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Adar S, Keskin D, Dündar Ü, Toktaş H, Yeşil H, Eroğlu S, Eyvaz N, Beştaş E, Demircan A. Effect of Robotic Rehabilitation on Hand Functions and Quality of Life in Children With Cerebral Palsy: A Prospective Randomized Controlled Study. Am J Phys Med Rehabil 2024; 103:716-723. [PMID: 38320248 DOI: 10.1097/phm.0000000000002430] [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: 02/08/2024]
Abstract
OBJECTIVE This study aimed to examine the impact of robotic hand rehabilitation on hand function and quality of life in children with cerebral palsy. DESIGN Children with cerebral palsy aged 7-16 yrs were divided into robotic rehabilitation ( n = 9) or conventional rehabilitation ( n = 10) groups for hand rehabilitation of 30 sessions. The primary outcomes were the Fugl-Meyer Assessment for Upper Extremity and Box and Block Test. The secondary outcomes were the Manual Ability Classification System, modified Ashworth scale, hand grasp and finger strengths, ABILHAND-Kids, Functional Independence Measure for Children, and PedsQL Quality of Life Inventory-CP Module. RESULTS In the robotic rehabilitation group, a significant improvement was found in all parameters after treatment ( P < 0.05), except for the Functional Independence Measure ( P = 0.081). In the conventional rehabilitation group, there was significant improvement after treatment in the modified Ashworth scale, Fugl-Meyer Assessment for Upper Extremity, hand grasp strength, Box and Block Test, ABILHAND-Kids, and PedsQL Quality of Life Inventory-CP Module ( P < 0.05). Before and after treatment, all outcome parameters in the groups were similar ( P > 0.05). CONCLUSIONS Robotic hand rehabilitation is effective in improving motor function, manual dexterity, spasticity, and quality of life in children with cerebral palsy. However, it was not demonstrated to be superior to conventional rehabilitation.
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Affiliation(s)
- Sevda Adar
- From the Department of Physical Medicine and Rehabilitation, School of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey (SA, DK, ÜD, HT, HY, SE, NE, EB); and Department of Ataturk Vocational School of Health Services, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey (AD)
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Zimmermann R, Poschmann M, Altschuck N, Bauer C, von Pfeil D, Bernius P, Mall V, Jung NH. Influence of the percutaneous myofasciotomy on gait of children with spastic cerebral palsy - A short term, retrospective controlled analysis. Gait Posture 2023; 104:159-164. [PMID: 37421812 DOI: 10.1016/j.gaitpost.2023.06.023] [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: 12/19/2022] [Revised: 05/19/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND One of the primary causes in children with cerebral palsy (CP) leading to gait disorders is an increased muscle tone which may secondary result in a shortening of the muscle fascia. Percutaneous myofasciotomy (pMF) is a minimal-invasive surgical intervention correcting the shortened muscle fascia and aims to extend the range of motion. RESEARCH QUESTION What is the effect of pMF on gait in children with CP three months and one year post-OP? METHODS Thirty-seven children (f: n = 17, m: n = 20; age: 9,1 ± 3,9 years) with spastic CP (GMFCS: I-III, bilateral (BSCP): n = 24, unilateral (USCP): n = 13) were retrospectively included. All children underwent a three dimensional gait analysis with the Plug-in-Gait-Model before (T0) and three months after pMF (T1). Twenty-eight children (bilateral: n = 19, unilateral: n = 9) underwent a one-year follow-up-measurement (T2). Differences in the Gait Profile Score (GPS), kinematic gait data, gait-related functions and mobility in daily living were statistically analyzed. Results were compared to a control group (CG) matched in age (9,5 ± 3,5 years), diagnosis (BSCP: n = 17; USCP: n = 8) and GMFCS-level (GMFCS I-III). This group was not treated with pMF but underwent two gait analyses in twelve months. RESULTS The GPS improved significantly in BSCP-pMF (16,46 ± 3,71° to 13,37 ± 3,19°; p < .0001) and USCP-pMF (13,24 ± 3,27° to 10,16 ± 2,06°; p = .003) from T0 to T1 with no significant difference between T1 and T2 in both groups. In CG there was no difference in the GPS between the two analyses. SIGNIFICANCE PMF may in some children with spastic CP improve gait function three months as well as for one-year post-OP. Medium and long-term effects, however, remain unknown and further studies are needed.
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Affiliation(s)
- Regina Zimmermann
- School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany; kbo-Kinderzentrum München, Munich, Germany.
| | | | - Natalie Altschuck
- School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany; Department Health Sciences, University of Applied Sciences, Fulda, Germany; Institute for Health Services Research and Clinical Epidemiology, Department of Medicine, University of Marburg, Germany
| | | | | | | | - Volker Mall
- School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany; kbo-Kinderzentrum München, Munich, Germany
| | - Nikolai H Jung
- School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany; kbo-Kinderzentrum München, Munich, Germany.
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Mendoza-Sengco P, Lee Chicoine C, Vargus-Adams J. Early Cerebral Palsy Detection and Intervention. Pediatr Clin North Am 2023; 70:385-398. [PMID: 37121632 DOI: 10.1016/j.pcl.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Early identification of cerebral palsy (CP) facilitates optimal care, support, and outcomes for children and their families. Ideally, infants with risk factors or developmental deviations should be evaluated early using standardized assessments of neurodevelopment and brain imaging. If a diagnosis of CP or high risk for CP (HRCP) is established, specialized, evidence-informed therapy and family support should be initiated. With task-specific motor skill training and an enriched environment, infants with CP show greater gross motor and cognitive gains. These enhanced outcomes are only achievable with early diagnosis and subsequent intervention.
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Affiliation(s)
- Paola Mendoza-Sengco
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 4009, Cincinnati, OH 45229-3026, USA.
| | - Caitlin Lee Chicoine
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 4009, Cincinnati, OH 45229-3026, USA
| | - Jilda Vargus-Adams
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 4009, Cincinnati, OH 45229-3026, USA
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Aloraini SM, Alyosuf EY, Aloraini LI, Aldaihan MM. Assessment of spasticity: an overview of systematic reviews. PHYSICAL THERAPY REVIEWS 2022. [DOI: 10.1080/10833196.2022.2059942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Saleh M. Aloraini
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Emtenan Y. Alyosuf
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Lamya I. Aloraini
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Mishal M. Aldaihan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
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Maitre NL, Byrne R, Duncan A, Dusing S, Gaebler-Spira D, Rosenbaum P, Winter S. "High-risk for cerebral palsy" designation: A clinical consensus statement. J Pediatr Rehabil Med 2022; 15:165-174. [PMID: 35275579 DOI: 10.3233/prm-220030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Nathalie L Maitre
- Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | | | | | - Stacey Dusing
- University of Southern California, Los Angeles, CA, USA
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Panda S, Somu R, Maitre N, Levin G, Singh AP. Impact of the Coronavirus Pandemic on High-Risk Infant Follow-Up (HRIF) Programs: A Survey of Academic Programs. CHILDREN-BASEL 2021; 8:children8100889. [PMID: 34682154 PMCID: PMC8534718 DOI: 10.3390/children8100889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/25/2022]
Abstract
Objective: The impact of the COVID-19 pandemic on the functioning and services of academic high-risk infant follow-up (HRIF) clinics throughout North America. Study Design: Prospective 25-question questionnaire survey through REDCAP links that was sent over 10 weeks, to 105 US and 10 Canadian programs. Finally, 59 of 105 US programs and 5 of 10 Canadian responses were analyzed using SAS version 9.4. Results: In the US, 67% of programs reported closures between 1–5 months, whereas in Canada 80% of programs closed for 1–3 months. In the US 86% of programs provided telemedicine visits and only 42.5% provided multidisciplinary HRIF telemedicine visits. We enumerated innovative approaches specifically for the conduct of Telemedicine visits, the need for the standardization of various tests and services in a telemedicine setting, and to emphasize the urgent need for more government funding to improve follow-up and developmental services to this fragile group of newborns.
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Affiliation(s)
- Sanjeet Panda
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso 4800 Alberta Avenue, El Paso, TX 79905, USA; (R.S.); (G.L.); (A.P.S.)
- Correspondence: ; Tel.: +1-361-876-6940
| | - Rashmi Somu
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso 4800 Alberta Avenue, El Paso, TX 79905, USA; (R.S.); (G.L.); (A.P.S.)
- Harbor UCLA Medical Center, Torrance, CA 90502, USA
| | - Nathalie Maitre
- Director of Early Development and Cerebral Palsy Research, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Garrett Levin
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso 4800 Alberta Avenue, El Paso, TX 79905, USA; (R.S.); (G.L.); (A.P.S.)
| | - Ajay Pratap Singh
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso 4800 Alberta Avenue, El Paso, TX 79905, USA; (R.S.); (G.L.); (A.P.S.)
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Affiliation(s)
- E Steve Roach
- Department of Neurology, University of Texas Dell Medical School, Austin, Texas.
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