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Iscorsoni F, Bueno KMP, Feitosa AM, Mancini MC, Brandão MB. Building independence in self-care and household tasks: a qualitative study with adolescents with cerebral palsy and their caregivers. Disabil Rehabil 2024:1-8. [PMID: 39254491 DOI: 10.1080/09638288.2024.2401142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/26/2024] [Accepted: 08/29/2024] [Indexed: 09/11/2024]
Abstract
PURPOSE Adolescents with cerebral palsy (CP) may experience limitations in self-care and household tasks. The aim of the study was to understand the process of building independence in self-care and household tasks from the perspective of adolescents and their caregivers. MATERIALS AND METHODS We conducted a qualitative study with a phenomenological approach with 10 adolescents (15-17 years old) and 11 caregivers from a transition service in Brazil. Semistructured, remote interviews were conducted with each participant. The interviews were recorded for transcription and content analysis. RESULTS Two thematic categories emerged: (1) "Thinking about independence" and (2) "Possible ways to foster independence." The first category was divided into three subcategories: "Expectations and the desire to be independent," "Obstacles to independence," "Concerns about the future." The second category was divided into four subcategories: "People and places," "Opportunities for practice," "Personal attitude" and "Adaptations that facilitate." CONCLUSION Adolescents' independence in several everyday activities involves physical, socioemotional and environmental aspects. Enabling opportunities for practice, an adapted environment, support from rehabilitation services and developing collaborative relationships with caregivers are elements that may favor the independence of adolescents with CP.
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Affiliation(s)
- Fernanda Iscorsoni
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kátia M P Bueno
- Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline M Feitosa
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marisa C Mancini
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marina B Brandão
- Department of Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Quartermaine JR, Rose TA, Auld ML, Johnston LM. Reflections on Participation at Home, As Self-Reported by Young People with Cerebral Palsy. Dev Neurorehabil 2024; 27:69-82. [PMID: 38695307 DOI: 10.1080/17518423.2024.2347993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/23/2024] [Indexed: 07/08/2024]
Abstract
This study explored the home-based participation of young people with cerebral palsy (CP) and described factors that make participation easier or harder. Fifteen young people with CP aged 15 to 26 years provided written reflections, photographs, or videos about their home-based participation experiences. Data were analyzed using reflexive thematic analysis. Self-reported reflections were grouped inductively into 129 codes, then 20 subthemes and 5 themes which emphasized CP characteristics, thoughts, emotions, equipment, environment, supports, and inclusion as important factors influencing home-based participation. Young people with CP largely described the home environment as an inclusive place to participate.
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Affiliation(s)
- Jacinta R Quartermaine
- The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
- Choice, Passion, Life, Brisbane, Australia
- Queensland Cerebral Palsy Register, Brisbane, Australia
| | - Tanya A Rose
- The University of Queensland, Brisbane, Australia
| | - Megan L Auld
- The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
- Choice, Passion, Life, Brisbane, Australia
- Queensland Cerebral Palsy Register, Brisbane, Australia
| | - Leanne M Johnston
- The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
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Prosser LA, Pierce SR, Skorup JA, Paremski AC, Alcott M, Bochnak M, Ruwaih N, Jawad AF. Motor training for young children with cerebral palsy: A single-blind randomized controlled trial. Dev Med Child Neurol 2024; 66:233-243. [PMID: 37550991 DOI: 10.1111/dmcn.15729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 08/09/2023]
Abstract
AIM To compare the effect of iMOVE (Intensive Mobility training with Variability and Error) therapy with dose-matched conventional therapy on gross motor development and secondary outcomes in young children with cerebral palsy. METHOD This single-blind, randomized controlled trial included repeated assessments of gross motor function (using the Gross Motor Function Measure) and secondary outcomes during a 12- to 24-week intervention phase and at three follow-up points after treatment. Treatment was delivered three times per week in both groups. Forty-two children aged 12 to 36 months were stratified by age and motor function to ensure equivalence between groups at baseline. RESULTS Thirty-six children completed treatment and follow-up phases. Treatment fidelity was high and adherence was equivalent between groups (77.3% conventional therapy, 76.2% iMOVE). There were no group differences on the primary (gross motor function after 12 weeks p = 0.18; after 24 weeks p = 0.94) or any secondary (postural control p = 0.88, caregiver satisfaction p = 0.52, child engagement p = 0.98) measure after treatment or at the follow-up points. However, one-third of total participants exceeded predicted change after 12 weeks and 77% exceeded predicted change after 24 weeks of treatment. INTERPRETATION Our observations indicate a potential dose-response effect of rehabilitation therapy. We further demonstrated that individual therapeutic ingredients can be manipulated. When delivered consistently, both iMOVE and conventional therapy interventions might both be more effective than standard care. WHAT THIS PAPER ADDS Those receiving iMOVE therapy demonstrated more independent practice time, error, and child-initiation than those receiving the dose-matched control. iMOVE therapy was not superior to the control (conventional physical) therapy. Most participants exceeded predicted change after 24 weeks of treatment.
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Affiliation(s)
- Laura A Prosser
- Division of Rehabilitation Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Samuel R Pierce
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Julie A Skorup
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Athylia C Paremski
- Division of Rehabilitation Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Morgan Alcott
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Meghan Bochnak
- Department of Physical Therapy, Rady Children's Hospital, San Diego, CA, USA
| | - Noor Ruwaih
- Division of Rehabilitation Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Abbas F Jawad
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Clough I, Culnane E, Loftus H. Exploring the transition experiences of young adults with cerebral palsy. Child Care Health Dev 2024; 50:e13186. [PMID: 37874030 DOI: 10.1111/cch.13186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 08/24/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND It is important that young adults with a chronic health condition or developmental disability, such as cerebral palsy, receive adequate healthcare transition preparation and support to optimise the transition period and transfer from paediatric to adult health services. Understanding the healthcare experiences of young adults during and after the transition period will provide valuable insights into what enables a positive healthcare experience for young adults in the adult health setting. METHODS Eleven young adults with cerebral palsy who had their last appointment at the Royal Children's Hospital between 2016 and 2018 were purposively recruited for this study. Ten participants completed one-on-one telephone interviews, and one participant provided written responses to interview questions. Five participated via parent proxy. Interviews were recorded, transcribed verbatim, and analysed using the Braun and Clarke six-step thematic analysis to create an interpretive description of participants' transition experiences. RESULTS Three themes were generated: (1) "preparedness of the young adult and parent," which discussed the preparation for adult healthcare, with subthemes (a) expectations of adult care and (b) development of self-management skills during transition; (2) "coordination of transfer process and continuity of care," which illustrated the impact of transfer coordination on continuity of care; and (3) "adjusting to adult services," which highlighted experiences of care in the adult setting, with subthemes (a) differences between paediatric and adult services, (b) availability and accessibility of adult and community services to meet needs, and (c) autonomy and agency. CONCLUSION Dedicated transition support for young adults and their parents during transition from paediatric to adult healthcare plays an important role in ensuring a supportive and well-coordinated transition and transfer of care. Experience of care in the adult setting is influenced by a combination of both transition experience and the capacity of adult services to cater for young adults' needs.
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Affiliation(s)
- Isabelle Clough
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Evelyn Culnane
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia
| | - Hayley Loftus
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia
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Czencz J, Shields N, Wallen M, Wilson PH, McGuckian TB, Imms C. Does exercise affect quality of life and participation of adolescents and adults with cerebral palsy: a systematic review. Disabil Rehabil 2023; 45:4190-4206. [PMID: 36458738 DOI: 10.1080/09638288.2022.2148297] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE Investigate the effect of exercise for adults with cerebral palsy (CP) on quality of life, participation (attendance and involvement in life situations), functional mobility, pain, fatigue, mood, and self-efficacy. METHODS A systematic review was completed. Twelve databases were searched from inception to August 2022 for studies including participants (≥16 years) with cerebral palsy, and that evaluated an exercise intervention. Two reviewers independently assessed eligibility, risk of bias, and extracted data. RESULTS Seventeen studies (total n = 532) were included: 12 randomised control trials, four non-randomised trials, and one single case experimental design. Interventions studied were predominantly strength, aerobic or treadmill training, dance, and swimming. No study assessed participation, pain or mood. Of two studies that assessed quality of life, one reported a positive effect on an aspect of mental health immediately after the programme finished. All studies assessed functional mobility, but only one reported a positive effect. One study assessed self-efficacy and found no effect, and another assessed fatigue and reported conflicting results. CONCLUSIONS The effect of exercise for adults with CP, on outcomes that adults report as important to them - quality of life, participation, pain, mood, and fatigue - are unknown.IMPLICATIONS FOR REHABILITATIONTo address outcomes important to adults with cerebral palsy (CP), it is important to understand how exercise affects participation and quality of life.All modes of exercise reviewed appear safe for adults with CP and choice should be based on the client's preferences, access to services, and convenience.Addressing any needed accommodations in the environment and context is likely more important than exercise prescription parameters when tailoring exercise to meet the needs of adults with CP and sustain participation.
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Affiliation(s)
- James Czencz
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Nora Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia
| | - Margaret Wallen
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, Australia
| | - Peter H Wilson
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Thomas B McGuckian
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Christine Imms
- Healthy Trajectories: Child and Youth Disability Research Hub, The University of Melbourne, Murdoch Children's Research Institute, Melbourne, Australia
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Sakzewski L, Pool D, Armstrong E, Reedman SE, Boyd RN, Elliott C, Novak I, Trost S, Ware RS, Comans T, Toovey R, Peterson MD, Kentish M, Horan S, Valentine J, Williams S. ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy. BMJ Open 2023; 13:e068774. [PMID: 36990490 PMCID: PMC10069600 DOI: 10.1136/bmjopen-2022-068774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION For children with cerebral palsy (CP), who are marginally ambulant, gross motor capacity peaks between 6 and 7 years of age with a subsequent clinical decline, impacting their ability to engage in physical activity. Active Strides-CP is a novel package of physiotherapy targeting body functions, activity and participation outcomes for children with bilateral CP. This study will compare Active Strides-CP to usual care in a multisite randomised waitlist-controlled trial. METHODS AND ANALYSIS 150 children with bilateral CP (5-15 years), classified in Gross Motor Function Classification System (GMFCS) levels III and IV will be stratified (GMFCS III vs IV, age 5-10 years; 11-15 years and trial site) and randomised to receive either (1) 8 weeks of Active Strides-CP two times/week for 1.5 hours in clinic and one time/week for 1 hour alternating home visits and telehealth (total dose=32 hours) or (2) usual care. Active Strides-CP comprises functional electrical stimulation cycling, partial body weight support treadmill training, overground walking, adapted community cycling and goal-directed training. Outcomes will be measured at baseline, immediately post-intervention at 9 weeks primary endpoint and at 26 weeks post-baseline for retention. The primary outcome is the Gross Motor Function Measure-66. Secondary outcomes include habitual physical activity, cardiorespiratory fitness, walking speed and distance, frequency/involvement of community participation, mobility, goal attainment and quality of life. Analyses will follow standard principles for randomised controlled trials using two-group comparisons on all participants on an intention-to-treat basis. Comparisons between groups for primary and secondary outcomes will be conducted using regression models. A within-trial cost utility analysis will be performed. ETHICS AND DISSEMINATION The Children's Health Queensland Hospital and Health Service, The University of Queensland, The University of Melbourne and Curtin University Human Research Ethics Committees have approved this study. Results will be disseminated as conference abstracts and presentations, peer-reviewed articles in scientific journals, and institution newsletters and media releases. TRIAL REGISTRATION NUMBER ACTRN12621001133820.
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Affiliation(s)
- Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Dayna Pool
- School of Allied Health, Curtin University, Carlisle, Western Australia, Australia
| | - Ellen Armstrong
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
| | - Sarah Elizabeth Reedman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Catherine Elliott
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Stewart Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Tracy Comans
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Rachel Toovey
- The University of Melbourne Melbourne School of Health Sciences, Melbourne, Victoria, Australia
| | - Mark D Peterson
- Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan Kentish
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Herston, Queensland, Australia
| | - Sean Horan
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Jane Valentine
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Sian Williams
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- The University of Auckland Liggins Institute, Auckland, New Zealand
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Figueiredo PRP, Nóbrega RAA, Coster WJ, Montenegro LCC, Sampaio RF, Silva LP, Brandão MB, Mancini MC. Is Mobility Sufficient to Understand Community Participation of Adolescents and Young Adults With Cerebral Palsy? The Mediating and Moderating Roles of Contextual Factors. Arch Phys Med Rehabil 2023:S0003-9993(23)00047-3. [PMID: 36708858 DOI: 10.1016/j.apmr.2022.12.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/16/2022] [Accepted: 12/30/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To explore whether self-determination and family socioeconomic status (SES) mediate and/or moderate the relationship between mobility and community participation of adolescents and young adults with cerebral palsy (CP). DESIGN Survey. SETTING Online platform. PARTICIPANTS Of 55 eligible adolescents/young adults with CP, 50 agreed to participate and 2 were excluded. The final convenience sample included 48 individuals (N=48), aged 15-32 years, levels I-IV of the Gross Motor Function Classification System and I-II of the Communication Function Classification System. MAIN OUTCOME MEASURES The Temple University Community Participation Measure documented the amount, breadth, and insufficiency/sufficiency ratios of participation across 26 community settings. The ARC Self-determination Scale and the Mobility Scale of the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) measured individuals' self-determination (ie, autonomy, psychological empowerment, self-realization) and mobility skills, respectively. The Brazilian Economic Classification Criteria-2021 assessed family SES. RESULTS Analyses of mediating/moderating effects revealed that the influence of individuals' mobility skills on their breadth of community participation was mediated by autonomy. Family SES moderated the indirect effect of mobility on community participation breadth through autonomy. When the model was adjusted for participants' age, individuals with higher SES reported greater breadth in community participation than those from moderate and lower SES for all mobility levels. However, the magnitude of the differences among individuals of different SES levels diminished as mobility increased. CONCLUSIONS The mobility skills of youths with CP influence their community participation through autonomy. To foster greater engagement of these individuals in the community, rehabilitation professionals should focus not only on improvement of mobility skills but also on the promotion of self-determined behaviors, especially autonomy.
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Affiliation(s)
- Priscilla R P Figueiredo
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Associação Mineira de Reabilitação, Belo Horizonte, Brazil
| | - Rodrigo A A Nóbrega
- Graduate Program in Analysis and Modeling of Environmental Systems, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Wendy J Coster
- Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA
| | | | - Rosana F Sampaio
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Letícia P Silva
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marina B Brandão
- Department of Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marisa C Mancini
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Connaghan KP, Baylor C, Romanczyk M, Rickwood J, Bedell G. Communication and Social Interaction Experiences of Youths With Congenital Motor Speech Disorders. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2609-2627. [PMID: 36215658 PMCID: PMC9911099 DOI: 10.1044/2022_ajslp-22-00034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE The purpose of this study was to explore the communication and social interaction experiences of adolescents with congenital motor speech disorders due to cerebral palsy or Down syndrome, with the aim of identifying clinical and research needs to support the development and implementation of speech-language interventions. METHOD Five male youths (ages 14-18 years) with congenital motor speech disorders and one of their parents participated in face-to-face, semistructured interviews designed to understand communication and social experiences in daily life. Interviews were audio-recorded and orthographically transcribed offline. Content was coded according to topic areas emerging in the data. Themes were developed to illustrate the most salient and representative aspects of participants' experiences according to the phenomenological tradition that recognizes that participants are experts in their "lived experience." RESULTS Participants described the youths' day-to-day communication experiences, including facilitators and barriers to successful social interactions. Thematic analysis revealed three main themes: (a) strong core relationships amidst sparse, superficial interactions in daily life; (b) the complicated picture of why; and (c) how speech-language pathologists can help. CONCLUSIONS Participants reported that the impact of congenital motor speech disorders on social interactions and experiences became more apparent in adolescence than in earlier childhood. Addressing communication challenges to meet the unique social demands of this period requires tailored interventions that target multiple contributing factors beyond speech impairment, such as social communication skills, negative communication partner attitudes, and participation opportunities. Shifting practice toward a life participation approach to communication intervention stands to substantially improve the long-term social outcomes of adolescents with motor speech disorders.
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Affiliation(s)
- Kathryn P. Connaghan
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Carolyn Baylor
- Department of Rehabilitation Sciences, University of Washington, Seattle
| | - Megan Romanczyk
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| | - Jessica Rickwood
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| | - Gary Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA
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van Alphen GJ, Ketelaar M, Voorman JM, Scholten EW, Post MW. Assessing Participation in Adolescents With Cerebral Palsy: Comparison of Life-Habits and USER-Participation. Arch Rehabil Res Clin Transl 2022; 4:100240. [PMID: 36545524 PMCID: PMC9761302 DOI: 10.1016/j.arrct.2022.100240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective To explore and compare the contents and scores of the Assessment of Life Habits (Life-H) with the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) in adolescents with cerebral palsy. Design Youth versions of both instruments were used for (1) content comparison and (2) analyses of relations between both instruments, based on cross-sectional data. Setting Clinic. Participants Participants were adolescents with cerebral palsy, aged 12-18 years; Gross Motor Function Classification System I-V; N=45. Interventions Not applicable. Main outcome measures Assessment of Life Habits (Life-H) with USER-Participation. Results Both instruments measure independence in participation, called accomplishment (Life-H) and restrictions (USER-Participation), and satisfaction with participation. Life-H provides a profile of 6 domain scores and the USER-Participation a total score per dimension. Compared with the USER-Participation, the Life-H contains more specific items, more items not-applicable to many participants and more ceiling effects. Total scores on the accomplishment/restrictions and satisfaction scales between both instruments showed strong correlation coefficients (0.87 and 0.67, respectively). Correlations between domain scores were stronger within the accomplishment/restrictions scales (range 0.37-0.88) compared with the satisfaction scales (range 0.22-0.68). Conclusions Compared with the USER-Participation, the Life-H takes more effort to complete but provides a more comprehensive assessment of participation. Participation accomplishment/restrictions scores were more similar between the instruments compared with satisfaction scores. Researchers and clinicians should carefully compare participation instruments in selecting one that matches their purpose.
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Affiliation(s)
| | - Marjolijn Ketelaar
- UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands,De Hoogstraat Rehabilitation, Utrecht, The Netherlands,Corresponding author M. Ketelaar, PhD, University Medical Center Utrecht, Brain Center, Department of Rehabilitation Medicine, Physical Therapy Science and Sports, Huispostnummer W01.121, PO Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Jeanine M. Voorman
- Wilhelmina Children's Hospital Utrecht, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Eline W.M. Scholten
- UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marcel W.M. Post
- UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands,De Hoogstraat Rehabilitation, Utrecht, The Netherlands,University of Groningen, University Medical Centre Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
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Michael R, Ran G, Gali Cinamon R. Thinking About the Future: Perceived Barriers and Supports Among Israeli Young Adults With Physical Disabilities. REHABILITATION COUNSELING BULLETIN 2022. [DOI: 10.1177/00343552221124564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Young adults with disabilities tend to have lower rates of employment and career indicators as compared with youth without disabilities. Therefore, understanding the factors that may influence such outcomes is crucial. This study examined the future perceptions of 18 young adults with physical disabilities while focusing on the barriers and supports that may impact their transition into adult life. All participants were living in a rehabilitative student community in southern Israel. They participated in an in-depth semi-structured interview. Data analysis, which was conducted according to an adaptation of the Consensual Qualitative Research method, revealed four major domains: emotions, future life roles, barriers, and supports. Findings emphasized that the participants’ disability was extremely dominant in their future perceptions. In general, they expressed caution and concern about their future. They also tended not to express detailed long-term planning. Their perceptions focused on their future work, future intimate relationships, and the need to manage simultaneously different roles. When addressing their possible barriers and supports, they related both to environmental (e.g., social stigma and community support) and to personal (e.g., low self-esteem and high motivation) factors. Implications for research and practice are discussed.
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Affiliation(s)
| | - Galia Ran
- Kibbutzim College of Education, Tel Aviv, Israel
- Tel-Aviv University, Israel
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11
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Roseira CE, Fittipaldi TRM, da Costa LCS, da Silva DM, Dias AAL, de Figueiredo RM. Good practices with injectables: digital technology for nursing education to control infections. Rev Bras Enferm 2022; 75:e20210716. [PMID: 36102470 PMCID: PMC9749769 DOI: 10.1590/0034-7167-2021-0716] [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: 10/13/2021] [Accepted: 04/06/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to build, validate, implement, and evaluate an educational strategy for nursing professionals and students aiming at good practices in administrating injectable medications. METHODS methodological study for the development of an open course, without tutoring, in a virtual learning environment about good practices with injectable medications. RESULTS ten evaluators validated the educational material that supported the course "Good Practices with Injectables: actions for infection control" regarding objectives, structure, and relevance for the e-book and podcast. The evaluation by the target population (17 individuals) suggests that it is relevant and motivating. However, the forum may be the least attractive tool, and other studies should be conducted to identify its effectiveness as a tool for content retention in open courses. CONCLUSIONS the course is open and has no mentoring for students and nursing professionals with validated educational material for this purpose may be used for nursing education in formal or informal settings.
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Brandão MB, Bueno KMP, Silvério APM, Antunes FIT, Feitosa AM, Figueiredo PRP, Mancini MC. "Listen to us!" A qualitative study of adolescents with disabilities to help plan a transition service. Child Care Health Dev 2022; 48:833-841. [PMID: 35229345 DOI: 10.1111/cch.12992] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 01/17/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The development and implementation of transition services for adolescents with disabilities should incorporate perceptions of their needs and interests. The aim of the study was to understand the concerns of adolescents with physical disabilities during adolescence and their expectations regarding adulthood to help plan a transition programme in Brazil. METHODS This is a qualitative study, using a phenomenological approach. Eight adolescents with physical disabilities (seven with cerebral palsy, one with muscular dystrophy), aged between 15 and 17 years, participated in two focus groups. Prior to the conduction of the groups, clinicians selected topics related to adolescence and the transition to adulthood, based on their professional experience and available literature. During the focus groups, illustrative images of each topic were presented to the participants. Each adolescent was asked to select five topics that he/she considered important to be discussed in a future transition programme. The participants justified their individual choices and, in groups, reached a consensus on the groups' priorities. This strategy was chosen to motivate the discussion among the participants and to explore their concerns regarding adolescence and transition to adulthood. The focus groups were audio recorded and transcribed for content analysis. RESULTS Three themes emerged from the content analysis: (1) "Adolescents and their social relationships," (2) "Identity formation: self-awareness and development of autonomy," and (3) "What about adulthood?" CONCLUSION The themes revealed conflicts between the adolescents' desire to achieve independence and autonomy and the awareness of their limitations. The interpretation of the results helped structuring the actions of the Adolescence in Focus Programme, with two main actions: promotion of the adolescent's functional performance in daily living activities and assistance with their identity formation and preparation for adulthood.
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Affiliation(s)
- Marina B Brandão
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kátia M P Bueno
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Fernanda I T Antunes
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline M Feitosa
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Priscilla R P Figueiredo
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Associação Mineira de Reabilitação, Belo Horizonte, Brazil
| | - Marisa C Mancini
- Gradutate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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13
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Noten S, Selb M, Troenosemito LAA, Thorpe DE, Rodby‐Bousquet E, van der Slot WMA, Roebroeck ME. ICF Core Sets for the assessment of functioning of adults with cerebral palsy. Dev Med Child Neurol 2022; 64:569-577. [PMID: 34800032 PMCID: PMC9299033 DOI: 10.1111/dmcn.15104] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/17/2021] [Accepted: 09/25/2021] [Indexed: 01/19/2023]
Abstract
AIM To report on the results of the online international consensus process to develop the comprehensive and brief International Classification of Functioning, Disability and Health (ICF) Core Sets for adults with cerebral palsy (CP). METHOD An online iterative decision-making and consensus process involved 25 experts, including clinicians and researchers working with adults with CP, an adult with CP, and the parents of adults with CP from all six regions of the World Health Organization. The most relevant categories were selected from a list of 154 unique second-level candidate categories to develop the ICF Core Sets for adults with CP. This list resulted from evidence gathered during four preparatory studies, that is, a systematic literature review, a qualitative study, an expert survey, and an empirical study. RESULTS The consensus process resulted in the comprehensive ICF Core Set containing 120 second-level ICF categories: 33 body functions; eight body structures; 50 activities and participation; and 29 environmental factors, from which the most essential categories, 33 in total, were selected for the brief ICF Core Set. For body functions, most of the categories were mental functions and neuromusculoskeletal and movement-related functions. Body structures were mostly related to movement. All the chapters of the activities and participation component were represented, with mobility and self-care as the most frequently covered chapters. For environmental factors, most of the categories addressed products and technology and services, systems, and policies. INTERPRETATION The comprehensive and brief ICF Core Sets for adults with CP were created using a new online version of an established ICF Core Set consensus process. These Core Sets complement the age-specific ICF Core Sets for children and young people with CP and will promote standardized data collection worldwide.
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Affiliation(s)
- Suzie Noten
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam RehabilitationRotterdamthe Netherlands.
| | - Melissa Selb
- ICF Research BranchNottwilSwitzerland,Swiss Paraplegic ResearchNottwilSwitzerland.
| | - Lorenzo A A Troenosemito
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Deborah E Thorpe
- Division of Physical TherapySchool of MedicineUniversity of North Carolina at Chapel HillChapel HillNCUSA.
| | - Elisabet Rodby‐Bousquet
- Centre for Clinical ResearchUppsala University – Region VästmanlandVästeråsSweden,Department of Clinical SciencesOrthopaedicsLund UniversityLundSweden
| | - Wilma M A van der Slot
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam RehabilitationRotterdamthe Netherlands.
| | - Marij E Roebroeck
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam RehabilitationRotterdamthe Netherlands.
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14
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Abdel Malek S, Mesterman R, Switzer L, DiRezze B, deVeber G, Fehlings D, Lunsky Y, Phoenix M, Gorter JW. Exploring demographic, medical, and developmental determinants of adaptive behaviour in children with hemiplegic cerebral palsy. Eur J Paediatr Neurol 2022; 36:19-25. [PMID: 34823070 DOI: 10.1016/j.ejpn.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022]
Abstract
Hemiplegic cerebral palsy (CP), the most common subtype, is characterized by high levels of mobility. Despite this, children with hemiplegic CP can face challenges functioning in and adapting to situations of everyday life. The purpose of this cross-sectional study (Hemi-NET database) was to identify factors associated with adaptive behaviour in 59 children with hemiplegic CP (ages 4-18; GMFCS I-IV). Using multivariate regression analyses, the relationship between demographic, medical, and developmental factors and adaptive behaviour (measured by the Adaptive Skills Composite score of the BASC-2) was explored. Results indicate that 34% of children had impaired adaptive skills. An autism diagnosis and lower communication functioning were significantly associated with poorer adaptive skills (R2 = 0.42, F(4, 43) = 7.87, p < 0.001), while factors such as IQ scores and GMFCS level were not. The results contribute to the growing literature that suggests that clinicians and researchers need to look beyond motor functioning when working with individuals with CP.
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Affiliation(s)
- Sandra Abdel Malek
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada.
| | - Ronit Mesterman
- Department of Paediatrics, McMaster University, 1280 Main Street West, Health Sciences Centre, 3A, Hamilton, Ontario, L8S 4K1, Canada
| | - Lauren Switzer
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada
| | - Briano DiRezze
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - Gabrielle deVeber
- Division of Neurology, Hospital for Sick Children, 555 University Avenue, Neurology Clinic, 6C Atrium, Toronto, Ontario, M5G 1X8, Canada
| | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada; Department of Pediatrics, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, Ontario, M5G 1X8, Canada; Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Yona Lunsky
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario, M5T 1R8, Canada; Azrieli Centre for Adult Neurodevelopmental Disabilities, CAMH, McCain Complex Care & Recovery Building, 1025 Queen Street West, Toronto, Ontario, M6K 1H4, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada
| | - Jan Willem Gorter
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada; Department of Paediatrics, McMaster University, 1280 Main Street West, Health Sciences Centre, 3A, Hamilton, Ontario, L8S 4K1, Canada
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15
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Ruhde L, Hulla R. An overview of the effects of whole-body vibration on individuals with cerebral palsy. J Pediatr Rehabil Med 2022; 15:193-210. [PMID: 35275570 DOI: 10.3233/prm-201508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this review is to examine how whole-body vibration can be used as a tool in therapy to help improve common physical weaknesses in balance, bone density, gait, spasticity, and strength experienced by individuals with cerebral palsy. Cerebral palsy is the most common movement disorder in children, and whole-body vibration is quickly becoming a potential therapeutic tool with some advantages compared to traditional therapies for individuals with movement disorders. The advantages of whole-body vibration include less strain and risk of injury, more passive training activity, and reduced time to complete an effective therapeutic session, all of which are appealing for populations with physiological impairments that cause physical weakness, including individuals with cerebral palsy. This review involves a brief overview of cerebral palsy, whole-body vibration's influence on physical performance measures, its influence on physical performance in individuals with cerebral palsy, and then discusses the future directions of whole-body vibration therapy in the cerebral palsy population.
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Affiliation(s)
- Logan Ruhde
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | - Ryan Hulla
- Department of Psychology, University of Texas at Arlington, Arlington, TX, USA
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16
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Böhm H, Dussa CU. Prefabricated ankle-foot orthoses for children with cerebral palsy to overcome spastic drop-foot: does orthotic ankle stiffness matter? Prosthet Orthot Int 2021; 45:491-499. [PMID: 34723908 DOI: 10.1097/pxr.0000000000000050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/09/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Spastic drop-foot is a common problem in children with cerebral palsy that may lead to tripping and falling. To improve ankle dorsiflexion in swing phase, prefabricated carbon-composite ankle-foot orthoses are commonly prescribed; by increasing ankle stiffness, these orthoses may also improve knee extension in stance. OBJECTIVES To compare the effect of a stiff vs. flexible prefabricated ankle-foot orthosis on sagittal plane ankle and knee kinematics and kinetics during walking. STUDY DESIGN Cross-sectional, repeated-measures, interventional study. METHODS Twenty-seven children and adolescents with cerebral palsy who had drop-foot in swing were included. Gait analysis was conducted under four conditions: barefoot, shod, with a stiff, and with a flexible orthosis. Participants were divided into two groups including children and adolescents who have a flexed knee during stance (KF, N = 12) and without flexed knee during stance (KE, N = 15). RESULTS Ankle dorsiflexion in swing phase was significantly improved compared with the shod condition by 6.3 degrees (SD = 3.3 degrees) only in the KE group when using the flexible orthosis. For the stiff orthosis, knee extension in stance was significantly increased by 2.4 degrees (SD = 3.3 degrees) in the KE group compared with the shod condition. No significant improvements were observed for the KF group. Further analysis indicated that only seven patients in the KF group with weak ankle plantarflexors improved knee extension while using the stiff orthosis. CONCLUSIONS Our results suggested that in the KE group, the flexible orthosis was best suited for patients with drop-foot without a knee extension deficit. The stiff orthosis was not suitable in this group as it caused a hyperextended knee without improving dorsiflexion in swing phase. Therefore, stiffness should be considered when prefabricated orthoses are prescribed.
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Affiliation(s)
- Harald Böhm
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr, Chiemgau, Germany
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17
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Jonsson U, Eek MN, Sunnerhagen KS, Himmelmann K. Changes in walking ability, intellectual disability, and epilepsy in adults with cerebral palsy over 50 years: a population-based follow-up study. Dev Med Child Neurol 2021; 63:839-845. [PMID: 33772773 DOI: 10.1111/dmcn.14871] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 01/01/2023]
Abstract
AIM To determine if walking ability and presence of intellectual disability and epilepsy change from childhood to 50 years of age in individuals with cerebral palsy (CP), and if such changes are related to age, sex, or CP subtype. METHOD This was a population-based follow-up study of 142 adults born from 1959 to 1978 (82 males, 60 females; mean age 48y 4mo, range 37-58y; 44% unilateral, 35% bilateral, 17% dyskinetic, and 4% ataxic CP) listed in the CP register of western Sweden. We compared childhood data with a follow-up assessment in 2016. RESULTS At follow-up, walking ability had changed significantly (p<0.001). The proportion of participants walking without aids had decreased from 71% to 62%, and wheelchair ambulation increased from 18% to 25%. Walking ability was related to subtype (p=0.001), but not to age, sex, pain, fatigue, or body mass index. The proportion classified as having intellectual disability had increased from 16% to 22% (p=0.039) and the proportion with epilepsy from 9% to 18% (p=0.015). Of those with childhood epilepsy, 46% were seizure-free without medication. INTERPRETATION Walking ability and the presence of intellectual disability and epilepsy had changed significantly since childhood. Life-long access to specialized health care is warranted for re-evaluation of impairments, treatment, and assistance. What this paper adds Changes in impairments in individuals with cerebral palsy (CP) over time are related to CP subtype. After 50 years, walking ability in CP may have deteriorated or improved. Intellectual disability in CP may not always be detected in early childhood assessments. Epilepsy in CP may develop after childhood or may be outgrown.
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Affiliation(s)
- Ulrica Jonsson
- Region Västra Götaland, Habilitation and Health, Gothenburg, Sweden.,Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Meta Nyström Eek
- Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Katharina Stibrant Sunnerhagen
- Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kate Himmelmann
- Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden.,Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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18
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Decline in Motor Function during the COVID-19 Pandemic Restrictions and Its Recovery in a Child with Cerebral Palsy: A Case Report. CHILDREN-BASEL 2021; 8:children8060511. [PMID: 34204239 PMCID: PMC8234799 DOI: 10.3390/children8060511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 11/17/2022]
Abstract
Children with cerebral palsy (CP) experience various restrictions owing to their underdeveloped mobility. Home confinement due to the coronavirus disease 2019 pandemic may further increase these restrictions. We report the case of a 7-year-old boy with CP (Gross Motor Function Classification System level IV) whose motor function declined during the period when physical therapy was discontinued due to lockdown, approximately four months. At the end of the home confinement, the patient's ability to maintain a sitting posture and weight-bearing capacity of the lower extremities decreased. His Gross Motor Function Measure total score also decreased from 34.5% to 31.9%. After resuming physical therapy, the patient recovered the function status seen before the discontinuation of physical therapy, but this took almost twice as long as the confinement period. We reaffirm that frequent physical therapy is crucial for maintaining motor function in non-ambulatory children with CP. As a countermeasure for the future, urgent efforts are needed for the development of telerehabilitation.
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19
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van der Kemp J, Ketelaar M, Gorter JW. Environmental factors associated with participation and its related concepts among children and youth with cerebral palsy: a rapid review. Disabil Rehabil 2021; 44:1571-1582. [PMID: 34057002 DOI: 10.1080/09638288.2021.1923839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To provide an overview of environmental factors associated with participation and participation-related constructs in children and youth with cerebral palsy (CP). METHODS A rapid review following the principles from scoping methodology was performed with a literature search in September 2019. The CINAHL, Embase, Ovid MEDLINE and PsychINFO databases were searched to identify original articles which addressed participation in children and youth (aged 0-18) with CP. RESULTS In total, 9511 unique articles were identified, of which 34 met all inclusion criteria. Many different measures for environmental factors were used. Most common environmental factors associated with participation (i.e., attendance and involvement) were family ecology, type of school, and parental stress. Regarding participation-related constructs (activity competence, sense of self and preferences), most common factors were parental stress and the physical environment. CONCLUSIONS While environmental factors are found to be associated with participation attendance and activity competence in children with CP, there is a lack of research of environmental factors in relation to both participation involvement and other participation-related constructs. To increase impact in clinical practice, future research should involve structured assessments of the environment and focus more on modifiable factors, to help service providers develop treatment paradigms needed for meaningful participation outcomes.IMPLICATIONS FOR REHABILITATIONFamily ecology, type of school, and parental stress were the most common factors associated with participation.Future research should focus on modifiable factors associated with participation outcomes.Modifiable environmental factors associated with participation included parental stress, family activity and type of school.In clinical practice, environmental factors are to be assessed in a more systematic way in relation to current or future participation restrictions.
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Affiliation(s)
- Jet van der Kemp
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Canada.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Canada
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20
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Stability of the Communication Function Classification System among Children with Cerebral Palsy in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041881. [PMID: 33671982 PMCID: PMC7919265 DOI: 10.3390/ijerph18041881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022]
Abstract
Interest in the prognosis of skill levels has been an important issue among children with cerebral palsy (CP). This study aimed to verify the stability of the Communication Function Classification System (CFCS) in 2- to 18-year-old children with CP. Data collected from 171 children with CP who received rehabilitation therapy in hospitals or attended special elementary schools in South Korea were reviewed. They were divided into two groups, children <4 years and children ≥4 years. Participants were evaluated over 1-year and 2-year intervals from the first rating. Agreement between the three measurements and the weighted kappa were analyzed. At the 1-year interval, results demonstrated a high agreement rate of the CFCS in children ≥4 years old, and during the 2-year interval the study revealed a low agreement rate in children aged 2–4 years. The results indicated the stability of the CFCS in children ≥4 years old but some change of the CFCS in 2- to 4-year-old children. Moreover, the findings suggested that the change of the CFCS varied with time and age. Based on these results, it is recommended that the CFCS assessments be performed periodically, especially among 2- to 4-year-old children with CP.
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21
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Feitosa AM, Mancini MC, Silvério APM, Gordon AM, Brandão MB. "Help Me to Improve my Own Priorities!": A Feasibility Study of an Individualized Intensive Goal Training for Adolescents with Cerebral Palsy. Phys Occup Ther Pediatr 2021; 41:601-619. [PMID: 33653225 DOI: 10.1080/01942638.2021.1891186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM To investigate the feasibility and the preliminary effects of an individualized intensive goal training for adolescents with cerebral palsy (CP). METHODS Twelve adolescents with CP (12-17 years old, MACS II-III, GMFCS I-IV) identified functional goals to be practiced three hours/day, five days/week, for two weeks. The feasibility aspects included the participant's adherence (i.e., daily logs), the adequacy of the instruments used, and the participant's satisfaction with the intervention (i.e., structured questionnaire). Outcome measures included the Canadian Occupational Performance Measure (COPM), Pediatric Evaluation of Disability Inventory (PEDI) (self-care; mobility), Children Helping Out: Responsibilities, Expectations and Supports (CHORES), Participation and Environment Measure-Children and Youth (PEM-CY) (home) and Box and Blocks Test (BBT). Assessments were conducted one month and two days before the intervention, immediately and three months after the intervention. Friedman tests were used to test time-related differences in the outcome measures. RESULTS All adolescents completed and reported satisfaction with the proposed intervention. Significant improvements were observed in performance and satisfaction (COPM), in functional skills and caregiver assistance in self-care and in the performance of household tasks. There were no significant differences in mobility skills, independence in mobility or household tasks, home participation, or manual dexterity. CONCLUSION The intensive training was feasible and promoted improvements in functional goals and daily functioning of adolescents with CP.
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Affiliation(s)
- Aline M Feitosa
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marisa C Mancini
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Paula M Silvério
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Marina B Brandão
- Graduate Program in Rehabilitation Sciences, Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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22
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McPhee PG, Verschuren O, Peterson MD, Tang A, Gorter JW. The Formula for Health and Well-Being in Individuals With Cerebral Palsy: Cross-Sectional Data on Physical Activity, Sleep, and Nutrition. Ann Rehabil Med 2020; 44:301-310. [PMID: 32721989 PMCID: PMC7463117 DOI: 10.5535/arm.19156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/23/2019] [Indexed: 01/02/2023] Open
Abstract
Objective To determine physical activity, sleep, and nutrition patterns in individuals with cerebral palsy (CP) and investigate the association of Gross Motor Function Classification System (GMFCS) and age with these health behaviors. Methods A cross-sectional study was conducted in an outpatient setting. Participants included adolescents and adults with CP (n=28; GMFCS level I–V; mean age 35.1±14.4 years). An Exercise Questionnaire or Leisure Time Physical Activity Questionnaire was used to measure physical activity in adolescents and adults, respectively. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). An adapted version of the PrimeScreen questionnaire was used to assess nutrition. Linear regression analyses were performed to investigate the association between GMFCS and age with physical activity, sleep, and nutrition. Results The average total physical activity was 29.2±30.0 min/day. Seventy-five percent of the participants had poor sleep quality (PSQI score >5). Seventy-one percent reported “fair” eating behaviors; none reported “excellent” eating behaviors. Neither GMFCS nor age were significantly associated with PSQI score, PrimeScreen score, or total physical activity. A negative correlation existed between sleep quantity (hr/night) and PSQI score (r=-0.66, p=0.01). Conclusion The triad of health components, consisting of physical activity, sleep, and nutrition, was not associated with GMFCS or age in our sample of 28 individuals with CP, suggesting that these three health behaviors should be assessed during clinical encounters of CP in adolescents and adults at all levels of the GMFCS.
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Affiliation(s)
- Patrick G McPhee
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.,CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Olaf Verschuren
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Mark D Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan-Medicine, Ann Arbor, MI, USA
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Jan Willem Gorter
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.,CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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23
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Cominetti EPA, Gerzson LR, Almeida CSD. Aplicação da escala Spinal Alignment and Range of Motion Measure (SAROMM) em crianças e adultos com paralisia cerebral, em uma instituição de abrigagem de Porto Alegre (RS). FISIOTERAPIA E PESQUISA 2020. [DOI: 10.1590/1809-2950/19024427032020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo do estudo foi descrever o perfil de crianças e adultos institucionalizados com Paralisia Cerebral, bem como, suas alterações musculoesqueléticas, alinhamento da coluna vertebral e amplitude de movimento; também, traçar estratégias para minimizar o avanço das deformidades já instaladas. Estudo de caráter transversal e descritivo. Crianças e adultos com Paralisia Cerebral de uma Instituição de abrigagem da cidade de Porto Alegre/RS foram avaliados (n=28). Utilizou-se a escala Spinal Alignment and Range of Motion Measure (SAROMM) para avaliar as deformidades e Gross Motor Function Classification System (GMFCS) para classificar o nível funcional. 96% dos sujeitos foram do tipo espástico; 42,85% apresentaram nível motor V do total dos participantes; as maiores deformidades encontradas foram em joelho, quadril e coluna avaliados pela escala de SAROMM, associado com a idade mais avançada e quadro de quadriplegia espástica, com diagnóstico clínico em prontuário. Sujeitos maiores de 20 anos obtiveram uma pontuação média de 68,7 (varia de 0 a 104) e sujeitos menores de 20 anos, sua pontuação média foi de 55,1 pontos, sendo quanto menor, melhor o alinhamento e menos deformidades. Sujeitos com PC de um local de abrigagem apresentaram, na sua maioria, espasticidade do tipo bilateral dos quatro membros, nível de GMFCS predominante foi o V e alterações articulares em joelhos, quadril e coluna vertebral como maiores deformidades encontrada. As estratégias devem ser traçadas e iniciadas o mais cedo possível para diminuir e ou minimizar deformidades e a escala SAROMM pode ser uma escolha para avaliar esse público.
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I Want to Play: Children With Cerebral Palsy Talk About Their Experiences on Barriers and Facilitators to Participation in Leisure Activities. Pediatr Phys Ther 2020; 32:190-200. [PMID: 32604358 DOI: 10.1097/pep.0000000000000719] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore how children with cerebral palsy (CP) experience participation in leisure activities and to describe the environmental barriers and facilitators. METHODS Sixteen children with cerebral palsy aged 7 to 17 years participated in 3 focus groups. Data were analyzed thematically by 3 researchers on the basis of the International Classification of Functioning, Disability and Health. RESULTS A total of 38 International Classification of Functioning, Disability and Health categories were identified (4 linked to Body functions; 2 linked to Body structures; 8 linked to Activities & Participation, and 24 to Environmental factors: 10 facilitators and 14 barriers). The most mentioned categories were Voluntary movement control functions, Functions related to gait pattern, Structure of upper arm, Recreation and leisure, Nuclear family and finally, and Individual attitudes of acquaintances. CONCLUSIONS The main barriers identified by children with cerebral palsy highlight aspects of the physical, social, and attitudinal environment that could be modified to enhance participation in leisure activities.
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Park EY. Stability of the gross motor function classification system in children with cerebral palsy for two years. BMC Neurol 2020; 20:172. [PMID: 32375677 PMCID: PMC7203831 DOI: 10.1186/s12883-020-01721-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 04/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prognosis of gross motor function is a major concern for therapy and intervention in children with cerebral palsy (CP). The classification system for gross motor function, the Gross Motor Function Classification System (GMFCS), is actively studied because it could be useful in the communication between professionals and families. This study aimed to verify the stability of GMFCS over 2 years in children with CP aged 2-12 years. METHODS The GMFCS level of 100 children with CP who underwent rehabilitation therapy in hospitals or who attended special elementary schools in South Korea were collected in the study. The agreements across three measurement points were analyzed in these children. RESULTS The weighted kappa coefficients were statistically significant (p < .05). The coefficients ranged from 0.690 to 0.789 in children with CP aged 2-12 years. The lowest coefficient of 0.557 was observed in children with CP aged 2-4 years between the first and third measurements points. CONCLUSIONS The results provided evidence of GMFCS stability for the first year and change of the GMFCS during the two-year study period in children aged 2-4 years. Moreover, the findings indicate that the stability of GMFCS varies with time, duration, and age. It is recommended that GMFCS assessments be performed periodically, which are even more necessary for children with CP aged 2-4 years.
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Affiliation(s)
- Eun-Young Park
- Department of Secondary Special Education, College of Education, Jeonju University, 1200 3-ga, Hyoja-dong, Wansan-gu, Jeonju, 560-759, Republic of Korea.
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Eken MM, Lamberts RP, Du Toit J, Verkoeijen PPJL, Kosel E, Langerak NG. The level of accomplishment and satisfaction in activity and participation of adults with cerebral palsy and spastic diplegia. J Orthop Sci 2020; 25:507-512. [PMID: 31262451 DOI: 10.1016/j.jos.2019.05.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/24/2019] [Accepted: 05/30/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND Orthopaedic surgery is commonly performed in children with cerebral palsy (CP) and spastic diplegia to improve functional mobility. However, no research has quantified levels of accomplishment and satisfaction in daily activities and participation long-term after surgery. Therefore, this study aimed to investigate 1) the level of accomplishment and satisfaction of life habits in adults with CP, 2) whether there were differences between Gross Motor Function Classification System (GMFCS) levels, and 3) associations with contextual factors, functional level and frequency of pain. METHODS Levels of accomplishment and satisfaction in activity and participation were assessed using the Life-Habits 3.1 questionnaire in 30 adults with CP and spastic diplegia who received the first orthopaedic intervention more than 15 years ago (age: median [interquartile range (IQR)] = 27:8 [21:7-33:8] y:mo; GMFCS level I/II/III: n = 15/11/4). GMFCS and Functional Mobility Scale (FMS) assessed mobility over 5 m, 50 m and 500 m. Participants reported frequency of back pain and pain in the lower and upper limb. RESULTS On average 63% of the participants were independent and faced no difficulties in the accomplishment of all life habits. Difficulties were mostly experienced for 'mobility', 'housing' and 'recreation' (all 61%). Participants were overall satisfied, with lowest scores for 'employment' (13% dissatisfied). Between the GMFCS levels, accomplishment scores of participants with level I were significantly higher than level II. In addition, negative associations were found between accomplishment of life habits and GMFCS level, FMS, and pain on spinal level. CONCLUSION Levels of accomplishment and satisfaction were relatively high among adults with CP who underwent orthopaedic interventions during childhood. However, negative associations between accomplishment levels and level of functioning and back pain argue for rehabilitation programs specialized on these factors. This information is imperative for physicians and allied health care professionals to guide adults with CP during ageing.
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Affiliation(s)
- Maaike M Eken
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Tygerberg, South Africa
| | - Robert P Lamberts
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Tygerberg, South Africa; Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Tygerberg, South Africa
| | - Jacques Du Toit
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Tygerberg, South Africa
| | - Peter P J L Verkoeijen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands; Learning and Innovation Center, Avans University of Applied Sciences, Breda, the Netherlands
| | - Elisa Kosel
- Department of Biomechanics in Sports, Technical University Munich, Munich, Germany
| | - Nelleke G Langerak
- Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Neurosurgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
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Epidemiology of Cerebral Palsy in Adulthood: A Systematic Review and Meta-analysis of the Most Frequently Studied Outcomes. Arch Phys Med Rehabil 2020; 101:1041-1052. [PMID: 32059945 DOI: 10.1016/j.apmr.2020.01.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/13/2019] [Accepted: 01/08/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To describe the epidemiology of health status, impairments, activities and participation in adults with cerebral palsy (CP). DATA SOURCES Embase, MEDLINE, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health, Cochrane, and Google Scholar were searched for 3 themes ("cerebral palsy," "adult," and "outcome assessment") in literature published between January 2000 and December 2018. STUDY SELECTION Full-article peer-reviewed English journal articles on descriptive, observational, or experimental studies describing the most studied outcomes in adults with CP (n≥25, age≥18y) were included. Studies were included in the analyses if frequently studied outcomes were described in at least 3 studies using similar methods of assessment. DATA EXTRACTION Data were extracted independently by 2 authors from 65 articles (total N=28,429) using a standardized score sheet. DATA SYNTHESIS Meta-analyses revealed that overall, on average 65.1% (95% confidence interval [CI], 55.1-74.5) of adults with CP experienced pain, 57.9% (95% CI, 51.1-64.6) were ambulant, 65.5% (95% CI, 61.2-69.7) had little or no limitation in manual ability, 18.2% (95% CI, 10.6-27.2) had tertiary education, 39.2% (95% CI, 31.5;47.1) were employed, and 29.3% (95% CI, 9.0-55.3) lived independently. In adults without intellectual disability, proportions of individuals who were ambulant (72.6% [95% CI, 58.8-84.5]) and lived independently (90.0% [95% CI, 83.8-94.9]) were higher (P=.014 and P<.01, respectively). The Fatigue Severity Scale score was 4.1 (95% CI, 3.8-4.4). Epilepsy (28.8% [95% CI, 20.1-38.4]) and asthma (28.3% [95% CI, 18.7-38.9]) were especially prevalent comorbidities. CONCLUSIONS The present systematic review and meta-analysis on the epidemiology of adults with CP provided state-of-the-art knowledge on the most frequently studied outcomes. On average, adults with CP are fatigued, and a majority experience pain, are ambulant, and have little or no difficulty with manual ability. On average, 40% are employed and 30% live independently. More uniformity in assessment and reports is advised to improve knowledge on epidemiology and gain insight in more outcomes.
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van Wely L, van Gorp M, Tan SS, van Meeteren J, Roebroeck ME, Dallmeijer AJ. Teenage predictors of participation of adults with cerebral palsy in domestic life and interpersonal relationships: A 13-year follow-up study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 96:103510. [PMID: 31865228 DOI: 10.1016/j.ridd.2019.103510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 07/07/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Adults with cerebral palsy (CP) may experience problems with participation in domestic life and interpersonal relationships. AIMS To identify teenage predictors of adult participation in domestic life and interpersonal relationships. METHODS AND PROCEDURES This 13-year follow-up of the PERRIN 16-24 cohort included 53 adults with CP without intellectual disability [current age 31.7 (SD = 1.4) years]. Participation performance was assessed as attendance (Vineland Adaptive Behavior Scales), and difficulty/assistance with participation (Life Habits questionnaire). 56 teenage factors were categorized in ICF components. Stepwise multiple linear regression analyses explored predictors of participation. OUTCOMES AND RESULTS Lower gross motor capacity, following special education, having protective parents and a rigid personality predicted less participation in domestic life. Having rejective parents, receiving little daily support, having a socially avoidant personality or coping style and the male gender predicted less participation in interpersonal relationships. Lower activity and participation levels as a teenager predicted less participation in both domestic life and interpersonal relationships of adults with CP. CONCLUSIONS AND IMPLICATIONS Environmental and personal factors, gross motor capacity and teenage participation were predictors of participation of adults with CP. These factors help identify subgroups at risk for suboptimal adult participation and provide targets for rehabilitation.
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Affiliation(s)
- Leontien van Wely
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, the Netherlands
| | - Marloes van Gorp
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, the Netherlands; Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Siok Swan Tan
- Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, the Netherlands; Erasmus MC University Medical Center, Department of Public Health, Rotterdam, the Netherlands
| | - Jetty van Meeteren
- Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, the Netherlands; Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Marij E Roebroeck
- Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, the Netherlands; Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Annet J Dallmeijer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
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Tan SS, van Gorp M, Voorman JM, Geytenbeek JJM, Reinders‐Messelink HA, Ketelaar M, Dallmeijer AJ, Roebroeck ME. Development curves of communication and social interaction in individuals with cerebral palsy. Dev Med Child Neurol 2020; 62:132-139. [PMID: 31541474 PMCID: PMC6916560 DOI: 10.1111/dmcn.14351] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2019] [Indexed: 11/28/2022]
Abstract
AIM To determine development curves of communication and social interaction from childhood into adulthood for individuals with cerebral palsy (CP). METHOD This Pediatric Rehabilitation Research in the Netherlands (PERRIN)-DECADE study longitudinally assessed 421 individuals with CP, aged from 1 to 20 years at baseline, after 13 years (n=121 at follow-up). Communication and social interactions were assessed using the Vineland Adaptive Behavior Scales. We estimated the average maximum performance limit (level) and age at which 90% of the limit was reached (age90 ) using nonlinear mixed-effects modeling. RESULTS One-hundred individuals without intellectual disability were aged 21 to 34 years at follow-up (39 females, 61 males) (mean age [SD] 28y 5mo [3y 11mo]). Limits of individuals without intellectual disability, regardless of Gross Motor Function Classification System (GMFCS) level, approached the maximum score and were significantly higher than those of individuals with intellectual disability. Ages90 ranged between 3 and 4 years for receptive communication, 6 and 7 years for expressive communication and interrelationships, 12 and 16 years for written communication, 13 and 16 years for play and leisure, and 14 and 16 years for coping. Twenty-one individuals with intellectual disability were between 21 and 27 years at follow-up (8 females, 13 males) (mean age [SD] 24y 7mo [1y 8mo]). Individuals with intellectual disability in GMFCS level V showed the least favourable development, but variation between individuals with intellectual disability was large. INTERPRETATION Individuals with CP and without intellectual disability show developmental curves of communication and social interactions similar to typically developing individuals, regardless of their level of motor function. Those with intellectual disability reach lower performance levels and vary largely in individual development. WHAT THIS PAPER ADDS Communication and social interactions in individuals with cerebral palsy without intellectual disability develop similarly to typically developing individuals. Communication and social interactions of individuals with intellectual disability develop less favourably and show large variation.
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Affiliation(s)
- Siok Swan Tan
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Department of Public HealthErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Marloes van Gorp
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Jeanine M Voorman
- Center of Excellence for Rehabilitation MedicineBrain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht University and De Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Joke JM Geytenbeek
- Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Heleen A Reinders‐Messelink
- Department of Rehabilitation MedicineUniversity Medical Center GroningenGroningenthe Netherlands,Rehabilitation Center Revalidatie FrieslandBeetsterzwaagthe Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation MedicineBrain Center Rudolf MagnusUniversity Medical Center UtrechtUtrecht University and De Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Annet J Dallmeijer
- Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam RehabilitationRotterdamthe Netherlands
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Veerbeek BE, Lamberts RP, Fieggen AG, Verkoeijen PPJL, Langerak NG. Daily activities, participation, satisfaction, and functional mobility of adults with cerebral palsy more than 25 years after selective dorsal rhizotomy: a long-term follow-up during adulthood. Disabil Rehabil 2019; 43:2191-2199. [PMID: 31815556 DOI: 10.1080/09638288.2019.1695001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To determine changes in level of accomplishment and satisfaction in daily activities and social participation, and functional mobility in adults with cerebral palsy (CP) more than 25 years after selective dorsal rhizotomy (SDR). MATERIALS AND METHODS This long-term observational nine-year follow-up study included 26 adults (median age 35 years) with CP and spastic diplegia, and 26 matched typically developing adults. Assessment tools used were the Life-Habits questionnaire and the Functional Mobility Scale. RESULTS Most of the adults with CP were independent and satisfied with accomplishing life habits and no changes were determined, except for a small change in the Housing accomplishment level. Compared to typically developing adults, the CP cohort was more dependent in accomplishing Mobility and Recreation. However, the level of satisfaction was similar for most life habits except for Mobility. Functional mobility did not change, but correlated with Life-Habits results. CONCLUSIONS Adults with CP showed high and stable levels of accomplishment and satisfaction in daily activities and social participation more than 25 years after SDR. This is in contrast with the literature, where functional decline was shown for individuals with CP as they age. The relation with functional mobility highlights the importance to focus the rehabilitation on maintaining walking ability in order to enable high level of daily activities and social participation in adults with CP.Implications for rehabilitationSelective dorsal rhizotomy (SDR) is a valuable treatment option for a selective group of children with cerebral palsy (CP) in order to reduce spasticity.The long-term outcomes of SDR on level of accomplishment and satisfaction in daily activities and social participation as well functional mobility in adults with CP are not clear.More than 25 years after SDR adults with CP experienced stable and lasting high levels of functioning regarding daily activities and social participation and were satisfied with the way they accomplished life habits.Functional mobility was correlated to level of accomplishment and satisfaction in daily activities and social participation, which highlights the importance to focus rehabilitation programs on maintaining functional mobility in order to enable daily activities and social participation in adults with CP.
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Affiliation(s)
- Berendina E Veerbeek
- Department of Surgery, Faculty of Health Sciences, Neuroscience Institute and Division of Neurosurgery, University of Cape Town, Cape Town, South Africa
| | - Robert P Lamberts
- Department of Surgical Sciences, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.,Department of Surgical Sciences, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Institute of Sport and Exercise Medicine, Stellenbosch University, Tygerberg, South Africa
| | - A Graham Fieggen
- Department of Surgery, Faculty of Health Sciences, Neuroscience Institute and Division of Neurosurgery, University of Cape Town, Cape Town, South Africa
| | - Peter P J L Verkoeijen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Learning and Innovation Center, Avans University of Applied Sciences, Breda, The Netherlands
| | - Nelleke G Langerak
- Department of Surgery, Faculty of Health Sciences, Neuroscience Institute and Division of Neurosurgery, University of Cape Town, Cape Town, South Africa
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Bal MI, Roelofs PPDM, Hilberink SR, van Meeteren J, Stam HJ, Roebroeck ME, Miedema HS. Entering the labor market: increased employment rates of young adults with chronic physical conditions after a vocational rehabilitation program. Disabil Rehabil 2019; 43:1965-1972. [PMID: 31707868 DOI: 10.1080/09638288.2019.1687764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Employment of young adults with chronic physical conditions entering the labor market after finishing post-secondary education remains behind compared to typically developing peers. The aim of this study is to evaluate changes in their paid employment levels after following a vocational rehabilitation intervention ('At Work'). MATERIALS AND METHODS Participants aged between 16 and 27 years (n = 90) were recruited via rehabilitation physicians and a jobcoach agency and participated in a vocational rehabilitation program. Cochran's Q and McNemar tests served to test the development of intervention participants' paid employment over time. Chi-square tests were used to compare intervention participants' paid employment level with national reference data selected on age and having a self-reported chronic physical condition. RESULTS Paid employment level of the intervention cohort significantly increased from 10.0% at baseline to 42.4% at 2-years follow-up (p < 0.001). At 2-years follow-up, their employment rates approached the employment rates of national reference data (42.4% versus 52.9%, p = 0.17). CONCLUSION Starting from a disadvantaged position, the paid employment rate of the intervention cohort substantially increased over time, approaching the employment rate of reference data. 'At Work' seems to be appropriate for supporting this specific group who face obstacles to enter the labor market, to find competitive employment.IMPLICATIONS FOR REHABILITATION'At Work' is a vocational rehabilitation intervention for young adults with chronic physical conditions who experience problems with finding and maintaining competitive employment after finishing post-secondary education.The 'At Work' intervention entails a combination of group sessions and individual coaching sessions based on the supported employment methodology.Paid employment rates of the intervention cohort substantially increased on the short- and long term, and approached employment rates of reference data of persons with chronic physical conditions.The 'At Work' intervention seems appropriate to support young adults with chronic physical conditions who experience barriers for work participation, to enter the labor market and find competitive and sustainable employment.
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Affiliation(s)
- Marjolijn I Bal
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Pepijn P D M Roelofs
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Sander R Hilberink
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Henk J Stam
- Department of Rehabilitation Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.,Rijndam Rehabilitation, Rotterdam, The Netherlands
| | - Harald S Miedema
- Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
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Sakzewski L, Bleyenheuft Y, Boyd RN, Novak I, Elliott C, Reedman S, Morgan C, Pannek K, Fripp J, Golland P, Rowell D, Chatfield M, Ware RS. Protocol for a multisite randomised trial of Hand-Arm Bimanual Intensive Training Including Lower Extremity training for children with bilateral cerebral palsy: HABIT-ILE Australia. BMJ Open 2019; 9:e032194. [PMID: 31501133 PMCID: PMC6738737 DOI: 10.1136/bmjopen-2019-032194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Children with bilateral cerebral palsy often experience difficulties with posture, gross motor function and manual ability, impacting independence in daily life activities, participation and quality of life (QOL). Hand-Arm Bimanual Intensive Training Including Lower Extremity (HABIT-ILE) is a novel intensive motor intervention integrating upper and lower extremity training. This study aimed to compare HABIT-ILE to usual care in a large randomised controlled trial (RCT) in terms of gross motor function, manual ability, goal attainment, walking endurance, mobility, self-care and QOL. A within-trial cost-utility analysis will be conducted to synthesise costs and benefits of HABIT-ILE compared with usual care. METHODS AND ANALYSIS 126 children with bilateral cerebral palsy aged 6-16 years will be recruited across three sites in Australia. Children will be stratified by site and Gross Motor Function Classification System and randomised using concealed allocation to either receiving HABIT-ILE immediately or being waitlisted for 26 weeks. HABIT-ILE will be delivered in groups of 8-12 children, for 6.5 hours per day for 10 days (total 65 hours, 2 weeks). Outcomes will be assessed at baseline, immediately following intervention, and then retention of effects will be tested at 26 weeks. Primary outcomes will be the Gross Motor Function Measure and ABILHAND-Kids. Secondary outcomes will be brain structural integrity, walking endurance, bimanual hand performance, self-care, mobility, performance and satisfaction with individualised goals, and QOL. Analyses will follow standard principles for RCTs using two-group comparisons on all participants on an intention-to-treat basis. Comparisons between groups for primary and secondary outcomes will be conducted using regression models. ETHICS AND DISSEMINATION Ethics approval has been granted by the Medical Research Ethics Committee of Children's Health Queensland Hospital and the Health Service Human Research Ethics Committee (HREC/17/QRCH/282) of The University of Queensland (2018000017/HREC/17/QRCH/2820), and The Cerebral Palsy Alliance Ethics Committee (2018_04_01/HREC/17/QRCH/282). TRIAL REGISTRATION NUMBER ACTRN12618000164291.
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Affiliation(s)
- Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The Faculty of Medicine, University of Queensland, South Brisbane, Queensland, Australia
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The Faculty of Medicine, University of Queensland, South Brisbane, Queensland, Australia
| | - Iona Novak
- Cerebral Palsy Alliance, Brookvale, New South Wales, Australia
| | - Catherine Elliott
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Sarah Reedman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The Faculty of Medicine, University of Queensland, South Brisbane, Queensland, Australia
| | - Cathy Morgan
- Cerebral Palsy Alliance, Brookvale, New South Wales, Australia
| | - Kerstin Pannek
- CSIRO Health and Biosecurity, CSIRO Australian e-Health Research Centre, Herston, Queensland, Australia
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, CSIRO Australian e-Health Research Centre, Herston, Queensland, Australia
| | - Prue Golland
- Cerebral Palsy Alliance, Brookvale, New South Wales, Australia
| | - David Rowell
- Faculty of Business, Economics and Law, University of Queensland, Wooloongabba, Queensland, Australia
| | - Mark Chatfield
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The Faculty of Medicine, University of Queensland, South Brisbane, Queensland, Australia
| | - Robert Stuart Ware
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
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Smits DW, van Gorp M, van Wely L, Verheijden J, Voorman J, Wintels S, van der Cruijsen J, Ketelaar M. Participation in Social Roles of Adolescents With Cerebral Palsy: Exploring Accomplishment and Satisfaction. Arch Rehabil Res Clin Transl 2019; 1:100021. [PMID: 33543052 PMCID: PMC7853369 DOI: 10.1016/j.arrct.2019.100021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective To explore participation in social roles of adolescents (aged 12-18y) with cerebral palsy (CP), in terms of satisfaction compared with accomplishment. Design Cohort study as part of a prospective longitudinal research program. Setting Clinic. Participants Participants were adolescents (N=45; 58% male, mean age 15y 6mo) with CP at levels I-II (88%) and III-IV-V (12%) of the Gross Motor Function Classification System. Interventions Not applicable. Main Outcome Measures Accomplishment (0-9 scale; with score <8 “having difficulties”) and satisfaction (1-5 scale; with score 3 “neutral”) were assessed using the Life-Habits questionnaire, on 6 domains (Responsibilities, Interpersonal relationships, Community life, Education, Employment, Recreation). Per domain, we analyzed scatterplots of accomplishment vs satisfaction. Additionally, we compared determinant-models (including factors of CP, activity, person, and environment) using regression analysis. Results For accomplishment, mean scores were <8.00 except for Interpersonal relationships. For satisfaction, mean scores varied between 3.85 and 4.34. Overall, individuals with similar levels of accomplishment showed large ranges in their levels of satisfaction, which was expressed by low explained variances, especially on Education (6%). Furthermore, different sets of determinants were found for accomplishment (predominantly CP factors) compared with satisfaction (predominantly environment factors). Conclusions This study revealed a dissociation between participation accomplishment and satisfaction with participation among adolescents with CP. For practice and research, we recommend not only to focus on accomplishment but also, if not mainly, on satisfaction.
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Key Words
- Adolescent
- CP, cerebral palsy
- Cerebral palsy
- GMFCS, Gross Motor Function Classification System
- GMFM, Gross Motor Function Measure
- ICF, International Classification of Functioning, Disability, and Health
- Life-H, Life Habits questionnaire
- MACS, Manual Ability Classification System
- PEDI, Pediatric Evaluation of Disability Inventory
- PERRIN, Pediatric Rehabilitation Research in the Netherlands
- Personal satisfaction
- PiP, Participation in Perspective
- Rehabilitation
- Social participation
- UCL, Utrecht Coping List
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Affiliation(s)
- Dirk-Wouter Smits
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marloes van Gorp
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Leontien van Wely
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Johannes Verheijden
- BOSK, Association of Persons with a Physical Disability, Utrecht, The Netherlands
| | - Jeanine Voorman
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sophie Wintels
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Joyce van der Cruijsen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Corresponding author Marjolijn Ketelaar, PhD, Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Rembrandtkade 10, 3583 TM Utrecht, The Netherlands.
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van Gorp M, E Roebroeck M, van Eck M, M Voorman J, Twisk JWR, J Dallmeijer A, van Wely L. Childhood factors predict participation of young adults with cerebral palsy in domestic life and interpersonal relationships: a prospective cohort study. Disabil Rehabil 2019; 42:3162-3171. [PMID: 31060408 DOI: 10.1080/09638288.2019.1585971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To determine childhood predictors of participation in domestic life and interpersonal relationships of young adults with cerebral palsy (CP).Materials and methods: This 13-year follow-up of an existing cohort (baseline age 9-13 years) included 67 young adults with CP (age 21-27 years). The Vineland adaptive behavior scales (VABS) and Life Habits questionnaire were used to assess attendance and difficulty in participation in domestic life and interpersonal relationships. Baseline factors were categorised according to the international classification of functioning, disability, and health. Stepwise multiple linear regression analyses determined significant predictors (p < 0.05).Results: Lower manual ability, intellectual disability (ID), epilepsy and lower motor capacity predicted decreased future participation in domestic life, and/or interpersonal relationships (explained variance R2 = 67-87%), whereas no association was found with environmental and personal factors. Extending models with baseline fine motor skills, communication, and interpersonal relationships increased R2 to 79-90%.Conclusions: Childhood factors account for 79-90% of the variation in young adult participation in domestic life and interpersonal relationships of individuals with CP. Children with limited motor capacity, low manual ability, ID, or epilepsy are at risk for restrictions in participation in young adulthood. Addressing fine motor, communication, and social skills in paediatric rehabilitation might promote young adult participation.Implications for rehabilitationChildhood risk factors for limited participation in domestic life and interpersonal relationships as a young adult with CP are ID, epilepsy, low manual ability, low motor capacity, and low activity & participation levels.In line with current practice, this study confirms the importance of addressing gross and fine motor skills in children with CP for their future participation in domestic life.In addition, results suggest that addressing communication and social skills during paediatric rehabilitation may optimise future participation in interpersonal relationships.
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Affiliation(s)
- Marloes van Gorp
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Rijndam Rehabilitation, Rotterdam, The Netherlands
| | - Mirjam van Eck
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,HU University of Applied Sciences, Utrecht, The Netherlands
| | - Jeanine M Voorman
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annet J Dallmeijer
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Leontien van Wely
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Cherriere C, Robert M, Fung K, Tremblay Racine F, Tallet J, Lemay M. Is there evidence of benefits associated with dancing in children and adults with cerebral palsy? A scoping review. Disabil Rehabil 2019; 42:3395-3402. [PMID: 30973761 DOI: 10.1080/09638288.2019.1590866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Purpose: Cerebral palsy is a neurological disorder not only affecting motor functions but also cognitive and psychosocial dimension. Multispecialty therapies are needed to address these dimensions. Dance practice provides multidimensional benefits for people with various neurological disorders and may present a real potential for people with cerebral palsy. A scoping review is conducted to evaluate the impact of dance in children and adults with cerebral palsy, based on the Human Development Model-Disability Creation Process 2 and its three key concepts: personal factors, environmental factors and life habits.Materials and methods: Studies were selected based on a systematic search of published literature in the following databases PubMed, Medline, EBM Reviews, EMBASE and CINAHL. Studies addressing any concepts on the impact of dance training on motor, cognitive and psychosocial dimensions in people with cerebral palsy were included.Results: Seven studies representing 45 children and 12 adults with cerebral palsy were selected. They had heterogeneous populations, protocols and outcomes measures, but overall covered the three main concepts of the model. Dance may have both motor and social benefits although the evidence remains weak.Conclusions: Dance appears to be a promising activity for people with cerebral palsy. Recommendations are proposed for future studies.Implications for rehabilitationCerebral palsy affects motor and cognitive functions and has social repercussions.Dance can be a promising activity for people with a cerebral palsy.Dance may have both motor and social benefits although the evidence remains weak.
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Affiliation(s)
- Claire Cherriere
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montréal, Canada.,ToNIC Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Maxime Robert
- Department of Biobehavioral Sciences, Columbia University, New York, USA
| | - Karen Fung
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montréal, Canada.,Ecole de réadaptation, Université De Montréal, Montréal, Canada
| | - Fannie Tremblay Racine
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montréal, Canada
| | - Jessica Tallet
- ToNIC Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Martin Lemay
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montréal, Canada.,Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montréal, Canada
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van Gorp M, Van Wely L, Dallmeijer AJ, de Groot V, Ketelaar M, Roebroeck ME. Long-term course of difficulty in participation of individuals with cerebral palsy aged 16 to 34 years: a prospective cohort study. Dev Med Child Neurol 2019; 61:194-203. [PMID: 30187926 PMCID: PMC7379932 DOI: 10.1111/dmcn.14004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2018] [Indexed: 11/29/2022]
Abstract
AIM To determine the long-term course of difficulty in participation of individuals with cerebral palsy (CP) without intellectual disability between 16 years and 34 years of age. METHOD One hundred and fifty-one individuals with CP aged 16 to 20 years were included (63% male, 37% female; Gross Motor Function Classification System [GMFCS] levels I-IV; without intellectual disability). The Assessment of Life Habits questionnaire 3.0 general short form was used up to three times biennially and at 13-year follow-up (13-year follow-up: n=98). Scores (range 0-10) reflect difficulty and assistance in participation in housing, education and employment, interpersonal relationships, recreation, community life, and responsibilities. Multilevel models were used to determine the course of difficulty in participation by GMFCS level. RESULTS Despite high average participation levels, 41% to 95% of adolescents and young adults with CP experienced difficulty. Difficulty in participation in housing and interpersonal relationships increased from age 16 years onwards and in most other life areas in the mid- and late 20s. In adolescents in GMFCS levels III and IV, participation in recreation and community life improved up to age 23 years. INTERPRETATION Individuals with CP experience increasing difficulties in participation in their mid- and late 20s. Clinicians should systematically check for participation difficulties in young adults with CP and offer timely personalized treatment. WHAT THIS PAPER ADDS Many individuals with cerebral palsy (CP) aged 16 to 34 years experience difficulty in participation. Difficulty in participation increases in the mid- and late 20s for individuals with CP. Participation in recreation/community life improves before age 23 years for those in Gross Motor Function Classification System levels III and IV.
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Affiliation(s)
- Marloes van Gorp
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Leontien Van Wely
- Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Annet J Dallmeijer
- Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Vincent de Groot
- Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam UMCVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation MedicineBrain Center Rudolf MagnusUniversity Medical Center UtrechtDe Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam Rehabilitation InstituteRotterdamthe Netherlands
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Maximizing Participation During Walking in Children With Disabilities: Is Response to Unpredictability Important? Pediatr Phys Ther 2019; 31:122-127. [PMID: 30507853 DOI: 10.1097/pep.0000000000000575] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Walking ability is one of the primary components of human motor function, and interventions aimed at improving walking ability are common in physical therapy, particularly in children. One element encountered in a participatory, or natural, environment is unpredictability, defined as the presence of an unexpected obstacle, stimulus, or alteration of the environmental conditions. Little research has assessed the influence of unpredictability on biomechanical adaptations to walking in children who are developing typically or children with motor disabilities. A variety of impairments may result in an inadequate response to unpredictability, and we propose that there may be a relationship between response to an unpredictable visual cue and mobility-based participation.
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Altschuck N, Bauer C, Nehring I, Böhm H, Jakobeit M, Schröder AS, Mall V, Jung NH. Efficacy of prefabricated carbon-composite ankle foot orthoses for children with unilateral spastic cerebral palsy exhibiting a drop foot pattern. J Pediatr Rehabil Med 2019; 12:171-180. [PMID: 31227662 DOI: 10.3233/prm-170524] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE This study aims to evaluate the effectiveness of a prefabricated carbon-composite ankle foot orthoses (c-AFOs) on gait parameters in children with unilateral spastic cerebral palsy (USCP) exhibiting a drop foot pattern. METHODS Sixteen ambulatory children with USCP and a drop foot pattern were included (mean age: 9 years; gross motor function classification system: I = 14, II = 2) and three-dimensional gait analysis was applied under randomly assigned conditions (barefoot; shoe; c-AFO). Kinematics, kinetics, time-distance parameters and gait indices were investigated. RESULTS Effects on the drop foot pattern were investigated while the children walked in shoes only. The shoes already increased the maximum ankle dorsiflexion in swing (p= 0.004) and initiated more knee flexion during single support (p⩽ 0.013). Compared to shoe walking, the c-AFO led to additional benefits regarding further ankle dorsiflexion during swing (p⩽ 0.001) and initial contact (p< 0.001), ankle movement during loading response (p= 0.002), improved the sole angle during initial contact (p< 0.001) and during mid stance (p= 0.015). Plantarflexion and ankle power generation during push-off decreased when wearing the c-AFO (p⩽ 0.008). CONCLUSION Investigated c-AFOs are beneficial for improving drop foot patterns in children with USCP. Significant effects on pathological barefoot pattern were already achieved with the child's regular shoes. This could be considered in clinical decision processes. In comparison to shoe walking, c-AFO additionally improved foot clearance and normalized initial heel contact. The third rocker deteriorates with the c-AFO. Since kinematics improved with the orthoses during swing and early stance phase, c-AFOs might reduce tripping and falling caused by a drop foot during long distance walking.
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Affiliation(s)
- Natalie Altschuck
- School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany
| | | | - Ina Nehring
- School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany
| | - Harald Böhm
- Behandlungszentrum Aschau, Aschau im Chiemgau, Germany
| | | | - A Sebastian Schröder
- Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.,Center of Vertigo and Balance Disorders, IFBLMU, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Volker Mall
- School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany.,kbo-Kinderzentrum München, Munich, Germany
| | - Nikolai H Jung
- School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany.,kbo-Kinderzentrum München, Munich, Germany
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van Gorp M, Roebroeck ME, Swan Tan S, de Groot V, Gorter JW, Smits DW, Schmidt AK, Dallmeijer AJ. Activity Performance Curves of Individuals With Cerebral Palsy. Pediatrics 2018; 142:peds.2017-3723. [PMID: 30287591 DOI: 10.1542/peds.2017-3723] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2018] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5804911840001PEDS-VA_2017-3723Video Abstract OBJECTIVES: Describe development curves of motor and daily activity performance in individuals with cerebral palsy (CP). METHODS Participants with CP aged 1 to 20 years at baseline (n = 421) and Gross Motor Functioning Classification System (GMFCS) levels I to V (27% of participants with intellectual disability [ID]) were longitudinally assessed up to a 13-year follow-up period. Motor and daily activity performance were assessed using the relevant subdomains of the Vineland Adaptive Behavior Scales survey. Nonlinear mixed effects analyses were used, estimating the limit (average maximal performance level) and the age by which individuals reached 90% of the limit (age90). RESULTS Limits of motor performance decreased with each lower functional level. Age90 for motor performance was reached at ∼6 to 8 years of age in children with GMFCS levels I to III, and at younger ages in those with lower functional levels. Limits of daily activity performance did not differ between individuals without ID with GMFCS levels I to III. The age90s of daily activities were reached between 11 and 14 (personal), 26 and 32 (domestic), and 22 and 26 years of age (community). Individuals with ID reached lower daily activity performance limits earlier. CONCLUSIONS Individuals with CP continue to develop motor performance after gross motor capacity limits are reached. For those without ID, daily activities continue to develop into their 20s. Individuals who are severely affected functionally have the least favorable development of motor performance, and those with ID have the least favorable development of daily activity performance.
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Affiliation(s)
- Marloes van Gorp
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; .,Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Siok Swan Tan
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Vincent de Groot
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research and Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; and
| | - Dirk-Wouter Smits
- Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Ann Katrin Schmidt
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Annet J Dallmeijer
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
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Prosser LA, Pierce SR, Dillingham TR, Bernbaum JC, Jawad AF. iMOVE: Intensive Mobility training with Variability and Error compared to conventional rehabilitation for young children with cerebral palsy: the protocol for a single blind randomized controlled trial. BMC Pediatr 2018; 18:329. [PMID: 30326883 PMCID: PMC6192360 DOI: 10.1186/s12887-018-1303-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 10/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is the most common cause of physical disability in children. The best opportunity to maximize lifelong independence is early in motor development when there is the most potential for neuroplastic change, but how best to optimize motor ability during this narrow window remains unknown. We have systematically developed and pilot-tested a novel intervention that incorporates overlapping principles of neurorehabilitation and infant motor learning in a context that promotes upright mobility skill and postural control development. The treatment, called iMOVE therapy, was designed to allow young children with CP to self-initiate motor learning experiences similar to their typically developing peers. This manuscript describes the protocol for a subsequent clinical trial to test the efficacy of iMOVE therapy compared to conventional therapy on gross motor development and other secondary outcomes in young children with CP. METHODS The study is a single-blind randomized controlled trial. Forty-two participants with CP or suspected CP between the ages of 1-3 years will be randomized to receive either the iMOVE or conventional therapy group. Distinguishing characteristics of each group are detailed. Repeated measures of gross motor function will be collected throughout the 12-24 week intervention phase and at three follow-up points over one year post therapy. Secondary outcomes include measures of postural control, physical activity, participation and caregiver satisfaction. DISCUSSION This clinical trial will add to a small, but growing, body of literature on early interventions to optimize the development of motor control in young children with CP. The information learned will inform clinical practice of early treatment strategies and may contribute to improving the trajectory of motor development and reducing lifelong physical disability in individuals with CP. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02340026 . Registered January 16, 2015.
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Affiliation(s)
- Laura A. Prosser
- Division of Rehabilitation Medicine, The Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Samuel R. Pierce
- Division of Rehabilitation Medicine, The Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
- Widener University, Institute for Physical Therapy Education, One University Place, Chester, PA 19013 USA
| | - Timothy R. Dillingham
- Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Judy C. Bernbaum
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
- Division of General Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104 USA
| | - Abbas F. Jawad
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
- Division of General Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104 USA
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Chae S, Park EY, Choi YI. The psychometric properties of the Childhood Health Assessment Questionnaire (CHAQ) in children with cerebral palsy. BMC Neurol 2018; 18:151. [PMID: 30236077 PMCID: PMC6149205 DOI: 10.1186/s12883-018-1154-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/14/2018] [Indexed: 12/22/2022] Open
Abstract
Background The evaluation of children with cerebral palsy (CP) focuses on activity level measurement to examine the effect of health-care interventions on their physical functioning in the home, school, and community settings. This study aimed to identify the psychometric properties of the Korean version of the Childhood Health Assessment Questionnaire (CHAQ) by applying the Rasch model. The use of the Rasch model has an advantage in that item characteristic curve estimation is not affected by the characteristics of subject groups. Methods Data were collected from 65 children with CP aged 75–190 months using the Korean version of the CHAQ. Response data were analyzed according to the Rasch model, and item fitness and difficulty and the appropriateness and reliability of the rating scale were evaluated. Results Among the 30 items of the Korean version of the CHAQ, two items (nail-cutting and opening a bottle cap that was already opened) were shown to be misfit items with low fitness. The analysis results for item difficulty indicated the requirement for modification of item difficulty, pointing out the need for the addition of question items with both higher and lower difficulty. The use of 4-point rating scale in the evaluation questionnaire was shown to be appropriate. With respect to analysis outcomes, the subjects’ separation reliability value and separation index were 0.97 and 5.92, respectively. In contrast, the separation reliability value and separation index for the question items were 0.95 and 4.51, respectively. Conclusions The results of this study suggest the need for the modification of item fitness and difficulty. The psychometric properties of the Korean version of the CHAQ were identified using the item response theory-based Rasch analysis.
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Affiliation(s)
- Soojung Chae
- Department of Secondary Special Education, College of Education, Jeonju University, 1200 3-ga, Hyoja-dong, Wansan-gu, Jeonju, 560-759, South Korea
| | - Eun-Young Park
- Department of Secondary Special Education, College of Education, Jeonju University, 1200 3-ga, Hyoja-dong, Wansan-gu, Jeonju, 560-759, South Korea
| | - Yoo-Im Choi
- Department of Occupational Therapy, School of Medicine and Institute for Health Improvement, Wonkwang University, Iksan, South Korea.
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Wintels SC, Smits DW, van Wesel F, Verheijden J, Ketelaar M. How do adolescents with cerebral palsy participate? Learning from their personal experiences. Health Expect 2018; 21:1024-1034. [PMID: 29858544 PMCID: PMC6250857 DOI: 10.1111/hex.12796] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2018] [Indexed: 11/30/2022] Open
Abstract
Background Participation in society can be difficult for adolescents with cerebral palsy (CP). Information is often based on quantitative studies, and little is known about their personal participation experiences. Objective The aim of this study was to examine the participation experiences of adolescents (aged 12‐17 years) with CP. Methods A qualitative participatory research method was used. Twenty‐three semi‐structured open interviews were conducted with 13 male and 10 female adolescents (mean age 15 years) with CP. An interview checklist was developed jointly with adolescents with CP. This checklist ensured that the adolescents reflected on various participation areas, that is school, sports, health care and work. The analysis was based on principles of grounded theory. Findings From the adolescents’ experiences, 4 key categories were identified. One concerned participation, as such, expressed as “My participation experiences,” including experiences, thoughts and feelings while participating in daily life. Three other categories concerned factors that influence participation experiences, expressed as “My disability,” “Me as a person” and “My environment.” These 4 categories together formed a model showing the interactions and dynamics of participation according to adolescents with CP. Conclusion Adolescents with CP expressed their participation experiences, including various important influencing factors. This study conceptualized these experiences into a dynamic model. This experience‐based participation model may provide new, personalized perspectives for practice, for instance in rehabilitation, but also for schools and sports (or sports clubs) attended by adolescents. Focusing on personal and environmental factors might be the key to successful participation.
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Affiliation(s)
- Sophie Catharina Wintels
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, University Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Dirk-Wouter Smits
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, University Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Floryt van Wesel
- Department of Methodology & Statistics, Utrecht University, Utrecht, The Netherlands
| | | | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, University Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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Remijn L, van den Engel-Hoek L, Satink T, de Swart BJM, Nijhuis-van der Sanden MWG. "Everyone sees you sitting there struggling with your food": experiences of adolescents and young adults with cerebral palsy. Disabil Rehabil 2018; 41:1898-1905. [PMID: 29558834 DOI: 10.1080/09638288.2018.1451923] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective: The impact of difficulties with eating and drinking in adolescents and young adults with cerebral palsy is unknown. The purpose of this study is to find out which difficulties adolescents and young adults with cerebral palsy experience with eating and drinking in daily life and how they deal with these difficulties. The study also explores how they think about themselves with respect to eating and what does or does not help regarding social participation. Method: We collected the data from ten participants with spastic cerebral palsy (aged 15-23 years) living in the Netherlands. We used a qualitative study design with a conventional content analysis. Semi-structured in-depth interviews were used to identify meaningful factors related to eating and drinking difficulties. We coded relevant phrases from each interview and clustered and synthesized them into categories. Result: We derived four categories from the transcripts: (I) perceived eating and drinking difficulties (e.g., not managing to eat all food textures and/or choking); (II) challenges in physical and social context (e.g., accessibility of restaurants, menu supply, and/or needing assistance or not); (III) dealing with eating and drinking difficulties (e.g., adaptation, food avoidance, and/or giving up); (IV) Negative feelings about their eating and drinking (e.g., shame, frustration, fear for choking, and/or concerns about the future). One striking finding was that most participants had not recently received either monitoring or intervention for their feeding skills. Conclusion: This study shows that adolescents and young adults with cerebral palsy experience many restrictions in eating and drinking situations leading to negative feelings and lower participation levels, while little attention is directed towards these difficulties. Regular multidisciplinary rehabilitation programs should include evaluation, advice, and intervention regarding eating and drinking ability in order to increase social participation and self-management. Implications for Rehabilitation Adolescents and young adults with cerebral palsy experience difficulties with eating, drinking, and swallowing, and they encounter difficulties in participating in mealtimes with family and friends. Although adolescents and young adults with cerebral palsy rated their eating and drinking abilities as reasonable, they reported feelings of shame, frustration, fear, distress, and concerns for the future or unknown environments. Regular multidisciplinary involvement with eating and drinking is needed for purposes of evaluation, advice, and intervention throughout the life course, adjusted to living conditions and the latest evidence. Adolescents and young adults with cerebral palsy showed limited initiative in asking for personal assistance in eating and drinking activities.
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Affiliation(s)
- Lianne Remijn
- a HAN University of Applied Sciences , Institute of Health Studies , Nijmegen , The Netherlands.,b Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare , Nijmegen , The Netherlands
| | - Lenie van den Engel-Hoek
- c Donders Centre for Neuroscience, Department of Rehabilitation , Radboud University Medical Center , Nijmegen , The Netherlands
| | - Ton Satink
- a HAN University of Applied Sciences , Institute of Health Studies , Nijmegen , The Netherlands
| | - Bert J M de Swart
- a HAN University of Applied Sciences , Institute of Health Studies , Nijmegen , The Netherlands.,c Donders Centre for Neuroscience, Department of Rehabilitation , Radboud University Medical Center , Nijmegen , The Netherlands
| | - Maria W G Nijhuis-van der Sanden
- b Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare , Nijmegen , The Netherlands.,c Donders Centre for Neuroscience, Department of Rehabilitation , Radboud University Medical Center , Nijmegen , The Netherlands
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Czapla K, Otrębski W. Differences in Sexual Behavior of Teenagers and Young Adults with Cerebral Palsy: The Role of Sexual Needs and Sexual Esteem. SEXUALITY AND DISABILITY 2017; 36:33-46. [PMID: 29568142 PMCID: PMC5847148 DOI: 10.1007/s11195-017-9512-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Sexuality is an inherent attribute of all human beings regardless of their race, religion and the level of physical fitness. The way it is perceived and manifested is determined by a number of biopsychosocial factors. In some people, including persons with cerebral palsy, the factors and their influence are rooted in the psychophysical condition of the human body. The aim of this study was to answer the question about how the levels of sexual esteem and sexual needs differentiate the sexual behaviors of young people with cerebral palsy. The study being presented was conducted with 62 young persons with cerebral palsy (half women and half men), who were selected using purposive sampling. They were aged 15-25 years and were individuals without cognitive difficulties. The research tool used was the Cerebral Palsy Individual's Sexual Behavior Questionnaire developed by the authors. The findings of the study showed that half of the participants engaged in various sexual behaviors from the list that was presented to them. The frequencies of these engagements depended on the levels of their sexual esteem and sexual needs. Persons characterized by high levels of sexual esteem and sexual needs (much fewer than those with the low levels of both characteristics) engaged in sexual behaviors significantly more frequently. The most frequent among them was direct engagement in sexual activity (petting and sexual intercourse; p ≤ .001) and then exposure to sexually explicit magazines or films (p ≤ .05).
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Affiliation(s)
- Klaudia Czapla
- The John Paul II Catholic University of Lublin, Al. Racławickie 14, 20-950 Lublin, Poland
| | - Wojciech Otrębski
- The John Paul II Catholic University of Lublin, Al. Racławickie 14, 20-950 Lublin, Poland
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González-Alonso MY, García-Moltó A, Ovejero Bruna MM. Envejecimiento en parálisis cerebral, un reto en investigación e innovación: revisión sistemática. UNIVERSITAS PSYCHOLOGICA 2017. [DOI: 10.11144/javeriana.upsy16-3.epcr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Apenas existen iniciativas de investigación en el ámbito del envejecimiento activo y saludable de las personas con parálisis cerebral. Encontrar soluciones a este reto social requiere una red de excelencia en investigación que contribuya a vivir mejor a toda la sociedad. Se recopiló información sobre parálisis cerebral y envejecimiento concretamente sobre necesidades percibidas, calidad de vida y repercusión del envejecimiento en las personas con parálisis cerebral. Se revisaron los conceptos que constituyen el marco teórico para investigar. A continuación se analizó la literatura encontrada sobre el proceso de envejecimiento. Por último se recogieron atendiendo a los principios de igualdad de oportunidades, no discriminación y accesibilidad universal, líneas de actuación a tener en cuenta por los investigadores en el desarrollo de actividades innovadoras. Invertir en investigación e innovación es esencial para el futuro, es la manera de impulsar productos y servicios y así crear una sociedad mejor para todos los ciudadanos.
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van der Holst M, Groot J, Steenbeek D, Pondaag W, Nelissen RG, Vliet Vlieland TP. Participation restrictions among adolescents and adults with neonatal brachial plexus palsy: the patient perspective. Disabil Rehabil 2017; 40:3147-3155. [PMID: 28944700 DOI: 10.1080/09638288.2017.1380717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To examine the impact of neonatal brachial plexus palsy (NBPP) on societal participation of adolescents and adults. METHODS This cross-sectional study was conducted among patients with NBPP, aged ≥16 years, who had visited our NBPP clinic. Patients completed questions on the influence of NBPP on their choices regarding education/work and their work-performance, the Impact on Participation/Autonomy questionnaire and the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P). In addition, health-related quality of life (HRQoL) was assessed. RESULTS Seventy-five patients participated (median age 20, inter quartile range 17-27). Twenty were full-time students, 28 students with a job, 21 employed, two unemployed, and four work-disabled. Sixty-six patients had had a job at some stage. Patients' overall HRQoL was comparable to the general population. 27/75 patients reported that NBPP had affected their choices regarding education and 26/75 those regarding work. 33/66 reported impact on their work performance. On the Impact on Participation/Autonomy questionnaire, 80% (49/61) reported restrictions in the work-and-education domain, 74% in social-relations and 67% in autonomy-outdoors. 37/61 reported participation restrictions on the USER-P. CONCLUSIONS Although their overall HRQoL was not impaired, a substantial proportion of adolescent/adult patients reported that NBPP had an impact on choices regarding education and profession, as well as on work-performance. Restrictions in participation, especially in work and education were also reported. Guiding patients in making choices on education and work at an early stage and providing tailored physical as well as psychosocial care may prevent or address restrictions, which may improve participation. Implications for Rehabilitation Adolescent and adult patients with neonatal brachial plexus palsy perceive restrictions in societal participation, especially regarding the work-and-education domain. All patients with neonatal brachial plexus palsy may perceive restrictions in societal participation regardless of lesion severity, treatment history and side of the lesion. Adolescents and adults with neonatal brachial plexus palsy report that their choices regarding education and work, as well as their work-performance are influenced by their neonatal brachial plexus palsy. Patients with neonatal brachial plexus palsy should be followed throughout their life in order to provide them with appropriate information and treatment when health- or participation-related issues arise. Rehabilitation treatment is the best option to address all of the aforementioned issues, as surgical options in adolescents and adults are limited.
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Affiliation(s)
- Menno van der Holst
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands.,b Rijnlands Rehabilitation Center , Leiden , The Netherlands
| | - Jeroen Groot
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands.,c Sophia Rehabilitation , The Hague , The Netherlands
| | - Duco Steenbeek
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands.,b Rijnlands Rehabilitation Center , Leiden , The Netherlands
| | - Willem Pondaag
- d Department of Neurosurgery , Leiden University Medical Center , Leiden , The Netherlands
| | - Rob Ghh Nelissen
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands
| | - Thea Pm Vliet Vlieland
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands.,b Rijnlands Rehabilitation Center , Leiden , The Netherlands.,c Sophia Rehabilitation , The Hague , The Netherlands
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Dance Improves Functionality and Psychosocial Adjustment in Cerebral Palsy. Am J Phys Med Rehabil 2017; 96:424-429. [DOI: 10.1097/phm.0000000000000646] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bal MI, Sattoe JNT, van Schaardenburgh NR, Floothuis MCSG, Roebroeck ME, Miedema HS. A vocational rehabilitation intervention for young adults with physical disabilities: participants' perception of beneficial attributes. Child Care Health Dev 2017; 43:114-125. [PMID: 27704596 DOI: 10.1111/cch.12407] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 06/09/2016] [Accepted: 08/07/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Finding and maintaining employment is a major challenge for young adults with physical disabilities and their work participation rate is lower than that of healthy peers. This paper is about a program that supports work participation amongst young adults with chronic physical disabilities. The study aims to explore their experienced barriers and facilitators for finding and maintaining employment after starting this program, the participant-perceived beneficial attributes of the program and participants' recommendations for additional intervention components. METHODS Semi-structured interviews (n = 19) were held with former intervention participations. Interviews were recorded and transcribed ad verbatim. Themes were derived using the phenomenological approach. RESULTS Physical functions and capacities, supervisor's attitude, self-esteem and self-efficacy and openness and assertiveness were experienced barriers and facilitators for finding and maintaining employment. Improvement of self-promoting skills and disclosure skills through job interview-training, increased self-esteem or self-efficacy through peer-support, a suitable job through job placement, improvement of work ability through arrangement of adjusted work conditions and change of supervisor's attitude through education provided to the supervisor were perceived as beneficial attributes of the intervention. Respondents recommended to incorporate assertiveness and openness skills training into future intervention programs. CONCLUSIONS The findings suggest that programs supporting work participation should be designed to provide challenging, real-world experiential opportunities that provide young adults with physical disabilities with new insights, self-efficacy and life skills. Also, such programs should facilitate context centered learning. Former intervention participants, therefore, evaluated job-interview training, sharing learning and social experiences with peers, job placement, arrangement of adjusted work conditions and education as beneficial attributes of the 'At Work' program. In addition, they recommended, to incorporate more training on assertiveness and disclosure. We advise professionals to include these beneficial attributes in similar interventions in other contexts.
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Affiliation(s)
- M I Bal
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.,Erasmus University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands
| | - J N T Sattoe
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands.,Erasmus University Rotterdam, Department of Health Policy & Management, Rotterdam, The Netherlands
| | | | | | - M E Roebroeck
- Erasmus University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.,Rijndam Rehabilitation Institute, Rotterdam, The Netherlands
| | - H S Miedema
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands
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Teixeira JS, Santos LMLDJ, Santos NLD, Casali CCC, Chaves CMCM. A case study of the effect of cardiovascular training on cerebral palsy. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/1980-5918.029.004.ao07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Cerebral palsy (CP) is a non-progressive disorder characterized by changes in muscle tone and voluntary movement, leading to adaptive changes in muscle length and in some cases, resulting in bone deformities and increased energy expenditure while performing activities of daily living. Objective: The aim of this study was to investigate the effects of cardiovascular training by an adult with athetoid CP. Methods: The sample was composed of one patient with athetoid CP. The instruments used were the timed ten-meter walk test; the SF-36 quality of life questionnaire, a six-minute walk test and the Timed Up and Go test. Using an exercise bike and resistance exercises for the upper limbs, the patient underwent 24 sessions lasting fifty minutes each during eight weeks. Results: In all tests, significant improvement was observed at four and eight weeks, especially in the first four, and progressed in the following four weeks. In the post-training period, improvement was observed when compared to pre-training values. The SF-36 questionnaire on quality of life showed increase in some areas and decrease in others. Conclusion: Patients with CP can benefit from a physical training program, which can improve their quality of life and be included in their rehabilitation protocol.
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Tan SS, van der Slot WMA, Ketelaar M, Becher JG, Dallmeijer AJ, Smits DW, Roebroeck ME. Factors contributing to the longitudinal development of social participation in individuals with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 57:125-135. [PMID: 27423104 DOI: 10.1016/j.ridd.2016.03.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 03/23/2016] [Accepted: 03/29/2016] [Indexed: 06/06/2023]
Abstract
AIMS We aimed to determine factors associated with the longitudinal development of social participation in a Dutch population of individuals with Cerebral Palsy (CP) aged 1-24 years. METHODS AND PROCEDURES For this multicentre prospective longitudinal study, 424 individuals with CP aged 1-24 years were recruited from various rehabilitation centers in The Netherlands. Social participation was measured with the Vineland Adaptive Behavior Scales. We assessed associations with age, intellectual impairment, level of gross motor function, gender, type of CP, manual ability, epilepsy, hearing-, visual-, speech impairment and pain, internalizing- and externalizing behavioral problems, type of education and parental level of education. Each individual was measured 3 or 4 times. The time between measurements was 1 or 2 years. OUTCOMES AND RESULTS Epilepsy and speech impairment were each independently associated with the longitudinal development of social participation. The effects were rather small and did not change with age. Also, a trend was found that children attending special education develop less favorably in social participation. CONCLUSIONS AND IMPLICATIONS Our results might provide parents and caregivers with starting points to further develop tailored support for individuals with epilepsy, with speech impairment and/or attending special education at risk for suboptimal social participation.
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Affiliation(s)
- Siok Swan Tan
- Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute for Medical Technology Assessment, Rotterdam, The Netherlands.
| | - Wilma M A van der Slot
- Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands; Rijndam Rehabilitation Institute, Rotterdam, The Netherlands
| | - Marjolijn Ketelaar
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, The Netherlands; Partner of NetChild, Network for Childhood Disability Research, The Netherlands
| | - Jules G Becher
- VU University Medical Center, department of Rehabilitation Medicine, Amsterdam, The Netherlands
| | - Annet J Dallmeijer
- VU University Medical Center, department of Rehabilitation Medicine, Amsterdam, The Netherlands
| | - Dirk-Wouter Smits
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, The Netherlands; Partner of NetChild, Network for Childhood Disability Research, The Netherlands
| | - Marij E Roebroeck
- Erasmus MC University Medical Center, Department of Rehabilitation Medicine, Rotterdam, The Netherlands; Rijndam Rehabilitation Institute, Rotterdam, The Netherlands
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