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Grey I, Brennan D, Cody B. Outcomes for children with autism spectrum disorder and their families after two years of school based early intensive behavioural intervention. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241231039. [PMID: 38346005 DOI: 10.1177/17446295241231039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The effectiveness of a school based Early Intensive Behavioural Intervention (EIBI) program was assessed over a two-year period for a cohort of 16 pre-school children with autism spectrum disorder (ASD) and their families. Children with a mean age of 40 months, were assessed prior to intervention, after 1 year of intervention, and again after 2 years. Significant improvements were observed on measures of adaptive behaviour, communication ability and challenging behaviour. Parents of children attending the program also reported increased familial quality of life, specifically improved emotional and physical well-being and increased parenting capacity over the duration of the program. The current study suggests that EIBI for young children with ASD can be effective in facilitating improvements in communication ability, reducing challenging behaviours and improving quality of life for families. Children's pre-intervention adaptive skills appeared to be the strongest predictor of post intervention gains as initial level of adaptive ability was positively related to improved post-intervention outcomes.
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Affiliation(s)
- Ian Grey
- Department of Cognitive Science, College of Humanities and Social Sciences, United Arab Emirates University, United Arab Emirates
| | | | - Brettjet Cody
- Department of Cognitive Science, College of Humanities and Social Sciences, United Arab Emirates University, United Arab Emirates
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Bingol H, Kerem Gunel M, Alkan H. The Efficacy of Two Models of Intensive Upper Limb Training on Health-Related Quality of Life in Children with Hemiplegic Cerebral Palsy Mainstreamed in Regular Schools: A Double-Blinded, Randomized Controlled Trial. Physiother Theory Pract 2023; 39:10-25. [PMID: 34743663 DOI: 10.1080/09593985.2021.1999355] [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: 12/16/2022]
Abstract
BACKGROUND Children with hemiplegic cerebral palsy (CP) are at risk of reduced upper limb function and poorer quality of life than their typically developing peers. Although upper limb impairments have potential negative impact on the health-related quality of life (HRQOL) in children with hemiplegic CP, the efficacy of upper limb rehabilitation approaches aiming to improve upper limb impairments on HRQOL has not been adequately investigated. OBJECTIVE This study compares the efficacy of two modes of activity-based upper limb rehabilitation (modified constraint-induced movement therapy [mCIMT] and bimanual training [BIM]) on HRQOL outcomes in children with hemiplegic CP mainstreamed in regular schools. METHODS Thirty children with hemiplegic CP aged between 7 and 11 years (mean age 8.53 ± 1.54 years) who had functional ability levels of I-III according to the Manual Ability Classification System (MACS), Gross Motor Classification System (GMFCS), and Communication Function Classification System (CFCS) were randomly assigned to receive mCIMT or BIM training. Result: Both mCIMT and BIM yielded statistically significant improvements in all HRQOL domains immediately after the 10-week interventions (P < .001), which were retained at 16 weeks. CONCLUSION While there were some differences in the intervention effects, both of these upper limb rehabilitation approaches based on intensive unimanual or bimanual activity may be beneficial for improving perceived life satisfaction related to physical activity, general mood, family, friends, and school among children with hemiplegic CP mainstreamed in regular schools.
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Affiliation(s)
- Hasan Bingol
- Department of Therapy and Rehabilitation, Vocational School of Health Services, Mus Alparslan University, 49250-Güzeltepe/Mus, Turkey.,Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Hacettepe University, 06100-Samanpazarı/Ankara, Turkey
| | - Mintaze Kerem Gunel
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Hacettepe University, 06100-Samanpazarı/Ankara, Turkey
| | - Halil Alkan
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100-Samanpazarı/Ankara, Turkey.,Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Mus Alparslan University, 49250-Güzeltepe/Mus, Turkey
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Almasri NA, Alquaqzeh FA. Determinants of Quality of Life of Children and Adolescents with Cerebral Palsy: A Systematic Review. Phys Occup Ther Pediatr 2023:1-22. [PMID: 36588347 DOI: 10.1080/01942638.2022.2162358] [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: 01/03/2023]
Abstract
OBJECTIVE To summarize research findings on the determinants of Quality of Life (QoL) in children with cerebral palsy based on the International Classification of Functioning, Disability, and Health (ICF). METHODS The protocol of the review was registered in the International Prospective Register of The Systematic Reviews PROSPERO (CRD42021261966). A PubMed, Web of Science, MEDLINE complete, and CINAHL Plus search was conducted between January 2020 and October 2021 to identify studies that examined determinants of QoL. Inclusion criteria for the studies were children between the ages of birth and 20 years with cerebral palsy. The data extraction and quality evaluation of studies were carried out independently by two reviewers. RESULTS A total of 664 studies were identified in the search, of which 23 studies were included in the review. The majority of the studies were conducted in high-income countries. According to the ICF, 48% of the studies examined body function determinants, 52% examined activities determinants, and 26% examined environmental determinants. In contrast, 13% of the studies examined determinants related to participation and 13% examined determinants related to personal factors. CONCLUSIONS Based on our findings, most of the determinants identified in the literature are related sequentially to functional activities, body functions and structures, and environmental factors. Researchers should focus on assessing the determinants of QoL related to participation and personal characteristics for children with cerebral palsy in order to improve their QoL.
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Affiliation(s)
- Nihad A Almasri
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Fatima Alzahra Alquaqzeh
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
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Bingol H, Kerem Gunel M. The effects of hand deformity on upper-limb function and health-related quality of life in children with spastic hemiplegic cerebral palsy. HAND SURGERY & REHABILITATION 2021; 40:722-728. [PMID: 34454162 DOI: 10.1016/j.hansur.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/17/2021] [Accepted: 08/23/2021] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate the effect of hand deformity on upper-limb function and health-related quality of life (HRQOL) in children with hemiplegic cerebral palsy (CP). The study included 44 children with hemiplegic CP between the ages of 6 and 14 years (mean age, 10.04 years; SD, 3.1; 23 males, 21 females). The Manual Ability Classification System (MACS) and Gross Motor Function Classification System (GMFCS) were used, with the Zancolli classification to characterize hand deformities on the more affected side. Upper-limb function was assessed in terms of unilateral capacity (Quality of Upper Extremity Skills Test: QUEST) and bimanual performance (Children's Hand-use Experience Questionnaire: CHEQ), while HRQOL was evaluated on the KIDSCREEN-27 questionnaire. Comparison of bimanual performance and unilateral capacity in children with Zancolli level 1 and 2a hemiplegic CP found statistically significant differences (p < 0.01). There was also a significant difference on the HRQOL 'physical activities and health' subdomain, in favor of Zancolli level I deformity (p = 0.003), but not on the other HRQOL domains (p > 0.05). Upper-limb function and the HRQOL physical health domain were poorer with greater hand deformity in children with hemiplegic CP.
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Affiliation(s)
- H Bingol
- Department of Therapy and Rehabilitation, Vocational School of Health Service, Muş Alparslan University, 49250, Güzeltepe/Mus, Turkey; Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Hacettepe University, 06100, Samanpazarı/Ankara, Turkey.
| | - M Kerem Gunel
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100, Samanpazarı/Ankara, Turkey.
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Rezaei A, Raji P, Mousavi ST, Mahmoodian M, Baghestani AR. Study of environmental factors and quality of life in children with cerebral palsy based on international classification of functioning, disability and health. Br J Occup Ther 2021. [DOI: 10.1177/03080226211008724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Identification of environmental barriers is an important factor for improving quality of life. The aim was to investigate the relationship between environmental factors and quality of life of children with cerebral palsy and to prioritize environmental factors affecting the quality of life. Method In this cross-sectional study, participants were children with cerebral palsy ( n = 67) 8–12 years. The European Child Environment Questionnaire and cerebral palsy quality of life questionnaire were used. In order to prioritize environmental codes, each of the items in the European Child Environment Questionnaire was linked to environmental codes of the cerebral palsy ICF Core Set. Data were analyzed using SPSS and Pearson correlation and regression tests. Results There was a significant negative relationship between quality of life and environmental barriers ( p < 0.05, r = −0.36). The European Child Environment Questionnaire covered 75% of the environmental codes of cerebral palsy ICF Core Set. Also, e5 (services, systems and policies) was identified as the main priority of environmental factors affecting the quality of life. Conclusion Occupational Therapists should devote part of the interventional plan to reduce environmental barriers. On the other hand, decision-making organizations have to make supportive laws to improve the physical environment of the home, community, school, and work.
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Affiliation(s)
- Amin Rezaei
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Department of Occupational Therapy, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Parvin Raji
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Tahmineh Mousavi
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Mahmoodian
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Baghestani
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Meert KL, Reeder RW, Maddux AB, Banks R, Berg RA, Newth CJ, Hall MW, Quasney M, Carcillo JA, McQuillen PS, Mourani PM, Chima RS, Holubkov R, Sorenson S, McGalliard J, Dean JM, Zimmerman JJ. Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities. Pediatr Crit Care Med 2021; 22:e302-e313. [PMID: 33156209 PMCID: PMC8099927 DOI: 10.1097/pcc.0000000000002606] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To serially evaluate health-related quality of life during the first year after community-acquired septic shock in children with preexisting severe developmental disabilities and explore factors associated with health-related quality of life changes in these children. DESIGN Secondary analysis of the Life after Pediatric Sepsis Evaluation investigation. SETTING Twelve academic PICU in the United States. PATIENTS Children greater than or equal to 1 month and less than 18 years old identified by their family caregiver (e.g., parent/guardian) as having severe developmental disability prior to septic shock. INTERVENTIONS Family caregivers completed the Stein-Jessop Functional Status II-R Short Form as a measure of their child's health-related quality of life at baseline (reflecting preadmission status), day 7, and months 1, 3, 6, and 12 following PICU admission. Stein-Jessop Functional Status II-R Short Form scores were linearly transformed to a 0-100 scale, with higher scores indicating better health-related quality of life. MEASUREMENTS AND MAIN RESULTS Of 392 Life after Pediatric Sepsis Evaluation participants, 137 were identified by their caregiver as having a severe developmental disability. Sixteen children (11.6%) with severe disability died during the 12 months following septic shock. Among 121 survivors, Stein-Jessop Functional Status II-R Short Form scores declined from preadmission baseline to day 7 (70.7 ± 16.1 vs 55.6 ± 19.2; p < 0.001). Stein-Jessop Functional Status II-R Short Form scores remained below baseline through month 12 (59.1 ± 21.0, p < 0.001 vs baseline). After adjusting for baseline Stein-Jessop Functional Status II-R Short Form, the caregiver being a single parent/guardian was associated with lower month 3 Stein-Jessop Functional Status II-R Short Form scores (p = 0.041). No other baseline child or caregiver characteristic, or critical illness-related factors were significantly associated with month 3 Stein-Jessop Functional Status II-R Short Form scores. CONCLUSIONS Health-related quality of life among children with severe developmental disability remains, on average, below baseline during the first year following community-acquired septic shock. Children with severe disability and septic shock that are in single parent families are at increased risk. Clinical awareness of the potential for decline in health-related quality of life among disabled children is essential to prevent this adverse outcome from being missed.
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Affiliation(s)
- Kathleen L. Meert
- Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, MI
| | - Ron W. Reeder
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Aline B. Maddux
- Department of Pediatrics, Children’s Hospital of Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Russell Banks
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Robert A. Berg
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Christopher J. Newth
- Department of Anesthesiology Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Mark W. Hall
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH
| | - Michael Quasney
- Department of Pediatrics, C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI
| | - Joseph A. Carcillo
- Department of Critical Care Medicine, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Patrick S. McQuillen
- Department of Pediatrics, Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Peter M. Mourani
- Department of Pediatrics, Children’s Hospital of Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Ranjit S. Chima
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Richard Holubkov
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Samuel Sorenson
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Julie McGalliard
- Center for Child Health, Behavior and Development, Seattle Children’s Hospital, Seattle Research Institute, Seattle, WA
| | - J. Michael Dean
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Jerry J. Zimmerman
- Department of Pediatrics, Seattle Children’s Hospital, Seattle Research Institute, University of Washington School of Medicine, Seattle, WA
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Hassanein EEA, Adawi TR, Johnson ES. Social support, resilience, and quality of life for families with children with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 112:103910. [PMID: 33621821 DOI: 10.1016/j.ridd.2021.103910] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/11/2021] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
A family's quality of life (FQOL) has been shown to impact the quality of life for the child with intellectual disabilities. Therefore, it is important to understand the factors that contribute to FQOL to inform the types of interventions and supports that are provided to families. The goal of this study was to determine whether social support and resilience account for variance in Family Quality of Life as reported by mothers of children with intellectual disabilities. Eight-eight Qatari mothers responded to three surveys, the Brief Resilience Scale, the 2-Way Social Support Scale, and the Beach Center Family Quality of Life Scale. Regression results indicate that giving and receiving social support accounted for significant variance in FQOL, explaining 62 % of the variance. Resilience was not a significant predictor. Implications for research and practice are discussed.
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Affiliation(s)
| | - Taha R Adawi
- Department of Psychological Sciences, Qatar University, Qatar
| | - Evelyn S Johnson
- Department of Early and Special Education, Boise State University, United States.
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Şimşek TT, Sertel M, Yümin ET, Aras B, Narayanan UG. Validation of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) in a sample of Turkish non-ambulatory children with cerebral palsy. TURK PEDIATRI ARSIVI 2019; 54:13-27. [PMID: 31217705 PMCID: PMC6559974 DOI: 10.14744/turkpediatriars.2019.57778] [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: 02/07/2018] [Accepted: 01/15/2019] [Indexed: 12/04/2022]
Abstract
AIM The aim of this study was to translate and transculturally adapt the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire into the Turkish language and test the reliability and validity. MATERIAL AND METHODS Eighty-two children with cerebral palsy and their parents were included in the study. The majority of children had spastic cerebral palsy. According to the Gross Motor Function Classification System, 26 children were level III, 30 children were level IV, and 26 children were level V. International accepted guidelines were used in the transcultural adaptation and validation process. Reliability was assessed through statistical analysis of the test results for test-retest and internal consistency. To assess construct validity, Caregiver Priorities and Child Health Index of Life with Disabilities was compared with the Child Health Questionnaire Parent Form. Concurrent validity was assessed by examining how Caregiver Priorities and Child Health Index of Life with Disabilities scores changed according to Gross Motor Function Classification System levels. RESULTS The mean total score of Caregiver Priorities and Child Health Index of Life with Disabilities was 58.34±26.39. The intraclass correlation coefficient for the total questionnaire score was 0.75, ranging from 0.43 to 0.89 for six domains. Cronbach's alpha was above 0.80 in all domains of Caregiver Priorities and Child Health Index of Life with Disabilities, except the health domain. The construct validity was good because there was a positive correlation between total Child Health Questionnaire Parent Form and Caregiver Priorities and Child Health Index of Life with Disabilities scores (r=0.58, p<0.01) according to the Pearson correlation analysis. Caregiver Priorities and Child Health Index of Life with Disabilities scores were found to be different between Gross Motor Function Classification System levels (p<0.05). CONCLUSION This study showed that the Caregiver Priorities and Child Health Index of Life with Disabilities appears to be easy to administer, seems to have significant validity and reliability, and may be useful in the evaluation of health-related quality of life of children with cerebral palsy.
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Affiliation(s)
- Tülay Tarsuslu Şimşek
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmir, Turkey
| | - Meral Sertel
- Department of Physiotherapy and Rehabilitation, Kırıkkale University Faculty of Health Science, Kırıkkale, Turkey
| | - Eylem Tütün Yümin
- Department of Physiotherapy and Rehabilitation, Abant İzzet Baysal University Faculty of Health Science, Bolu, Turkey
| | - Bahar Aras
- Department of Physiotherapy and Rehabilitation, Kütahya Health Science University Faculty of Health Science, Kütahya, Turkey
| | - Unni G. Narayanan
- Department of Surgery & Child Health Evaluative Sciences, Toronto University, Toronto, Kanada
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Lee MH, Matthews AK, Park C. Determinants of Health-related Quality of Life Among Mothers of Children With Cerebral Palsy. J Pediatr Nurs 2019; 44:1-8. [PMID: 30683274 DOI: 10.1016/j.pedn.2018.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 10/03/2018] [Accepted: 10/03/2018] [Indexed: 01/04/2023]
Abstract
PURPOSE Caring for a child with cerebral palsy (CP) can impact both the physical and mental health of parents. However, determinants associated with health-related quality of life (HRQOL) in these parents have yet to be adequately examined. The study aims were to identify the determinants affecting HRQOL among mothers of children with CP. DESIGN AND METHODS Participants in this cross-sectional study (N = 180) were mothers of children with CP recruited from clinical and school-based settings in Korea. Variables examined were characteristics of child (demographic factors and disability parameter), mother (demographic factors, number of chronic conditions, health-promoting behaviors (HPB), and parenting stress), and environmental factors (use of personal assistant care, leisure time and social support). Multivariate regression analysis was performed to examine the child, mother, and environmental factors associated with HRQOL. RESULTS The HRQOL results revealed that the physical HRQOL was higher than mental HRQOL in the sample. Longer length of disability of children and lower number of chronic conditions of mothers were significant factors of higher physical HRQOL. Lower parenting stress, more leisure time, engagement in HPB, and greater social support were significantly associated with higher mental HRQOL. CONCLUSIONS The levels of HRQOL of mothers of children with CP were very low and our findings suggest modifiable factors. Decreasing parenting stress, engaging in HPB, and providing social support should be considered when developing psychosocial intervention for this population. PRACTICE IMPLICATIONS Study results may inform programs aimed at health promotion, stress reduction, and QOL improvement among parents of children with disabilities.
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Affiliation(s)
- Meen Hye Lee
- School of Nursing, University of North Carolina at Wilmington, Wilmington, NC, USA.
| | - Alicia K Matthews
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Chang Park
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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Nguyen TL, Nguyen HP, Nguyen TK. The effects of bone marrow mononuclear cell transplantation on the quality of life of children with cerebral palsy. Health Qual Life Outcomes 2018; 16:164. [PMID: 30107811 PMCID: PMC6092872 DOI: 10.1186/s12955-018-0992-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 08/01/2018] [Indexed: 02/08/2023] Open
Abstract
Background Quality of life (QOL) is an important factor in evaluating the effectiveness of treatment in children with cerebral palsy (CP). The aim of this study was to evaluate the effects of autologous bone marrow mononuclear cells (BM MNCs) on the QOL of children with CP. Methods From December 2015 to December 2016, 30 children with CP aged from 2 to 15 years received two intrathecal infusions of BM MNCs, one at baseline and the other 3 months later, at Vinmec International Hospital. The motor function and muscle tone of the patients were evaluated using the Gross Motor Function Measure (GMFM)-88 and Modified Ashworth Score, respectively. Their QOL was assessed at baseline and 6 months after the first BM MNC transplant using the Vietnamese version of the Cerebral Palsy Quality of Life Questionnaire for children (CP QOL-Child)–the parental proxy report, which comprises seven domains. Nineteen mothers (mean age: 32.9±4.9 years) and 11 fathers (mean age: 36.1±6.8 years) were invited to complete the CP QOL-Child assessment before and after the transplantations, Paired t-tests and multivariate regression analyses were used to evaluate the changes in QOL and GMFM scores and to identify the key factors correlated with the QOL score. Results Significant changes were observed in the children’s gross motor function and muscle spasticity, as evidenced by the GMFM-88 total score, scores for each of its domains, the GMFM-66 percentile and the muscle tone (P < 0.001). Six months after the transplantations, the QOL scores of children with CP were markedly increased (P < 0.001) for all the domains, except for the domain of access to services. In the multivariate regression analysis, significant associations were found between higher age of children and higher QOL except for feeling about functioning and pain and impact of disability domains. Gross Motor Function Classification System (GMFCS) level was negatively correlated with the score of pain and impact of disability domain, while the GMFM-88 scores were positively correlated with the QOL in terms of feelings about functioning and family health domain (P < 0.05). Conclusion The QOL of the children with CP was noticeably improved 6 months after BM MNC transplantation and was accompanied by improvements in gross motor function and muscle tone. Trial registration ClinicalTrials.gov Identifier: NCT02574923. Registered on October 14, 2015.
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Affiliation(s)
- Thanh Liem Nguyen
- Vinmec Research Institute of Stem Cell and Gene Technology, 458 Minh Khai Street, Hanoi, Vietnam.
| | - Hoang Phuong Nguyen
- Vinmec Research Institute of Stem Cell and Gene Technology, 458 Minh Khai Street, Hanoi, Vietnam
| | - Trung Kien Nguyen
- Vinmec Research Institute of Stem Cell and Gene Technology, 458 Minh Khai Street, Hanoi, Vietnam
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Participation in Daily Life: Influence on Quality of Life in Ambulatory Children with Cerebral Palsy. PM R 2018; 10:1185-1191. [PMID: 29783065 DOI: 10.1016/j.pmrj.2018.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cerebral palsy (CP) is a chronic condition that affects children and has an impact on social and physical activity, as well as participation in daily life. Participation and quality of life (QOL) are 2 important measures of successful rehabilitation that have not been well studied in children with CP. OBJECTIVE To report levels of participation and examine the relationship of participation to QOL in ambulatory children with CP. DESIGN Secondary analysis, cross-sectional cohort study. SETTING Regional pediatric specialty care center. PARTICIPANTS A cohort of 128 ambulatory children with CP, Gross Motor Function Classification System levels I-III, age 2-9 years. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Pediatric Quality of Life Inventory; Assessment of Life Habits; and Children's Assessment of Participation and Enjoyment and Assessment of Preschool Children's Participation. RESULTS Participation was negatively associated with increasing Gross Motor Function Classification System but not age. Level of participation was associated with psychosocial QOL (2.97, P = .001) and total QOL (54.70, P = .03) but not physical QOL. There was a positive relationship between physical activity performance (0.63, P = .001), walking performance (0.002, P = .01), and communication level (7.23, P = .05) with physical QOL. Increasing age and decreased frequency of participation were negatively associated with all QOL domains. CONCLUSIONS The results suggest that participation in daily life is negatively influenced by physical impairment and that levels of participation are positively associated with psychosocial and total QOL among ambulatory children with CP. This suggests that participation influences QOL and further studies are needed to determine the aspects of participation directly impacting QOL in ambulatory children with CP. LEVEL OF EVIDENCE III.
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A review of preference-based measures for the assessment of quality of life in children and adolescents with cerebral palsy. Qual Life Res 2018; 27:1781-1799. [DOI: 10.1007/s11136-018-1837-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2018] [Indexed: 11/26/2022]
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Madden RH, Bundy A. The ICF has made a difference to functioning and disability measurement and statistics. Disabil Rehabil 2018; 41:1450-1462. [PMID: 29433362 DOI: 10.1080/09638288.2018.1431812] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS Fifteen years after the publication of the International Classification of Functioning, Disability and Health (ICF), we investigated: How ICF applications align with ICF aims, contents and principles, and how the ICF has been used to improve measurement of functioning and related statistics. METHODS In a scoping review, we investigated research published 2001-2015 relating to measurement and statistics for evidence of: a change in thinking; alignment of applications with ICF specifications and philosophy; and the emergence of new knowledge. RESULTS The ICF is used in diverse applications, settings and countries, with processes largely aligned with the ICF and intended to improve measurement and statistics: new national surveys, information systems and ICF-based instruments; and international efforts to improve disability data. Knowledge is growing about the components and interactions of the ICF model, the diverse effects of the environment on functioning, and the meaning and measurement of participation. CONCLUSION The ICF provides specificity and a common language in the complex world of functioning and disability and is stimulating new thinking, new applications in measurement and statistics, and the assembling of new knowledge. Nevertheless, the field needs to mature. Identified gaps suggest ways to improve measurement and statistics to underpin policies, services and outcomes. Implications for Rehabilitation The ICF offers a conceptualization of functioning and disability that can underpin assessment and documentation in rehabilitation, with a growing body of experience to draw on for guidance. Experience with the ICF reminds practitioners to consider all the domains of participation, the effect of the environment on participation and the importance of involving clients/patients in assessment and service planning. Understanding the variability of functioning within everyday environments and designing interventions for removing barriers in various environments is a vital part of rehabilitation planning.
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Affiliation(s)
- Rosamond H Madden
- a Faculty of Health Sciences , University of Sydney , Sydney , Australia
| | - Anita Bundy
- a Faculty of Health Sciences , University of Sydney , Sydney , Australia.,b Department of Occupational Therapy , Colorado State University , Fort Collins , CO , USA
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Cheong SK, Lang CP, Johnston LM. Self-concept of children with cerebral palsy measured using the population-specific myTREEHOUSE Self-Concept Assessment. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 73:96-105. [PMID: 29277013 DOI: 10.1016/j.ridd.2017.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 11/05/2017] [Accepted: 12/01/2017] [Indexed: 06/07/2023]
Abstract
Self-concept is an individual's perception of him/herself. Research into the self-concept of children with cerebral palsy (CP) has been sparse due to the lack of a population-specific self-concept instrument. Using the new myTREEHOUSE Self-Concept Assessment, this study investigated the self-concept of children with CP in relation to age, gender, motor, communication and cognitive function. Children with CP aged 8-12 years (n = 50; 29 males; mean 10 years 2 months; GMFCS-E&R I = 36, II = 8, III = 5, IV = 1) completed myTREEHOUSE and a standardised intelligence measure. Most children reported positive self-concept from all three myTREEHOUSE Performance Perspectives and over half (60%) fell within the Low range for the Personal Concern Score. Self-concept was not associated with age, gender, motor function, or communication function. However, for cognitive function, associations were observed for Social Skills (Below Average > Average cognitive function; Cohen's d = 1.07) and Learning Skills (Above Average > Average cognitive function; Cohen's d = 0.95) domains when rated from a Personal Performance Perspective. As the first study of the self-concept of children with CP using a CP-specific assessment, this study offers important insights into what children with CP think about themselves. Generally, the self-concept of children with CP was sound. Future research on environmental facilitators and barriers to robust self-concept development is recommended.
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Affiliation(s)
- Sau Kuan Cheong
- School of Psychology, Australian Catholic University, 1100 Nudgee Road, Banyo, Queensland 4014, Australia.
| | - Cathryne P Lang
- School of Psychology, Australian Catholic University, 1100 Nudgee Road, Banyo, Queensland 4014, Australia.
| | - Leanne M Johnston
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia Queensland 4072, Australia.
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15
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Proxy-reported quality of life in adolescents and adults with dyskinetic cerebral palsy is associated with executive functions and cortical thickness. Qual Life Res 2016; 26:1209-1222. [PMID: 27766516 DOI: 10.1007/s11136-016-1433-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Quality of life (QOL) is a key outcome for people with cerebral palsy (CP), and executive functioning is an important predictor of QOL in other health-related conditions. Little is known about this association in CP or about its neural substrate. We aim to analyze the influence of executive functioning (including cognitive flexibility) as well as that of other psychological, motor, communication and socioeconomic variables on QOL and to identify neuroanatomical areas related to QOL in adolescents and adults with CP. METHODS Fifty subjects diagnosed with dyskinetic CP (mean age 25.96 years) were recruited. Their caregivers completed the primary caregiver proxy report version of the CP QOL-Teen questionnaire. Motor status, communication, IQ, four executive function domains, anxiety/depression and socioeconomic status were evaluated. Correlations and multiple linear regression models were used to relate CP QOL domains and total score to these variables. Thirty-six participants underwent an MRI assessment. Correlations were examined between cortical thickness and CP QOL total score and between cortical thickness and variables that might predict the CP QOL total score. RESULTS Executive functions predict scores in four domains of CP QOL (General well-being and participation, Communication and physical health, Family health and Feelings about functioning) in the regression model. Among the cognitive domains that comprise executive function, only cognitive flexibility measured in terms of performance on the Wisconsin card sorting test (WCST) predicts the CP QOL total score. Monthly income, fine motor functioning and communication ability predict scores on the domains Access to services and Family Health, Feelings about functioning and School well-being, respectively. The clusters resulting from the correlation between cortical thickness and both CP QOL total score and WCST performance overlapped in the posterior cingulate and precuneus cortices. CONCLUSIONS Cognitive flexibility predicts proxy report CP QOL-Teen total score in dyskinetic CP. This relationship has its anatomical correlate in the posterior cingulate and precuneus cortices.
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Mohammed FMS, Ali SM, Mustafa MAA. Quality of life of cerebral palsy patients and their caregivers: A cross sectional study in a rehabilitation center Khartoum-Sudan (2014 - 2015). J Neurosci Rural Pract 2016; 7:355-61. [PMID: 27365951 PMCID: PMC4898102 DOI: 10.4103/0976-3147.182778] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Cerebral palsy (CP) is group of disorders characterized by long-term disabilities that affect the quality of life (QoL) of both patients and those caring for them. Objective: The objective of this study was to measure the QoL of CP patients and their caregivers and determine the factors affecting both of them. Methods: This was a cross-sectional facility-based study. 65 caregivers of children with CP aged 4–18 years completed a self-structured questionnaire. Descriptives of the samples were displayed, and logistic regression was used in the analysis. Results: The scores of overall QoL of both children and caregivers were low, however, variations were observed among different domains. Both health-related and sociodemographic factors were found to affect the QoL of children and caregivers. The increase in the degree of disability and presence of complications decreased the children QoL while the availability of health insurance improved it. Whereas the QoL of the caregiver was affected by his/her occupation, the degree of child disability did not affect it. Conclusions: This study showed that many feasible changes can be adopted to improve the QoL of CP patients and their caregivers.
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Affiliation(s)
- Fadwa M S Mohammed
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Omdurman, Khartoum, Sudan
| | - Suad M Ali
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Omdurman, Khartoum, Sudan
| | - Mutaz A A Mustafa
- Department of Biochemistry, Faculty of Medicine, University of Khartoum, Omdurman, Khartoum, Sudan
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17
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Schertz M, Karni-Visel Y, Tamir A, Genizi J, Roth D. Family quality of life among families with a child who has a severe neurodevelopmental disability: Impact of family and child socio-demographic factors. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 53-54:95-106. [PMID: 26871463 DOI: 10.1016/j.ridd.2015.11.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/17/2015] [Accepted: 11/23/2015] [Indexed: 06/05/2023]
Abstract
We aimed to examine family quality of life (FQOL) of Northern Israeli families having a child with a severe neurodevelopmental disability and its relation to socio-demographics. The cohort included caregivers of 70 children ages (mean ± standard deviation) 5.36 ± 3.53 years. Families were two-parent (85.7%), lived in the periphery (67.1%) and included Jews (60%), Muslims (18.6%), Druze (14.3%) and Christians (7.1%). Religiosity included: secular (38.6%), traditional (31.4%), religious (30%). Children's diagnosis included autistic spectrum disorder (41.4%), intellectual disability (21.4%), cerebral palsy (17.1%), genetic syndromes (17.1%) and sensorineural hearing loss (2.9%). Degree of support (1-minimal,5-greatest) required by the child was 3.67 ± 1.28 for physical and 3.49 ± 1.36 for communication. Primary caregivers completed the FQOL Survey. Domain scores were highest for family relations and lowest for financial well-being. Dimension scores were highest for importance and lowest for opportunities. Overall FQOL approximated average. Jewish families and residents of a major urban area reported higher and more religious families reported lower overall FQOL. Regression analysis found ethnicity contributing to overall FQOL and domain scores with residence contributing to support from services. Ethnicity and child dependence contributed to dimension scores. Northern Israeli families having a child with a severe neurodevelopmental disability report average FQOL scores. However, family and child dependence characteristics affect FQOL scores. Professionals working with these families should consider FQOL information when making recommendations.
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Affiliation(s)
- Mitchell Schertz
- Child Development & Pediatric Neurology Service, Meuhedet-Northern Region, Simtat Atlit 6, Haifa, Israel.
| | - Yael Karni-Visel
- Child Development & Pediatric Neurology Service, Meuhedet-Northern Region, Simtat Atlit 6, Haifa, Israel
| | - Ada Tamir
- Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Jacob Genizi
- Department of Pediatrics, Bnei Zion Hospital, Haifa, Israel
| | - Dana Roth
- Beit Issie Shapiro, Ra'anana, Israel
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18
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Bearden DR, Monokwane B, Khurana E, Baier J, Baranov E, Westmoreland K, Mazhani L, Steenhoff AP. Pediatric Cerebral Palsy in Botswana: Etiology, Outcomes, and Comorbidities. Pediatr Neurol 2016; 59:23-9. [PMID: 27114082 PMCID: PMC4912921 DOI: 10.1016/j.pediatrneurol.2016.03.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 03/03/2016] [Accepted: 03/04/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cerebral palsy is the most common cause of motor dysfunction in children worldwide and is often accompanied by multiple comorbidities. Although cerebral palsy has been studied extensively in high-resource settings, there are few published studies on cerebral palsy etiology, outcomes and comorbidities in low-resource settings. METHODS Children with cerebral palsy were prospectively enrolled from inpatient and outpatient settings at a referral center in Gaborone, Botswana, in a cross-sectional study conducted from 2013 to 2014. Cerebral palsy etiology, outcomes, and comorbidities were determined through caregiver interviews, review of medical records, and direct physical examination. RESULTS Sixty-eight children with cerebral palsy were enrolled. Subjects were 41% male, with a median age of 4 years (interquartile range = 2 to 7). The most common etiologies for cerebral palsy in our cohort were intrapartum hypoxic events (18%), postnatal infections (15%), prematurity (15%), focal ischemic strokes (10%), and prenatal infections (10%). Severe motor impairment was common, with the most severe category present in 41%. The predominant comorbidities were cognitive impairment (84%), epilepsy (77%), and visual impairment (46%). CONCLUSIONS Cerebral palsy in Botswana has different etiologies and is associated with poorer outcomes and higher prevalence of comorbidities than what has been reported in high-resource settings. Further studies are necessary to determine optimal preventative and treatment strategies in this population.
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Affiliation(s)
- David R Bearden
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia; Department of Pediatrics, University of Botswana, Gaborone, Botswana.
| | | | - Esha Khurana
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James Baier
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Esther Baranov
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kate Westmoreland
- Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia; Department of Pediatrics, University of Botswana, Gaborone, Botswana; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Loeto Mazhani
- Department of Pediatrics, University of Botswana, Gaborone, Botswana
| | - Andrew P Steenhoff
- Botswana-UPenn Partnership, University of Pennsylvania, Philadelphia; Department of Pediatrics, University of Botswana, Gaborone, Botswana; Division of Infectious Disease, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Badia M, Begoña Orgaz M, Gómez-Vela M, Verdugo MA, Ullán AM, Longo E. Do environmental barriers affect the parent-reported quality of life of children and adolescents with cerebral palsy? RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 49-50:312-321. [PMID: 26788697 DOI: 10.1016/j.ridd.2015.12.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 12/12/2015] [Accepted: 12/14/2015] [Indexed: 06/05/2023]
Abstract
Physical, social, and attitudinal environment may affect the quality of life (QoL) of children and adolescents with cerebral palsy (CP). Participants in this study included parents of 206 children and adolescents with CP (55.8% males) aged 8-18 years (M=11.96, SD=3). Distribution according to the Gross Motor Function Classification System (GMFCS) was 24.3% level I, 18% level II, 18% level III, 12.6% level IV, and 27.2 level V. Environmental barriers were assessed with the Spanish version of the European Child Environment Questionnaire (ECEQ), and QoL was assessed with the KIDSCREEN parents' version. The results of the correlation analysis revealed that GMFCS level, IQ, and type of schooling are significantly correlated with QoL. Barriers were also associated with QoL. A series of hierarchical regression analyses indicated that, after controlling for the effect of child and parent's variables, barriers at home and at school significantly contribute to QoL. These findings underscore the importance of providing interventions to produce environmental changes that contribute to the improvement of QoL.
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Affiliation(s)
- Marta Badia
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain.
| | - M Begoña Orgaz
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.
| | - María Gómez-Vela
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain.
| | - Miguel A Verdugo
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain.
| | - Ana M Ullán
- Department of Social Psychology, University of Salamanca, Spain.
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Tseng MH, Chen KL, Shieh JY, Lu L, Huang CY, Simeonsson RJ. Child characteristics, caregiver characteristics, and environmental factors affecting the quality of life of caregivers of children with cerebral palsy. Disabil Rehabil 2016; 38:2374-82. [DOI: 10.3109/09638288.2015.1129451] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mei-Hui Tseng
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Lin Chen
- School of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Jeng-Yi Shieh
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Lu Lu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Yu Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Rune J. Simeonsson
- School of Education & FPG Child Development Institute, University of North Carolina, Chapel Hill, NC, USA
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Real-World Performance: Physical Activity, Play, and Object-Related Behaviors of Toddlers With and Without Disabilities. Pediatr Phys Ther 2015; 27:433-41. [PMID: 26397093 DOI: 10.1097/pep.0000000000000181] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe and compare the occurrence and co-occurrence of physical activity (PA), play, and object-related behaviors in toddlers with and without disabilities. METHODS Participants included 23 toddlers (21 with typical development (TD) and 2 with disabilities). Direct observation was used to describe the type and level of PA, play interactions, and object-related behaviors through video recordings. RESULTS Toddlers demonstrated high variability, occurrence, and co-occurrence of all behaviors. Toddlers with disabilities displayed less variability, occurrence, and co-occurrence of several behaviors. CONCLUSION Toddlers with TD engage simultaneously in PA, play, and object-related behaviors for about 3 hours in a typical day. This same level of co-occurrence of behaviors may not be observed for children with disabilities. Intervention providers are encouraged to consider the behaviors of toddlers with TD, beyond the findings of this pilot study, as the reference standard when implementing technology and intervention strategies for children with disabilities.
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Compagnone E, Maniglio J, Camposeo S, Vespino T, Losito L, De Rinaldis M, Gennaro L, Trabacca A. Functional classifications for cerebral palsy: correlations between the gross motor function classification system (GMFCS), the manual ability classification system (MACS) and the communication function classification system (CFCS). RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2651-2657. [PMID: 25062096 DOI: 10.1016/j.ridd.2014.07.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 07/02/2014] [Indexed: 06/03/2023]
Abstract
This study aimed to investigate a possible correlation between the gross motor function classification system-expanded and revised (GMFCS-E&R), the manual abilities classification system (MACS) and the communication function classification system (CFCS) functional levels in children with cerebral palsy (CP) by CP subtype. It was also geared to verify whether there is a correlation between these classification systems and intellectual functioning (IF) and parental socio-economic status (SES). A total of 87 children (47 males and 40 females, age range 4-18 years, mean age 8.9±4.2) were included in the study. A strong correlation was found between the three classifications: Level V of the GMFCS-E&R corresponds to Level V of the MACS (rs=0.67, p=0.001); the same relationship was found for the CFCS and the MACS (rs=0.73, p<0.001) and for the GMFCS-E&R and the CFCS (rs=0.61, p=0.001). The correlations between the IQ and the global functional disability profile were strong or moderate (GMFCS and IQ: rs=0.66, p=0.001; MACS and IQ: rs=0.58, p=0.001; CFCS and MACS: rs=0.65, p=0.001). The Kruskal-Wallis test was used to determine if there were differences between the GMFCS-E&R, the CFCS and the MACS by CP type. CP types showed different scores for the IQ level (Chi-square=8.59, df=2, p=0.014), the GMFCS-E&R (Chi-square=36.46, df=2, p<0.001), the CFCS (Chi-square=12.87, df=2, p=0.002), and the MACS Level (Chi-square=13.96, df=2, p<0.001) but no significant differences emerged for the SES (Chi-square=1.19, df=2, p=0.554). This study shows how the three functional classifications (GMFCS-E&R, CFCS and MACS) complement each other to provide a better description of the functional profile of CP. The systematic evaluation of the IQ can provide useful information about a possible future outcome for every functional level. The SES does not appear to affect functional profiles.
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Affiliation(s)
- Eliana Compagnone
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Jlenia Maniglio
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Serena Camposeo
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 2 (Developmental Psychopathology), Brindisi Research Centre, Brindisi, Italy
| | - Teresa Vespino
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Luciana Losito
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Marta De Rinaldis
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Leonarda Gennaro
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Antonio Trabacca
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy.
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Simon ADS, do Pinho AS, Grazziotin Dos Santos C, Pagnussat ADS. Facilitation handlings induce increase in electromyographic activity of muscles involved in head control of cerebral palsy children. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2547-2557. [PMID: 25010566 DOI: 10.1016/j.ridd.2014.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/14/2014] [Accepted: 06/19/2014] [Indexed: 06/03/2023]
Abstract
This study aimed to investigate the electromyographic (EMG) activation of the main cervical muscles involved in the head control during two postures widely used for the facilitation of head control in children with Cerebral Palsy (CP). A crossover trial involving 31 children with clinical diagnosis of CP and spastic quadriplegia was conducted. Electromyography was used to measure muscular activity in randomized postures. Three positions were at rest: (a) lateral decubitus, (b) ventral decubitus on the floor and (c) ventral decubitus on the wedge. Handlings for facilitating the head control were performed using the hip joint as key point of control in two postures: (a) lateral decubitus and (b) ventral decubitus on wedge. All children underwent standardized handlings, performed by the same researcher with experience in the neurodevelopmental treatment. EMG signal was recorded from muscles involved in the head control (paraspinal and sternocleidomastoid muscles) in sagittal, frontal and transverse planes, at the fourth cervical vertebra (C4), tenth thoracic vertebra (T10) and sternocleidomastoid muscle (SCM) levels. The results showed a significant increase in muscle activation when handling was performed in the lateral decubitus at C4 (P<0.001), T10 (P<0.001) and SCM (P=0.02) levels. A significant higher muscle activation was observed when handling was performed in lateral decubitus when compared to ventral decubitus at C4 level (P<0.001). Handling in ventral decubitus also induced an increase in EMG activation at T10 (P=0.018) and SCM (P=0.004) levels but not at C4 level (P=0.38). In conclusion, handlings performed in both positions may induce the facilitation of head control, as evaluated by the activity of cervical and upper trunk muscles. Handling performed in lateral decubitus may induce a slightly better facilitation of head control. These findings contribute to evidence-based physiotherapy practice for the rehabilitation of severely spastic quadriplegic CP children.
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Affiliation(s)
- Anelise de Saldanha Simon
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil
| | - Alexandre Severo do Pinho
- Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil
| | - Camila Grazziotin Dos Santos
- Programa de Pós Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Aline de Souza Pagnussat
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Programa de Pós Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil.
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