1
|
Mushta SM, Alghamdi R, Almalki H, Waqas S, Alawwadh A, Barasheed O, Garnan M, McIntyre S, Rashid H, Badawi N, Khandaker G. Saudi Cerebral Palsy Register (SCPR): Protocol on the Methods and Technical Details. J Epidemiol Glob Health 2024; 14:453-461. [PMID: 38358616 PMCID: PMC11176122 DOI: 10.1007/s44197-024-00198-5] [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: 09/13/2023] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
This protocol presents a comprehensive proposal for the establishment of the Saudi Cerebral Palsy Register (SCPR), a crucial project for investigating and addressing the prevalence, etiology, and management of cerebral palsy (CP) in Saudi Arabia. The SCPR will not only provide a robust database for ongoing research and analysis but will also serve as a platform for investigating the causes of CP, implementing preventative strategies, and improving the quality of care and outcomes for people with CP and their families in Saudi Arabia. Detailed case definitions, inclusion/exclusion criteria, and data collection protocols are discussed to ensure the integrity and comparability of the data. The plan also outlines strategic funding, institutional and government endorsement, sustainability considerations, potential challenges and proposed solutions, and expected outcomes and impact. These include creating research and educational opportunities, fostering regional and international collaborations, and significantly contributing to CP prevention strategies. Overcoming anticipated obstacles, such as stigma, institutional policies, and collaborations, and securing both necessary funding and endorsements are highlighted as critical for the success of the SCPR. The project is not only aligned with promote prevention of health risks, a target of Vision 2030 in Saudi Arabia, but is also expected to have a substantial impact on the health and quality of life of people with CP and their families in Saudi Arabia, serving as inspiration for similar efforts worldwide.
Collapse
Affiliation(s)
- Sami Mukhdari Mushta
- Public Health Authority (PHA), 13351, Riyadh, Saudi Arabia.
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.
| | - Riyad Alghamdi
- Public Health Authority (PHA), 13351, Riyadh, Saudi Arabia
| | - Hani Almalki
- Public Health Agency, Ministry of Health, 12382, Riyadh, Saudi Arabia
| | - Saadia Waqas
- King Fahad Center, Children with Disability Association (CDA), 12273, Riyadh, Saudi Arabia
| | - Adel Alawwadh
- Khamis Mushayt Maternity and Children Hospital (KMMCH), 62454, Khamis Mushayt, Saudi Arabia
| | - Osamah Barasheed
- The Executive Administration of Research and Innovation, King Abdullah Medical City in Holy Capital (KAMC-HC), 24246, Makkah, Saudi Arabia
| | - Mohammad Garnan
- Public Health Administration, Asir Health, 62523, Abha, Saudi Arabia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2050, Australia
| | - Harunor Rashid
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
- Sydney Institute for Infectious Diseases, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2050, Australia
- Grace Centre for Newborn Intensive Care, Sydney Children's Hospital Network (SCHN), Westmead, NSW, 2145, Australia
| | - Gulam Khandaker
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD, 4700, Australia
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, 4701, Australia
| |
Collapse
|
2
|
Subaşi İÖ, Bingöl İ, Yaşar NE, Dumlupinar E, Ata N, Ülgü MM, Birinci Ş, Ayvali MO, Erkuş S, Söylemez MS, Özdemir G. Prevalence, Incidence, and Surgical Treatment Trends of Cerebral Palsy across Türkiye: A Nationwide Cohort Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1182. [PMID: 37508679 PMCID: PMC10377957 DOI: 10.3390/children10071182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Cerebral Palsy (CP) is the most prevalent neurodevelopmental disorder in childhood. Our aim is to identify the demographics of CP in Turkish children in addition to clinical associations and surgical preferences. METHODS Based on national health system data and the International Classification of Diseases (ICD)-10 code for CP, data were evaluated from a total of 53,027 children with CP born between 2016 and 2022, and 9658 of them underwent orthopedic surgery in those years. The incidence and frequency of CP were assessed for the parameters of age and gender. Age at the time of surgery; codes pertaining to surgical interventions; and regions, cities, and hospitals where diagnoses and surgical procedures were performed were also evaluated. RESULTS There were 29,606 male (55.8%) and 23,421 (44.2%) female patients. The diagnoses of the patients were mostly (76.1%) performed in secondary and tertiary hospitals. The prevalence of CP among children in 2016-2022 was estimated to be 7.74/1000 children. The minimum and maximum incidence rates of cerebral palsy among children between 2016 and 2022 were calculated to be 0.45 and 1.05 per 1000, respectively. Tenoplasty-myoplasty tendon transfer operations were the most common surgeries (47.1%). CONCLUSION CP remains a significant health challenge, underpinning a considerable proportion of childhood motor dysfunction. A dedicated national registry system for CP focused on classifying the condition, streamlining treatment, and tracking outcomes would be a valuable tool in our collective efforts to address this critical issue more effectively.
Collapse
Affiliation(s)
- İzzet Özay Subaşi
- Department of Orthopedics and Traumatology, Faculty of Medicine, Erzincan University, Erzincan 24002, Türkiye
| | - İzzet Bingöl
- Department of Orthopedics and Traumatology, Oncology Training and Research Hospital, Ankara 06230, Türkiye
| | - Niyazi Erdem Yaşar
- Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, Ankara 06800, Türkiye
| | - Ebru Dumlupinar
- Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara 06230, Türkiye
| | - Naim Ata
- Ministry of Health, Ankara 06430, Türkiye
| | | | | | | | - Serkan Erkuş
- Department of Orthopedics and Traumatology, Medifema Hospital, İzmir 35860, Türkiye
| | - Mehmet Salih Söylemez
- Department of Orthopedics and Traumatology, Umraniye Training and Research Hospital, Istanbul 34764, Türkiye
| | - Güzelali Özdemir
- Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, Ankara 06800, Türkiye
| |
Collapse
|
3
|
Wright K, Dehar A, Stott NS, Mackey A, Sorhage A, Tapera R, Williams SA. Prioritizing indigenous health equity in health registers: an environmental scan of strategies for equitable ascertainment and quality data. Glob Health Res Policy 2022; 7:24. [PMID: 35854338 PMCID: PMC9295285 DOI: 10.1186/s41256-022-00250-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
Background Cerebral palsy (CP) registers serve as instrumental tools to support development of care pathways, preventative strategies, and health gains. Such health gains, however, are not always universal, with Indigenous health inequities common. To support Indigenous health, health registers need complete, consistent, and high-quality data. The aim of this study was to identify perceived barriers to the ascertainment of Indigenous peoples on health registers and to collate strategies supporting comprehensive ascertainment and achievement of high-quality Indigenous data. Methods Environmental scanning methods were utilized within a Kaupapa Māori theoretical framework, which aims to produce research that is transformational and supportive of Indigenous health gain. Knowledge and insights were obtained from CP registers in countries with Indigenous populations and complemented by information from health registers in Aotearoa New Zealand (NZ). Data collection methods included an online survey and scan of organizational websites. Data extraction focused on general information about the register, barriers to ascertainment, and strategies to support ascertainment and high data quality. Results 52 registers were identified, 20 completed the survey and 19 included in the study (CP registers, n = 10, NZ health registers, n = 9). Web scan data were included for the other 32 registers (CP registers, n = 21, NZ health registers, n = 11). Indigenous health equity was identified in the visions and aims of only two health registers. Ethnicity data collection was identified in nearly three quarters of survey respondents and a limited number of organizational websites. Over half of survey respondents described system, health provider/service, or workforce barriers to ascertainment. Strategies were categorized into collaboration, health provider/service, workforce, and systems-levels. Indigenous-specific strategies were limited and focused on personal behaviour and access to registration. Conclusions CP and other health registers can have a significant role in identifying and addressing Indigenous health inequities. However, this is not currently an overt priority for many registers in this study and few registers describe ascertainment and data quality strategies specific to Indigenous peoples. Significant opportunity exists for health registers to be accountable and to implement approaches to support Indigenous health equity, address structural determinants of inequities, and achieve health gain for all.
Collapse
Affiliation(s)
- Karen Wright
- Faculty of Medical and Health Sciences, Te Kupenga Hauora Māori, Auckland, New Zealand.
| | - Aria Dehar
- Faculty of Medical and Health Sciences, Te Kupenga Hauora Māori, Auckland, New Zealand
| | - N Susan Stott
- Department of Surgery, University of Auckland, Auckland, New Zealand.,New Zealand Cerebral Palsy Register, Starship Child Health, Auckland, New Zealand
| | - Anna Mackey
- New Zealand Cerebral Palsy Register, Starship Child Health, Auckland, New Zealand
| | - Alexandra Sorhage
- New Zealand Cerebral Palsy Register, Starship Child Health, Auckland, New Zealand
| | - Rachel Tapera
- Faculty of Medical and Health Sciences, Te Kupenga Hauora Māori, Auckland, New Zealand
| | - Sîan A Williams
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Curtin School of Allied Health, Curtin University, Perth, Australia
| |
Collapse
|
4
|
Peixoto MVDS, Duque AM, Carvalho SD, Gonçalves TP, Novais APDS, Nunes MAP. Características epidemiológicas da paralisia cerebral em crianças e adolescentes em uma capital do nordeste brasileiro. FISIOTERAPIA E PESQUISA 2020. [DOI: 10.1590/1809-2950/20012527042020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo foi descrever a prevalência de paralisia cerebral entre crianças e adolescentes, seus subtipos, as possíveis comorbidades e as características socioeconômicas das famílias. Foi realizado um estudo epidemiológico do tipo transversal a partir de um inquérito de base populacional sobre a paralisia cerebral em crianças e adolescentes na cidade de Aracaju (SE), Brasil. O estudo obteve informações sobre 240 crianças e adolescentes com paralisia cerebral a partir das respostas a um questionário feitas por seus responsáveis. Foi encontrada a prevalência de período de 1,37 em cada mil. Alguns bairros possuem prevalência de três a quatro vezes maior, revelando que a taxa de prevalência total não é um indicador homogêneo. A maioria dos participantes foi do sexo masculino (56,25%), de raça/cor declarada como parda ou preta (67,50%), sendo que a média de idade foi de 8,56 anos. A paralisia cerebral de tipo espástica bilateral foi a mais frequente (45,42%) e a comorbidade referida na maioria dos casos foi a epilepsia (48,33%). A renda familiar mensal correspondia a $252,87 dólares. O estudo revelou que as crianças e adolescentes com paralisia cerebral são, em grande parte, pertencentes a minorias sociais, de raça/cor parda ou preta, e suas famílias vivem na linha da extrema pobreza.
Collapse
|
5
|
Afzali M, Etemad K, Kazemi A, Rabiei R. Cerebral palsy information system with an approach to information architecture: a systematic review. BMJ Health Care Inform 2020; 26:bmjhci-2019-100055. [PMID: 31892529 PMCID: PMC7252971 DOI: 10.1136/bmjhci-2019-100055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/06/2019] [Accepted: 12/13/2019] [Indexed: 11/13/2022] Open
Abstract
Background Long-term complications and high costs of cerebral palsy (CP) as well as inconsistency in data related to this disease reveal the need for extensive planning to obtain accurate and complete data for the effective management of patients. Objective The present study reviews the information architecture of CP information system. Method The relevant articles published from early 1988 to 31 July 2018 were extracted through searching PubMed, Scopus, Cochran, Web of Science and Embase databases conducted independently by two researchers. Results A total of 39 articles on CP information system were reviewed. Hospitals, rehabilitation centres and outpatient clinics were found to be the main organisations in charge of generating CP data. Each CP database used several data sources, with hospitals serving as the most important sources of information and the main generators of data. The main CP datasets were categorised into four groups of demographic data, diagnosis, motor function and visual impairment. The majority of data standards were related to the use of the International Classification of Functioning, Disability and Health and the Gross Motor Function Classification System. Finally, accuracy, completeness and consistency were the criteria employed in data quality control. Conclusion Developing a robust CP information system requires deploying the principles of information architecture when developing the system, as these can improve data structure and content of CP system, as well as data quality and data sharing.
Collapse
Affiliation(s)
- Mina Afzali
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences School of Paramedical Sciences, Tehran, Iran
| | - Korosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences School of Public Health, Tehran, Iran
| | - Alireza Kazemi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences School of Paramedical Sciences, Tehran, Iran
| | - Reza Rabiei
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences School of Paramedical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Affiliation(s)
- Elodie Sellier
- Grenoble University Hospital - Public Health Department, Grenoble, France
| |
Collapse
|
7
|
Pilloni G, Pau M, Costici PF, Condoluci C, Galli M. Use of 3D gait analysis as predictor of Achilles tendon lengthening surgery outcomes in children with cerebral palsy. Eur J Phys Rehabil Med 2019; 55:250-257. [PMID: 30156089 DOI: 10.23736/s1973-9087.18.05326-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND In children with spastic cerebral palsy (CP), the treatment of equinus foot with Achilles tendon lengthening (ATL) surgery is associated with high incidence of overcorrection, which may result in crouch gait. AIM We aimed to assess if gait pattern in preoperative time could be a predictor of the surgery outcome. DESIGN Cross-sectional retrospective study. SETTING Movement Analysis Lab of IRCCS San Raffaele Pisana Hospital in Rome (Italy). POPULATION Eighteen children (mean age 9.6±4.7 years) with spastic diplegia CP who underwent bilateral ATL surgery to correct equinus foot were involved. METHODS Participants underwent 3D gait analysis before and approximately 12 months after surgery. Primary measures were spatiotemporal, kinematic (summarized by Gait Variable Scores, GVSs) and kinetic parameters. The gait patterns for each leg was defined from kinematic data, using a quantitative classification: plantar flexor knee extension (PFKE) index. The CP group was split into true equinus and jump gait. RESULTS The equinus foot was successfully corrected as demonstrated by the improvement of GVS ankle dorsi-plantarflexion. However, there was a high rate of overcorrection in the true equinus, characterized by increases in knee flexion-extension GVS (8.7° pre vs. 16.7° post P<0.05) and knee flexion angle at initial contact (5.2° vs. 20.6° P<0.05) and by a decrease in the maximum ankle power generated at push-off (1.49 vs. 0.83 W/kg P<0.05). CONCLUSIONS Assessment of motor phenotype in preoperative time are good predictors of the results of ATL surgery. In children with true equinus gait, the increase of knee flexion subsequent to ATL is an early indicator that this technique will lead to crouch gait. These results show the influence of true equinus and jump gait patterns on the outcomes of the ATL. CLINICAL REHABILITATION IMPACT Therefore, we propose that this approach could have clinical value to evaluate and prescribe rehabilitation in children with CP disease, proposing different solutions depending on motor phenotype.
Collapse
Affiliation(s)
- Giuseppina Pilloni
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy -
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy -
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | | | | | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| |
Collapse
|
8
|
Abstract
PURPOSE Cerebral palsy (CP) is the most common motor disability of childhood. Less is known about its prevalence and associated factors in Switzerland, so we aimed to fill this knowledge gap in one Swiss canton, evaluating the feasibility to build up a CP registry. METHODS A retrospective review of medical records was undertaken. Children born during 1995 and 2009 in the canton of Saint Gallen diagnosed with CP were eligible for inclusion. RESULTS A total of 140 patients formed the study cohort. The prevalence of CP was 0.19%, with 85% of children affected by spastic CP. CONCLUSIONS The results of the present study were comparable with data of the Surveillance of Cerebral Palsy in Europe network. Moreover, this pilot study demonstrated the feasibility and usefulness of creating a registry of children affected by CP.
Collapse
|
9
|
Almasri NA, Saleh M, Abu-Dahab S, Malkawi SH, Nordmark E. Development of a Cerebral Palsy Follow-up Registry in Jordan (CPUP-Jordan). Child Care Health Dev 2018; 44:131-139. [PMID: 28983951 DOI: 10.1111/cch.12527] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 08/27/2017] [Accepted: 09/18/2017] [Indexed: 11/27/2022]
Abstract
AIMS This study aims to describe the development of a Cerebral Palsy Follow-up Registry in Jordan (CPUP-Jordan) and to provide a baseline child and parent demographic information, birth history of the child participants, and distribution of the participants based on topographical distribution of cerebral palsy (CP) and functional classification systems. METHODS The CPUP-Jordan was developed using a similar framework of a follow-up surveillance programme for persons with CP in Sweden (CPUP). Standard assessment forms were utilized to collect data related to child and family demographics, child birth history, and functional classifications and physiotherapy and occupational therapy assessments and interventions. Research assistants were trained to conduct the assessments. A secured web-based system was developed to store data and disseminate knowledge maintained in the registry. Children with CP were included in the registry if they have confirmed diagnosis of CP. The ascertainment age of inclusion and the minimum age of survival required are 4 years. RESULTS One hundred sixty-seven children were registered between 2013 and 2015 (mean age is 3.6 ± 3.0 years). Forty-two percent were born premature, and 48% were less than the normal birthweight. Perinatal causes were reported for 54% of the participants. The most common type of CP based on tone disturbance was spastic type, and the most common topographical distributions of motor dysfunction were quadriplegia followed by diplegia. Fifty-six percent of the participants had severe limitation in ambulation; 48% had restricted manual abilities, and 47% had limited communication abilities even with familiar family members and partners. CONCLUSIONS The development of CPUP-Jordan registry for children with CP proved to be both feasible and informative. The registry baseline descriptive data were similar to those reported in previous research in Jordan supporting validity of the data. The implementation of CPUP-Jordan at national level is expected to have a positive impact on children with CP, clinicians, policymakers, and researchers.
Collapse
Affiliation(s)
- N A Almasri
- Department of Physiotherapy, Faculty of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - M Saleh
- Department of Physiotherapy, Faculty of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - S Abu-Dahab
- Department of Occupational Therapy, Faculty of Rehabilitation Sciences The University of Jordan, Queen Rania Al Abdallah St., Amman, Jordan
| | - S H Malkawi
- Department of Occupational Therapy, Faculty of Rehabilitation Sciences The University of Jordan, Queen Rania Al Abdallah St., Amman, Jordan
| | - E Nordmark
- Paediatric Physiotherapy, Senior lecturer in Disability Research, Excellent Teaching Practitioner (ETP), Faculty of Medicine, Lund University, Lund, Sweden
| |
Collapse
|
10
|
Yim SY, Yang CY, Park JH, Kim MY, Shin YB, Kang EY, Lee ZI, Kwon BS, Chang JC, Kim SW, Kim MO, Kwon JY, Jung HY, Sung IY. Korean Database of Cerebral Palsy: A Report on Characteristics of Cerebral Palsy in South Korea. Ann Rehabil Med 2017; 41:638-649. [PMID: 28971049 PMCID: PMC5608672 DOI: 10.5535/arm.2017.41.4.638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 12/14/2016] [Indexed: 11/13/2022] Open
Abstract
Objective To introduce the Korean Database of Cerebral Palsy (KDCP) and to provide the first report on characteristics of subjects with cerebral palsy (CP). Methods The KDCP is a nationwide database of subjects with CP, which includes a total of 773 subjects. Characteristics such as demography, birth history, onset and type of CP, brain magnetic resonance imaging (MRI) findings, functional ability and accompanying impairments, were extracted and analyzed. Results Preterm delivery and low birth weight were found in 59.51% and 60.28% of subjects, respectively. Postnatally acquired CP was 15.3%. The distribution of CP was 87.32%, 5.17%, and 1.81% for spastic, dyskinetic, and ataxic types, respectively. Functional ability was the worst in dyskinetic CP, as compared to other types of CP. Speech-language disorder (43.9%), ophthalmologic impairment (32.9%), and intellectual disability (30.3%) were the three most common accompanying impairments. The number of accompanying impairments was elevated in subjects with preterm birth and low birth weight. Brain MRI showed normal findings, malformations, and non-malformations in 10.62%, 9.56%, and 77.35% of subjects, respectively. Subjects with normal MRI findings had better functional ability than subjects with other MRI findings. MRI findings of a non-malformation origin, such as periventricular leukomalacia, were more common in subjects with preterm birth and low birth weight. Conclusion The KDCP and its first report are introduced in this report, wherein the KDCP established agreement on terminologies of CP. This study added information on the characteristics of subjects with CP in South Korea, which can now be compared to those of other countries and ethnicities.
Collapse
Affiliation(s)
- Shin-Young Yim
- Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon Korea
| | - Chung-Yong Yang
- Rehabilitation Institute of Chicago, Chicago, IL, USA and The Seum Hospital, Jeonju, Korea
| | - Joo Hyun Park
- Department of Physical Medicine and Rehabilitation, The Catholic University of Korea, Seoul, Korea
| | - Min Young Kim
- Department of Physical Medicine and Rehabilitation, CHA University, Seongnam, Korea
| | - Yong-Beom Shin
- Department of Physical Medicine and Rehabilitation, Pusan National University School of Medicine, Busan, Korea
| | - Eun-Young Kang
- Department of Physical Medicine and Rehabilitation, Kwangju Christian Hospital, Gwangju, Korea
| | - Zee-Ihn Lee
- Department of Physical Medicine and Rehabilitation, Daegu Fatima Hospital, Daegu, Korea
| | - Bum-Sun Kwon
- Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea
| | - Ji Chan Chang
- Department of Physical Medicine and Rehabilitation, Hanmaeum Hospital, Jeju, Korea
| | - Seong Woo Kim
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Myeong-Ok Kim
- Department of Physical Medicine and Rehabilitation, Inha University School of Medicine, Incheon, Korea
| | - Jeong-Yi Kwon
- Department of Physical Medicine and Rehabilitation, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Han-Young Jung
- Department of Physical Medicine and Rehabilitation, Inha University School of Medicine, Incheon, Korea
| | - In Young Sung
- Department of Physical Medicine and Rehabilitation, University of Ulsan College of Medicine, Seoul, Korea
| | | |
Collapse
|
11
|
Oskoui M, Ng P, Dorais M, Pigeon N, Koclas L, Lamarre C, Malouin F, Richards CL, Shevell M, Joseph L. Accuracy of administrative claims data for cerebral palsy diagnosis: a retrospective cohort study. CMAJ Open 2017; 5:E570-E575. [PMID: 28720597 PMCID: PMC5621965 DOI: 10.9778/cmajo.20170013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cerebral palsy is the most common cause of childhood physical disability, with multiple associated comorbidities. Administrative claims data provide population-level prevalence estimates for cerebral palsy surveillance; however, their diagnostic accuracy has never been validated in Quebec. This study aimed to assess the accuracy of administrative claims data for the diagnosis of cerebral palsy. METHODS We conducted a retrospective cohort study of children with cerebral palsy born between 1999 and 2002 within 6 health administrative regions of Quebec. Provincial cerebral palsy registry data (reference standard) and administrative physician claims were linked. We explored differences between true-positive and false-negative cases using subgroup sensitivity analysis. RESULTS A total of 301 children were identified with confirmed cerebral palsy from the provincial registry, for an estimated prevalence of 1.8 (95% confidence interval [CI] 1.6-2.1) per 1000 children 5 years of age. The sensitivity and specificity of administrative claims data for cerebral palsy were 65.5% (95% CI 59.8%-70.8%) and 99.9% (95% CI 99.9%-99.9%), respectively, yielding a prevalence of 2.0 (95% CI 1.9-2.3) per 1000 children 5 years of age. The positive and negative predictive values were 58.8% (95% CI 53.3%-64.1%) and 99.9% (95% CI 99.9%-99.9%), respectively. The κ value was 0.62 (95% CI 0.57-0.67). Administrative claims data were more sensitive for children from rural regions, born preterm, with spastic quadriparesis and with higher levels of motor impairment. INTERPRETATION Administrative claims data do not capture the full spectrum of children with cerebral palsy. This suggests the need for a more sensitive case definition and caution when using such data without validation.
Collapse
Affiliation(s)
- Maryam Oskoui
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| | - Pamela Ng
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| | - Marc Dorais
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| | - Nicole Pigeon
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| | - Louise Koclas
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| | - Céline Lamarre
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| | - Francine Malouin
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| | - Carol L Richards
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| | - Michael Shevell
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| | - Lawrence Joseph
- Affiliations: Departments of Pediatrics, Neurology and Neurosurgery (Oskoui, Shevell), McGill University; Research Institute of the McGill University Health Centre (Ng), Montréal, Que.; StatSciences Inc. (Dorais), Notre-Dame-de-l'Île-Perrot, Que.; Centre hospitalier universitaire de Sherbrooke (Pigeon), Sherbrooke, Que.; Centre de réadaptation Marie-Enfant (Koclas), Centre hospitalier universitaire Sainte-Justine; Institut de réadaptation Gingras-Lindsay de Montréal (Lamarre), Centre intégré universitaire de santé et de services sociaux du Centre-Est-de-l'Île-de-Montréal, Montréal, Que.; Département de réadaptation and Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Malouin, Richards), Université Laval, Québec, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Joseph), McGill University, Montréal, Que
| |
Collapse
|
12
|
Gatica-Rojas V, Cartes-Velásquez R, Guzmán-Muñoz E, Méndez-Rebolledo G, Soto-Poblete A, Pacheco-Espinoza AC, Amigo-Mendoza C, Albornoz-Verdugo ME, Elgueta-Cancino E. Effectiveness of a Nintendo Wii balance board exercise programme on standing balance of children with cerebral palsy: A randomised clinical trial protocol. Contemp Clin Trials Commun 2017; 6:17-21. [PMID: 29740634 PMCID: PMC5936865 DOI: 10.1016/j.conctc.2017.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 02/11/2017] [Indexed: 11/25/2022] Open
Abstract
Background Patients with cerebral palsy (CP) typically receive limited physical therapy services. However, the Nintendo Wii system offers a simple and affordable mode of virtual reality therapy. There are no clinical trials assessing the Nintendo Wii balance board for improving standing balance in CP. Methods This randomised clinical trial will evaluate the effectiveness of an 18-session/six-week protocol using Wii therapy (W-t) compared with conventional therapy (C-t) in Chilean CP patients. The C-t group will perform the typical exercises prescribed by physical therapists for 40 min each session. W-t will consist of a virtual reality training session using the Nintendo Wii balance board console for 30 min each session. The primary outcome variable is the area of centre-of-pressure (CoP) sway (CoPSway). The secondary outcomes are the standard deviation (SDML; SDAP) and velocity (VML; VAP) of CoP in the ML and AP directions. For a mean difference of 21.5 cm2 (CoPSway) between the groups, we required a minimum of 16 participants in each group. Data will be collected at baseline (week 0), during the study (weeks 2 and 4), at the end of the study (week 6), and during the follow-up (weeks 8 and 10). Measurements of postural control during quiet standing for both groups will be assessed on a force platform AMTI OR67. Discussion This is the first trial that measures and compares the effects of a Nintendo Wii Balance Board exercise programme on standing balance in children with cerebral palsy compared to conventional therapy.
Collapse
Affiliation(s)
- Valeska Gatica-Rojas
- Human Motor Control Laboratory, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Ricardo Cartes-Velásquez
- Department of Preventive and Public Health Dentistry, School of Dentistry, Universidad de Concepción, Roosevelt 1550, Concepción, Chile
| | - Eduardo Guzmán-Muñoz
- School of Kinesiology, Faculty of Health Sciences, Universidad Santo Tomás, Carlos Schorr 255, Talca, Chile
| | - Guillermo Méndez-Rebolledo
- Department of Human Movement Sciences, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Alex Soto-Poblete
- Institute of Mathematics and Physics, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Ana Carolina Pacheco-Espinoza
- Department of Human Movement Sciences, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Carlos Amigo-Mendoza
- School of Kinesiology, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - M Eliana Albornoz-Verdugo
- Department of Basic Biomedical Sciences, Faculty of Health Sciences, Universidad de Talca, Av. Lircay S/N, Talca, Chile
| | - Edith Elgueta-Cancino
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4072, Brisbane, Australia
| |
Collapse
|
13
|
Virella D, Pennington L, Andersen GL, Andrada MDG, Greitane A, Himmelmann K, Prasauskiene A, Rackauskaite G, De La Cruz J, Colver A. Classification systems of communication for use in epidemiological surveillance of children with cerebral palsy. Dev Med Child Neurol 2016; 58:285-91. [PMID: 26272847 DOI: 10.1111/dmcn.12866] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2015] [Indexed: 11/30/2022]
Abstract
AIM Children with cerebral palsy (CP) often experience communication difficulties. We aimed to identify a classification system for communication of children with CP suitable for epidemiological surveillance. METHOD Systems to classify the communication of children with CP were identified. The Communication Function Classification System (CFCS), Functional Communication Classification System (FCCS), and Viking Speech Scale (VSS) were chosen for further investigation and translated. They were administered to 155 children aged 4 to 13 years with CP (across all motor severity levels) from eight European countries. Children's parents/carers, speech therapists, and other health professionals applied the systems through direct observation. Other professionals applied them from case notes only. The systems were assessed for agreement, stability, ease, and feasibility of application. RESULTS Test-retest stability was moderate-to-high for VSS (k=0.66-0.88), CFCS (k=uncomputed-0.91), and FCCS (k=0.52-0.91). Overall interrater agreement was fair to very good for every classification system. VSS achieved the best agreement between parents/carers and speech therapists. VSS was considered the easiest instrument to apply. INTERPRETATION Because of its ease of use by a range of healthcare professionals, the VSS should be considered for CP registers which intend to survey speech intelligibility. For a wider assessment of communication, the CFCS or FCC should be considered.
Collapse
Affiliation(s)
- Daniel Virella
- Epidemiology and Statistics Office of the Research Unit and Área de Pediatria Médica do Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Lindsay Pennington
- Institute of Health and Society, Royal Victoria Infirmary, Sir James Spence Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Guro L Andersen
- The Cerebral Palsy Register of Norway, Vestfold Hospital Trust and Department of Laboratory Medicine, Women's and Children's Health, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Maria da Graça Andrada
- Federação das Associações Portuguesas de Paralisia Cerebral, Avenida Rainha Dona Amélia, Lisbon, Portugal
| | | | - Kate Himmelmann
- Department of Paediatrics, Institute of Clinical Sciences, Queen Silvia Children's Hospital, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Audrone Prasauskiene
- Children's Rehabilitation Hospital affiliated to the Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gija Rackauskaite
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Javier De La Cruz
- Clinical Research Unit, Imas12-Ciberesp, Hospital 12 Octubre, Madrid, Spain
| | - Allan Colver
- Institute of Health and Society, Royal Victoria Infirmary, Sir James Spence Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | | |
Collapse
|
14
|
Goldsmith S, McIntyre S, Smithers-Sheedy H, Blair E, Cans C, Watson L, Yeargin-Allsopp M. An international survey of cerebral palsy registers and surveillance systems. Dev Med Child Neurol 2016; 58 Suppl 2:11-7. [PMID: 26781543 PMCID: PMC4837944 DOI: 10.1111/dmcn.12999] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2015] [Indexed: 01/31/2023]
Abstract
AIM To describe cerebral palsy (CP) surveillance programmes and identify similarities and differences in governance and funding, aims and scope, definition, inclusion/exclusion criteria, ascertainment and data collection, to enhance the potential for research collaboration. METHOD Representatives from 38 CP surveillance programmes were invited to participate in an online survey and submit their data collection forms. Descriptive statistics were used to summarize information submitted. RESULTS Twenty-seven surveillance programmes participated (25 functioning registers, two closed owing to lack of funding). Their aims spanned five domains: resource for CP research, surveillance, aetiology/prevention, service planning, and information provision (in descending order of frequency). Published definitions guided decision making for the definition of CP and case eligibility for most programmes. Consent, case identification, and data collection methods varied widely. Ten key data items were collected by all programmes and a further seven by at least 80% of programmes. All programmes reported an interest in research collaboration. INTERPRETATION Despite variability in methodologies, similarities exist across programmes in terms of their aims, definitions, and data collected. These findings will facilitate harmonization of data and collaborative research efforts, which are so necessary on account of the heterogeneity and relatively low prevalence of CP.
Collapse
Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | | | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Christine Cans
- RHEOP–ThEMAS - Centre Hospitalier Universitaire de Grenoble, Grenoble Université, Grenoble, France
| | - Linda Watson
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia,Department of Health Western Australia, Perth, WA, Australia
| | - Marshalyn Yeargin-Allsopp
- Developmental Disabilities Branch, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | |
Collapse
|
15
|
Mitry D, Williams C, Northstone K, Akter A, Jewel J, Khan N, Muhit M, Gilbert CE, Bowman R. Perceptual visual dysfunction, physical impairment and quality of life in Bangladeshi children with cerebral palsy. Br J Ophthalmol 2016; 100:1245-50. [DOI: 10.1136/bjophthalmol-2015-307296] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 12/02/2015] [Indexed: 11/04/2022]
|
16
|
García P D, San Martín P P. [Sociodemographic and clinical characteristic of the population attended in the Instituto Teletón de Santiago]. REVISTA CHILENA DE PEDIATRIA 2015; 86:161-167. [PMID: 26363856 DOI: 10.1016/j.rchipe.2015.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 03/05/2015] [Indexed: 06/05/2023]
Abstract
UNLABELLED The Institutos Teletón care for 85% of the Chilean child population with neuromusculoskeletal disability, the large percentage concentrating in this population. However, there are no registers that enable a profile to be determined on this population. OBJECTIVE To determine the profile of patients attending the Instituto Teletón de Santiago during the year 2012. PATIENTS AND METHOD The sociodemographic characteristics were analyzed from the computerised records of the Instituto Teletón de Santiago on active patients who were seen during the year 2012. RESULTS A total of 8,959 patients were seen during the study year in the Instituto Teletón de Santiago. As regards socioeconomic level, 33.3% were in extreme poverty, 28.7% to low-middle level. The main clinical diagnoses were cerebral palsy and other encephalopathies that also lead to motor disability, and accounted for 55.4% of the cases. CONCLUSIONS As a result of determining this profile, it would be appropriate to encourage the need for a national register of the child population with disability, as well as their particular characteristics in order to make decisions on public policy, as a destination for funds or support programs.
Collapse
Affiliation(s)
- Daniela García P
- Médico Fisiatra, Instituto Teletón de Santiago, Santiago, Chile.
| | | |
Collapse
|
17
|
Hurley DS, Sukal-Moulton T, Gaebler-Spira D, Krosschell KJ, Pavone L, Mutlu A, Dewald JPA, Msall ME. Systematic Review of Cerebral Palsy Registries/Surveillance Groups: Relationships between Registry Characteristics and Knowledge Dissemination. INTERNATIONAL JOURNAL OF PHYSICAL MEDICINE & REHABILITATION 2015; 3:266. [PMID: 27790626 PMCID: PMC5079705 DOI: 10.4172/2329-9096.1000266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The aims of this study were to provide a comprehensive summary of the body of research disseminated by Cerebral Palsy (CP) registries and surveillance programs from January 2009 through May 2014 in order to describe the influence their results have on our overall understanding of CP. Secondly, registries/surveillance programs and the work they produced were evaluated and grouped using standardized definitions and classification systems. METHOD A systematic review search in PubMed, CINAH and Embase for original articles published from 1 January 2009 to 20 May 2014 originating from or supported by population based CP registries and surveillance programs or population based national registries including CP were included. Articles were grouped by 2009 World CP Registry Congress aim, registry/surveillance program classification, geographical region, and the International Classification of Function, Disability and Health (ICF) domain. Registry variables were assessed using the ICF-CY classification. RESULTS Literature searches returned 177 articles meeting inclusion criteria. The majority (69%) of registry/surveillance program productivity was related to contributions as a Resource for CP Research. Prevention (23%) and Surveillance (22%) articles were other areas of achievement, but fewer articles were published in the areas of Planning (17%) and Raising the Profile of CP (2%). There was a range of registry/surveillance program classifications contributing to this productivity, and representation from multiple areas of the globe, although most of the articles originated in Europe, Australia, and Canada. The domains of the ICF that were primarily covered included body structures and function at the early stages of life. Encouragingly, a variety of CP registry/surveillance program initiatives included additional ICF domains of participation and environmental and personal factors. INTERPRETATION CP registries and surveillance programs, including novel non-traditional ones, have significantly contributed to the understanding of how CP affects individuals, families and society. Moving forward, the global CP registry/surveillance program community should continue to strive for uniformity in CP definitions, variables collected and consistency with international initiatives like the ICF so that databases can be consolidated for research use. Adaptation to new technologies can improve access, reduce cost and facilitate information transfer between registrants, researchers and registries/surveillance programs. Finally, increased efforts in documenting variables of individuals with CP into adulthood should be made in order to expand our understanding of CP across the lifespan.
Collapse
Affiliation(s)
- Donna S Hurley
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Theresa Sukal-Moulton
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Kristin J Krosschell
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | | | - Akmer Mutlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Julius PA Dewald
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Michael E Msall
- University of Chicago Comer Children’s Hospital and Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, IL, USA
| |
Collapse
|
18
|
Abstract
Objective:To quantify the prevalence of cerebral palsy (CP) in British Columbia within a four-year birth cohort.Methods:The study was a population-based record linkage study of a birth cohort of British Columbian children born between April 1, 1991 and March 31, 1995. Cases were identified by the presence of International Classification of Diseases, Version 9 (ICD-9) diagnostic code “343” recorded at three years of age or older or by having the ICD-9 diagnostic code “343” recorded prior to the third birthday with two confirmatory diagnoses within the first three years of life through a record search of the BC Medical Services Plan billing files for the fiscal years 1991 to 1995.Results/Conclusion:This research has provided an estimate of the prevalence of CP in the four-year birth cohort 1991 to 1995 in British Columbia. An aggregate prevalence rate of CP was measured as 2.68 per 1000 live births, and a congenital rate was measured at 2.57 for the same population. Birth weight and gestational age demonstrated a significant relationship with the development of CP. This study should lend credence to the establishment of a CP register in British Columbia.
Collapse
|
19
|
Dhas BN, Samuel PS, Manigandan C. Use of computer access technology as an alternative to writing for a pre-school child with athetoid cerebral palsy--a case report. Occup Ther Health Care 2014; 28:318-32. [PMID: 24555722 DOI: 10.3109/07380577.2013.874063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to demonstrate the use of an outcome-driven model of decision-making in the implementation of computer access technology (CAT) for a pre-school child with athetoid cerebral palsy. The child did not have the fine motor skills required to hold a pencil but had the cognitive abilities to learn to write; therefore, we explored the use of a CAT device to enable written communication. Case study methodology was used to describe the selection process, child-level outcomes, and clinical challenges faced by the therapist in the use of a consortium model that was designed for an outcome-driven model of decision-making. The critical role of an occupational therapist in this process using a family-centered approach is discussed.
Collapse
Affiliation(s)
- Brightlin Nithis Dhas
- 1Department of Occupational Therapy, Rumailah Hospital, Hamad Medical Corporation , Doha , Qatar
| | | | | |
Collapse
|
20
|
El-Tallawy HN, Farghaly WM, Shehata GA, Rageh TA, Metwally NA, Badry R, Sayed MA, Abd El Hamed M, Abd-Elwarth A, Kandil MR. Cerebral palsy in Al-Quseir City, Egypt: prevalence, subtypes, and risk factors. Neuropsychiatr Dis Treat 2014; 10:1267-72. [PMID: 25045270 PMCID: PMC4099193 DOI: 10.2147/ndt.s59599] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cerebral palsy (CP) is the most frequent cause of motor handicap. The present door-to-door survey was conducted in Al-Quseir City, Egypt, to investigate the epidemiology of CP. All inhabitants were screened by three neurologists. Medical and neurological examinations were performed for all residents and suspected cases of CP were confirmed by meticulous neurological assessment, brain magnetic resonance imaging, electroencephalography, and testing with the Stanford-Binet Intelligence Scale. Forty-six of 12,788 children aged ≤18 years were found to have CP, yielding a childhood prevalence of 3.6 (95% confidence interval 1.48-2.59) per 1,000 live births. Five adults (aged 19-40 years) among 13,056 inhabitants had CP, giving an adult prevalence of 0.4 (95% confidence interval 0.04-0.72) per 1,000. The risk factors for CP identified in this study were premature birth, low birth weight, neonatal jaundice, neonatal seizures, and recurrent abortion in mothers of children with CP.
Collapse
Affiliation(s)
- Hamdy N El-Tallawy
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | - Wafaa Ma Farghaly
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | - Ghaydaa A Shehata
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | - Tarek A Rageh
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | - Nabil A Metwally
- Department of Neurology, El Azhr University, Assiut Branch, Assuit, Egypt
| | - Reda Badry
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| | | | | | - Ahmed Abd-Elwarth
- Department of Neurology, El Azhr University, Assiut Branch, Assuit, Egypt
| | - Mahmoud R Kandil
- Department of Neurology, Assiut University, Assiut Branch, Assuit, Egypt
| |
Collapse
|
21
|
Tezcan S, Simsek TT. Comparison of Health-Related Quality of Life between children with cerebral palsy and spina bifida. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:2725-2733. [PMID: 23787116 DOI: 10.1016/j.ridd.2013.05.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 05/07/2013] [Accepted: 05/07/2013] [Indexed: 06/02/2023]
Abstract
This study has two aims-the first is to compare the Health Related Quality of Life (HRQoL) between children with cerebral palsy (CP) and children with spina bifida (SB); the second is to investigate the relationship between HRQoL and age, sex, body mass index (BMI), level of ambulation, cooperation, family income and the mother's education level in both groups of children. The study included 96 children with CP and 70 children with SB (aged 5-18) who attended a physiotherapy and rehabilitation program at an institute of special training and rehabilitation. Socio-demographic information was obtained within the study. The Child Health Questionnaire (CHQ-PF50) was used to evaluate HRQoL. A significant difference was found in terms of age and BMI between children with CP and SB (p<0.05). HRQoL was lower for children with CP. There was a significant difference between the two groups in terms of role/social limitations - emotional behavioral, behavior, global behavior, parental impact-emotional and parental impact-time (p<0.05). A positive correlation was found between BMI and self-esteem in children with SB, unlike children with CP. The HRQoL of children with CP was lower than children with SB. The parameters of behavior and parental impact were particularly affected in the children with CP. Minimizing behavioral problems (which can improve with advancing age) of the children with CP and reducing parental impact are important for improving the HRQoL of both the child and parents. There is a need for further studies on this issue.
Collapse
Affiliation(s)
- Sezen Tezcan
- Special Ilgim Special Education and Rehabilitation Center, Düzce, Turkey
| | | |
Collapse
|
22
|
Shevell M, Dagenais L, Oskoui M. The epidemiology of cerebral palsy: new perspectives from a Canadian registry. Semin Pediatr Neurol 2013; 20:60-4. [PMID: 23948680 DOI: 10.1016/j.spen.2013.06.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Michael Shevell
- Department of Neurology/Neurosurgery, McGill University, Montreal, Quebec, Canada.
| | | | | |
Collapse
|
23
|
Houtrow A, Kang T, Newcomer R. In-home supportive services for individuals with cerebral palsy in California. J Pediatr Rehabil Med 2012; 5:187-95. [PMID: 23023251 PMCID: PMC3610921 DOI: 10.3233/prm-2012-0211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Individuals with cerebral palsy (CP) may require personal assistance services for optimal functioning. The primary goal of this project is to determine if differences in health services exist between individuals with CP with family versus non-family member paid personal assistance providers. The secondary goal is to describe the population of children and non-elderly adults with CP receiving in-home supportive services (IHSS) and determine their health care costs compared to other IHSS recipients. METHODS Administrative data from the California Departments of Health and Human Services, Social Services and Developmental Services were linked and de-identified to provide information about individuals receiving IHSS in California in 2005. Recipients with CP were characterized and compared by age. Then to determine the factors associated with hospital use and emergency room (ER) use for IHSS recipients with CP adjusted odds were calculated. Monthly expenditures were calculated from claims data. RESULTS 2.3% of all IHSS recipients in 2005 had CP of which 46% were children. 59% of recipients with CP have a parent as their paid provider. The presence of other medical diagnoses was the only factor associated with increased adjusted odds of hospital and ER use for both child-aged and non-elderly adult recipients with CP. Functional limitations and provider type were not associated with increased odds of health care utilization. Monthly health care expenditures for recipients with CP were ∼$1000 higher than for other IHSS recipients. CONCLUSIONS Having a parent as the IHSS provider was not associated with difference in health service utilization. This finding supports the policy of allowing parents to be paid providers.
Collapse
Affiliation(s)
- Amy Houtrow
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.
| | | | | |
Collapse
|
24
|
Hurley DS, Sukal-Moulton T, Msall ME, Gaebler-Spira D, Krosschell KJ, Dewald JP. The cerebral palsy research registry: development and progress toward national collaboration in the United States. J Child Neurol 2011; 26:1534-41. [PMID: 21677201 PMCID: PMC3223319 DOI: 10.1177/0883073811408903] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cerebral palsy is the most common neurodevelopmental motor disability in children. The condition requires medical, educational, social, and rehabilitative resources throughout the life span. Several countries have developed population-based registries that serve the purpose of prospective longitudinal collection of etiologic, demographic, and functional severity. The United States has not created a comprehensive program to develop such a registry. Barriers have been large population size, poor interinstitution collaboration, and decentralized medical and social systems. The Cerebral Palsy Research Registry was created to fill the gap between population and clinical-based cerebral palsy registries and promote research in the field. This is accomplished by connecting persons with cerebral palsy, as well as their families, to a network of regional researchers. This article describes the development of an expandable cerebral palsy research registry, its current status, and the potential it has to affect families and persons with cerebral palsy in the United States and abroad.
Collapse
Affiliation(s)
- Donna S. Hurley
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Department of Biomedical Engineering, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Michael E. Msall
- Section of Developmental and Behavioral Pediatrics, University of Chicago, Chicago, IL, USA, Comer and La Rabida Children's Hospitals, Chicago, IL, USA, Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, IL, USA
| | - Deborah Gaebler-Spira
- Department of Pediatrics, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Rehabilitation Institute of Chicago, Chicago, IL, USA, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Kristin J. Krosschell
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Julius P. Dewald
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Department of Biomedical Engineering, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| |
Collapse
|
25
|
Population-based study of neuroimaging findings in children with cerebral palsy. Eur J Paediatr Neurol 2011; 15:29-35. [PMID: 20869285 DOI: 10.1016/j.ejpn.2010.07.005] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 06/30/2010] [Accepted: 07/01/2010] [Indexed: 11/20/2022]
Abstract
BACKGROUND Neuroimaging is currently recommended as a standard evaluation in children with cerebral palsy (CP). AIMS Utilizing imaging findings from a population-based registry (REPACQ), the frequency and proportion of cerebral radiologic abnormalities in children CP over a four year birth cohort was investigated. METHODS Descriptions of CT and MRI studies were extracted from the Registry dataset and classified into 10 distinct categories. RESULTS Two hundred and thirteen children had imaging available (119 males, 94 females, mean age of 44 months [SD. ± 14 months] at Registry inscription). Eighty seven percent of participants had documented cerebral abnormalities, the most common of which were periventricular white matter injury (PVWMI) (19.2%), diffuse gray matter injury (14.6%), cerebral vascular accident (CVA) (11.7%), and cerebral malformation (11.3%). Also, 18.8% of participants had non-specific radiologic findings and 13.1% of participants had normal imaging results. Severe CP (i.e. GMFCS Level IV-V) and spastic quadriplegic CP were significantly associated with the neuroimaging findings of gray matter injury, while spastic hemiplegic CP was association with CVA, and dyskinetic and spastic diplegic CP were both associated with normal and non-specific neuroimaging findings. CONCLUSIONS Specific patterns of neuroimaging findings in children with CP were found to be associated with neurological subtype, CP severity (i.e. GMFCS Level) and other categorical variables.
Collapse
|
26
|
Kerr C, McDowell BC, Parkes J, Stevenson M, Cosgrove AP. Age-related changes in energy efficiency of gait, activity, and participation in children with cerebral palsy. Dev Med Child Neurol 2011; 53:61-7. [PMID: 20875041 DOI: 10.1111/j.1469-8749.2010.03795.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to use a prospective longitudinal study to describe age-related trends in energy efficiency during gait, activity, and participation in ambulatory children with cerebral palsy (CP). METHOD Gross Motor Function Measure (GMFM), Paediatric Evaluation of Disability Inventory (PEDI), and Lifestyle Assessment Questionnaire-Cerebral Palsy (LAQ-CP) scores, and energy efficiency (oxygen cost) during gait were assessed in representative sample of 184 children (112 male; 72 female; mean age 10y 9mo; range 4-16y) with CP. Ninety-four children had unilateral spastic CP, 84 bilateral spastic CP, and six had other forms of CP. Fifty-seven were classified as Gross Motor Function Classification System (GMFCS) level I, 91 as level II, 22 as level III, and 14 as level IV). Assessments were carried out on two occasions (visit 1 and visit 2) separated by an interval of 2 years and 7 months. A total of 157 participants returned for reassessment. RESULTS Significant improvements in mean raw scores for GMFM, PEDI, and LAQ-CP were recorded; however, mean raw oxygen cost deteriorated over time. Age-related trends revealed gait to be most inefficient at the age of 12 years, but GMFM scores continued to improve until the age of 13 years, and two PEDI subscales to age 14 years, before deteriorating (p<0.05). Baseline score was consistently the single greatest predictor of visit 2 score. Substantial agreement in GMFCS ratings over time was achieved (κ(lw) =0.74-0.76). INTERPRETATION These findings have implications in terms of optimal provision and delivery of services for young people with CP to maximize physical capabilities and maintain functional skills into adulthood.
Collapse
Affiliation(s)
- Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
| | | | | | | | | |
Collapse
|
27
|
|
28
|
Abstract
Cerebral palsy is a heterogeneous syndrome that is the most common form of physical impairment encountered in pediatrics. Its heterogeneity, which is apparent in all aspects of the disorder, challenges our attempts to classify it. Several classification structures do exist that seek to further our understanding of the basic mechanisms and needs associated with this entity. The most long-standing classification approach utilizes the neurologic examination to characterize and stratify the predominant qualitative pattern of motor impairment (i.e., spastic, dyskinetic, ataxic–hypotonic or mixed), and if spastic, the particular limb distribution. The severity of cerebral palsy can be summarized in the domains of gross motor and fine motor skills by the Gross Motor Function Classification System and the Manual Ability Classification System, respectively. Frequently for patients with cerebral palsy, the major health burden may not be that of a neuromotor impairment, but rather that of the associated conditions (i.e., epilepsy, intellectual disability, etc.) affecting the individual. Finally, one may employ a mechanistic approach to stratifying according to imaging results and etiology, which are linked and provide an insight into the pathogenesis and the timing of malformation or acquired injury. While the approaches used in each of these classification schemes are separate, distinct and single axial, inter-relationships are readily apparent. Each of the classification approaches capture only one aspect of a complex disorder and is thus too simplistic. A multimodal classification approach can be employed in a complimentary fashion to provide a more holistic profile of the individual with cerebral palsy.
Collapse
Affiliation(s)
- Michael I Shevell
- Room A-514, Montreal Children’s Hospital, 2300 Tupper, Montreal, Quebec H3H 1P3, Canada and Department of Neurology/Neurosurgery & Pediatrics, Division of Pediatric Neurology, McGill University, Quebec, Canada
| |
Collapse
|
29
|
Abstract
AIM Our aim was to determine the proportion of children with cerebral palsy (CP) who have a congenital anomaly (CA) in three regions (Isère Region, French Alps; Funen County, Denmark; Northern Region, England) where population-based CP and CA registries exist, and to classify the children according to CA subtype. METHOD Data for children born between 1991 and 1999 were linked using electronic matching of cases. All potential matches were checked manually by each centre and verified as true matches. RESULTS A total of 1104 children with CP were born during the study period (663 males, 441 females). Of these, 166 (15%; 95% Confidence Interval [CI] 13.0-17.3) children with CP had a CA: 8.8% had a cerebral anomaly, 4.8% had a non-cerebral anomaly, and 1.4% had a non-cerebral-related syndrome or a chromosomal/genetic anomaly. INTERPRETATION The prevalence of cerebral anomaly was highest in children with ataxic CP (41.7%) and lowest in those with dyskinetic CP (2.1%). Cerebral anomalies were found in 8.4% and 7% of children with bilateral and unilateral spastic CP respectively. The most frequent cerebral anomalies were primary microcephaly (26.5%) and congenital hydrocephalus (17.3%). The most common non-cerebral anomalies recorded were cardiac (12.6% of children with CP and CA), urinary (5.4%), and musculoskeletal (5.4%). The prevalence of cerebral anomalies was higher among children born at term (13%) than among those born preterm (3.8%). Associated sensorineural or intellectual impairments occurred more often in children with CP and cerebral anomalies. We concluded that cerebral and non-cerebral CA prevalence was higher among the CP population than in the general population of live births.
Collapse
|
30
|
Zarrinkalam R, Russo RN, Gibson CS, van Essen P, Peek AK, Haan EA. CP or not CP? A review of diagnoses in a cerebral palsy register. Pediatr Neurol 2010; 42:177-80. [PMID: 20159426 DOI: 10.1016/j.pediatrneurol.2009.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Revised: 07/02/2009] [Accepted: 09/02/2009] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to document the inaccuracy rate of diagnosis of cerebral palsy recorded on the South Australian Cerebral Palsy Register. A total of 402 children born in South Australia from 1993 to 2002 and notified to the Register as having cerebral palsy were identified through the Register database, and 21 children (5.2%) were later identified to have a noncerebral palsy diagnosis. Of these, 5 had either a metabolic or a neurodegenerative disorder and 2 had a syndromic disorder (1 Joubert syndrome and 1 Sotos syndrome); the remaining 14 children had one of the following final diagnoses: developmental delay, gross motor delay, perinatal myositis, spinal subdural and subarachnoid arteriovenous malformation, and Erb's palsy. In 16 of 21 children (76%), the diagnosis was changed at 5 years of age or older. Studies based on population registers may need to take into account the possibility of misclassification, estimated to be at least 5.2% in this study. A complete clinical assessment at the time of diagnosis followed by regular reassessment would enable the clinician to exclude children with alternative diagnoses, which has important implications for clinical management and research based on cerebral palsy registers.
Collapse
Affiliation(s)
- Rosa Zarrinkalam
- Department of Paediatric Rehabilitation Medicine, The Women's and Children's Hospital, North Adelaide, SA, Australia
| | | | | | | | | | | |
Collapse
|
31
|
Meester-Delver A, Beelen A, van Eck M, Voorman J, Dallmeijer A, Nollet F, Becher J. Construct validity of the Capacity Profile in adolescents with cerebral palsy. Clin Rehabil 2010; 24:258-66. [DOI: 10.1177/0269215509346086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To establish construct validity of the Capacity Profile, a method to comprehensively classify additional care needs in five domains of body functions (physical health, motor, sensory, mental, voice and speech functions), in adolescents with non-progressive, permanent conditions such as cerebral palsy. Design: Cross-sectional study. Subjects: Ninety-four adolescents with cerebral palsy: 60 boys, 34 girls, median age 14.3, range 12—16 years, unilateral (n = 37), bilateral (n = 57), spastic (n = 76), ataxic (n = 4), dyskinetic (n = 5), mixed (dyskinetic and spastic, n =9), Gross Motor Function Classification System: level I (n = 50), level II (n = 6), level III (n = 10), level IV (n = 8), level V (n = 20). Methods: Associations were calculated between Capacity Profile domains and Vineland Adaptive Behavior Scales (communication, daily activities, social and motor skills) and Gross Motor Function Classification System using Spearman’s rho. Furthermore, we explored the independent contribution of the Capacity Profile domains to activities and participation measured with the Vineland Adaptive Behavior Scales. Results: All Capacity Profile domains were significantly associated with all domains of the Vineland Adaptive Behavior Scales and the Gross Motor Function Classification System (P<0.05). Multiple regression analysis showed that the Capacity Profile contributed 87% to variance in communication (Capacity Profile-voice 78%, mental 8% and physical 1%), 85% to daily activities (Capacity Profile-mental 75%, motor 8% and voice 2%), 60% to social skills (Capacity Profile-voice 56% and mental 4%), and 91% to motor skills (Capacity Profile-motor 87%, mental 3% and sensory 1%). Conclusion: These findings support the construct validity of the Capacity Profile in adolescents with cerebral palsy. Construct validity in other medical conditions should be further investigated.
Collapse
Affiliation(s)
- Anke Meester-Delver
- Department of Rehabilitation, Academic Medical Center, University of Amsterdam,
| | - Anita Beelen
- Department of Rehabilitation, Academic Medical Center, University of Amsterdam
| | - Mirjam van Eck
- Department of Rehabilitation Medicine, VU University Medical Center and EMGO Institute, VU University Medical Center
| | - Jeanine Voorman
- Department of Rehabilitation Medicine, VU University Medical Center and EMGO Institute, VU University Medical Center
| | - Annet Dallmeijer
- Department of Rehabilitation Medicine, VU University Medical Center and EMGO Institute, VU University Medical Center
| | - Frans Nollet
- Department of Rehabilitation, Academic Medical Center, University of Amsterdam
| | - Jules Becher
- Department of Rehabilitation Medicine, VU University Medical Center and EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
32
|
Al-Macki N, Miller SP, Hall N, Shevell M. The spectrum of abnormal neurologic outcomes subsequent to term intrapartum asphyxia. Pediatr Neurol 2009; 41:399-405. [PMID: 19931160 DOI: 10.1016/j.pediatrneurol.2009.06.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Accepted: 06/09/2009] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to describe the spectrum of possible abnormal neurologic outcomes in term infants with intrapartum asphyxia and to identify those clinical factors associated with the later occurrence of cerebral palsy. All children with term intrapartum asphyxia encountered in a single pediatric neurologic practice with at least 2 years of follow-up and an abnormal neurologic outcome were identified. Abnormal outcomes were grouped into those with or without cerebral palsy. A total of 40 children (28 male, 12 female) met study criteria. Of these, 23 developed cerebral palsy; the remaining 17 children developed an abnormal neurologic outcome that did not include cerebral palsy. A more severe grade of neonatal encephalopathy, a higher number of neonatal seizures, the neonatal use of phenytoin, diffuse abnormalities on imaging, and abnormal findings on neurologic examination at neonatal discharge were all significantly (P<0.05) associated with an abnormal outcome that included cerebral palsy. Abnormal neurologic outcomes other than cerebral palsy subsequent to term intrapartum asphyxia may occur. It appears that a more severe grade of apparent initial clinical injury is more likely to result in an outcome featuring cerebral palsy.
Collapse
Affiliation(s)
- Nabil Al-Macki
- Department of Neurology and Neurosurgery, Montreal Children's Hospital-McGill University Health Center, Montreal, Quebec H3H 1P3, Canada
| | | | | | | |
Collapse
|
33
|
Levin K. ‘I am what I am because of who we all are’: International perspectives on rehabilitation: South Africa. ACTA ACUST UNITED AC 2009; 9:285-92. [PMID: 17050406 DOI: 10.1080/13638490500293358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article provides an overview of some of the important factors that impinge on people with cerebral palsy and their families, on medical and rehabilitation personnel, and on systems of healthcare and education in South Africa. Information is provided with regard to the national contextual variables that influence intervention in the country. The incidence of cerebral palsy is related to some of the more prominent aetiological variables including poverty, malaria, HIV/Aids and premature birth. Health care systems available for children with cerebral palsy are discussed, including the role of traditional healers. Access to education, training and care of children with cerebral palsy is described, including a brief history of specialized education in South Africa. An overview of the personnel, approaches and work contexts involved in rehabilitation highlights the unique nature of intervention in South Africa. The article concludes with recommendations for interventionists with reference to lessons that can be learned in terms of adapting skills and knowledge to local needs, in order to work successfully with children with cerebral palsy and to develop the resilience of their families. In addition, it is suggested that the definition of cerebral palsy needs to reflect the context in which the person lives.
Collapse
Affiliation(s)
- Karen Levin
- Speech Pathology and Audiology, School of Human and Community Development, University of Witwatersrand, Johannesburg, South Africa.
| |
Collapse
|
34
|
Meester-Delver A, Beelen A, Ketelaar M, Hadders-Algra M, Nollet F, Gorter JW. Construct validity of the Capacity Profile in preschool children with cerebral palsy. Dev Med Child Neurol 2009; 51:446-53. [PMID: 19416343 DOI: 10.1111/j.1469-8749.2008.03151.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Capacity Profile (CAP) classifies additional care needs, subdivided into five domains of body functions (physical health, motor, sensory, mental, and voice/speech) of children with stable conditions. Construct validity of the CAP was established in 72 children (56 males, 16 females) with cerebral palsy (CP); median age 2 years 7 months, range 2 years 6 months to 3 years; 34 unilateral and 37 bilateral spastic-type CP, one dyskinetic-type CP. Gross Motor Function Classification System (GMFCS) classification was 24 in level I, eight in level II, 18 in level III, 14 in level IV, and eight in level V. All CAP domains were significantly associated (p<0.001) with the Functional Skills (rho=-0.42 to -0.85) and Caregiver Assistance scales (rho=-0.42 to -0.82) of the Dutch Paediatric Evaluation of Disability Inventory. The CAP-motor domain and GMFCS were strongly correlated (rho=0.91, p<0.001). Stepwise regression analysis demonstrated that the CAP domains contributed 74% to mobility (CAP-motor 66%, mental 6%, voice 2%); 75% to self-care (CAP-voice 61%, mental 12%, physical 2%); and 70% to social functionality (CAP-mental 68%, voice 2%). CAP demonstrated good construct validity in young children with CP. The independent contribution of CAP domains to daily function underscores the importance of comprehensive assessment with regard to all domains of body functions in heterogeneous conditions like CP.
Collapse
Affiliation(s)
- Anke Meester-Delver
- Department of Rehabilitation, Academic Medical Center, University of Amsterdam, PO Box 22660 1100 DD Amsterdam, The Netherlands.
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
Classification of the quality and topographical pattern of motor impairment is used to describe cerebral palsy (CP). As an adjunct to a study characterizing the quality of life and participation of school-age children with C P, initial and follow-up classification of CP were compared. A cohort of 93 children (58 males, 35 females) were initially assessed at a mean age of 2 years 6 months (SD 2y 2mo) and re-assessed at 9 years 4 months (SD 2y 2mo) with a mean interval of 6 years 6 months (SD 2y 4mo) between assessments. Sixty children had Gross Motor Function Classification System levels I-III. All but one of the children were still classified has having CP at follow-up. Type of CP documented remained constant in 67 children (72%; 95% confidence interval 62-80). Clinical factors that were statistically significant (p<0.05) as possible predictors of CP subtype change were original classification of a non-spastic subtype or a non-spastic quadriparetic subtype. Change in CP subtype occurs in an appreciable minority of children with CP, which is likely to reflect a combination of intrinsic and extrinsic influences. Such change may challenge efforts to monitor the effects of interventions in this population.
Collapse
Affiliation(s)
- Michael I Shevell
- Neurology/Neurosurgery and Pediatrics, McGill University, Montreal, Quebec, Canada.
| | | | | | | |
Collapse
|
36
|
Garne E, Dolk H, Krägeloh-Mann I, Holst Ravn S, Cans C. Cerebral palsy and congenital malformations. Eur J Paediatr Neurol 2008; 12:82-8. [PMID: 17881257 DOI: 10.1016/j.ejpn.2007.07.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2007] [Revised: 07/04/2007] [Accepted: 07/10/2007] [Indexed: 11/18/2022]
Abstract
AIM To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS Overall 547 out of 4584 children (11.9%) with CP were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children with cerebral malformations. The most frequent groups of non-cerebral malformations were cardiac, facial clefts and limb and skeleton malformations. Children born at term had a significantly higher prevalence of cerebral malformations compared to children born before 32 weeks (12.1% versus 2.1%, p<0.001). CONCLUSION Cerebral malformations were much more frequent among children with CP than among all livebirths in the population. Malformations in organ systems close to the brain (eye, facial clefts) were more frequent in the CP population while malformations in organ systems further from the brain (renal, genital) were more frequent in the general population.
Collapse
Affiliation(s)
- Ester Garne
- Paediatric Department, Kolding Hospital, DK-6000 Kolding, Denmark.
| | | | | | | | | |
Collapse
|
37
|
Drougia A, Giapros V, Krallis N, Theocharis P, Nikaki A, Tzoufi M, Andronikou S. Incidence and risk factors for cerebral palsy in infants with perinatal problems: a 15-year review. Early Hum Dev 2007; 83:541-7. [PMID: 17188824 DOI: 10.1016/j.earlhumdev.2006.10.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Revised: 10/17/2006] [Accepted: 10/18/2006] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Cerebral palsy (CP) is associated with prenatal, perinatal and postnatal factors. This is a retrospective case-control study aiming to determine the frequency of CP and examine risk factors for CP among infants cared for in the Neonatal Intensive Care Unit (NICU) covering Northwest Greece. DESIGN AND PATIENTS All neonates who were admitted to the NICU during the period 1989-2003 inclusive, and subsequently developed CP, were enrolled in the study, with matched controls. The incidence of CP was evaluated according to gestational age (GA): GA<34 weeks (group A) and GA>34 (group B), and study period: 1989-1996 (period I) and 1997-2003 (period II, during which intrauterine transfer and prenatal steroids were used). RESULTS CP was diagnosed in 78 children, 55 in group A and 23 in group B. The incidence of CP increased significantly with decreasing GA. Survival without CP increased significantly in children of GA<34 weeks during period II. The main factors associated with CP, identified by multivariate analysis, were (odds ratios, confidence interval), for group A: being small for gestational age (SGA) (2.5, 1.2-4.5) and patent ductus arteriosus (PDA) (3.4, 1.3-9.2) in period I, periventricular leucomalacia (PVL) (27, 4.8-209), prolonged rupture of membranes (PROM) (5.6, 1.8-18) and duration of mechanical ventilation (1.1, 1.05-1.2) in period II, and for group B: SGA (3.6, 1.3-9.9), neonatal transfer (3.06, 1.2-7.6), duration of mechanical ventilation (1.1, 1.06-1.25) and sepsis-meningitis (4.3, 1.2-16). CONCLUSION Improvement in survival without CP was observed in infants of GA<34 weeks during the later period of the study, and risk factors for CP in preterm infants depended on the study period. PVL, PROM and PDA were the most powerful independent predictors of CP in children of GA<34 weeks and SGA, neonatal transfer and sepsis/meningitis in children of GA>34 weeks.
Collapse
Affiliation(s)
- A Drougia
- Neonatal Intensive Care Unit (NICU), University Hospital of Ioannina, Greece
| | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
Cerebral palsy (CP) is one of the most common conditions we follow in our pediatric neurology offices. This review will hopefully convince you that the care of children with CP extends far beyond the diagnosis. The review addresses issues surrounding diagnosis, coimpairments, prognosis, and family-centeredness of care. It will also deal with routine office follow-up to prevent or identify complications, management of spasticity and other morbidities, alternative and complementary therapies, and finally transition.
Collapse
Affiliation(s)
- Ellen Wood
- IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
| |
Collapse
|
39
|
Abstract
The prevalence of cerebral palsy (CP) ranges from 1.5 to 2.5 per 1000 live births with little or no variation among western nations, although data from the Americas are sparse. Time trends in overall CP prevalence for the past 40 years are most notable for their stability, but a modest increase in prevalence probably occurred in the last decades of the twentieth century. European countries have pioneered the development of CP registries, and as a result, CP is a condition that is enumerated regularly in several parts of the world. The United States has no CP registries, although ongoing surveillance of CP, along with other developmental disabilities, is performed by the Centers for Disease Control and Prevention in metropolitan Atlanta.
Collapse
Affiliation(s)
- Nigel Paneth
- Department of Epidemiology, College of Human Medicine, B 636 West Fee Hall, Michigan State University, East Lansing, 48823, USA.
| | | | | |
Collapse
|
40
|
Affiliation(s)
- Ho Jin Park
- Department of Pediatrics, College of Medicine, Eulji University, Daejeon, Korea
| |
Collapse
|