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Wu X, Liu R, Zhang Z, Yang J, Liu X, Jiang L, Fang M, Wang S, Lai L, Song Y, Li Z. The RhoB p.S73F mutation leads to cerebral palsy through dysregulation of lipid homeostasis. EMBO Mol Med 2024; 16:2002-2023. [PMID: 39080495 PMCID: PMC11393352 DOI: 10.1038/s44321-024-00113-2] [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: 12/22/2023] [Revised: 07/09/2024] [Accepted: 07/15/2024] [Indexed: 09/14/2024] Open
Abstract
Cerebral palsy (CP) is a prevalent neurological disorder that imposes a significant burden on children, families, and society worldwide. Recently, the RhoB p.S73F mutation was identified as a de novo mutation associated with CP. However, the mechanism by which the RhoB p.S73F mutation causes CP is currently unclear. In this study, rabbit models were generated to mimic the human RhoB p.S73F mutation using the SpG-BE4max system, and exhibited the typical symptoms of human CP, such as periventricular leukomalacia and spastic-dystonic diplegia. Further investigation revealed that the RhoB p.S73F mutation could activate ACAT1 through the LYN pathway, and the subsequently altered lipid levels may lead to neuronal and white matter damage resulting in the development of CP. This study presented the first mammalian model of genetic CP that accurately replicates the RhoB p.S73F mutation in humans, provided further insights between RhoB and lipid metabolism, and novel therapeutic targets for human CP.
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Affiliation(s)
- Xinyu Wu
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, and College of Veterinary Medicine, Jilin University, Changchun, 130062, China
| | - Ruonan Liu
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, and College of Veterinary Medicine, Jilin University, Changchun, 130062, China
| | - Zhongtian Zhang
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China
- Sanya Institute of Swine Resource, Hainan Provincial Research Centre of Laboratory Animals, Sanya, 572000, China
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Wuyi University, Jiangmen, 529020, China
- Jilin Provincial Key Laboratory of Animal Embryo Engineering, Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun, 130062, China
- Institute of Stem Cells and Regeneration, Chinese Academy of Sciences, Beijing, 100039, China
- Research Unit of Generation of Large Animal Disease Models, Chinese Academy of Medical Sciences, Guangzhou, 510530, China
| | - Jie Yang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, and College of Veterinary Medicine, Jilin University, Changchun, 130062, China
| | - Xin Liu
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, and College of Veterinary Medicine, Jilin University, Changchun, 130062, China
| | - Liqiang Jiang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, and College of Veterinary Medicine, Jilin University, Changchun, 130062, China
| | - Mengmeng Fang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, and College of Veterinary Medicine, Jilin University, Changchun, 130062, China
| | - Shoutang Wang
- School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Liangxue Lai
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, and College of Veterinary Medicine, Jilin University, Changchun, 130062, China.
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510530, China.
- Sanya Institute of Swine Resource, Hainan Provincial Research Centre of Laboratory Animals, Sanya, 572000, China.
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Wuyi University, Jiangmen, 529020, China.
- Jilin Provincial Key Laboratory of Animal Embryo Engineering, Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun, 130062, China.
- Institute of Stem Cells and Regeneration, Chinese Academy of Sciences, Beijing, 100039, China.
- Research Unit of Generation of Large Animal Disease Models, Chinese Academy of Medical Sciences, Guangzhou, 510530, China.
| | - Yuning Song
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, and College of Veterinary Medicine, Jilin University, Changchun, 130062, China.
| | - Zhanjun Li
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, and College of Veterinary Medicine, Jilin University, Changchun, 130062, China.
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Lambert G, Husein N, Fehlings D, Andersen J, Oskoui M, Shevell M. Early Biomarkers in the Prediction of Later Functional Impairment in Preterm Children With Cerebral Palsy. Pediatr Neurol 2024; 161:55-60. [PMID: 39276578 DOI: 10.1016/j.pediatrneurol.2024.08.013] [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: 04/14/2024] [Revised: 07/17/2024] [Accepted: 08/19/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND To identify early biomarkers that could predict later functional capabilities in preterm children with later cerebral palsy (CP). METHODS Data from 968 preterm children with later CP were extracted from the Canadian Cerebral Palsy Registry. One hundred eighty-two infants were born before 27 weeks of gestation, 461 infants were born between 27 and 33 weeks, and 325 infants were born between 34 and 37 weeks. Univariate and chi-square analyses were conducted to measure the association between early objective biomarkers and later mobility status defined as Gross Motor Function Classification System (GMFCS) levels IV and V as well as tube feeding dependence. RESULTS Univariate analysis suggested no significant association between GMFCS levels IV and V or impaired feeding status and bilateral white matter injury on magnetic resonance imaging, high-grade intraventricular hemorrhage on head ultrasound, chorioamnionitis, a birth weight of 1000 to 1500 g or <1000 g, as well as an Apgar score of ≤5 at five minutes of life. Similar results were found for gestational age <28 weeks at birth. Only a significant association between GMFCS levels IV and V and a cord or first hour of life pH of ≤7 was reported (mobility status: odds ratio [OR] 1.95, 95% confidence interval [CI] 1.09 to 3.57) and feeding status: OR 2.23, CI 0.97 to 4.65)]. CONCLUSIONS Prediction of functional outcomes based on specific early biomarkers appears hard to obtain in children with CP born preterm in contrast to those born at term. The complications and causal pathways inherent to prematurity may contribute to making prognostication less determinant.
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Affiliation(s)
- Gabrielle Lambert
- Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada.
| | - Nafisa Husein
- Canadian Cerebral Palsy Registry, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Darcy Fehlings
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - John Andersen
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Oskoui
- Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada; Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Michael Shevell
- Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada; Department of Pediatrics, McGill University, Montreal, Quebec, Canada
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Maronga-Feshete F, Pilusa S, Dreyer A. 'I'm proud of my son with CP': Cerebral palsy caregivers' experiences, Gauteng province. Afr J Disabil 2024; 13:1357. [PMID: 38962747 PMCID: PMC11219972 DOI: 10.4102/ajod.v13i0.1357] [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: 10/19/2023] [Accepted: 02/14/2024] [Indexed: 07/05/2024] Open
Abstract
Background Caregivers of children with cerebral palsy (CP) are critical in the survival and well-being of their children. Despite the caregivers' particularly demanding responsibilities, literature on their experiences is limited. Objectives This study explored the caregivers' experiences of providing care to children with CP. Method An explorative qualitative study design using semi-structured interviews was employed. All interviews were audio-recorded, transcribed verbatim and analysed guided by Colaizzi's seven-step methodology. Results Two themes emerged: the challenges in caregiving and positive experiences of providing care. Caregivers faced financial, psychological, social and physical challenges such as stigmatisation, a lack of work accommodations, time constraints due to demands of providing care, strained family relations, isolation, exclusion, emotional and physical exhaustion in their caregiving role. Despite the challenges, they also had fulfilling, positive experiences. Caregivers became more resilient, some relationships were strengthened and awareness of the CP condition increased over time. Conclusion Caring for a child with CP is challenging. Cerebral palsy is a permanent disability; therefore, a holistic, long-term perspective to supporting caregivers is necessary to ensure they can care for their children adequately. Contribution There is a need for various support structures for caregivers to lessen the burden of care. It is necessary to establish the relationships between the support structures available and the way that these structures are viewed and consequently utilised by the caregivers. This study highlights the experiences and needs of caregivers to inform stakeholders on intervention strategies.
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Affiliation(s)
- Faith Maronga-Feshete
- Department of Rural Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sonti Pilusa
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Abigail Dreyer
- Department of Rural Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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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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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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Szkoda L, Szopa A, Siwiec A, Kwiecień-Czerwieniec I, Domagalska-Szopa M. Body Composition and Spasticity in Children with Unilateral Cerebral Palsy-A Case-Control Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1904. [PMID: 36553347 PMCID: PMC9776702 DOI: 10.3390/children9121904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/17/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
The aim of this study was to identify the correlations between segmental body composition and the spasticity level of the affected lower limb in children with unilateral cerebral palsy (spastic hemiplegia). Additionally, an attempt was made to identify the differences in composition between the affected and unaffected lower limbs using segmental body composition analysis. This case-control study included 31 children with spastic hemiplegia aged 8 to 16 years with differing severities of spasticity in the lower limbs. The reference group consisted of a control group which included 31 peers with corresponding age and sex to the tested group. Negative correlations obtained in the statistical analysis showed that higher spasticity level in the iliopsoas muscle is associated with lower limb fat-free mass and lower limb muscle mass. Our results showed that children with spastic hemiplegia have worse parameters of body composition in the affected limb than in the unaffected one. To confirm the importance of these results, further studies are needed in a larger population which includes non-ambulatory children.
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Affiliation(s)
- Lawia Szkoda
- Department of Physiotherapy, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Andrzej Szopa
- Department of Physiotherapy, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
- Neuromed, Rehabilitation and Medical Center in Katowice, 40-698 Katowice, Poland
| | - Andrzej Siwiec
- John Paul II Pediatric Center in Sosnowiec, 41-218 Sosnowiec, Poland
| | | | - Małgorzata Domagalska-Szopa
- Department of Developmental Age Physiotherapy, Medical University of Silesia in Katowice, 40-751 Katowice, Poland
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Ayed AE, Hanna S, Abdelazeim FH. Reliability of the TUDS test for children with cerebral palsy. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2022. [DOI: 10.1186/s43161-022-00104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
The timed up and down stairs (TUDS) test is widely used to assess the time required by a patient to climb up and down stairs as a measure of functional mobility.
Aim
This cross-sectional study was conducted to examine test-retest, intra-rater, and inter-rater reliability of TUDS test in children with cerebral palsy (CP).
Subjects
Forty children (22 boys and 18 girls) with unilateral and bilateral spastic CP were selected from the Cairo University Hospitals to participate in this study. The age range was 3–9 years. Subjects classified according to Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) in categories 1 or 2 only were included. All subjects with muscle tone above normal (spasticity) were included.
Methods
The TUDS test was performed at two testing sessions on the same day to determine test-retest reliability; the main investigator scored all children at real time using a stopwatch and then rescored them later from video recording to determine intra-rater reliability. Another research team member scored all children from video recording to determine inter-rater reliability. Scoring was carried out at real time and from video recordings of the trials. Reliability was estimated using intra-class correlation coefficients (ICC).
Results
The TUDS test showed excellent reliability for all measured types of reliability. ICC score for test-retest reliability was 0.978, ICC score for intra-rater reliability was 0.999, while ICC score for inter-rater reliability was 0.998 and 0.999.
Conclusion
The TUDS test is a reliable outcome measure for children with spastic CP. It can be measured at real time or later from video recording of the performance trials. The TUDS test is an important tool in the re-evaluation process of children with 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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Gjesdal BE, Mæland S, Bogen B, Cumming KT, Nesse VC, Torberntsson SMR, Rygh CB. Ballistic strength training in adults with cerebral palsy may increase rate of force development in plantar flexors, but transition to walking remains unclear: a case series. BMC Sports Sci Med Rehabil 2022; 14:101. [PMID: 35659348 PMCID: PMC9166478 DOI: 10.1186/s13102-022-00487-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 05/13/2022] [Indexed: 11/16/2022]
Abstract
Background Persons with cerebral palsy (CP) walk with reduced ankle plantar flexor power compared to typically developing. In this study, we investigated whether a ballistic strength-training programme targeting ankle plantar flexors could improve muscle strength, muscle architecture and walking function in adults with CP. Methods Eight adults (mildly affected CP) underwent eight weeks of ballistic strength training, with two sessions per week. Before and after the intervention preferred walking speed, ankle plantar flexion rate of force development (RFD), maximal voluntary contraction (MVC), muscle thickness, pennation angle and fascicle length were measured. Data are presented for individuals, as well as for groups. Group changes were analysed using the Wilcoxon signed-rank test. Results Data were analysed for eight participants (five women, mean age 37.9 years; six GMFCS I and two GMFCS II). Two participants increased their walking speed, but there were no significant group changes. In terms of muscle strength, there were significant group changes for RFD at 100 ms and MVC. In the case of muscle architecture, there were no group changes. Conclusion In this study, we found that eight weeks of ballistic strength training improved ankle plantar flexor muscle strength but walking function and muscle architecture were unchanged. Larger studies will be needed to obtain conclusive evidence of the efficacy of this training method. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00487-1.
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Affiliation(s)
- Beate Eltarvåg Gjesdal
- Department of Health and Function, Western Norway University of Applied Sciences, PO Box 7030, 5020, Bergen, Norway. .,Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - S Mæland
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - B Bogen
- Department of Health and Function, Western Norway University of Applied Sciences, PO Box 7030, 5020, Bergen, Norway
| | - K T Cumming
- Faculty of Health, Welfare and Organisation, Østfold University College, Fredrikstad, Norway
| | - V C Nesse
- Department of Health and Function, Western Norway University of Applied Sciences, PO Box 7030, 5020, Bergen, Norway
| | - S M R Torberntsson
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - C B Rygh
- Department of Health and Function, Western Norway University of Applied Sciences, PO Box 7030, 5020, Bergen, Norway
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Chen D, Huang M, Yin Y, Gui D, Gu Y, Zhuang T, Chen C, Huo K. Risk factors of cerebral palsy in children: a systematic review and meta-analysis. Transl Pediatr 2022; 11:556-564. [PMID: 35558974 PMCID: PMC9085939 DOI: 10.21037/tp-22-78] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/07/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND This study aimed to explore the main risk factors for cerebral palsy in children by meta-analysis of the literature on the risk factors of cerebral palsy. METHODS We performed a literature search of the PubMed, EMBASE, Medline, and CENTRAL databases using the following search terms: ("cerebrl plsy" or "cerebrl plsis" or "infantile cerebral palsy") and ("risk factors"). Case-control or cohort studies of children with cerebral palsy and healthy children were included for meta-analysis. The Newcastle-Ottawa Scale (NOS) of case-control studies was used to evaluate the quality of the included studies. The Chi-square test was used to test the heterogeneity of the literature. This study used subgroup analysis and sensitivity analysis to identify sources of heterogeneity. If subgroup analyses and sensitivity analyses could not identify the source of heterogeneity, no pooling between study results was performed, and only individual study results were described. In this study, Egger's test was used to test for publication bias. The random-effects model was used when heterogeneity existed, and the fixed-effect model was applied when heterogeneity did not exist. RESULTS A total of 1,836 related articles were retrieved. After screening, 13 articles were included in the analysis, involving a total of 2,489 children with cerebral palsy and 4,782 children without cerebral palsy. None of the included articles achieved a NOS score of 9, four articles scored 8, eight articles scored 7, and one article scored 6. Meta-analysis showed that maternal hypertension during pregnancy, premature rupture of membranes, premature delivery and emergency cesarean section were risk factors for cerebral palsy in children, and there was no heterogeneity among the literatures and no publication bias. CONCLUSIONS This study identified gestational hypertension, preterm birth, premature rupture of membranes, and emergency cesarean section as risk factors for cerebral palsy in children through meta-analysis, providing a reference for risk monitoring and clinical intervention.
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Affiliation(s)
- Dandan Chen
- Department of Pediatrics, the First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Meiyuan Huang
- Department of Neonatology, Hainan Women and Children's Medical Center, Haikou, China
| | - Yangyan Yin
- Department of Pediatrics, the First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Dongmei Gui
- Department of Pediatrics, the First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yuniao Gu
- Department of Neonatology, Hainan Women and Children's Medical Center, Haikou, China
| | - Taiping Zhuang
- Department of Neonatology, Hainan Women and Children's Medical Center, Haikou, China
| | - Caihua Chen
- Department of Neonatology, Hainan Women and Children's Medical Center, Haikou, China
| | - Kaiming Huo
- Department of Pediatrics, The Second Affiliated Hospital of Hainan Medical College, Haikou, China
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Gjesdal BE, Mæland S, Williams G, Aaslund MK, Rygh CB, Cumming KT. Can adults with cerebral palsy perform and benefit from ballistic strength training to improve walking outcomes? A mixed methods feasibility study. BMC Sports Sci Med Rehabil 2021; 13:160. [PMID: 34922592 PMCID: PMC8684268 DOI: 10.1186/s13102-021-00382-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 11/18/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Power bursts of hips and ankle plantar flexors are prerequisites to walking propulsion. However, these power bursts are reduced during gait for persons with cerebral palsy (CP) and mainly in the ankle plantar flexors. Hence, task specific training, such as ballistic strength training, is suggested to increase muscle power in walking but not investigated in adults with CP. Therefore, the aim was to investigate if adults with CP could perform and benefit from ballistic strength training to improve walking, evaluated through physical measures and self-reported measures and interviews. METHODS In this mixed methods feasibility study, eight ambulatory adults (aged 24-56) with spastic CP conducted ballistic strength training on a glideboard targeting the ankle plantarflexors two times a week for eight weeks. The feasibility of the training was assessed through objectives described by Orsmond and Cohn. Before and after the intervention, physical measures (6-Minute Walk Test and the eight-item High-level Mobility Assessment Tool) and self-reported measures (Patient Global Impression of Change, Numeric Pain Rating Scale, Fatigue Impact and Severity Self-Assessment, and Walk-12) were collected. After the intervention, semi-structured interviews explored experiences of this training. RESULTS The participants experienced training the ankle plantar flexor as relevant but reported it took about four weeks to coordinate the exercises successfully. Although we observed no changes in the physical performance measures, most participants reported improvements; some felt steadier when standing, walking, and hopping. CONCLUSION This study demonstrated that ballistic strength training was feasible and suitable in adults with CP. However, guidance and a long (4 weeks) familiarization time were reported necessary to master the exercises. Most participants reported self-experienced improvements, although no physical performance measures improved. Thus, prolonged intervention may be required for perceived physical improvements to emerge. Also, other outcome measures sensitive to power output remains to be investigated.
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Affiliation(s)
- Beate Eltarvåg Gjesdal
- Department of Health and Function, Western Norway University of Applied Sciences, PO Box 7030, 5020, Bergen, Norway.
- Department of Global Public Health and Primary Care, Faculty of Medicine, The University of Bergen, Bergen, Norway.
| | - Silje Mæland
- Department of Global Public Health and Primary Care, Faculty of Medicine, The University of Bergen, Bergen, Norway
- Research Unit for General Practice in Bergen, Norwegian Research Centre, NORCE, Bergen, Norway
| | - Gavin Williams
- Department of Physiotherapy, Epworth Hospital, Richmond, Melbourne, VIC, Australia
- Department of Physiotherapy, The University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Mona Kristin Aaslund
- Department of Health and Function, Western Norway University of Applied Sciences, PO Box 7030, 5020, Bergen, Norway
| | - Cecilie Brekke Rygh
- Department of Health and Function, Western Norway University of Applied Sciences, PO Box 7030, 5020, Bergen, Norway
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Stadskleiv K, van Walsem MR, Andersen GL, Bergqvist L, Bøttcher L, Christensen K, Heyerdahl D, Hollung SJ, Høye H, Jahnsen R, Klevberg GL, Lindquist B, Passmark H, Rike PO, Rodby-Bousquet E, Alriksson-Schmidt AI. Systematic Monitoring of Cognition for Adults With Cerebral Palsy-The Rationale Behind the Development of the CP Cog-Adult Follow-Up Protocol. Front Neurol 2021; 12:710440. [PMID: 34630285 PMCID: PMC8492925 DOI: 10.3389/fneur.2021.710440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Cerebral palsy (CP) comprises a heterogeneous group of conditions recognized by disturbances of movement and posture and is caused by a non-progressive injury to the developing brain. Birth prevalence of CP is about 2-2.5 per 1,000 live births. Although the motor impairment is the hallmark of the diagnosis, individuals with CP often have other impairments, including cognitive ones. Cognitive impairments may affect communication, education, vocational opportunities, participation, and mental health. For many years, CP has been considered a "childhood disability," but the challenges continue through the life course, and health issues may worsen and new challenges may arise with age. This is particularly true for cognitive impairments, which may become more pronounced as the demands of life increase. For individuals with CP, there is no one-to-one correlation between cognition and functioning in other areas, and therefore, cognition must be individually assessed to determine what targeted interventions might be beneficial. To facilitate this for children with CP, a systematic follow-up protocol of cognition, the CPCog, has been implemented in Norway and Sweden. However, no such protocol currently exists for adults with CP. Such discontinuity in healthcare services that results from lack of follow-up of cognitive functioning and subsequent needs for adjustments and interventions makes transition from pediatric to adult healthcare services challenging. As a result, a protocol for the surveillance of cognition in adults with CP, the CPCog-Adult, has been developed. It includes assessment of verbal skills, non-verbal reasoning, visual-spatial perception, and executive functioning. It is recommended to perform these assessments at least once in young adulthood and once in the mid-fifties. This report describes the process of developing the CPCog-Adult, which has a three-fold purpose: (1) to provide equal access to healthcare services to enable the detection of cognitive impairments; (2) to provide interventions that increase educational and vocational participation, enhance quality of life, and prevent secondary impairments; and (3) to collect systematic data for research purposes. The consent-based registration of data in the well-established Swedish and Norwegian national CP registries will secure longitudinal data from childhood into adulthood.
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Affiliation(s)
- Kristine Stadskleiv
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Marleen R. van Walsem
- Department of Neurohabilitation, Oslo University Hospital, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Guro L. Andersen
- Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP), Vestfold Hospital Trust, Tønsberg, Norway
| | - Lena Bergqvist
- Unit of Occupational Therapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Louise Bøttcher
- Danish School of Education, Aarhus University, Copenhagen, Denmark
| | | | | | - Sandra Julsen Hollung
- Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP), Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Reidun Jahnsen
- Center for Habilitation and Rehabilitation Models and Services, Institute of Health and Society, University of Oslo, Oslo, Norway
- Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP), Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Gunvor L. Klevberg
- Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP), Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | | | - Henrik Passmark
- The Cerebral Palsy Surveillance Programme (CPUP), User board, Lund, Sweden
| | - Per-Ola Rike
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Elisabet Rodby-Bousquet
- Center for Clinical Research, Uppsala University-Region Västmanland, Västerås, Sweden
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
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13
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Roitman MS, Wainstock T, Sheiner E, Leibson T, Pariente G. Ectopic pregnancy: perinatal outcomes of future gestations and long-term neurological morbidity of the offspring. Arch Gynecol Obstet 2021; 304:633-640. [PMID: 33566161 DOI: 10.1007/s00404-021-05991-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/29/2021] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate perinatal outcomes and long-term neurological morbidity of offspring to mothers with a history of ectopic pregnancy. METHODS In this retrospective study, perinatal outcomes and long-term neurological morbidity of offspring were assessed among mothers with a history of ectopic pregnancy, either medically or surgically treated. The study groups were followed until 18 years of age for neurological-related morbidity. For perinatal outcomes, generalized estimated equation (GEE) models were used to control for confounders. A Kaplan-Meier survival curve was used to compare cumulative neurological morbidity incidence and Cox proportional hazards model was conducted to control for confounders. RESULTS A total of 243,682 mothers were included; 1424 mothers (0.58%) had a previous ectopic pregnancy, of which 25.6% (n = 365) were treated medically, and 74.3% (n = 1059) were treated surgically. Using GEE models, controlling for confounders, both surgically and medically treated ectopic pregnancies were noted as independent risk factors for preterm delivery in the subsequent pregnancies. Maternal history of surgically treated ectopic pregnancy was also independently associated with cesarean delivery. Offspring to mothers with previous ectopic pregnancy had comparable rates of long-term neurological morbidity. In the Cox proportional hazards model, controlling for confounders, being born to a mother with a history of previous ectopic pregnancy was not found to be independently associated with long-term neurological morbidity of offspring. CONCLUSIONS Maternal history of ectopic pregnancy is independently associated with preterm delivery. However, offspring of mothers with a history of ectopic pregnancy are not at an increased risk for long-term neurological morbidity.
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Affiliation(s)
- Melanie Shanie Roitman
- Faculty of Health Sciences, Joyce and Irving Goldman Medical School at Ben Gurion University of the Negev, Beer-Sheva, Israel.,Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, POB 151, 84101, Beer-Sheva, Israel
| | - Tamar Wainstock
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, POB 151, 84101, Beer-Sheva, Israel.
| | - Tom Leibson
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada.,Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, Toronto, ON, Canada
| | - Gali Pariente
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, POB 151, 84101, Beer-Sheva, Israel
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Gjesdal BE, Jahnsen R, Morgan P, Opheim A, Mæland S. Walking through life with cerebral palsy: reflections on daily walking by adults with cerebral palsy. Int J Qual Stud Health Well-being 2020; 15:1746577. [PMID: 32238123 PMCID: PMC7170275 DOI: 10.1080/17482631.2020.1746577] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Walking is a major target in childhood physiotherapy for children with cerebral palsy (CP). Little information exists on the importance or value of walking when these children grow up. The aim of this study was to explore personal reflections on daily walking by adults with CP. Method: Semi-structured individual interviews were conducted and analysed with systematic text condensation, a four-step thematic cross-case analysis. Results: Eight ambulatory adults (26–60 years, four women and four men) with CP were interviewed. Almost all had experienced deteriorated walking ability in adulthood and reported that walking was restricted and affected by intrinsic features, such as pain, fatigue, reduced balance and fear of falling. Extrinsic features such as being looked at due to walking abnormality and environmental factors, such as seasonal changes affected their free walking and was common. Some had accepted using mobility aids for energy conservation. Conclusions: Both intrinsic and extrinsic factors influence walking in adults with CP. Reflections by the adults with CP suggest these features may reduce participation in public spaces and potentially increase acceptance and use of mobility aids.
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Affiliation(s)
- Beate Eltarvåg Gjesdal
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Reidun Jahnsen
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, CHARM, University of Oslo, Oslo, Norway
| | - Prue Morgan
- Department of Physiotherapy, Monash University, Victoria, Australia
| | - Arve Opheim
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Habilitation & Health, Gothenburg, Sweden.,Research Department, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Silje Mæland
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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15
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Cetin SY, Erel S. Investigation of the validity and reliability of the L test in children with cerebral palsy. Physiother Theory Pract 2020; 38:182-188. [DOI: 10.1080/09593985.2020.1731894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sebahat Yaprak Cetin
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Akdeniz University, Konyaalti/Antalya, Turkey
| | - Suat Erel
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
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Jahnsen R, Ramstad K, Myklebust G, Elkjaer S, Pripp AH, Klevberg GL. Independence of young people with cerebral palsy during transition to adulthood: a population-based 3 year follow-up study. JOURNAL OF TRANSITION MEDICINE 2020. [DOI: 10.1515/jtm-2019-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractBackgroundThis study describes developmental and service transitions during a 3-year period among young people with cerebral palsy (CP) as measured by the Rotterdam Transition Profile (RTP) and evaluates the test-retest reliability of the RTP. The RTP is a questionnaire developed to classify phases of transition across nine participation domains.MethodsA three-step design was applied: Step I consisted of a translation and test-retest reliability study of the RTP, Step II was a comparison of independence between youth with and without CP and Step III was a follow-up survey of youth with CP describing changes of independence after a 3-year transition period. A sample of 103 typically developing youth were recruited for Steps I and II, and a population-based sample of 76 (response rate = 59%) youth with CP (males = 40) from South-Eastern Norway aged 16–17 years were recruited for Steps II and III. The subtypes of CP were classified as spastic unilateral (n = 30), spastic bilateral (n = 37), dyskinetic (n = 8) and ataxic (n = 1) CP. The levels of gross motor function followed the categories of the Gross Motor Function Classification System (GMFCS) as level I (n = 30), level II (n = 17), level III (n = 6), level IV (n = 8) and level V (n = 15).ResultsTwenty-six participants had epilepsy and 13 had gastrostomy. Forty-four of the youth with CP (response rate = 58%) responded to the 3-year follow-up survey in Step III. The test-retest study of the RTP showed excellent reliability (Kw 0.76–0.93). At baseline (Step II), the reference group was significantly more independent than the youth with CP in all the participation domains. At the 3-year follow-up (Step III), the levels of independence had increased significantly for all the participation domains in the youth with CP except for transportation and leisure. Despite increased independence during the transition period regarding health services, only 25% independently formulated their own care needs or applied for services and assistance at 19–20 years of age. Youth who responded to the RTP by a caregiver proxy more often had a diagnosis of epilepsy and/or gastrostomy and higher GMFCS levels. These individuals were significantly less independent than those who self-reported, both at baseline and at follow-up.ConclusionsIn conclusion, the excellent test-retest results support the use of the RTP as a tool for classifying phases of transition among youth with CP. The youth with CP were significantly less independent than their typically developing peers at baseline, yet increased their independence during a 3-year period. Those who self-reported to the RTP were generally more independent than those who proxy-reported, which supports the need to distinguish between the service needs of subgroups during the transition phase.
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Affiliation(s)
- Reidun Jahnsen
- Cerebral Palsy follow-up Program (CPOP), Department of Clinical Neurosciences for Children, Oslo University Hospital, Ullevaal, Postbox 4956 Nydalen, 0424 Oslo, Norway
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Kjersti Ramstad
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Gerd Myklebust
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
- Cerebral Palsy follow-up Program (CPOP), Department of Clinical Neurosciences for Children, Oslo University Hospital, Ullevaal, Postbox 4956 Nydalen, 0424 Oslo, Norway
| | - Sonja Elkjaer
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
- Cerebral Palsy follow-up Program (CPOP), Department of Clinical Neurosciences for Children, Oslo University Hospital, Ullevaal, Postbox 4956 Nydalen, 0424 Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Gunvor Lilleholt Klevberg
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
- Cerebral Palsy follow-up Program (CPOP), Department of Clinical Neurosciences for Children, Oslo University Hospital, Ullevaal, Postbox 4956 Nydalen, 0424 Oslo, Norway
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Lacerda DC, Manhães-de-Castro R, Gouveia HJCB, Tourneur Y, Costa de Santana BJ, Assunção Santos RE, Olivier-Coq J, Ferraz-Pereira KN, Toscano AE. Treatment with the essential amino acid L-tryptophan reduces masticatory impairments in experimental cerebral palsy. Nutr Neurosci 2019; 24:927-939. [PMID: 31766953 DOI: 10.1080/1028415x.2019.1695360] [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: 10/25/2022]
Abstract
Purpose Children with cerebral palsy (CP) often exhibit difficulties in feeding resulting from deficits in chewing. This study investigates the therapeutic potential of L-tryptophan (TRI) to reduce deficits in chewing in rats subjected to an experimental model of CP.Methods A total of 80 Wistar albino rats were used. Pups were randomly assigned to 4 experimental groups: Control Saline, Control TRI, CP Saline, and CP TRI groups. The experimental model of CP was based on the combination of perinatal anoxia associated with postnatal sensorimotor restriction of the hind limbs. TRI was administered subcutaneously during the lactation period. Anatomical and behavioral parameters were evaluated during maturation, including body weight gain, food intake, chewing movements, relative weight and the distribution of the types of masseter muscle fibers.Results The induction of CP limited body weight gain, decreased food intake and led to impairment in the morphological and functional parameters of chewing. Moreover, for a comparable amount of food ingested, CP TRI animals grew the most. In addition, supplementation with TRI improved the number of chewing movements, and increased the weight and proportion of type IIB fibers of the masseter in rats subjected to CP.Conclusion These results demonstrate that experimental CP impaired the development of mastication and that TRI supplementation increased masticatory maturation in animals subjected to CP.
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Affiliation(s)
- Diego Cabral Lacerda
- Post Graduate Program in Nutrition, Federal University of Pernambuco Recife, Brazil
| | | | | | | | | | | | - Jacques Olivier-Coq
- Institut de Neuroscience de la Timone (INT), UMR 7289, CNRS Aix Marseille Université, Marseille, France
| | | | - Ana Elisa Toscano
- Department of Nursing, CAV, Federal University of Pernambuco Recife, Brazil
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