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Aza A, Riquelme I, Gómez Vela M, Badia M. Proxy- and self-report evaluation of quality of life in cerebral palsy: Using Spanish version of CPQOL for Children and adolescents. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 154:104844. [PMID: 39321691 DOI: 10.1016/j.ridd.2024.104844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 09/11/2024] [Accepted: 09/15/2024] [Indexed: 09/27/2024]
Abstract
BACKGROUND Promoting quality of life (QoL) is one of the main goals in interventions carried out with children and adolescents with cerebral palsy (CP). AIMS The aim of this study was to analyze the determinants of QoL in children with CP, including evaluations by the children themselves and their parents, and to identify discrepancies between evaluators. METHODS AND PROCEDURES The adapted Spanish version of the Cerebral Palsy Quality of Life (CP-QOL) for children and adolescents (self-report and primary caregiver-reports versions) was applied to a sample of 74 children with CP and their respective parents (totaling 222 participants), as well as instruments to measure functioning (i.e., GMFCS, MACS, CFCS and EDACS). The average age of the children was 12.50 (SD=4.07), with a higher number of boys (55.7 %). OUTCOMES AND RESULTS The lowest QoL levels were found in the Functional dimension in both assessments (Mchildren/adolescents=70.21, Mparents=58.14). For children, the highest rated dimension was Social Well-being (M=74.54), while for parents it was School (M=71.03). The degree of agreement between evaluators was low in almost all dimensions (ICC≤.40). More satisfactory predictive models were constructed from the evaluations carried out by parents, except in the case of the Access to Services dimension, with functioning measures being the main predictors of QoL levels. CONCLUSIONS AND IMPLICATIONS The CP-QOL in its two available versions is a useful and specific instrument for assessing QoL in children with CP in both research and professional fields.
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Affiliation(s)
- Alba Aza
- Institute for Community Inclusion (INICO), University of Salamanca, Salamanca 37005, Spain; Department of Personality, Assessment, and Psychological Treatments. University of Salamanca, Salamanca 37005, Spain.
| | - Inmaculada Riquelme
- Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma 07122, Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma 07010, Spain; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma 07122, Spain.
| | - María Gómez Vela
- Institute for Community Inclusion (INICO), University of Salamanca, Salamanca 37005, Spain; Department of Personality, Assessment, and Psychological Treatments. University of Salamanca, Salamanca 37005, Spain.
| | - Marta Badia
- Institute for Community Inclusion (INICO), University of Salamanca, Salamanca 37005, Spain.
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Blasco M, García-Galant M, Ballester-Plané J, Laporta-Hoyos O, Caldú X, Leiva D, Boyd RN, Ortibus E, Pueyo R. Transferability of an executive function intervention in children with cerebral palsy: A randomized controlled trial. Dev Med Child Neurol 2024. [PMID: 39258948 DOI: 10.1111/dmcn.16057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/04/2024] [Accepted: 07/08/2024] [Indexed: 09/12/2024]
Abstract
AIM To evaluate the transfer effects of a home-based computerized executive function intervention on non-targeted cognitive functions (visual perception and memory), quality of life (QoL), and participation in children with cerebral palsy (CP), and to determine whether any improvements were maintained 9 months after the intervention. METHOD Sixty children with CP (aged 8-12 years) were randomly allocated to the intervention (15 females/15 males, mean age 10 years 4 months [SD = 1 years 8 months], age range 8-12 years) or waitlist (control) (15 females/15 males, mean age 10 years [SD = 1 years 9 months], age range 8-12 years) group. The intervention group underwent a home-based executive function intervention programme for 30 minutes per day, 5 days a week, for 12 weeks. All participants were assessed before the intervention, immediately after and 9 months after the intervention was completed. RESULTS After the intervention was completed, performance in immediate verbal memory, verbal learning, and visual perception (object and picture recognition) was significantly better in the intervention group than in the waitlist (control) group. No improvements were found in visual memory, visuospatial perception, QoL, or participation after the intervention. Scores at the follow-up showed that any beneficial effects were not maintained 9 months after the intervention was completed. INTERPRETATION A home-based computerized executive function intervention produced transfer effects on memory and visual perception immediately after the intervention in children with CP, although any beneficial effects were not sustained at the 9-month follow-up.
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Affiliation(s)
- Montse Blasco
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues del Llobregat, Barcelona, Spain
| | - María García-Galant
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues del Llobregat, Barcelona, Spain
| | - Júlia Ballester-Plané
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues del Llobregat, Barcelona, Spain
- Departament de Psicologia, Universitat Abat Oliba CEU, CEU Universities, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues del Llobregat, Barcelona, Spain
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Xavier Caldú
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues del Llobregat, Barcelona, Spain
| | - David Leiva
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Barcelona, Spain
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Els Ortibus
- Leuven Child and Youth Institute, KU Leuven, Leuven, Belgium
- Department of Development and Regeneration, Locomotor and Neurological Disorders, KU Leuven, Leuven, Belgium
| | - Roser Pueyo
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues del Llobregat, Barcelona, Spain
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3
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Hoffman RM, Trevarrow MP, Lew BJ, Wilson TW, Kurz MJ. Alpha oscillations during visual selective attention are aberrant in youth and adults with cerebral palsy. Cereb Cortex 2024; 34:bhae365. [PMID: 39233375 PMCID: PMC11374708 DOI: 10.1093/cercor/bhae365] [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: 05/09/2024] [Revised: 08/14/2024] [Accepted: 08/27/2024] [Indexed: 09/06/2024] Open
Abstract
Our understanding of the neurobiology underlying cognitive dysfunction in persons with cerebral palsy is very limited, especially in the neurocognitive domain of visual selective attention. This investigation utilized magnetoencephalography and an Eriksen arrow-based flanker task to quantify the dynamics underlying selective attention in a cohort of youth and adults with cerebral palsy (n = 31; age range = 9 to 47 yr) and neurotypical controls (n = 38; age range = 11 to 49 yr). The magnetoencephalography data were transformed into the time-frequency domain to identify neural oscillatory responses and imaged using a beamforming approach. The behavioral results indicated that all participants exhibited a flanker effect (greater response time for the incongruent compared to congruent condition) and that individuals with cerebral palsy were slower and less accurate during task performance. We computed interference maps to focus on the attentional component and found aberrant alpha (8 to 14 Hz) oscillations in the right primary visual cortices in the group with cerebral palsy. Alpha and theta (4 to 7 Hz) oscillations were also seen in the left and right insula, and these oscillations varied with age across all participants. Overall, persons with cerebral palsy exhibit deficiencies in the cortical dynamics serving visual selective attention, but these aberrations do not appear to be uniquely affected by age.
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Affiliation(s)
- Rashelle M Hoffman
- Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, 6902 Pine St, Omaha, NE 68106, United States
- Department of Physical Therapy, Creighton University, 2500 California Plz, Omaha, NE 68178, United States
| | - Michael P Trevarrow
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Omaha, NE 68010, United States
| | - Brandon J Lew
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Omaha, NE 68010, United States
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Omaha, NE 68010, United States
- Department of Pharmacology and Neuroscience, Creighton University, 2500 California Plz, Omaha, NE 68178, United States
| | - Max J Kurz
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Omaha, NE 68010, United States
- Department of Pharmacology and Neuroscience, Creighton University, 2500 California Plz, Omaha, NE 68178, United States
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García-Galant M, Blasco M, Moral-Salicrú P, Soldevilla J, Ballester-Plané J, Laporta-Hoyos O, Caldú X, Miralbell J, Alonso X, Toro-Tamargo E, Meléndez-Plumed M, Gimeno F, Leiva D, Boyd RN, Pueyo R. Understanding social cognition in children with cerebral palsy: exploring the relationship with executive functions and the intervention outcomes in a randomized controlled trial. Eur J Pediatr 2024; 183:3997-4008. [PMID: 38951253 PMCID: PMC11322257 DOI: 10.1007/s00431-024-05635-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/18/2024] [Accepted: 05/29/2024] [Indexed: 07/03/2024]
Abstract
Children with Cerebral Palsy (CP) experience Social Cognition (SC) difficulties, which could be related to executive functioning. While motor interventions are common, there is limited knowledge about the impact of cognitive interventions on SC in this population. This study examined the relationship between SC and Executive Function (EF) skills and the effectiveness of an EF intervention that included some SC tasks for improving SC in children with CP. SC and EF domains were assessed in 60 participants with CP (30 females; 8-12 years). The relationship between SC and EF baseline scores was analyzed by bivariate correlations and contingency tables. Participants were matched by age, sex, motor ability, and intelligence quotient and randomized into intervention or control groups. The intervention group underwent a 12-week home-based computerized EF intervention. Analysis of covariance was used to examine differences in SC components between groups at post-intervention and 9 months after. Significant positive correlations were found between the SC and EF scores. The frequencies of impaired and average scores in SC were distributed similarly to the impaired and average scores in EFs. The intervention group showed significant improvements in Affect Recognition performance post-intervention, which were maintained at the follow-up assessment, with a moderate effect size. Long-term improvements in Theory of Mind were observed 9 months after. CONCLUSIONS This study highlights the association between SC and EFs. A home-based computerized cognitive intervention program improves SC in children with CP. Including SC tasks in EF interventions may lead to positive short- and long-term effects for children with CP. CLINICAL TRIAL REGISTRATION NCT04025749 retrospectively registered on 19 July 2019. WHAT IS KNOWN • Executive functions and social cognition are associated with social and community participation in people with cerebral palsy. • A home-based computerized cognitive intervention can improve the executive functioning of children with cerebral palsy. WHAT IS NEW • Social cognition performance is related to core and higher-order executive functions. • A home-based computerized executive function intervention, including social cognition tasks, has positive short- and long-term effects on social cognition skills in children with cerebral palsy.
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Affiliation(s)
- María García-Galant
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Montse Blasco
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Paula Moral-Salicrú
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - Jorge Soldevilla
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - Júlia Ballester-Plané
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Facultat de Ciències de la salut i de la vida, Universitat Abat Oliba CEU, CEU Universities, Bellesguard 30, 08022, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- School of Medicine, University of California, 1550 Fourth Street, 94158, San Francisco, CA, USA
| | - Xavier Caldú
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Júlia Miralbell
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Xènia Alonso
- Servei de Neurologia, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Esther Toro-Tamargo
- Servei de Traumatologia i Rehabilitació, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Mar Meléndez-Plumed
- Servei de Traumatologia i Rehabilitació, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Francisca Gimeno
- Associació de Paràlisi Cerebral (ASPACE), Servei de Salut i Rehabilitació, Camí Tres Pins 31-35, 08038, Barcelona, Spain
| | - David Leiva
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Roslyn N Boyd
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, 62 Graham St, Brisbane, 4101, QLD, Australia
| | - Roser Pueyo
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain.
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.
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Spencer APC, Goodfellow M, Chakkarapani E, Brooks JCW. Resting-state functional connectivity in children cooled for neonatal encephalopathy. Brain Commun 2024; 6:fcae154. [PMID: 38741661 PMCID: PMC11089421 DOI: 10.1093/braincomms/fcae154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/21/2024] [Accepted: 04/28/2024] [Indexed: 05/16/2024] Open
Abstract
Therapeutic hypothermia improves outcomes following neonatal hypoxic-ischaemic encephalopathy, reducing cases of death and severe disability such as cerebral palsy compared with normothermia management. However, when cooled children reach early school-age, they have cognitive and motor impairments which are associated with underlying alterations to brain structure and white matter connectivity. It is unknown whether these differences in structural connectivity are associated with differences in functional connectivity between cooled children and healthy controls. Resting-state functional MRI has been used to characterize static and dynamic functional connectivity in children, both with typical development and those with neurodevelopmental disorders. Previous studies of resting-state brain networks in children with hypoxic-ischaemic encephalopathy have focussed on the neonatal period. In this study, we used resting-state fMRI to investigate static and dynamic functional connectivity in children aged 6-8 years who were cooled for neonatal hypoxic-ischaemic without cerebral palsy [n = 22, median age (interquartile range) 7.08 (6.85-7.52) years] and healthy controls matched for age, sex and socioeconomic status [n = 20, median age (interquartile range) 6.75 (6.48-7.25) years]. Using group independent component analysis, we identified 31 intrinsic functional connectivity networks consistent with those previously reported in children and adults. We found no case-control differences in the spatial maps of these intrinsic connectivity networks. We constructed subject-specific static functional connectivity networks by measuring pairwise Pearson correlations between component time courses and found no case-control differences in functional connectivity after false discovery rate correction. To study the time-varying organization of resting-state networks, we used sliding window correlations and deep clustering to investigate dynamic functional connectivity characteristics. We found k = 4 repetitively occurring functional connectivity states, which exhibited no case-control differences in dwell time, fractional occupancy or state functional connectivity matrices. In this small cohort, the spatiotemporal characteristics of resting-state brain networks in cooled children without severe disability were too subtle to be differentiated from healthy controls at early school-age, despite underlying differences in brain structure and white matter connectivity, possibly reflecting a level of recovery of healthy resting-state brain function. To our knowledge, this is the first study to investigate resting-state functional connectivity in children with hypoxic-ischaemic encephalopathy beyond the neonatal period and the first to investigate dynamic functional connectivity in any children with hypoxic-ischaemic encephalopathy.
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Affiliation(s)
- Arthur P C Spencer
- Clinical Research and Imaging Centre, University of Bristol, Bristol BS2 8DX, UK
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK
- Department of Radiology, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Marc Goodfellow
- Living Systems Institute, University of Exeter, Exeter EX4 4QD, UK
- Department of Mathematics and Statistics, University of Exeter, Exeter EX4 4QF, UK
| | - Ela Chakkarapani
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK
- Neonatal Intensive Care Unit, St Michaels Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS2 8EG, UK
| | - Jonathan C W Brooks
- Clinical Research and Imaging Centre, University of Bristol, Bristol BS2 8DX, UK
- University of East Anglia Wellcome Wolfson Brain Imaging Centre (UWWBIC), University of East Anglia, Norwich NR4 7TJ, UK
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Kuijpers R, Groen BE, Smulders E, der Sanden MWGNV, Weerdesteyn V. Is the Walking Adaptability Ladder test for Kids (WAL-K) reliable and valid in ambulatory children with Cerebral Palsy? Disabil Rehabil 2024:1-7. [PMID: 38400694 DOI: 10.1080/09638288.2024.2321325] [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: 07/01/2023] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE Walking adaptability is essential for children to participate in daily life. We studied whether the Walking Adaptability Ladder test for Kids (WAL-K) is reliable and valid for assessing walking adaptability in 6-12 year old ambulatory children with Cerebral Palsy (CP). MATERIALS AND METHODS Thirty-six children with CP (26 GMFCS-level I, 10 GMFCS-level II) completed the single and double run of the WAL-K. Intra- and inter-rater reliability were determined by Intraclass Correlation Coefficients (ICCs). Construct validity was determined by comparing WAL-K scores between 122 typically developing (TD) and CP children taking age into account, comparing WAL-K scores between CP children in GMFCS-levels I and II, and correlating WAL-K scores with scores of the 10 times 5 m Sprint Test (10 × 5mST). RESULTS ICCs for reliability varied between 0.997 and 1.000. WAL-K scores were significantly higher (i.e., worse) in CP children compared to TD children (p < 0.001), and in children in GMFCS-level II compared to GMFCS-level I (p = 0.001). Significant positive correlations were found between the WAL-K and 10 × 5 mST (single run r = .89, double run r = .84). CONCLUSIONS The WAL-K shows to be a promising reliable, valid, and easy-to-use tool for assessing walking adaptability in children with CP. Responsiveness to change has yet to be evaluated.
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Affiliation(s)
- Rosanne Kuijpers
- Sint Maartenskliniek Research, Nijmegen, The Netherlands
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Brenda E Groen
- Sint Maartenskliniek Research, Nijmegen, The Netherlands
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Ellen Smulders
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
- Master Specialized Physical Therapy, Avans+, Breda, The Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
- IQ Healthcare, Research Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Vivian Weerdesteyn
- Sint Maartenskliniek Research, Nijmegen, The Netherlands
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
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7
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García-Galant M, Blasco M, Laporta-Hoyos O, Berenguer-González A, Moral-Salicrú P, Ballester-Plané J, Caldú X, Miralbell J, Alonso X, Medina-Cantillo J, Povedano-Bulló E, Leiva D, Boyd RN, Pueyo R. A randomized controlled trial of a home-based computerized executive function intervention for children with cerebral palsy. Eur J Pediatr 2023; 182:4351-4363. [PMID: 37462799 PMCID: PMC10587273 DOI: 10.1007/s00431-023-05072-3] [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: 01/30/2023] [Revised: 05/27/2023] [Accepted: 06/17/2023] [Indexed: 10/20/2023]
Abstract
Children with cerebral palsy (CP) often show executive function (EF) impairments that are key to quality of life. The aim of this study was to assess whether a home-based computerized intervention program improves executive functions (EFs) compared to usual care. Sixty participants (30 females) with CP (8-12 years old) were paired by age, sex, motor ability, and intelligence quotient score and then randomized to intervention and waitlist control groups. The intervention group received a 12-week home-based computerized EF intervention (5 days/week, 30 min/day, total dose 30 h). Core and higher-order EFs were assessed before, immediately after, and 9 months after completing the intervention. The intervention group performed better than the waitlist control group in the three core EFs (immediately and 9 months after the intervention): inhibitory control (F = 7.58, p = 0.13 and F = 7.85, p = 0.12), working memory (F = 8.34, p = 0.14 and F = 7.55, p = 0.13), and cognitive flexibility (F = 4.87, p = 0.09 and F = 4.19, p = 0.08). No differences were found between the groups in higher-order EFs or EF manifestations in daily life. CONCLUSIONS A home-based computerized EF intervention improved core EFs in children with CP, but further research is needed to identify strategies that allow the transfer of these improvements to everyday life. TRIAL REGISTRATION NCT04025749 retrospectively registered on 19 July 2019. WHAT IS KNOWN • One in two children with cerebral palsy has an intellectual impairment. Visual perception and executive functions are the most reported specific cognitive deficits. • The majority of interventions for cerebral palsy focus on motor impairments, but only a few randomized controlled trials have explored the effect of interventions on executive functions. WHAT IS NEW • A home-based computerized cognitive intervention can improve the core executive functions of children with cerebral palsy. • Short- and long-term effects on core executive functions have been found.
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Affiliation(s)
- María García-Galant
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Montse Blasco
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Alba Berenguer-González
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Paula Moral-Salicrú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Júlia Miralbell
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Xènia Alonso
- Servei de Neurologia, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Julita Medina-Cantillo
- Servei de Rehabilitació i Medicina Física, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08035, Barcelona, Spain
| | - Elsa Povedano-Bulló
- Servei de Rehabilitació i Medicina Física, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08035, Barcelona, Spain
| | - David Leiva
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Roslyn N Boyd
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, 62 Graham St, Brisbane, QLD, 4101, Australia
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain.
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8
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Beneventi H, Løhaugen GC, Andersen GL, Sundberg C, Østgård HF, Bakkan E, Walther G, Vik T, Skranes J. Working Memory Training in Norwegian Children with Cerebral Palsy (CP) Show Minimal Evidence of Near and No Far Transfer Effects. Dev Neurorehabil 2023; 26:364-370. [PMID: 37740724 DOI: 10.1080/17518423.2023.2259985] [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: 02/01/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
In children with cerebral palsy (CP), learning disabilities are well documented, and impairments in executive functions, such as attention, inhibition, shifting and working memory, represent significant burdens on patients, their families and the society. The aim of this study was to evaluate whether Cogmed RM working memory training could improve working memory in children with CP and investigate whether increased working memory capacity would generalize to other cognitive functions. Twenty-eight children completed the training and the results were compared to a waitlist control group (n = 32). The results yielded three main findings. First, children with CP improved with practice on trained working memory tasks. Second, the intervention group showed minimal near transfer effects to non-trained working memory tasks. Third, no effects on cognitive and behavioral far transfer measures were found.
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Affiliation(s)
- Harald Beneventi
- Department of Paediatric Habilitation, Stavanger University Hospital, Stavanger, Norway
| | - Gro Cc Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro L Andersen
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Cerebral Palsy Register of Norway, Habilitation Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Cato Sundberg
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Heidi Furre Østgård
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ellen Bakkan
- Department of Paediatric Habilitation, Stavanger University Hospital, Stavanger, Norway
| | - Geir Walther
- Department of Child and Adolescent Psychiatry, Vestfold Hospital Trust, Tønsberg, Norway
| | - Torstein Vik
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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