (i.e., the older children with TBI performed worse than the younger children with TBI). These differences between the groups may be a result of different areas of brain injury typically observed in CP and TBI, and the different amount of time that has passed since the injury.
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Affiliation(s)
- Aviva Mimouni-Bloch
- Pediatric Neurology and Development Unit, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Sharon Shaklai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel,Department of Child and Youth Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
| | - Moran Levin
- Department Physical Therapy, Sackler Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Moria Ingber
- Department of Child and Youth Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
| | - Tanya Karolitsky
- Department of Child and Youth Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
| | - Sigal Grunbaum
- Department of Child and Youth Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
| | - Jason Friedman
- Department Physical Therapy, Sackler Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv-Yafo, Israel,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv-Yafo, Israel,*Correspondence: Jason Friedman,
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86
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Zary N, Eysenbach G, Terroso Gil N. Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities. JMIR Serious Games 2023; 11:e36110. [PMID: 36637882 PMCID: PMC9947823 DOI: 10.2196/36110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 07/14/2022] [Accepted: 10/31/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND We developed the Blexer system consisting of a database and a web interface for therapists that can host different types of adaptive and personally configurable virtual reality exergames based on Kinect (Microsoft Corp) motion capture to provide entertaining exercises for children with motor disabilities. It allows for parameter adjustment and the monitoring of results remotely, thereby providing a useful tool to complement traditional physical therapy sessions with home exercises. OBJECTIVE The aim of this study was to observe the motor benefits achieved through the use of a video exergame and the importance and implications of correctly setting the game's difficulty parameters. METHODS This was an observational case study of 6 children with different physical disabilities receiving physical therapy at school combined with the use of a fully configurable exergame under research that forms a part of the Blexer environment. The game integrates 4 repeatedly appearing upper limb exercises with individually adjustable difficulties (intermittent arm rising, arm forward and backward movement, rising and holding of one arm, and trunk control in all directions). The outcomes were 3 assessments of 2 efficacy measures: Box and Block Test and Jebsen Taylor Hand Function Test. RESULTS A total of 5 children with cerebral palsy (mean 8.4, SD 2.7 years; Gross Motor Function Classification II-2/5, 40%; III-2/5, 40%; and IV-1/5, 20%) and 1 child with obstetric brachial plexus palsy (aged 8 years; Mallet Classification III) received between 8 and 11 sessions of training (10-20 minutes per session), depending on age, motivation, and fatigue. Significant associations were observed between game parameter settings and improvements in motor function, on the one hand, and between the type of improvement and disability severity, on the other: with adjusted game parameters goal and time in the range of 70% to 100%, only less affected children improved in the Box and Block Test (+11 blocks vs -1 block), and more affected children improved more in the Jebsen Taylor Hand Function Test (+90 seconds vs +27 seconds). CONCLUSIONS When defining the difficulty parameters for an exergame, we suggest a classification in levels ranging from very easy to very hard. For practical use, we suggest setting the difficulty for the player to an easy or medium level rather than high-commitment goals, as this leads to a longer playtime with more fun and, therefore, seems to improve the results of the game and, consequently, mobility.
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Affiliation(s)
| | | | - Noelia Terroso Gil
- Department of Physiotherapy, Primary School, Centro de Educación Infantil y Primaria Pinar de San José, Madrid, Spain
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Wahyuni LK. Multisystem compensations and consequences in spastic quadriplegic cerebral palsy children. Front Neurol 2023; 13:1076316. [PMID: 36698899 PMCID: PMC9868261 DOI: 10.3389/fneur.2022.1076316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Spastic quadriplegic cerebral palsy (CP) is a permanent neuromuscular disorder causing limitation on all four limbs following a lesion on the developing brain. Most children with spastic quadriplegic CP are identified to be Gross Motor Function Classification System (GMFCS) level V, thus they have more comorbidities compared to other types at lower levels. Spastic quadriplegic CP is characterized by weak and inactive postural muscles of the neck and trunk, hence, they will undergo a total body extension as a compensatory mechanism leading to an atypical movement pattern, that give rise to multisystem consequences that reduce their quality of life. The relationship between atypical movement patterns, compensatory strategies, and multisystem consequences have not yet been explored. In fact, these multisystem consequences aggravate their condition and make movement much more atypical, forming a vicious cycle. This review aimed to provide a summary and highlight the mechanism of atypical movement pattern, multisystem compensations, and consequences in spastic quadriplegic CP children. It is true that central nervous system (CNS) lesion in CP is non-progressive, however the multisystem consequences may impair overall function over time. An understanding of how compensatory strategy and multisystem consequences in spastic quadriplegic CP offers the opportunity to intervene as early as possible to improve their quality of life.
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Affiliation(s)
- Luh Karunia Wahyuni
- Physical Medicine and Rehabilitation Department, Dr. Cipto Mangunkusumo Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Akyurek G, Gurlek S, Ozturk LK, Bumin G. The effect of parent-based occupational therapy on parents of children with cerebral palsy: a randomised controlled trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2023. [DOI: 10.12968/ijtr.2022.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background/Aims Parents of children with cerebral palsy face higher levels of stress, anxiety and depression, sadness, exhaustion and burnout. Parent-based therapies have been found to increase parents' satisfaction with therapy, parent–child interactions and reduced parental stress. This study examined the effects of parent-based occupational therapy on stress levels, coping skills, and emotional skills and competencies of parents of children with cerebral palsy. Methods A total of 15 children and their parents who were admitted to the paediatric rehabilitation unit for occupational therapy were divided into two groups (control group: n=7, study group: n=8) using the coin toss randomisation method. The control group received standard occupational therapy, while the study group received parent-based occupational therapy for 45 minutes a session, twice a week, until 10 sessions had been completed. Participants were evaluated before and after the intervention. Results The study group showed a decrease in stress levels (P=0.034) and increases in coping skills (P=0.016), and emotional skills and competencies (P=0.036). In addition, only an improvement in parents' stress levels (P=0.046) was observed in the control group. Conclusions The parent-based occupational therapy programme was more effective regarding stress levels, coping skills, emotional skills and competencies of the families of children with cerebral palsy compared to classical occupational therapy. This study is important in terms of demonstrating the benefits of parent-based occupational therapy for parents of children with cerebral palsy.
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Affiliation(s)
- Gokcen Akyurek
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Sedanur Gurlek
- Department of Occupational Therapy, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - Leyla Kaya Ozturk
- Department of Occupational Therapy, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Gonca Bumin
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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89
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Cai X, Qian G, Cai S, Wang F, Da Y, Ossowski Z. The effect of whole-body vibration on lower extremity function in children with cerebral palsy: A meta-analysis. PLoS One 2023; 18:e0282604. [PMID: 36897858 PMCID: PMC10004558 DOI: 10.1371/journal.pone.0282604] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 02/18/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE The aim of this meta-analysis was to evaluate the effect of whole-body vibration training on lower limb motor function in children with cerebral palsy in randomized-controlled trials (RCTs). METHODS Two independent reviewers systematically searched the records of nine databases (PubMed, Cochrane, Web of Science, EMBASE, CNKI, etc.) from inception to December 2022. Tools from the Cochrane Collaboration were used to assess risk of bias. Standard meta-analyses were performed using Stata 16.0 and Revman 5.3. For continuous variables, the arms difference was calculated as the weighted mean difference (WMD) between the values before and after the intervention and its 95% confidence interval (95% CI). RESULTS Of the 472 studies identified, 13 (total sample size 451 participants) met the inclusion criteria. Meta-analysis showed that WBV training could effectively improve GMFM88-D [WMD = 2.46, 95% CI (1.26, 3.67), P<0.01] and GMFM88-E [WMD = 3.44, 95% CI (1.21, 5.68), P = 0.003], TUG [WMD = -3.17, 95% CI (-5.11, -1.24), P = 0.001], BBS [WMD = 4.00,95% CI (3.29, 4.71), P<0. 01] and the range of motion of ankle joint and the angle of ankle joint during muscle reaction in children with cerebral palsy. The effect of WBV training on 6MWT walking speed [WMD = 47.64, 95% CI (-25.57, 120.85), p = 0.20] in children with cerebral palsy was not significantly improved. CONCLUSION WBV training is more effective than other types of conventional physical therapy in improving the lower limb motor function of children with cerebral palsy. The results of this meta-analysis strengthen the evidence of previous individual studies, which can be applied to the clinical practice and decision-making of WBV training and rehabilitation in children with cerebral palsy.
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Affiliation(s)
- Xiaoye Cai
- Shanghai Normal University Tianhua College, Shanghai, P. R. China
| | - Guoping Qian
- Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Siyuan Cai
- Victoria university of Wellington, Wellington, New Zealand
| | - Feng Wang
- Shanghai Ocean University, Shanghai, P. R. China
| | - Yingjuan Da
- Shanghai Normal University Tianhua College, Shanghai, P. R. China
| | - Zbigniew Ossowski
- Gdansk University of Physical Education and Sport, Gdańsk, Poland
- * E-mail:
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90
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Galivanche AR, Gillinov SM, Mercier MR, Schneble CA, Varthi AG, Grauer JN, Frumberg DB. In-hospital complications after cervical fusion in cases with versus without cerebral palsy. NORTH AMERICAN SPINE SOCIETY JOURNAL 2022; 12:100167. [PMID: 36132746 PMCID: PMC9483629 DOI: 10.1016/j.xnsj.2022.100167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 01/22/2023]
Abstract
Background Patients with cerebral palsy (CP) are at increased risk for cervical spine pathology. Cervical fusion surgery may be considered in this population, but perioperative outcomes relative to patients without CP remains poorly understood. The purpose of this study was to compare in-hospital complications after cervical fusion in patients with versus without cerebral palsy (CP) using a retrospective cohort design. Methods Cervical fusion cases with and without CP were identified in the National Inpatient Sample (NIS) database. In-hospital adverse events were tabulated and grouped into any (AAE), serious (SAE), and minor adverse events (MAE). Length of hospital stay (LOS) and mortality were assessed. Multiple logistic regression models with and without 1:1 propensity matching were used to compare outcomes between cases with and without CP, controlling for demographic and preoperative variables. Results After weighting, 1,518,012 cases were included in the study population, of which 4,554 (0.30%) had CP. Those with CP were younger, more often male, suffered more comorbidities, more frequently operated on from a posterior or combined approach, and were more frequently addressed at more than one level. By multiple logistic regression after matching, CP cases had higher odds of AAE (OR 1.72; 95% CI 1.05-2.81; p=0.030) and MAE (OR 2.07; 95% CI 1.20-3.57; p=0.009), but no differences in odds of SAE or in-hospital mortality. Conclusions As there is increasing awareness of potentially cervical pathology in the CP population, the current study suggests that surgical intervention for this population can be appropriately considered without severe in-hospital morbidity or mortality.
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Affiliation(s)
- Anoop R. Galivanche
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA
- Department of Orthopaedic Surgery, University of California, San Francisco School of Medicine, 500 Parnassus Avenue, San Francisco, CA, 94143 USA
| | - Stephen M. Gillinov
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA
| | - Michael R. Mercier
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA
- Division of Orthopaedics, Department of Surgery, University of Toronto, 149 College Street, Toronto, ON M5T 1P5 USA
| | - Christopher A. Schneble
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA
| | - Arya G. Varthi
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA
| | - Jonathan N. Grauer
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA
| | - David B. Frumberg
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06511, USA
- Corresponding author at: PO Box 208071, New Haven, CT 06520-8071
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Ali IB, Elshazly FA, Ali MS. The effect of a thumb web spacer splint on hand function in children with hemiplegic cerebral palsy. J Taibah Univ Med Sci 2022; 18:429-435. [PMID: 36818181 PMCID: PMC9906010 DOI: 10.1016/j.jtumed.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/16/2022] [Accepted: 10/30/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Many children with hemiplegic cerebral palsy (HCP) cannot maintain thumb abduction and experience obstruction caused by the thumb remaining in the palm. A web spacer splint maintains the thumb web space and opposition of the thumb for a more functional position. The aim of this study was to analyze the impact of a thumb web spacer as a functional splint on hand function in children with hemiplegic cerebral palsy. Methods Thirty children with hemiplegic cerebral palsy (ages 4-7 years) were randomly divided into two groups (a control group and a study group). The treatment program for the control group was administered for 45 min three times/week for 8 successive weeks and the study group underwent the identical treatment regimen as the control group, as well as wearing a web spacer splint during the treatment program. Thereafter, the Peabody Developmental Motor Scale (PDMS-2) was used to assess hand function. Results Post-treatment values in the study group demonstrated a substantial improvement in grasping and visual motor integration in the PDMS-2 when compared to the control group. Therefore, there was a significant improvement in total fine motor quotient when compared post-treatment (86.93 ± 8.94, 145.73 ± 15.04) in the control and study groups, respectively (p > 0.05). Conclusion A web spacer splint can be a viable tool for improving hand function in children with HCP.
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Affiliation(s)
- Islam B. Ali
- Faculty of Physical Therapy, Cairo University, Egypt
| | | | - Mostafa S. Ali
- Faculty of Physical Therapy, Cairo University, Egypt,Faculty of Physical Therapy, O6 University, Egypt,Corresponding address: Faculty of Physical Therapy, Cairo University, Egypt, Faculty of Physical Therapy, O6 University, Egypt.
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Komisarek O, Malak R, Kwiatkowski J, Wiecheć K, Szczapa T, Kasperkowicz J, Matthews-Kozanecka M, Matthews-Brzozowska T, Wójcik M, Samborski W, Mojs E. The Evaluation of Facial Muscles by Surface Electromyography in Very Preterm Infants. Biomedicines 2022; 10:biomedicines10112921. [PMID: 36428488 PMCID: PMC9687131 DOI: 10.3390/biomedicines10112921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/11/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND It is reported that 40% of preterm infants have problems with eating. Neonatal feeding disorders may be one of the factors increasing neonatal mortality. The aim of our study was to evaluate the muscles involved in suckling and swallowing in premature newborns using surface electromyography (sEMG). We would like to objectively describe the tension of muscles engaged in feeding in order to properly plan the therapy. Another aim was to compare sEMG measurements to gestational age, birth weight, and umbilical blood pH to show which parameters put children at risk of feeding problems. METHODS Sixteen preterm neonates with gestational age less than 32 weeks, birth weight less than 1500 g, and oral feeding difficulties were analyzed for muscle response and electrical activity of nerves using sEMG (surface electromyography). RESULTS We found a negative correlation indicating that preterm infants with a younger gestational age had higher suprahyoid muscle tension, and a positive correlation was found between pH value and suprahyoid muscles. The lower the pH value, the lower the tension in the suprahyoid muscles. CONCLUSIONS sEMG may be a helpful diagnostic tool in the evaluation of the masticatory system of premature infants. Due to the abnormal tone of the muscles responsible for swallowing, it is advisable to rehabilitate as early as possible.
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Affiliation(s)
- Oskar Komisarek
- Department of Plastic, Reconstructive and Aesthetic Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-821 Bydgoszcz, Poland
- Correspondence: (O.K.); (R.M.)
| | - Roksana Malak
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznań, Poland
- Correspondence: (O.K.); (R.M.)
| | - Jacek Kwiatkowski
- Students Scientific Society of Maxillofacial Orthopaedics and Orthodontics, University of Medical Sciences, 60-812 Poznań, Poland
| | - Katarzyna Wiecheć
- Department of Clinical Psychology, Poznań University of Medical Sciences, 60-812 Poznań, Poland
| | - Tomasz Szczapa
- Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, II Department of Neonatology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Joanna Kasperkowicz
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznań, Poland
| | - Maja Matthews-Kozanecka
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 60-806 Poznań, Poland
| | - Teresa Matthews-Brzozowska
- Department of Orthodontics and Masticatory System Dysfunction, Poznan University of Medical Sciences, 60-812 Poznań, Poland
| | - Małgorzata Wójcik
- Department of Physiotherapy, Faculty of Physical Culture in Gorzów Wielkopolski, Poznan University of Physical Education, Estkowskiego 13, 66-400 Gorzów Wielkopolski, Poland
| | - Włodzimierz Samborski
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznań, Poland
| | - Ewa Mojs
- Department of Clinical Psychology, Poznań University of Medical Sciences, 60-812 Poznań, Poland
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Choudhary N, Tewari D, Nabavi SF, Kashani HRK, Lorigooini Z, Filosa R, Khan FB, Masoudian N, Nabavi SM. Plant based food bioactives: A boon or bane for neurological disorders. Crit Rev Food Sci Nutr 2022; 64:3279-3325. [PMID: 36369694 DOI: 10.1080/10408398.2022.2131729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Neurological disorders are the foremost occurring diseases across the globe resulting in progressive dysfunction, loss of neuronal structure ultimately cell death. Therefore, attention has been drawn toward the natural resources for the search of neuroprotective agents. Plant-based food bioactives have emerged as potential neuroprotective agents for the treatment of neurodegenerative disorders. This comprehensive review primarily focuses on various plant food bioactive, mechanisms, therapeutic targets, in vitro and in vivo studies in the treatment of neurological disorders to explore whether they are boon or bane for neurological disorders. In addition, the clinical perspective of plant food bioactives in neurological disorders are also highlighted. Scientific evidences point toward the enormous therapeutic efficacy of plant food bioactives in the prevention or treatment of neurological disorders. Nevertheless, identification of food bioactive components accountable for the neuroprotective effects, mechanism, clinical trials, and consolidation of information flow are warranted. Plant food bioactives primarily act by mediating through various pathways including oxidative stress, neuroinflammation, apoptosis, excitotoxicity, specific proteins, mitochondrial dysfunction, and reversing neurodegeneration and can be used for the prevention and therapy of neurodegenerative disorders. In conclusion, the plant based food bioactives are boon for neurological disorders.
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Affiliation(s)
- Neeraj Choudhary
- Department of Pharmacognosy, Adesh Institute of Pharmacy and Biomedical Sciences, Adesh University, Bathinda, Punjab, India
| | - Devesh Tewari
- Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Seyed Fazel Nabavi
- Advanced Medical Pharma (AMP-Biotec), Biopharmaceutical Innovation Centre Via Cortenocera, 82030, San Salvatore Telesino, (BN), Italy
- Nutringredientes Research Center, Federal Institute of Education, Science and Technology (IFCE), Baturite, Ceara, Brazil
| | - Hamid Reza Khayat Kashani
- Department of Neurosurgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Lorigooini
- Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Rosanna Filosa
- Advanced Medical Pharma (AMP-Biotec), Biopharmaceutical Innovation Centre Via Cortenocera, 82030, San Salvatore Telesino, (BN), Italy
- Department of Science and Technology, University of Sannio, 82100, Benevento, Italy
| | - Farheen Badrealam Khan
- Department of Biology, College of Science, The United Arab Emirates University, Al Ain, 15551 United Arab Emirates
| | - Nooshin Masoudian
- Advanced Medical Pharma (AMP-Biotec), Biopharmaceutical Innovation Centre Via Cortenocera, 82030, San Salvatore Telesino, (BN), Italy
| | - Seyed Mohammad Nabavi
- Advanced Medical Pharma (AMP-Biotec), Biopharmaceutical Innovation Centre Via Cortenocera, 82030, San Salvatore Telesino, (BN), Italy
- Nutringredientes Research Center, Federal Institute of Education, Science and Technology (IFCE), Baturite, Ceara, Brazil
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Muacevic A, Adler JR, Alghamdi RA, Alghamdi MS, Alzahrani TA. Level of Awareness and Attitude Toward Cerebral Palsy Among Parents in Al-Baha City, Saudi Arabia. Cureus 2022; 14:e31791. [PMID: 36569676 PMCID: PMC9778413 DOI: 10.7759/cureus.31791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cerebral palsy (CP) is a chronic disorder of motion, posture, and tone which occurs due to brain insult during the period of brain growth. It is a disabling disorder in both motor and intellectual aspects. Fortunately, CP is a manageable disease that can be managed in part by increasing the knowledge and understanding of the parents. Methodology This cross-sectional, prospective, community-based study aimed to assess the level of parents' knowledge and their attitude toward CP using an electronic questionnaire. The parents' knowledge was classified as good or poor based on an adopted scoring system. The parents' attitude was categorized as positive or negative. Results Our study results showed that good knowledge (those with a score more than 60% of the total score) was noted in 275 (61.1%) participants, whereas 175 of the participants had poor knowledge (38.9%), especially regarding awareness of the diagnosis of CP. Conclusions Most participants had an overall good knowledge of CP although they had insufficient knowledge of some aspects of the disease such as causes, disease course, clinical presentations, diagnosis, and prognosis. Although the results showed a positive attitude concerning playing with a child with CP, unfortunately, there was a negative attitude toward hiring a CP patient and a strongly negative attitude toward marrying a patient with CP.
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Pachkhede PM, Salphale VG, Dhage P, Deshmukh NS. Effectiveness of a Blend of Pelvic Proprioceptive Neuromuscular Facilitation, Task-Oriented Approach, and Rood's Approach in a Three-Year-Old Child With Spastic Diplegia: A Case Report. Cureus 2022; 14:e31063. [PMID: 36475170 PMCID: PMC9719398 DOI: 10.7759/cureus.31063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/03/2022] [Indexed: 01/25/2023] Open
Abstract
As a result of non-progressive brain damage, cerebral palsy (CP) has traditionally been seen as a disorder of movement and posture; however, more recent classifications enable clinicians to understand more than just the movement issue. Research has evolved with the accurate categorization of cerebral palsy into distribution, motor type, and functional level. Children with spastic diplegia usually have pelvic asymmetry, which affects the child's functional abilities, including their ability to balance and walk independently. Physical therapists currently treat this illness using a variety of treatments, each of which is significant in its own way. A model for enhancing organizational capabilities is clinical management in physical therapy, which incorporates effective practices supported by research and improves outcomes. This case study demonstrates the efficiency of a deliberate physical therapy strategy to enhance functional independence in a three-year-old male child with spastic diplegia. The young patient complained of difficulties with balance and toe-walking and a delay in reaching age-appropriate milestones when seen in the neuro physiotherapy outpatient department. History demonstrated that a delayed cry occurred with an abrupt onset of fever, foaming at the mouth, and other symptoms described.
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Affiliation(s)
- Pranali M Pachkhede
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Science, Wardha, IND
| | - Vikrant G Salphale
- Neuro Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Pooja Dhage
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Nikita S Deshmukh
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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96
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Muacevic A, Adler JR. Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation on Balance and Gait Parameters in Children With Spastic Diplegia. Cureus 2022; 14:e30571. [PMID: 36415346 PMCID: PMC9676993 DOI: 10.7759/cureus.30571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/21/2022] [Indexed: 01/25/2023] Open
Abstract
Background Among several variants of Cerebral Palsy, Spastic Diplegic is encountered most commonly in clinical setups. A majority of children with Spastic Diplegia manifest themselves with a disturbance in the geometrical orientation of their pelvis, which imposes an effect on their functional capabilities like walking with independence. This research had an emphasis on the extraction of the efficacy of Pelvic Proprioceptive Neuromuscular Facilitation (PNF) Techniques on Balance and Gait Parameters in children suffering from Spastic Diplegia. Method Participants included in the study were between the age groups of 8 to 12 years who were diagnosed with Spastic Diplegia with an independent sitting and walking ability and who are coming in stages I to III according to Gross Motor Function Classification System. Subjects in group A were given Pelvic PNF techniques for 15 minutes on both sides along with Task-Oriented training for 30 minutes, six days a week and continuously for four weeks, while the subjects in group B were given only Task-Oriented activity for the same duration. The pre- and post-treatment assessments of all 40 subjects were gathered using the Paediatric Balance Scale, Palpation Meter device, and Gait Parameters. Results The study included 40 participants, which were segregated into two groups of 20 subjects in each group. Group A received Pelvic Proprioceptive Neuromuscular Facilitation with Task-Oriented Training, and group B received only Task-Oriented training activities. The contrast of pre- and post-treatment findings of both the groups revealed that group A reported a significant improvement in their outcomes (P>0.0001). Conclusion The present study, which included 40 subjects, has generated evidence regarding the efficacy of Pelvic PNF on Balance and Gait Parameters in children with Spastic Diplegia.
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Elwagei Ahmed S. Physicians' Ineffective Communication Leading to Cerebral Injuries in Children With Cerebral Palsy. Cureus 2022; 14:e29510. [PMID: 36299928 PMCID: PMC9588399 DOI: 10.7759/cureus.29510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 11/05/2022] Open
Abstract
Inspirational enlightenment has guided me to write this review article while encountering, during my practice as a pediatrician, referred cases of previously stable, positively progressing cerebral palsy (CP) children who had not yet celebrated their first teen birthday but ended up being in a deep coma and mechanical ventilation-dependent post a cardiac arrest outside the hospital. The dramatic end was believed to be probably caused by food aspiration, which could have been prevented by effective counseling to the in-denial, struggling parents about their children’s condition. This report tries to emphasize the importance of effective communication between physicians and caregivers of children who were diagnosed with CP. The importance is elaborated by linking the level of the provided communication/education to the caregivers with cerebral injuries, such as intracranial hemorrhage (ICH), which potentially could have been prevented among CP children. The sequence of the injury is believed to be initiated by aspiration of food, which resulted in apnea/asphyxia, followed by a cardiopulmonary arrest outside hospital settings. Such a life-threatening event is hypothesized to be the leading cause of non-reversible intracranial injuries to the CP child of misinformed/unaware parents. Data on unsolved parental status, parent-provider miscommunications, and aspiration pneumonia leading to cerebral injuries and their permanent neurological insult in CP children were reviewed.
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Harjpal P, Raipure A, Kovela RK, Qureshi MI. The Effect of Neuro-Physiotherapy on Gross Motor Function in a Male Child With Spastic Diplegic Cerebral Palsy: A Case Report. Cureus 2022; 14:e29310. [PMID: 36277570 PMCID: PMC9579827 DOI: 10.7759/cureus.29310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/19/2022] [Indexed: 11/13/2022] Open
Abstract
Cerebral palsy (CP) is a condition caused by a non-progressive lesion in the developing brain. CP has a wide range of prevalence, ranging from 1.5 to three cases per 1,000 persons. Newborns weighing less than 2,500 grams now account for half of all incidences of CP. Clinical management in physical therapy is a paradigm for enhancing organizational capacity, integrating evidence-based best practices, and enhancing outcomes. This is a case report of a 21-month-old male child with a history of sudden onset of seizure, fever, drowsiness, frothing from the mouth, and up rolling of eyes. He had a global developmental delay with microcephaly and breakthrough seizures with anemia under evaluation. Magnetic resonance imaging (MRI) brain revealed the possibility of hypoxic-ischemic insult. The child was managed conservatively using medications i.e., ibuprofen (7.5mL/6hrly), cephalosporin (450mg/day in divided doses), and phenytoin. Physiotherapy management was provided with integrative approaches including Neurodevelopmental treatment principles, passive stretching, static weight-bearing exercises, and task-oriented approaches. The evaluation was done using the Modified Ashworth Scale and Gross Motor Function Measure-88 (GMFM-88). Early physiotherapy with integrative approaches helps in the improvement of gross motor developmental milestones in children with Spastic diplegic CP.
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Alwhaibi RM, Omer AB, Khan R. Factors Affecting Mothers' Adherence to Home Exercise Programs Designed for Their Children with Cerebral Palsy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10792. [PMID: 36078507 PMCID: PMC9517889 DOI: 10.3390/ijerph191710792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Cerebral palsy is a common motor disorder that results in long-term impairment. The purpose of this study was to find out what factors influence Saudi mothers' compliance with their Children with Cerebral Palsy (C-CP) Home Exercise Program (HEP). A self-administered online questionnaire was used to perform this qualitative research study on a group of 113 mothers who had children with CP. The study included mothers with children from birth to 12 years old who had received a HEP prescription from a physiotherapist. The measuring instrument tool was a questionnaire with two sections: demographic characteristics and a questionnaire about the parents' adherence to the HEP. The questionnaire utilized in this study was subjected to a reliability analysis, and the derived Cronbach's alpha was found to be 0.814 for the questionnaire (which had 17 phrases). These results imply that the questionnaire is reliable. A total of 113 responses were received, with 4 incomplete responses being eliminated. The majority of mothers (66.1%) did not follow the HEP, according to the findings of this survey. The demographics of the mothers revealed that 20-25-year-old mothers were more adherent than the other age groups. The findings of this study demonstrated that the physical therapist's treatment of the mother influenced exercise compliance.
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Affiliation(s)
- Reem M. Alwhaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Asma B. Omer
- Department of Basic Health Sciences, Deanship of Preparatory Year for the Health Colleges, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Ruqaiyah Khan
- Department of Public Health, Athar Institute of Health and Management Studies, New Delhi 110049, India
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A Review on Recent Advances of Cerebral Palsy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:2622310. [PMID: 35941906 PMCID: PMC9356840 DOI: 10.1155/2022/2622310] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/27/2022] [Accepted: 07/02/2022] [Indexed: 12/04/2022]
Abstract
This narrative review summarizes the latest advances in cerebral palsy and identifies where more research is required. Several studies on cerebral palsy were analyzed to generate a general idea of the prevalence of, risk factors associated with, and classification of cerebral palsy (CP). Different classification systems used for the classification of CP on a functional basis were also analyzed. Diagnosis systems used along with the prevention techniques were discussed. State-of-the-art treatment strategies for CP were also analyzed. Statistical distribution was performed based on the selected studies. Prevalence was found to be 2-3/1000 lives; the factors that can be correlated are gestational age and birth weight. The risk factors identified were preconception, prenatal, perinatal, and postnatal categories. According to the evidence, CP is classified into spastic (80%), dyskinetic (15%), and ataxic (5%) forms. Diagnosis approaches were based on clinical investigation and neurological examinations that include magnetic resonance imaging (MRI), biomarkers, and cranial ultrasound. The treatment procedures found were medical and surgical interventions, physiotherapy, occupational therapy, umbilical milking, nanomedicine, and stem cell therapy. Technological advancements in CP were also discussed. CP is the most common neuromotor disability with a prevalence of 2-3/1000 lives. The highest contributing risk factor is prematurity and being underweight. Several preventions and diagnostic techniques like MRI and ultrasound were being used. Treatment like cord blood treatment nanomedicine and stem cell therapy needs to be investigated further in the future to apply in clinical practice. Future studies are indicated in the context of technological advancements among cerebral palsy children.
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