1
|
Uysal İ, Özden F, Tümtürk İ, İmerci A. The effectiveness of dual task exercise training on balance, mobility, physical performance, and quality of life in children with cerebral palsy: a single-blind randomized controlled trial. Ir J Med Sci 2024; 193:813-821. [PMID: 37777679 DOI: 10.1007/s11845-023-03530-3] [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: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Most activities of daily living require more than one activity, including motor-motor or motor-cognitive task. Few studies have investigated the effects of dual-task training in children with cerebral palsy (CP). AIMS This study was aimed at investigating the effectiveness of motor-cognitive dual-task exercise training in children with cerebral palsy (CP). METHODS A single-blind randomized controlled trial was conducted with thirty children with CP. Participants were randomized into dual group training group (DTG) and control group (CG). Children were evaluated before the intervention and after 12 weeks of treatment with Gross Motor Function Classification Scale (GMFCS), Pediatric Berg Balance Test (PBBS), Single Leg Stance Test (SLST), Timed Up and Go Test (TUG), 3 Meter Backwards Walk Test (3-MBWT), 6 Meter Walk Test (6-MWT), and General Children's Quality of Life Measure (KINDL). RESULTS DTG demonstrated significantly improved all KINDL scores (p < 0.01). In comparisons between groups adjusted analysis, results showed a better improvement of all KINDL scores in-favor-of DTG (p < 0.01). Significant improvements were found in all SLST scores and PBS in DTG (p < 0.01). Adjusted analysis results proved there was a significant improvement in all balance scores on behalf of DTG (p < 0.01). Significant improvement was observed in DTG for TUG, 3MBWT, and 6MWT scores (p = 0.001). An improvement in-favor-of DTG was found for all performance tests in the adjusted analysis (p < 0.001). CONCLUSION The results of this randomized controlled trial highlighted the advantage of dual-task training on balance, physical performance, and quality of life in children with CP.
Collapse
Affiliation(s)
- İsmail Uysal
- Fethiye Vocational School of Health Services, Department of Health Care Services, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Fatih Özden
- Department of Health Care Services, Köyceğiz Vocational School of Health Services, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - İsmet Tümtürk
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Süleyman Demirel University, Isparta, Turkey
| | - Ahmet İmerci
- Faculty of Medicine, Department of Orthopaedics and Traumatology, Muğla Sıtkı Koçman University, Muğla, Turkey
| |
Collapse
|
2
|
Ghandour M, Klotz M, Horsch A. Research trends in the orthopedic surgical management of cerebral palsy: a cross-analytical study of publications in the past decade. Front Neurol 2023; 14:1200893. [PMID: 37681012 PMCID: PMC10482432 DOI: 10.3389/fneur.2023.1200893] [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: 04/05/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
Little is known about the trends in orthopedic surgical management of cerebral palsy (CP). In this cross-analytical study we examined alterations in research publications in this field in the past 10 years through four databases. Thus, we divided publications into old (2012-2017) and recent (2018-2022). To determine if the focus of research in this field has changed, we compared both periods based on publication's (authors' number, journal, country, design), patients' (number, gender, age, CP type), and surgery-related (indication, number, category, type) characteristics. Publications showed a positive trend over the past 10 years with a peak in 2020. The number of publications was similar between old and recent ones (47.58% vs. 52.42%). Most research outputs were from the United States and Germany. Differences were noted between recent and old publications regarding journals (p = 0.0001), journal category (p = 0.023), authors' number (p = 0.006), and patients' age (p = 0.02). The impact factor was also different (p = 0.0001). However, no differences were noted regarding other characteristics (p > 0.05). The research output regarding surgical orthopedic management in CP has increased in the past decade with no difference between 2012-2017 and 2018-2022. Except for the number of authors, journal name, and patients' age, no significant differences were noted between both periods.
Collapse
Affiliation(s)
- Maher Ghandour
- Department of Orthopedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Matthias Klotz
- Marienkrankenhaus Soest, Orthopedics and Trauma Surgery, Soest, Germany
| | - Axel Horsch
- Department of Orthopedics, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
3
|
Guinet AL, Khouri N, Desailly E. Rehabilitation After Single-Event Multilevel Surgery for Children and Young Adults With Cerebral Palsy: A Systematic Review. Am J Phys Med Rehabil 2022; 101:389-399. [PMID: 34393188 DOI: 10.1097/phm.0000000000001864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This review sought to describe and analyze published protocols for rehabilitation after single-event multilevel surgery for people with cerebral palsy, to identify their differences and limits, and to introduce a common step-by-step framework for future descriptions and assessments of postoperative rehabilitation protocols.The MEDLINE, Embase, CINAHL, and the Cochrane Library databases were searched. Inclusion criteria were as follows: (1) single-event multilevel surgery, (2) full-text reports published after 1985, and (3) articles with a method section describing the rehabilitation protocol. Interventions were coded using the Oxford Levels of Evidence and the Methodological Index for Non-Randomized Studies Index.Twenty-four articles were included in the review. Studies included patients aged 4-30 yrs with spastic cerebral palsy (hemiplegia, diplegia, and quadriplegia). The mean postoperative rehabilitation duration was 4.5 mos, with 4 sessions per week, and rehabilitation took place in a rehabilitation center. This review provides relevant information about the modalities, contents, limits, and difficulties associated with the post-SEMS rehabilitation protocol reported in the literature. Pain was identified as a major problem.A more precise and comprehensive description of post-SEMS rehabilitation protocols would be useful. The proposed five-step framework could be used by future studies to standardize their protocol description in terms of objective, content, and intensity.
Collapse
Affiliation(s)
- Anne-Laure Guinet
- From the Fondation Ellen Poidatz, Pôle Recherche & Innovation, Saint-Fargeau-Ponthierry, France (ALG, NK, ED); University Paris-Saclay, Univ. Evry, IBISC, Evry (ALG); and Orthopaedic Department, Necker-Enfants Malades Hospital, Paris, France (NK)
| | | | | |
Collapse
|
4
|
Al-azzawi SS, Khaksar S, Hadi EK, Agrawal H, Murray I. HeadUp: A Low-Cost Solution for Tracking Head Movement of Children with Cerebral Palsy Using IMU. SENSORS 2021; 21:s21238148. [PMID: 34884148 PMCID: PMC8662411 DOI: 10.3390/s21238148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 12/02/2022]
Abstract
Cerebral palsy (CP) is a common reason for human motor ability limitations caused before birth, through infancy or early childhood. Poor head control is one of the most important problems in children with level IV CP and level V CP, which can affect many aspects of children’s lives. The current visual assessment method for measuring head control ability and cervical range of motion (CROM) lacks accuracy and reliability. In this paper, a HeadUp system that is based on a low-cost, 9-axis, inertial measurement unit (IMU) is proposed to capture and evaluate the head control ability for children with CP. The proposed system wirelessly measures CROM in frontal, sagittal, and transverse planes during ordinary life activities. The system is designed to provide real-time, bidirectional communication with an Euler-based, sensor fusion algorithm (SFA) to estimate the head orientation and its control ability tracking. The experimental results for the proposed SFA show high accuracy in noise reduction with faster system response. The system is clinically tested on five typically developing children and five children with CP (age range: 2–5 years). The proposed HeadUp system can be implemented as a head control trainer in an entertaining way to motivate the child with CP to keep their head up.
Collapse
Affiliation(s)
- Sana Sabah Al-azzawi
- SRT Department, EISLAB, Luleå University of Technology, 97187 Luleå, Sweden
- College of Engineering, University of Information Technology and Communications, Baghdad 10013, Iraq
- Correspondence: or
| | - Siavash Khaksar
- School of Electrical Engineering, Computing and Mathematical Sciences, Curtin University, Bentley, WA 6102, Australia; (S.K.); (H.A.); (I.M.)
| | - Emad Khdhair Hadi
- Rehabilitation Medical Center and Joint Diseases, Baghdad 10001, Iraq;
| | - Himanshu Agrawal
- School of Electrical Engineering, Computing and Mathematical Sciences, Curtin University, Bentley, WA 6102, Australia; (S.K.); (H.A.); (I.M.)
| | - Iain Murray
- School of Electrical Engineering, Computing and Mathematical Sciences, Curtin University, Bentley, WA 6102, Australia; (S.K.); (H.A.); (I.M.)
| |
Collapse
|
5
|
Williams SA, Stott NS, Valentine J, Elliott C, Reid SL. Measuring skeletal muscle morphology and architecture with imaging modalities in children with cerebral palsy: a scoping review. Dev Med Child Neurol 2021; 63:263-273. [PMID: 33107594 DOI: 10.1111/dmcn.14714] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 12/22/2022]
Abstract
AIM To investigate the use of ultrasound and magnetic resonance imaging (MRI) methodologies to assess muscle morphology and architecture in children with cerebral palsy (CP). METHOD A scoping review was conducted with systematic searches of Medline, Embase, Scopus, Web of Science, PubMed, and PsycInfo for all original articles published up to January 2019 utilizing ultrasound and/or MRI to determine morphological and architectural properties of lower limb skeletal muscle in children with CP. RESULTS Eighty papers used ultrasound (n=44), three-dimensional ultrasound (n=16), or MRI (n=20) to measure at least one muscle parameter in children and adolescents with CP. Most research investigated single muscles, predominantly the medial gastrocnemius muscle, included children classified in Gross Motor Function Classification System levels I (n=62) and II (n=65), and assessed fascicle length (n=35) and/or muscle volume (n=35). Only 21 papers reported reliability of imaging techniques. Forty-six papers assessed measures of Impairment (n=39), Activity (n=24), and Participation (n=3). INTERPRETATION Current research study design, variation in methodology, and preferences towards investigation of isolated muscles may oversimplify the complexities of CP muscle but provide a foundation for the understanding of the changes in muscle parameters in children with CP. WHAT THIS PAPER ADDS Current evidence is biased towards the medial gastrocnemius muscle and more functionally able children with cerebral palsy (CP). Variations in imaging techniques and joint positioning limit comparisons between studies. Clinimetric testing of parameters of CP muscle is not always considered. Assessment of parameter(s) of muscle with measures of participation is sparse.
Collapse
Affiliation(s)
- Sîan A Williams
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.,Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - N Susan Stott
- Department of Surgery, The University of Auckland, Auckland, New Zealand.,Starship Child Health, Auckland, New Zealand
| | - Jane Valentine
- Kids Rehab WA, Perth Children's Hospital, Perth, Western Australia, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Catherine Elliott
- Kids Rehab WA, Perth Children's Hospital, Perth, Western Australia, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Siobhán L Reid
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
6
|
ALÍ-MORELL OSAMAJ, ZURITA-ORTEGA FÉLIX, FERNÁNDEZ-ESTÉVEZ BERENICE, PADILLA-OBISPO BEATRIZ, MARTÍNEZ-PORCEL ROBERTO. ERECTOR SPINAE AND SCOLIOSIS IN A POPULATION WITH CEREBRAL PALSY: A PRELIMINARY STUDY. COLUNA/COLUMNA 2018. [DOI: 10.1590/s1808-185120181701155345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To verify the relation of muscular response to the vestibular stimulation of the erector spinae, specifically longissimus thoracis and iliocostalis lumborum, with the origin of scoliosis in a population of individuals with level V cerebral palsy of the Gross Motor Function Classification System (GMFCS). Methods: Cross-sectional study of 12 individuals aged between four and 14 years. The muscular activity of the longissimus thoracis and iliocostalis lumborum was recorded by electromyography in the presence of anteroposterior and lateral imbalances, comparing it with that obtained in sitting position without imbalances. Scoliosis was assessed by radiological study following Cobb method. Results: Statistically significant differences were found between correct responses of both muscles to anteroposterior imbalances and absence of right thoracolumbar scoliosis (p=0.005; p=0.028), left thoracic scoliosis (p=0.005; p=0.046) and right lumbar scoliosis (p=0.005; p=0.046). Conclusions: The symmetry of muscular responses to anteroposterior imbalances, both of longissimus thoracis and iliocostalis lumborum, seems to be one of the factors that prevent the development of spine deviations in this population. Level of evidence: IV. Type of Study: Case series
Collapse
|
7
|
What is the Best Configuration of Wearable Sensors to Measure Spatiotemporal Gait Parameters in Children with Cerebral Palsy? SENSORS 2018; 18:s18020394. [PMID: 29385700 PMCID: PMC5855531 DOI: 10.3390/s18020394] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/23/2018] [Accepted: 01/25/2018] [Indexed: 01/25/2023]
Abstract
Wearable inertial devices have recently been used to evaluate spatiotemporal parameters of gait in daily life situations. Given the heterogeneity of gait patterns in children with cerebral palsy (CP), the sensor placement and analysis algorithm may influence the validity of the results. This study aimed at comparing the spatiotemporal measurement performances of three wearable configurations defined by different sensor positioning on the lower limbs: (1) shanks and thighs, (2) shanks, and (3) feet. The three configurations were selected based on their potential to be used in daily life for children with CP and typically developing (TD) controls. For each configuration, dedicated gait analysis algorithms were used to detect gait events and compute spatiotemporal parameters. Fifteen children with CP and 11 TD controls were included. Accuracy, precision, and agreement of the three configurations were determined in comparison with an optoelectronic system as a reference. The three configurations were comparable for the evaluation of TD children and children with a low level of disability (CP-GMFCS I) whereas the shank-and-thigh-based configuration was more robust regarding children with a higher level of disability (CP-GMFCS II–III).
Collapse
|
8
|
Cunha AB, Lima-Alvarez CDD, Rocha ACP, Tudella E. Effects of elastic therapeutic taping on motor function in children with motor impairments: a systematic review. Disabil Rehabil 2017; 40:1609-1617. [PMID: 28325096 DOI: 10.1080/09638288.2017.1304581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The elastic therapeutic taping has been considered a promising resource for disabled children. OBJECTIVE To systematically review the evidence of the effects of elastic therapeutic taping on motor function in children with motor impairments. METHOD Three independent evaluators conducted searches in electronic databases (MEDLINE/PubMed, Scopus, LILACS, BIREME/BVS, Science Direct, SciELO, and PEDro). Clinical studies design, published until 2016, involving elastic therapeutic taping and children aged 0-12 years with motor impairments were included. The variables considered were the methodological aspects (study design, participants, outcome measurements, and experimental conditions); results presented in the studies, and also the methodological quality of studies. RESULTS Final selection was composed by 12 manuscripts (five randomized controlled trials), published in the last 10 years. Among them, cerebral palsy (CP) was the most recurrent disorder (n = 7), followed by congenital muscular torticollis (n = 2) and brachial plexus palsy (n = 2). Positive results were associated with taping application: improvement in the upper limb function, gross motor skills, postural control, muscular balance, and performance in the dynamics functional and daily activities. LIMITATIONS Lower quality of the studies, clinical and population heterogeneity existed across studies. CONCLUSIONS The elastic therapeutic taping has been shown to be a promising adjunct resource to the conventional rehabilitation in children with motor impairments. However, high methodological studies about its efficacy in this population are already scarce. Implications for Rehabilitation Elastic therapeutic taping has been shown to be a promising adjunct resource to the conventional rehabilitation in disabled children. Clinical trials have indicated improvement in the postural control and functional activities with both, upper and lower limbs, and increase in the functional independency resulting from the taping use. Randomized control trials and well-established protocols are needed to increase the confidence in applying elastic therapeutic taping to specific clinical conditions.
Collapse
Affiliation(s)
- Andréa Baraldi Cunha
- a Department of Physical Therapy , Center for Studies in Neuropediatrics and Motricity, Federal University of São Carlos , São Carlos , São Paulo , Brazil.,b Department of Physical Therapy , University of Delaware , Newark , DE , USA
| | - Carolina Daniel de Lima-Alvarez
- a Department of Physical Therapy , Center for Studies in Neuropediatrics and Motricity, Federal University of São Carlos , São Carlos , São Paulo , Brazil.,c Department of Physical Therapy , Federal University of Rio Grande do Norte , Natal , Rio Grande do Norte , Brazil
| | - Ana Carolinne Portela Rocha
- a Department of Physical Therapy , Center for Studies in Neuropediatrics and Motricity, Federal University of São Carlos , São Carlos , São Paulo , Brazil
| | - Eloisa Tudella
- a Department of Physical Therapy , Center for Studies in Neuropediatrics and Motricity, Federal University of São Carlos , São Carlos , São Paulo , Brazil
| |
Collapse
|
9
|
Meyns P, Pans L, Plasmans K, Heyrman L, Desloovere K, Molenaers G. The Effect of Additional Virtual Reality Training on Balance in Children with Cerebral Palsy after Lower Limb Surgery: A Feasibility Study. Games Health J 2017; 6:39-48. [PMID: 28051880 DOI: 10.1089/g4h.2016.0069] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Impaired balance is disabling for children with cerebral palsy (CPc), especially for CPc who recently underwent lower limb surgery. Positive results of using virtual reality (VR) in balance rehabilitation have been published in several outpatient populations. We investigated the feasibility of applying additional VR training focused on sitting balance in CP inpatients of a rehabilitation center after lower limb surgery. Additionally, we investigated the rate of enjoyment of VR training compared with conventional physiotherapy. MATERIALS AND METHODS Eleven spastic CPc (4/7 males/females) following rehabilitation after lower limb orthopedic surgery were included (5-18 years). The control group received conventional physiotherapy. The intervention group received additional VR training. Balance was measured using the Trunk Control Measurement Scale every 3 weeks of the rehabilitation period. Enjoyment was analyzed using a 10-point Visual Analog Scale. RESULTS Providing additional VR training was feasible in terms of recruitment, treatment adherence, and assessment adherence. Both groups improved sitting balance after therapy. The current games were not perceived as more enjoyable than conventional physiotherapy. CONCLUSION Including additional VR training to conventional physiotherapy is feasible and might be promising to train sitting balance in CPc after lower limb surgery. Future research should take equal patient allocation and training duration between groups into consideration.
Collapse
Affiliation(s)
- Pieter Meyns
- 1 Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center , Amsterdam, The Netherlands .,2 Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University , Gent, Belgium .,3 Department of Kinesiology, Faculty of Kinesiology and Rehabilitation Sciences , KU Leuven, Heverlee, Belgium
| | - Liene Pans
- 4 Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences , KU Leuven, Heverlee, Belgium
| | - Kaat Plasmans
- 4 Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences , KU Leuven, Heverlee, Belgium
| | - Lieve Heyrman
- 4 Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences , KU Leuven, Heverlee, Belgium
| | - Kaat Desloovere
- 4 Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences , KU Leuven, Heverlee, Belgium .,5 Clinical Motion Analysis Laboratory, CERM, University Hospital Leuven , Leuven, Belgium
| | - Guy Molenaers
- 5 Clinical Motion Analysis Laboratory, CERM, University Hospital Leuven , Leuven, Belgium
| |
Collapse
|
10
|
Abstract
Orthopedic surgery (OS) plays an important role in the management of cerebral palsy (CP). The objectives of OS are to optimize functions and prevent deformity. Newer developments in OS for CP include emphasis on hip surveillance, minimally invasive procedures, use of external fixators instead of plates and screws, better understanding of lever arm dysfunctions (that can only be corrected by bony OS), orthopedic selective spasticity-control surgery, and single-event multilevel lever arm restoration and anti spasticity surgery, which have led to significant improvements in gross motor function and ambulation, especially in spastic quadriplegia, athetosis, and dystonia. The results of OS can be dramatic and life altering for the person with CP and their caregivers if it is performed meticulously by a specialized surgical team, at the appropriate age, for the correct indications, employing sound biomechanical principles and is followed by physician-led, protocol based, intensive, multidisciplinary, institutional rehabilitation, and long term followup. However, OS can be a double-edged sword, and if performed less than optimally, and without the supporting multidisciplinary medical and rehabilitation team, expertise and infrastructure, it often leads to significant functional worsening of the person with CP, including irretrievable loss of previous ambulatory capacity. OS must be integrated into the long term management of the person with CP and should be anticipated and planned at the optimal time and not viewed as a "last resort" intervention or failure of rehabilitation. This instructional course lecture reviews the relevant contemporary principles and techniques of OS in CP.
Collapse
Affiliation(s)
- Deepak Sharan
- Department of Pediatric Orthopedics and Rehabilitation, RECOUP Neuromusculoskeletal Rehabilitation Centre, Bengaluru, Karnataka, India,Address for correspondence: Dr. Deepak Sharan, Department of Pediatric Orthopedics and Rehabilitation, RECOUP Neuromusculoskeletal Rehabilitation Centre, 312, Further Extension of Anjanapura Layout, 10th Block, Bengaluru - 560 108, Karnataka, India. E-mail:
| |
Collapse
|
11
|
Dambi JM, Jelsma J, Mlambo T, Chiwaridzo M, Dangarembizi-Munambah N, Corten L. An evaluation of psychometric properties of caregiver burden outcome measures used in caregivers of children with cerebral palsy: a systematic review protocol. Syst Rev 2016; 5:42. [PMID: 26960677 PMCID: PMC4785644 DOI: 10.1186/s13643-016-0219-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/05/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is the most common, life-long paediatric disability. Taking care of a child with CP often results in caregiver burden/strain in the long run. As caregivers play an essential role in the rehabilitation of these children, it is therefore important to routinely screen for health outcomes in informal caregivers. Consequently, a plethora of caregiver burden outcome measures have been developed; however, there is a dearth of evidence of the most psychometrically sound tools. Therefore, the broad objective of this systematic review is to evaluate the psychometrical properties and clinical utility of tools used to measure caregiver burden in caregivers of children with CP. METHODS/DESIGN This is a systematic review for the evaluation of the psychometric properties of caregiver burden outcome tools. Two independent and blinded reviewers will search articles on PubMed, Scopus, Web of Science, CINAHL, PsychINFO and Africa-Wide Google Scholar. Information will be analysed using predefined criteria. Thereafter, three independent reviewers will then screen the retrieved articles. The methodological quality of studies on the development and validation of the identified tools will be evaluated using the four point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Finally, the psychometric properties of the tools which were developed and validated from methodological sound studies will then be analysed using predefined criteria. DISCUSSION The proposed systematic review will give an extensive review of the psychometrical properties of tools used to measure caregiver burden in caregivers of children with CP. We hope to identify tools that can be used to accurately screen for caregiver burden both in clinical setting and for research purposes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015028026.
Collapse
Affiliation(s)
- Jermaine M Dambi
- University of Cape Town, Cape Town, South Africa. .,Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P O Box AV 178, Avondale, Harare, Zimbabwe.
| | - Jennifer Jelsma
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
| | - Tecla Mlambo
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P O Box AV 178, Avondale, Harare, Zimbabwe.
| | - Matthew Chiwaridzo
- University of Cape Town, Cape Town, South Africa. .,Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P O Box AV 178, Avondale, Harare, Zimbabwe.
| | - Nyaradzai Dangarembizi-Munambah
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P O Box AV 178, Avondale, Harare, Zimbabwe.
| | - Lieselotte Corten
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
| |
Collapse
|
12
|
Dambi JM, Jelsma J, Mlambo T. Caring for a child with Cerebral Palsy: The experience of Zimbabwean mothers. Afr J Disabil 2015; 4:168. [PMID: 28730030 PMCID: PMC5433478 DOI: 10.4102/ajod.v4i1.168] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 06/15/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The needs of caregivers of children with disability may not be recognized despite evidence to suggest that they experience increased strain because of their care-giving role. This strain may be exacerbated if they live in under-resourced areas. OBJECTIVES We set out to establish the well-being of caregivers of children with Cerebral Palsy (CP) living in high-density areas of Harare, Zimbabwe. In addition, we wished to identify factors that might be predictive of caregivers' well-being. Finally, we examined the psychometric properties of the Caregiver Strain Index (CSI) within the context of the study. METHOD Caregivers of 46 children with CP were assessed twice, at baseline, and after three months, for perceived burden of care and health-related quality of life (HRQoL) using CSI and EQ-5D respectively. The psychometric properties of the CSI were assessed post hoc. RESULTS The caregivers reported considerable caregiver burden with half of the caregivers reporting CSI scores in the 'clinical distress' range. Many of the caregivers experienced some form of pain, depression and expressed that they were overwhelmed by the care-giving role. No variable was found to be associated with clinical distress. The CSI demonstrated good overall internal consistency (Cronbach's Alpha = 0.8), stability over time (Z = 0.87, p = 0.381) and was significantly and negatively correlated with the EQ-5D VAS (Spearman's rho = -0.33, p = 0.027), demonstrating concurrent validity. CONCLUSION Caregivers must be monitored routinely for their level of distress and there is an urgent need to provide them with support. The CSI is likely to be a valid measure of distress in this population.
Collapse
Affiliation(s)
| | - Jennifer Jelsma
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Tecla Mlambo
- Department of Rehabilitation, University of Zimbabwe, Zimbabwe
| |
Collapse
|
13
|
Kaya Kara O, Atasavun Uysal S, Turker D, Karayazgan S, Gunel MK, Baltaci G. The effects of Kinesio Taping on body functions and activity in unilateral spastic cerebral palsy: a single-blind randomized controlled trial. Dev Med Child Neurol 2015; 57:81-8. [PMID: 25213082 DOI: 10.1111/dmcn.12583] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2014] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to investigate the effects of Kinesio Taping (KT) on the body functions and activity of children with unilateral spastic cerebral palsy (CP). METHOD This study was designed as a single-blind, randomized, controlled trial. Thirty children with unilateral spastic CP were randomized and split equally between the KT group (eight males, seven females; mean age 9y [SD 2y 3mo] range 7-12y) and the control group (seven males, eight females; mean age 9y 7mo [SD 3y 4mo] range 7-14y) receiving usual care. All participants were evaluated with the Functional Independence Measure for Children (WeeFIM), the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), the Gross Motor Function Measure (GMFM), short-term muscle power, agility and functional muscle strength tests. Wilcoxon signed-rank and Mann-Whitney U tests were used to evaluate within and between-group differences respectively. The level of significance was accepted as p<0.05. RESULTS There were significant differences in muscle power sprint (p=0.003), lateral step-up test right (p=0.016), sit to stand (p=0.018), attain stand through half knee right (p=0.003), BOTMP Gross scores (p=0.019), and WeeFIM total (p=0.003) and self-care scores (p=0.022) between the groups (p<0.05). INTERPRETATION Kinesio Taping is a promising additional approach to increase proprioceptive feedback and improve physical fitness, gross motor function, and activities of daily living in children with CP.
Collapse
Affiliation(s)
- Ozgun Kaya Kara
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
14
|
The impact of hospital-based and community based models of cerebral palsy rehabilitation: a quasi-experimental study. BMC Pediatr 2014; 14:301. [PMID: 25476072 PMCID: PMC4265462 DOI: 10.1186/s12887-014-0301-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 11/25/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cerebral palsy requires appropriate on-going rehabilitation intervention which should effectively meet the needs of both children and parents/care-givers. The provision of effective support is a challenge, particularly in resource constrained settings. A quasi-experimental pragmatic research design was used to compare the impact of two models of rehabilitation service delivery currently offered in Harare, Zimbabwe, an outreach-based programme and the other institution-based. METHOD Questionnaires were distributed to 46 caregivers of children with cerebral palsy at baseline and after three months. Twenty children received rehabilitation services in a community setting and 26 received services as outpatients at a central hospital. The Gross Motor Function Measurement was used to assess functional change. The burden of care was measured using the Caregiver Strain Index, satisfaction with physiotherapy was assessed using the modified Medrisk satisfaction with physiotherapy services questionnaire and compliance was measured as the proportion met of the scheduled appointments. RESULTS Children receiving outreach-based treatment were significantly older than children in the institution-based group. Regression analysis revealed that, once age and level of severity were controlled for, children in the outreach-based treatment group improved their motor function 6% more than children receiving institution-based services. There were no differences detected between the groups with regard to caregiver well-being and 51% of the caregivers reported signs consistent with clinical distress/depression. Most caregivers (83%) expressed that they were overwhelmed by the caregiving role and this increased with the chronicity of care. The financial burden of caregiver was predictive of caregiver strain. Caregivers in the outreach-based group reported greater satisfaction with services and were more compliant (p < .001) as compared to recipients of institution-based services. CONCLUSION Long term caregiving leads to strain in caregivers and there is a need to design interventions to alleviate the burden. The study was a pragmatic, quasi-experimental study thus causality cannot be inferred. However findings from this study suggest that the provision of care within a community setting as part of a well-structured outreach programme may be preferable method of service delivery within a resource-constrained context. It was associated with a greater improvement in functioning, greater satisfaction with services and better compliance.
Collapse
|
15
|
Camerota F, Galli M, Cimolin V, Celletti C, Ancillao A, Blow D, Albertini G. Neuromuscular taping for the upper limb in Cerebral Palsy: A case study in a patient with hemiplegia. Dev Neurorehabil 2014; 17:384-7. [PMID: 24087981 DOI: 10.3109/17518423.2013.830152] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess quantitatively the effects of Neuromuscular Taping (NMT) on the upper limb in a female child with left hemiplegia, due to Cerebral Palsy (CP). METHODS The patient underwent NMT on cervical level, shoulder and hand only of the plegic upper limb, followed by physical therapy. Kinematic data of upper limbs during reaching task were collected before (PRE) and after 2 weeks of treatment (POST). RESULTS After the intervention, the affected limb improved in terms of movement duration, Average Jerk and Number of Unit Movements indices, indicating a faster, smoother and less segmented movement. Improvements appeared at the ranges of motion of the upper limb joints, both at shoulder and elbow joints. No significant changes were globally displayed for the unaffected arm. CONCLUSION NMT seems to be a promising intervention for improving upper limb movement in patients with CP. Further investigations are certainly needed to assess effectively the effects of the intervention in this pathological state.
Collapse
Affiliation(s)
- Filippo Camerota
- Physical Medicine and Rehabilitation Division, Orthopaedic Department, Umberto I Hospital, Sapienza University , Rome , Italy
| | | | | | | | | | | | | |
Collapse
|
16
|
Sehrawat N, Marwaha M, Bansal K, Chopra R. Cerebral palsy: a dental update. Int J Clin Pediatr Dent 2014; 7:109-18. [PMID: 25356010 PMCID: PMC4212167 DOI: 10.5005/jp-journals-10005-1247] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 11/26/2013] [Indexed: 11/23/2022] Open
Abstract
Special and medically compromised patients present a unique population that challenges the dentist’s skill and knowledge. Providing oral care to people with cerebral palsy (CP) requires adaptation of the skills we use everyday. In fact, most people with mild or moderate forms of CP can be treated successfully in the general practice setting. This article is to review various dental considerations and management of a CP patient. How to cite this article: Sehrawat N, Marwaha M, Bansal K, Chopra R. Cerebral Palsy: A Dental Update. Int J Clin Pediatr Dent 2014;7(2):109-118.
Collapse
Affiliation(s)
- Nidhi Sehrawat
- Postgraduate Student, Department of Pedodontics, SGT Dental College, Gurgaon Haryana, India
| | - Mohita Marwaha
- Reader, Department of Pedodontics and Preventive Dentistry, SGT Dental College and Research Institute, Gurgaon, Haryana India
| | - Kalpana Bansal
- Professor and Head, Department of Pedodontics and Preventive Dentistry, SGT Dental College, Gurgaon, Haryana, India
| | - Radhika Chopra
- Reader, Department of Pedodontics, ITS Dental College, Ghaziabad Uttar Pradesh, India
| |
Collapse
|
17
|
Marques MR, Stigger F, Segabinazi E, Augustin OA, Barbosa S, Piazza FV, Achaval M, Marcuzzo S. Beneficial effects of early environmental enrichment on motor development and spinal cord plasticity in a rat model of cerebral palsy. Behav Brain Res 2014; 263:149-57. [DOI: 10.1016/j.bbr.2014.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 01/09/2014] [Accepted: 01/11/2014] [Indexed: 11/25/2022]
|
18
|
Pagnussat ADS, Simon ADS, Santos CGD, Postal M, Manacero S, Ramos RR. Atividade eletromiográfica dos extensores de tronco durante manuseio pelo Método Neuroevolutivo Bobath. FISIOTERAPIA EM MOVIMENTO 2013. [DOI: 10.1590/s0103-51502013000400014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: Paralisia cerebral é um distúrbio caracterizado por alterações no desenvolvimento da atividade, do movimento e da postura. O Conceito Neuroevolutivo Bobath é um método utilizado na reabilitação neuropediátrica, fundamentando-se na facilitação da aquisição de habilidades sensório-motoras de acordo com a sequência de desenvolvimento neuropsicomotor normal. OBJETIVO: Verificar atividade eletromiográfica de músculos envolvidos no controle cervical nos planos frontal, sagital e transverso, mediante manuseio em pontos-chave de controle, objetivando transferência de peso e estabilização corporal. MATERIAIS E MÉTODOS: Trata-se de uma avaliação quantitativa em um estudo de caso, no qual uma paciente de sete anos de idade, com diagnóstico clínico de paralisia cerebral e síndrome de West, foi submetida à análise eletromiográfica da musculatura envolvida no controle cervical, mediante manuseio em pontos-chave de controle. O registo ocorreu durante o manuseio utilizando postura de decúbito ventral sobre cunha e postura de decúbito lateral sobre o solo. RESULTADOS: O sinal eletromiográfico dos extensores e flexores na região cervical intensificou-se mediante manuseio para transferência de peso em ponto-chave de quadril em ambas as posturas. Embora o sinal de base tenha sido ampliado durante a transferência de peso para o quadril, o registro eletromiográfico nos segmentos musculares avaliados foi superior no decúbito lateral. CONCLUSÕES: Verificou-se que a transferência de peso para o quadril induziu facilitação do controle cervical e que o decúbito lateral de forma repetida e sustentada, mediante correto manuseio, alinhamento e transferência de peso, facilitou de forma mais pronunciada a atividade muscular na região cervical e de tronco superior do que o manuseio em decúbito ventral sobre a cunha.
Collapse
Affiliation(s)
| | | | | | | | - Sonia Manacero
- Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
| | | |
Collapse
|
19
|
Meyer-Heim A, van Hedel HJA. Robot-assisted and computer-enhanced therapies for children with cerebral palsy: current state and clinical implementation. Semin Pediatr Neurol 2013; 20:139-45. [PMID: 23948688 DOI: 10.1016/j.spen.2013.06.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The field of pediatric neurorehabilitation has rapidly evolved with the introduction of technological advancements over recent years. Rehabilitation robotics and computer-assisted systems can complement conventional physiotherapeutics or occupational therapies. These systems appear promising, especially in children, where exciting and challenging virtual reality scenarios could increase motivation to train intensely in a playful therapeutic environment. Despite promising experience and a large acceptance by the patients and parents, so far, only a few therapy systems have been evaluated in children, and well-designed randomized controlled studies in this field are still lacking. This narrative review aims to provide an overview about the to-date robot-assisted and computer-based therapies and the current level of evidence and to share the authors experience about the clinical implication of these new technologies available for children with cerebral palsy.
Collapse
Affiliation(s)
- Andreas Meyer-Heim
- Head Division of Paediatric Rehabilitation and Rehabilitation Centre, Rehabilitation Centre Affoltern am Albis, University Children's Hospital, Zurich, Switzerland.
| | | |
Collapse
|
20
|
Mawase F, Bar-Haim S, Karniel A. Lack of predictive control in lifting series of virtual objects by individuals with diplegic cerebral palsy. IEEE Trans Neural Syst Rehabil Eng 2011; 19:686-95. [PMID: 21984525 DOI: 10.1109/tnsre.2011.2170589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To date, research on the motor control of hand function in cerebral palsy has focused on children with hemiplegia, although many persons with diplegic cerebral palsy (dCP) have asymmetrically decreased hand function. We explored the predictive capabilities of the motor system in a simple motor task of lifting a series of virtual objects for five persons with spastic dCP and five age-matched controls. When a person lifts an object, s/he uses an expectation of the weight of the object to generate a motor command. We asked the study subjects to lift a series of increasing weights and determined whether they extrapolated from past experience to predict the next weight in the series, even though that weight had never been experienced. Planning of precision grasp was assessed by measurement of the grip force at the beginning of the lifting task and by estimating the motor command. Execution of precision grasp was assessed by measurement of the time interval between the onset of grip and the onset of movement. We found that persons with dCP demonstrated a lack of predictive feed-forward control in their lifting movements: they exhibited a significantly longer time between onset of grip and onset of movement than the control subjects and they did not predict the weight of the next object in the lifting task. In addition, for subjects with dCP, the time between the onset of grip and the onset of movement of the dominant hand correlated strongly with the outcome of a hand function test. We postulate that a higher-order motor planning deficit in addition to execution deficit are evident in the subjects with spastic diplegic.
Collapse
Affiliation(s)
- Firas Mawase
- Department of Biomedical Engineering, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | | | | |
Collapse
|
21
|
Costa TDAD, Carvalho SMRD, Braccialli LMP. Análise do equilíbrio estático e de deformidades nos pés de crianças com paralisia cerebral. FISIOTERAPIA E PESQUISA 2011. [DOI: 10.1590/s1809-29502011000200005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O presente estudo analisou, por meio de um sistema de baropodometria, os tipos de pé, a influência da visão no equilíbrio estático na postura ortostática e a distribuição da pressão plantar em 16 crianças, de 6 a 15 anos, com diagnóstico de paralisia cerebral. Os resultados indicaram que o pé valgo foi o mais comum dentre os tipos de paralisia cerebral estudadas, diparesia espástica, hemiparesia espástica direita, hemiparesia espástica esquerda e ataxia; o equilíbrio estático na postura ortostática de olhos vendados apresentou maior instabilidade do que quando com os olhos abertos; a distribuição de pressão plantar não apresentou significância estatística e não houve correlação significativa entre a idade e as variáveis de equilíbrio e de distribuição da pressão plantar. Desse modo, conclui-se que a visão é um fator importante no controle postural de crianças com paralisia cerebral.
Collapse
|
22
|
|
23
|
Chung CY, Chen CL, Wong AMK. Pharmacotherapy of Spasticity in Children With Cerebral Palsy. J Formos Med Assoc 2011; 110:215-22. [DOI: 10.1016/s0929-6646(11)60033-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 01/05/2011] [Accepted: 01/07/2011] [Indexed: 11/17/2022] Open
|
24
|
Iosa M, Morelli D, Nanni MV, Veredice C, Marro T, Medici A, Paolucci S, Mazzà C. Functional taping: a promising technique for children with cerebral palsy. Dev Med Child Neurol 2010; 52:587-9. [PMID: 20041935 DOI: 10.1111/j.1469-8749.2009.03539.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
25
|
Pediatric Rehabilitation: 3. Facilitating Family-Centered Treatment Decisions. PM R 2010; 2:S19-25. [PMID: 20359675 DOI: 10.1016/j.pmrj.2009.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 12/09/2009] [Indexed: 11/21/2022]
|