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Brien M, Krishna D, Ponnusamy R, Cameron C, Moineddin R, Coutinho F. Motor development trajectories of children with cerebral palsy in a community-based early intervention program in rural South India. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 154:104829. [PMID: 39321692 DOI: 10.1016/j.ridd.2024.104829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/02/2024] [Accepted: 09/05/2024] [Indexed: 09/27/2024]
Abstract
BACKGROUND Developmental trajectories are crucial for evidence-based prognostication, planning interventions, and monitoring progress in children with cerebral palsy (CP). AIMS To describe gross motor development patterns of children with CP in rural South India for the five Gross Motor Function Classification System (GMFCS) levels. METHODS Longitudinal cohort study of 302 children (176 males, 126 females) with CP aged 0 to 10 years, followed by a community-based early intervention program. GMFCS levels were 5.4 % level 1, 16.5 % level II, 22.8 % level III, 26.8 % level IV, and 28.5 % level V. Assessments were undertaken using the Gross Motor Function Measure (GMFM-66) at 6-month intervals between April 2017 and August 2020. Longitudinal analyses were performed using mixed-effects linear regression models. OUTCOMES AND RESULTS Five distinct motor development curves were created for ages 0 to 10 years by GMFCS levels as a function of age and GMFM-66 with a stable limit model, variation in estimated limits and rates of development. CONCLUSIONS AND IMPLICATIONS Motor development trajectories for CP in an LMIC differ from those reported in HICs. Consideration of how social determinants of health, environmental and personal factors impact motor development in low-resource contexts is crucial. Further work is needed to describe developmental trajectories of children for CP in LMICs.
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Affiliation(s)
- Marie Brien
- Enabling Inclusion Program, Amar Seva Sangam, Ayikudi, India; International Centre for Disability and Rehabilitation, University of Toronto, Toronto, Canada.
| | - Dinesh Krishna
- Enabling Inclusion Program, Amar Seva Sangam, Ayikudi, India; International Centre for Disability and Rehabilitation, University of Toronto, Toronto, Canada.
| | - Ramasubramanian Ponnusamy
- Enabling Inclusion Program, Amar Seva Sangam, Ayikudi, India; International Centre for Disability and Rehabilitation, University of Toronto, Toronto, Canada.
| | - Cathy Cameron
- International Centre for Disability and Rehabilitation, University of Toronto, Toronto, Canada.
| | - Rahim Moineddin
- Dalla Lana School of Public Health, University of Toronto, Canada.
| | - Franzina Coutinho
- Enabling Inclusion Program, Amar Seva Sangam, Ayikudi, India; International Centre for Disability and Rehabilitation, University of Toronto, Toronto, Canada; School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
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Burgess A, Sakzewski L, Whittingham K, Wotherspoon J, Chatfield MD, Ware RS, Boyd RN. Development of social functioning in children with cerebral palsy: A longitudinal study. Dev Med Child Neurol 2023; 65:674-682. [PMID: 36282970 PMCID: PMC10953437 DOI: 10.1111/dmcn.15439] [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: 03/22/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/30/2022]
Abstract
AIM To describe the development of social function in children with cerebral palsy (CP) classified in all levels of the Communication Function Classification System (CFCS). METHOD This prospective, longitudinal population-based cohort study recruited children with CP born in Queensland, Australia. Social functioning was measured using the Pediatric Evaluation of Disability Inventory (PEDI) social function domain at 2 years, 2 years 6 months, 3 years, 4 years, and 5 years, and the PEDI Computer Adaptive Test (PEDI-CAT) social/cognitive domain at 8 to 12 years. RESULTS Seventy-four children provided 356 observations. PEDI-CAT social/cognitive scaled scores at 8 to 12 years were (mean [SD] n) CFCS level I, 68.6 (2.7) 45; CFCS level II, 64.0 (3.4) 10; CFCS level III, 63.5 (3.7) 4; CFCS level IV, 56.8 (5.0) 9; CFCS level V, 47.2 (5.8) 6. Scores within expected range for age (not less than 2 SD below mean) at 8 to 12 years were achieved by 35 (78%) children in CFCS level I and four (14%) in CFCS levels II to V. Forty-nine per cent of children scored at least two standard deviations below the population mean on a proxy measure of fluid intelligence. Intellectual impairment was associated with lower PEDI-CAT social/cognitive scaled scores in univariable analysis (β = -8.3, 95% confidence interval - 10.91 to -5.63; p < 0.001) but had a smaller effect when modelled together with CFCS. INTERPRETATION Social function attained by 8 to 12 years of age was strongly related to level of communication function (CFCS). The small number of children classified in CFCS levels II to V necessitates caution when viewing these individual CFCS level trajectories. WHAT THIS PAPER ADDS There is a strong relation between social functioning and Communication Function Classification System (CFCS) levels. At 8 to 12 years, 35 out of 45 children in CFCS level I met social functioning age expectations. Twenty-five out of 29 in CFCS levels II to V had social functioning below that expected for age. CFCS and age were more strongly associated with development of social functioning than Gross Motor Function Classification System or Manual Ability Classification System and age.
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Affiliation(s)
- Andrea Burgess
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research CentreFaculty of MedicineBrisbaneAustralia
| | - Leanne Sakzewski
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research CentreFaculty of MedicineBrisbaneAustralia
| | - Koa Whittingham
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research CentreFaculty of MedicineBrisbaneAustralia
| | - Jane Wotherspoon
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research CentreFaculty of MedicineBrisbaneAustralia
| | - Mark D. Chatfield
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research CentreFaculty of MedicineBrisbaneAustralia
| | - Robert S. Ware
- Griffith University, Menzies Health Institute QueenslandBrisbaneAustralia
| | - Roslyn N. Boyd
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research CentreFaculty of MedicineBrisbaneAustralia
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Chagas PSC, Magalhães EDD, Sousa Junior RR, Romeros ACSF, Palisano RJ, Leite HR, Rosenbaum P. Desenvolvimento de crianças, adolescentes e jovens adultos com Paralisia Cerebral de acordo com a CIF? Uma revisão do escopo. Dev Med Child Neurol 2022; 65:e61-e69. [PMID: 36529898 DOI: 10.1111/dmcn.15487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Estudos sobre o desenvolvimento de indivíduos com PC ajudam terapeutas e pais a planejarem abordagens de tratamento e prognóstico futuro. Os principais desfechos investigados em indivíduos com PC foram atividade e estruturas e funções corporais. Pouco tem sido explorado em desfechos de participação e de fatores contextuais ao longo do tempo.
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Affiliation(s)
- Paula S C Chagas
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico e Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil
| | - Elton D D Magalhães
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico e Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil.,Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Ricardo R Sousa Junior
- Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Angélica C S F Romeros
- Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Robert J Palisano
- Fisioterapia e Ciências da Reabilitação, Drexel University, Filadélfia, PA, EUA
| | - Hércules R Leite
- Programa de Pós-Graduação em Ciências da Reabilitação, Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Peter Rosenbaum
- Departamento de Pediatria, CanChild, McMaster University, Hamilton, Canada
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Chagas PSC, Magalhães EDD, Sousa Junior RR, Romeros ACSF, Palisano RJ, Leite HR, Rosenbaum P. Development of children, adolescents, and young adults with cerebral palsy according to the ICF: A scoping review. Dev Med Child Neurol 2022; 65:745-753. [PMID: 36469744 DOI: 10.1111/dmcn.15484] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/06/2022] [Accepted: 11/09/2022] [Indexed: 12/10/2022]
Abstract
AIM To identify and provide a descriptive overview of the development of children, adolescents, and young adults with cerebral palsy (CP) in longitudinal studies; and map areas of focus according to the components of the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). METHOD Longitudinal studies of the development of children, adolescents, and/or young adults with CP were included in this scoping review. A search for eligible studies was conducted in the databases MEDLINE, PubMed, LILACS, EMBASE, Cochrane, CINAHL, and Scopus, and was restricted to the years 2002 to 2022. All outcome measures of the studies were classified into ICF components. RESULTS In the 56 studies included, there were 19 438 participants, involving mainly children, followed by adolescents, and lastly young adults. All components of the ICF were investigated and many studies reported outcomes in more than one component. Activity was the most investigated (67.9%; n = 38 studies), followed by body functions and structures (42.9%; n = 24 studies). Participation (14.2%; n = 8 studies) and environmental factors (3.6%; n = 2 studies) were the least studied. None of the studies investigated personal factors as an outcome. INTERPRETATION This scoping review provides an overview of studies on the development of children, adolescents, and young adults with CP, using the ICF framework, identifying current areas of focus and gaps in the research. Future studies should target participation, contextual factors, and the transition into adulthood.
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Affiliation(s)
- Paula S C Chagas
- Graduate Program in Rehabilitation Sciences and Physical and Functional Performance, Faculty of Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Elton D D Magalhães
- Graduate Program in Rehabilitation Sciences and Physical and Functional Performance, Faculty of Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.,Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo R Sousa Junior
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Angélica C S F Romeros
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Robert J Palisano
- Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | - Hércules R Leite
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Peter Rosenbaum
- Department of Pediatrics, CanChild, McMaster University, Hamilton, Canada
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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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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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De Clercq LE, Soenens B, Dieleman LM, Prinzie P, Van der Kaap-Deeder J, Beyers W, De Pauw SSW. Parenting and Child Personality as Modifiers of the Psychosocial Development of Youth with Cerebral Palsy. Child Psychiatry Hum Dev 2022; 53:137-155. [PMID: 33405025 DOI: 10.1007/s10578-020-01106-1] [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] [Accepted: 12/05/2020] [Indexed: 11/26/2022]
Abstract
This two-year longitudinal study addressed the joint contribution of parent-rated parenting behaviors and child personality on psychosocial outcomes in 118 families of children with Cerebral Palsy (M age Time 1 = 10.9 years old, 64.4% boys). Latent change modeling revealed intra-individual changes in children's psychosocial development as internalizing and externalizing behaviors increased from the first to the second assessment and psychosocial strengths increased from the second to the third assessment, whereas externally controlling and autonomy-supportive parenting behavior remained stable over time. Externally controlling parenting related to higher levels of, and increases in behavioral problems, with these associations being most pronounced among children low on Extraversion, Conscientiousness, or Imagination. Autonomy-supportive parenting related to higher levels of psychosocial strengths, with this association being most pronounced among children high on Emotional Stability.
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Affiliation(s)
- Lana E De Clercq
- Department of Special Needs Education, Ghent University, Henri Dunantlaan 1, 9000, Ghent, Belgium.
| | - Bart Soenens
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Lisa M Dieleman
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Peter Prinzie
- Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Wim Beyers
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Sarah S W De Pauw
- Department of Special Needs Education, Ghent University, Henri Dunantlaan 1, 9000, Ghent, Belgium
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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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9
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de Leeuw MJ, Schasfoort FC, Spek B, van der Ham I, Verschure S, Westendorp T, Pangalila RF. Factors for changes in self-care and mobility capabilities in young children with cerebral palsy involved in regular outpatient rehabilitation care. Heliyon 2021; 7:e08537. [PMID: 34950787 PMCID: PMC8671866 DOI: 10.1016/j.heliyon.2021.e08537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/14/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Assessing prognosis of self-care and mobility capabilities in children with cerebral palsy (CP) is important for goal setting, treatment guidance and meaningful professional-caregiver conversations. Aims Identifying factors associated with changes in self-care and mobility capabilities in regular outpatient multidisciplinary paediatric CP rehabilitation care. Methods and procedures Routinely monitored longitudinal data, assessed with the Paediatric Evaluation of Disability Inventory (PEDI-Functional-Skills-Scale, FSS 0–100) was retrospectively analysed. We determined contributions of age, gross-motor function, bimanual-arm function, intellectual function, education type, epilepsy, visual function, and psychiatric comorbidity to self-care and mobility capability changes (linear-mixed-models). Outcomes and results For 90 children (53 boys), in all Gross-Motor-Function-Classification-System (GMFCS) levels, 272 PEDI's were completed. Mean PEDI–FSS–scores at first measurement (median age: 3,2 years) for self-care and mobility were 46.3 and 42.4, and mean final FSS-scores respectively were 55.1 and 53.1 (median age: 6,5 years). Self-care capability change was significantly associated with age (2.81, p < 0.001), GMFCS levels III-V (-9.12 to -46.66, p < 0.01), and intellectual impairment (-6.39, p < 0.01). Mobility capability change was significantly associated with age (3.25, p < 0.001) and GMFCS levels II-V (-6.58 to -47.12, p < 0.01). Conclusions and implications Most important prognostic factor for self-care and mobility capabilities is GMFCS level, plus intellectual impairment for self-care. Maximum capability levels are reached at different ages, which is important for individual goal setting and managing expectations. Capabilities of children with CP improve modestly over time in outpatient rehabilitation. Children with more severe CP reach maximum mobility and self-care levels at an earlier age. After this maintaining capabilities is more realistic than improvement. Important prognostic factors are GMFCS level and intellectual impairment. Routine monitoring can aid goal setting and expectation management in communication with families.
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Affiliation(s)
- Marleen J de Leeuw
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands.,Department of General Practice, Intellectual Disability Medicine, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Fabienne C Schasfoort
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands.,Department of Rehabilitation Medicine, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Bea Spek
- Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, the Netherlands
| | - Inez van der Ham
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands
| | - Stella Verschure
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands
| | - Tessa Westendorp
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands
| | - Robert F Pangalila
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands.,Department of Rehabilitation Medicine, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
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10
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Noten S, Troenosemito LAA, Limsakul C, Selb M, de Groot V, Konijnenbelt M, Driessen DMF, Hilberink SR, Roebroeck ME. Development of an ICF Core Set for adults with cerebral palsy: capturing their perspective on functioning. Dev Med Child Neurol 2021; 63:846-852. [PMID: 33634853 PMCID: PMC8248089 DOI: 10.1111/dmcn.14841] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 01/27/2023]
Abstract
AIM To examine the most relevant aspects of functioning of adults with cerebral palsy (CP) from their perspective, in order to develop an International Classification of Functioning, Disability and Health (ICF) Core Set for adults with CP. METHOD We conducted six focus group discussions with adults with CP without intellectual disability and seven interviews with adults with CP with intellectual disability and caregivers, addressing all ICF components. Meaningful concepts were identified from verbatim transcripts and linked to ICF categories by two independent researchers. RESULTS In total, 31 adults with CP without intellectual disability (mean [SD] age 46y 1mo [14y 1mo]; 20 females, 11 males; Gross Motor Function Classification System [GMFCS] levels I-IV) and seven adults with CP and intellectual disability (mean [SD] age 25y 8mo [6y 8mo]; four females, three males; GMFCS levels III-V) participated. We identified 132 unique second-level categories: 47 body functions, seven body structures, 43 activities and participation, and 35 environmental factors. The most frequently mentioned categories were emotional function, pain, muscle tone function, support of family, products and technology, and health services. INTERPRETATION Adults with CP experienced problems in a broad range of body functions and activities and indicated the importance of environmental factors for functioning. The identified categories will be added to the list of candidate items to reach consensus on an ICF Core Set for adults with CP. What this paper adds Including the lived experience is crucial for fully understanding functioning of adults with cerebral palsy (CP). Adults with CP perceive environmental factors as essential elements for everyday functioning. Adults with intellectual disability should be considered as a group with specific problems.
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Affiliation(s)
- Suzie Noten
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam RehabilitationRotterdamthe Netherlands
| | - Lorenzo A A Troenosemito
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Chonnanid Limsakul
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Department of Orthopedic Surgery and Physical MedicinePrince of Songkla UniversitySongkhlaThailand
| | - Melissa Selb
- ICF Research BranchNottwilSwitzerland,Swiss Paraplegic ResearchNottwilSwitzerland
| | - Vincent de Groot
- Department of Rehabilitation MedicineAmsterdam Movement SciencesAmsterdam University Medical CenterVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | | | | | - Sander R Hilberink
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Research Centre Innovations in CareRotterdam University of Applied SciencesRotterdamthe Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam RehabilitationRotterdamthe Netherlands
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Study protocol: functioning curves and trajectories for children and adolescents with cerebral palsy in Brazil - PartiCipa Brazil. BMC Pediatr 2020; 20:393. [PMID: 32819318 PMCID: PMC7439543 DOI: 10.1186/s12887-020-02279-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022] Open
Abstract
Background Gross motor development curves for children with Cerebral Palsy (CP), grouped by Gross Motor Function Classification System (GMFCS) levels, help health care professionals and parents to understand children’s motor function prognosis. Although these curves are widely used in Brazil to guide clinical decision-making, they were developed with Canadian children with CP. Little is known about how these patterns evolve in children and adolescents with CP in low-income countries like Brazil. The PARTICIPA BRAZIL aims to: (i) to identify and draw a profile of functioning and disability of Brazilian children and adolescents with CP by classifying them, for descriptive purposes, with all five valid and reliable functional classifications systems (gross motor function, manual ability, communication function, visual and eating and drinking abilities); (ii) to create longitudinal trajectories capturing the mobility capacity of Brazilian children and adolescents with CP for each level of the GMFCS; (iii) to document longitudinal trajectories in the performance of activities and participation of Brazilian children and adolescents with CP across two functional classification systems: GMFCS and MACS (Manual Abilities Classification System); (iv) to document longitudinal trajectories of neuromusculoskeletal and movement-related functions and exercise tolerance functions of Brazilian children and adolescents with CP for each level of the GMFCS; and (v) to explore interrelationships among all ICF framework components and the five functional classification systems in Brazilian children and adolescents with CP. Methods We propose a multi-center, longitudinal, prospective cohort study with 750 Brazilian children and adolescents with CP from across the country. Participants will be classified according to five functional classification systems. Contextual factors, activity and participation, and body functions will be evaluated longitudinally and prospectively for four years. Nonlinear mixed-effects models for each of the five GMFCS and MACS levels will be created using test scores over time to create prognosis curves. To explore the interrelationships among ICF components, a multiple linear regression will be performed. Discussion The findings from this study will describe the level and nature of activities and levels of participation of children and youth with CP in Brazil. This will support evidence-based public policies to improve care to this population from childhood to adulthood, based on their prognosis.
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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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13
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Mobility and self-care trajectories for individuals with cerebral palsy (aged 1–21 years): a joint longitudinal analysis of cohort data from the Netherlands and Canada. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 3:548-557. [DOI: 10.1016/s2352-4642(19)30122-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/19/2022]
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14
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Lopes PB, Shikako-Thomas K, Cardoso R, Simões Matsukura T. Social participation: the perspectives of adolescents with cerebral palsy and their mothers. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 67:263-272. [PMID: 34408861 PMCID: PMC8366635 DOI: 10.1080/20473869.2019.1623596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 06/13/2023]
Abstract
BACKGROUND Social participation is a complex construct, thus different factors may facilitate or restrict engagement. Adolescents with Cerebral Palsy (CP) and their mothers often experience barriers in social participation. Therefore, they are frequently facing challenges in order to engage in meaningful activities, in different contexts. OBJECTIVE We aimed at exploring the perspectives of mothers and adolescents with CP on their social participation. METHOD This is a cross-sectional and exploratory study, with a qualitative design. Seven adolescents with CP, aged from 11 to17 years old and their mothers, participated in a semi-structured interview, in São Paulo, Brazil. Data from interviews were analyzed with the Collective Subject Discourse (CSD) technique. RESULTS Mothers believed that their parenting practices contribute to the social participation of their children. Mothers revealed concerns about how to support the autonomy of their children and how to help them to establish meaningful and mature relationships. Adolescents with CP reported to engage in a range of social activities, with friends in different contexts, such as restaurants, cinema, concerts, parks and school. They also reported to appreciate social participation and to look for strategies in order to engage. CONCLUSIONS This work can contribute to the understanding of social participation of adolescents with CP, under the perspective of these people and their mothers by allowing them to express their thoughts and voice their fears and limitations. Healthcare providers should adopt a lifespan approach to disabilities and recognize the unique challenges of adolescence in the life of both child and parents.
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Affiliation(s)
| | - Keiko Shikako-Thomas
- School of Physical and Occupational Therapy, McGill University, Researcher, CRIR/Centre de réadaptation MAB-Mackay, Montreal, QC, Canada
| | - Roberta Cardoso
- Department of Occupational Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Thelma Simões Matsukura
- Department of Occupational Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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15
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Yi YG, Jung SH, Bang MS. Emerging Issues in Cerebral Palsy Associated With Aging: A Physiatrist Perspective. Ann Rehabil Med 2019; 43:241-249. [PMID: 31311245 PMCID: PMC6637058 DOI: 10.5535/arm.2019.43.3.241] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 10/17/2018] [Indexed: 11/16/2022] Open
Abstract
The population of adults diagnosed with cerebral palsy (CP) is increasing along with the survival rate of children born with the disability. Adults with CP need health services for the continued monitoring and management of their condition. Moreover, the development of additional health problems in adulthood increases the need for ongoing access to health services. Adults with CP manifest a higher rate of chronic health conditions and eventual decline in strength and functional reserve, deterioration in physical activity, increased risk of musculoskeletal complications, and gradual changes in swallowing ability. They are also reported to exhibit difficulty engaging socially and have a low health-related quality of life (QOL). However, there are a large number of adults with CP who cannot access medical services adequately and are therefore not effectively treated. To overcome these apparent challenges, we need to fully comprehend the healthcare needs of adults with CP to develop adult-focused health services. Further research is needed regarding the impact of physical activity, nutrition, sarcopenia, myeloradiculopathy, and swallowing function on QOL.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul University College of Medicine, Seoul, Korea
| | - Se Hee Jung
- Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Moon Suk Bang
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul University College of Medicine, Seoul, Korea
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16
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Brochard S, Pons C. Functional developmental trajectories: new knowledge and challenges. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 3:515-516. [PMID: 31178371 DOI: 10.1016/s2352-4642(19)30192-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 04/08/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Sylvain Brochard
- Department of Physical and Medical Rehabilitation, CHRU Morvan, Brest 29200, France; Laboratory of Medical Information Processing, INSERM U1101, Brest, France; Department of Paediatric Physical and Medical Rehabilitation, Fondation ILDYS, Brest, France; Université de Bretagne Occidentale, Brest, France.
| | - Christelle Pons
- Department of Physical and Medical Rehabilitation, CHRU Morvan, Brest 29200, France; Laboratory of Medical Information Processing, INSERM U1101, Brest, France; Department of Paediatric Physical and Medical Rehabilitation, Fondation ILDYS, Brest, France
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17
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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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Kim SW, Jeon HR, Kim Y, Choi SJ, Youk T, Kim J. Disability Registration State of Children With Cerebral Palsy in Korea. Ann Rehabil Med 2018; 42:730-736. [PMID: 30404422 PMCID: PMC6246860 DOI: 10.5535/arm.2018.42.5.730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/24/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the disability registration state of children with cerebral palsy (CP) in Korea. METHODS Based on the National Health Information Database, the disability registration state was examined for brain lesion disability and other possible complicated disabilities accompanying brain disorder in children diagnosed with CP aged up to 5 years old who were born between 2002 and 2008. RESULTS Of children diagnosed with CP, 73.1% were registered as having brain lesion disability for the first time before they turned 2 years old. The younger the children, the more likely they will have 1st and 2nd degree disability. However, when the age of children is increased, such likelihood is decreased. The percentage of children registered as having overlapping disabilities was 7%-20%. CONCLUSION It is important to establish a more accurate standard to rate disability and provide national support systems for children with CP with various severities and multiple disabilities. By reorganizing the current disability registration system for pediatric brain lesions, the system could serve as a classification standard to provide medical and social welfare services.
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Affiliation(s)
- Seong Woo Kim
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Ha Ra Jeon
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Yoon Kim
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Soo Jin Choi
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Taemi Youk
- Research Institute, National Health Insurance Service Ilsan Hospital, Ilsan, Korea.,Department of Statistics, Korea University, Seoul, Korea
| | - Jiyong Kim
- Department of Physical Medicine and Rehabilitation, Inje University Ilsan Paik Hospital, Ilsan, Korea
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Guzik A, Drużbicki M, Kwolek A, Przysada G, Bazarnik-Mucha K, Szczepanik M, Wolan-Nieroda A, Sobolewski M. The paediatric version of Wisconsin gait scale, adaptation for children with hemiplegic cerebral palsy: a prospective observational study. BMC Pediatr 2018; 18:301. [PMID: 30219044 PMCID: PMC6139123 DOI: 10.1186/s12887-018-1273-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 08/31/2018] [Indexed: 11/24/2022] Open
Abstract
Background In clinical practice there is a need for a specific scale enabling detailed and multifactorial assessment of gait in children with spastic hemiplegic cerebral palsy. The practical value of the present study is linked with the attempts to find a new, affordable, easy-to-use tool for gait assessment in children with spastic hemiplegic cerebral palsy. The objective of the study is to evaluate the Wisconsin Gait Scale (WGS) in terms of its inter- and intra-rater reliability in observational assessment of walking in children with hemiplegic cerebral palsy. Methods The study was conducted in a group of 34 patients with hemiplegic cerebral palsy. At the first stage, the original version of the ordinal WGS was used. The WGS, consisting of four subscales, evaluates fourteen gait parameters which can be observed during consecutive gait phases. At the second stage, a modification was introduced in the kinematics description of the knee and weight shift, in relation to the original scale. The same video recordings were rescored using the new, paediatric version of the WGS. Three independent examiners performed the assessment twice. Inter and intra-observer reliability of the modified WGS were determined. Results The findings show very high inter- and intra-observer reliability of the modified WGS. This was reflected by a lack of systematically oriented differences between the repeated measurements, very high value of Spearman’s rank correlation coefficient 0.9 ≤ |R| < 1, very high value of ICC > 0.9, and low value of CV < 2.5% for the specific physical therapists. Conclusions The new, ordinal, paediatric version of WGS, proposed by the authors, seems to be useful as an additional tool that can be used in qualitative observational gait assessment of children with spastic hemiplegic cerebral palsy. Practical dimension of the study lies in the fact that it proposes a simple, easy-to-use tool for a global gait assessment in children with spastic hemiplegic cerebral palsy. However, further research is needed to validate the modified WGS by comparing it to other observational scales and objective 3-dimensional spatiotemporal and kinematic gait parameters. Trial registration anzctr.org.au, ID: ACTRN12617000436370. Registered 24 March 2017.
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Affiliation(s)
- Agnieszka Guzik
- Institute of Physiotherapy, University of Rzeszów, Warszawska 26 a, 35-205, Rzeszów, Poland.
| | - Mariusz Drużbicki
- Institute of Physiotherapy, University of Rzeszów, Warszawska 26 a, 35-205, Rzeszów, Poland
| | - Andrzej Kwolek
- Institute of Physiotherapy, University of Rzeszów, Warszawska 26 a, 35-205, Rzeszów, Poland
| | - Grzegorz Przysada
- Institute of Physiotherapy, University of Rzeszów, Warszawska 26 a, 35-205, Rzeszów, Poland
| | | | - Magdalena Szczepanik
- Institute of Physiotherapy, University of Rzeszów, Warszawska 26 a, 35-205, Rzeszów, Poland
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Amini M, Saneii SH, Pashmdarfard M. Factors affecting social participation of Iranian children with cerebral palsy. Occup Ther Health Care 2018; 32:290-305. [PMID: 30183435 DOI: 10.1080/07380577.2018.1497820] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 07/03/2018] [Accepted: 07/03/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this study was to identify the factors affecting the social participation of Iranian children with cerebral palsy (CP). Participants were 274 (male = 62%; female = 38%) children with CP, 6- to 12-years old (mean = 1.64) and their parents. Several standardized measures were used to assess social participation, gather environmental factors, and demographic questionnaires. The results of stepwise linear regression analysis indicated that the type of CP, Manual ability level and cognitive level (IQ) appear to be strong predictors of social participation between personal and environmental factors.
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Affiliation(s)
- Malek Amini
- a Department of Occupational Therapy School of Rehabilitation Sciences, Iran University of Medical Sciences , Tehran , Iran
| | - Seyed Hassan Saneii
- b Department of Basic Sciences in rehabilitation , School of Rehabilitation Sciences, Iran University of Medical Sciences , Tehran , Iran
| | - Marzieh Pashmdarfard
- c Department of Occupational Therapy , School of Rehabilitation Sciences, Iran University of Medical Sciences , Tehran , Iran
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Sell K, Rapp M, Muehlan H, Spiegler J, Thyen U. Frequency of participation and association with functioning in adolescents born extremely preterm - Findings from a population-based cohort in northern Germany. Early Hum Dev 2018; 120:67-73. [PMID: 29674248 DOI: 10.1016/j.earlhumdev.2018.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/05/2018] [Accepted: 04/05/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Outcomes after extremely preterm birth (<28 weeks gestation) have been studied intensely, and follow-up into adulthood is well-established. Following the introduction of the International Classification of Functioning, Disability and Health, participation has been recognized to be a relevant outcome in rehabilitation research. During adolescence, participation is crucial to adapting to new social roles. The aim of our study was to investigate participation in the domains Autonomy, Relationships and Community Recreation. METHODS Participation was assessed as part of a cross-sectional, population-based study in a German federal state examining all adolescents born between January 1997 and December 1999 at under 27 weeks gestation. Of the surviving 90 adolescents, 72 (80%) were followed-up at age 14 to 17. Frequency of participation was assessed using the short form of the Questionnaire of Young People's Participation and compared to matched peers. Associations with physical, cognitive, and psychological functioning and contextual factors were examined using multivariate regression. RESULTS Frequency of participation in Autonomy, Relationships, and Community Recreation in adolescents born extremely preterm was significantly lower than that of matched peers from the general population (p < 0,001). Lower frequency of participation in Autonomy and Relationships was associated with severe physical and cognitive impairment, and psychological problems. Fifty-seven percent of the adjusted variance in Autonomy and 31% of the adjusted variance in Relationships was explained by our regression models. CONCLUSION Further research is warranted to investigate additional factors associated with the restricted frequency of participation of adolescents born preterm to design suitable interventions for improving participation.
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Affiliation(s)
- K Sell
- Klinik für Kinder- und Jugendmedizin, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
| | - M Rapp
- Klinik für Kinder- und Jugendmedizin, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
| | - H Muehlan
- Department Health & Prevention, Ernst-Moritz-Arndt-University Greifswald, Robert-Blum-Str. 13, 17487 Greifswald, Germany.
| | - J Spiegler
- Klinik für Kinder- und Jugendmedizin, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
| | - U Thyen
- Klinik für Kinder- und Jugendmedizin, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
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Benner JL, Hilberink SR, Veenis T, van der Slot WMA, Roebroeck ME. Course of employment in adults with cerebral palsy over a 14-year period. Dev Med Child Neurol 2017; 59:762-768. [PMID: 28304081 DOI: 10.1111/dmcn.13423] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2017] [Indexed: 11/28/2022]
Abstract
AIM To explore the course of employment in adults with cerebral palsy (CP) over 14 years, and to identify subgroups at risk for unemployment. METHOD Sixty-five adults with CP (33 males, 32 females; baseline age 25y 8mo, standard deviation [SD] 3y 2mo; intellectual impairment 25%; bilateral CP 65%) participated in a prospective cohort study. Self-reports of employment and work hours per week in 1996, 2000, and 2010 were documented. The course of employment (including sheltered work) and work hours per week were analysed, using generalized estimating equations (GEE). RESULTS Overall, employment rate was stable over time (38-45%, p=0.413), but lower than in the general population (75-86%, p<0.001). Employment rates were specifically low in adults with intellectual impairment, bilateral CP, and in adults with Gross Motor Function Classification System (GMFCS) levels IV and V. Work hours per week declined (35.0 [SD 7.9] to 31.2 [SD 10.3], p=0.033), especially among females (32.3 [SD 6.4] to 23.4 [SD 7.4], p<0.001). Similar to the general population, females often worked part-time. INTERPRETATION Employment was low compared with the general population, but remained stable in the long term; however, work hours per week decreased. Adults with intellectual impairment, bilateral CP, and GMFCS levels IV and V are subgroups at risk for unemployment.
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Affiliation(s)
- Joyce L Benner
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sander R Hilberink
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Thessa Veenis
- Sophia Rehabilitation Center, The Hague, the Netherlands
| | | | - Marij E Roebroeck
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
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Hielkema T, Hadders-Algra M. Motor and cognitive outcome after specific early lesions of the brain - a systematic review. Dev Med Child Neurol 2016; 58 Suppl 4:46-52. [PMID: 27027607 DOI: 10.1111/dmcn.13047] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2015] [Indexed: 11/30/2022]
Abstract
The aim of this systematic review was to study motor and cognitive outcome in infants with severe early brain lesions and to evaluate effects of side of the lesion, sex, and social economic status on outcome. A literature search was performed using the databases Pubmed and Embase. Included studies involved infants with either cystic periventricular leukomalacia (cPVL), preterm, or term stroke (i.e. parenchymal lesion of the brain). Outcome was expressed as cerebral palsy (CP) and intellectual disability (mental retardation). Median prevalence rates of CP after cPVL, preterm, and term stroke were 86%, 71%, and 29% respectively; of intellectual disability 50%, 27%, and 33%. Most infants with cPVL developed bilateral CP, those with term stroke unilateral CP, whereas after preterm stroke bilateral and unilateral CP occurred equally often. Information on the effects of sex and social economic status on outcome after specific brain lesions was very limited. Our findings show that the risk for CP is high after cPVL, moderate after preterm stroke, and lowest after term stroke. The risk for intellectual disability after an early brain lesion is lower than that for CP. Predicting outcome at individual level remains difficult; new imaging techniques may improve predicting developmental trajectories.
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Affiliation(s)
- Tjitske Hielkema
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, the Netherlands
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands
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Behavioral and emotional problems in children and adults with cerebral palsy. Eur J Paediatr Neurol 2016; 20:270-274. [PMID: 26748599 DOI: 10.1016/j.ejpn.2015.12.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 11/14/2015] [Accepted: 12/06/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE In patients with cerebral palsy (CP), psychological problems influence their participation in society. Little is known about the persistence of behavioral and social problems into adulthood. MATERIALS AND METHODS In a two-center cross-sectional study, caregivers of 121 adults and 88 children were ask to assess behavior of the patients through the parent/caregiver forms of the Child Behavior Checklist (CBCL), the Strengths and Difficulties Questionnaire (SDQ), and the Vineland Adaptive Behavior Scale II (VABS). Questionnaires were returned from 43 adults and 39 children. RESULTS In both groups we found the same frequency of abnormalities in attention problems (32.4 vs. 36.1%, p = 0.826) and social interaction problems (32.3 vs. 33.3%; p = 0.926) in the CBCL, and peer problems (38.9 vs. 75.7%; p = 0.115) in the SDQ. Children show a lower percentage of abnormal prosocial behavior (41.7 vs. 16.2%, p = 0.016) and lower abnormal rates of communication (88.2 vs. 61.5; p = 0.01) and daily living skills (90.0 vs. 71.8; p = 0.041), whereas the level of abnormalities in both groups in these dimensions of VABS notably high. CONCLUSION The persistence of psychological and social problems from childhood into adulthood underlines the importance of focusing on early intervention.
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Hadders-Algra M. Early diagnosis and early intervention in cerebral palsy. Front Neurol 2014; 5:185. [PMID: 25309506 PMCID: PMC4173665 DOI: 10.3389/fneur.2014.00185] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/09/2014] [Indexed: 01/06/2023] Open
Abstract
This paper reviews the opportunities and challenges for early diagnosis and early intervention in cerebral palsy (CP). CP describes a group of disorders of the development of movement and posture, causing activity limitation that is attributed to disturbances that occurred in the fetal or infant brain. Therefore, the paper starts with a summary of relevant information from developmental neuroscience. Most lesions underlying CP occur in the second half of gestation, when developmental activity in the brain reaches its summit. Variations in timing of the damage not only result in different lesions but also in different neuroplastic reactions and different associated neuropathologies. This turns CP into a heterogeneous entity. This may mean that the best early diagnostics and the best intervention methods may differ for various subgroups of children with CP. Next, the paper addresses possibilities for early diagnosis. It discusses the predictive value of neuromotor and neurological exams, neuroimaging techniques, and neurophysiological assessments. Prediction is best when complementary techniques are used in longitudinal series. Possibilities for early prediction of CP differ for infants admitted to neonatal intensive care and other infants. In the former group, best prediction is achieved with the combination of neuroimaging and the assessment of general movements, in the latter group, best prediction is based on carefully documented milestones and neurological assessment. The last part reviews early intervention in infants developing CP. Most knowledge on early intervention is based on studies in high-risk infants without CP. In these infants, early intervention programs promote cognitive development until preschool age; motor development profits less. The few studies on early intervention in infants developing CP suggest that programs that stimulate all aspects of infant development by means of family coaching are most promising. More research is urgently needed.
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Affiliation(s)
- Mijna Hadders-Algra
- Department of Pediatrics - Developmental Neurology, University Medical Center Groningen, University of Groningen , Groningen , Netherlands
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Abstract
OBJECTIVE To investigate risks of recurrence of cerebral palsy in family members with various degrees of relatedness to elucidate patterns of hereditability. DESIGN Population based cohort study. SETTING Data from the Medical Birth Registry of Norway, linked to the Norwegian social insurance scheme to identify cases of cerebral palsy and to databases of Statistics Norway to identify relatives. PARTICIPANTS 2,036,741 Norwegians born during 1967-2002, 3649 of whom had a diagnosis of cerebral palsy; 22,558 pairs of twins, 1,851,144 pairs of first degree relatives, 1,699,856 pairs of second degree relatives, and 5,165,968 pairs of third degree relatives were identified. MAIN OUTCOME MEASURE Cerebral palsy. RESULTS If one twin had cerebral palsy, the relative risk of recurrence of cerebral palsy was 15.6 (95% confidence interval 9.8 to 25) in the other twin. In families with an affected singleton child, risk was increased 9.2 (6.4 to 13)-fold in a subsequent full sibling and 3.0 (1.1 to 8.6)-fold in a half sibling. Affected parents were also at increased risk of having an affected child (6.5 (1.6 to 26)-fold). No evidence was found of differential transmission through mothers or fathers, although the study had limited power to detect such differences. For people with an affected first cousin, only weak evidence existed for an increased risk (1.5 (0.9 to 2.7)-fold). Risks in siblings or cousins were independent of sex of the index case. After exclusion of preterm births (an important risk factor for cerebral palsy), familial risks remained and were often stronger. CONCLUSIONS People born into families in which someone already has cerebral palsy are themselves at elevated risk, depending on their degree of relatedness. Elevated risk may extend even to third degree relatives (first cousins). The patterns of risk suggest multifactorial inheritance, in which multiple genes interact with each other and with environmental factors. These data offer additional evidence that the underlying causes of cerebral palsy extend beyond the clinical management of delivery.
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Affiliation(s)
- Mette C Tollånes
- Department of Global Public Health and Primary Care, University of Bergen, PB 7804, 5020 Bergen, Norway
| | - Allen J Wilcox
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Rolv T Lie
- Department of Global Public Health and Primary Care, University of Bergen, PB 7804, 5020 Bergen, Norway Medical Birth Registry of Norway, National Institute of Public Health, Bergen, Norway
| | - Dag Moster
- Department of Global Public Health and Primary Care, University of Bergen, PB 7804, 5020 Bergen, Norway Medical Birth Registry of Norway, National Institute of Public Health, Bergen, Norway Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
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Tan SS, van Meeteren J, Ketelaar M, Schuengel C, Reinders-Messelink HA, Raat H, Dallmeijer AJ, Roebroeck ME. Long-term trajectories of health-related quality of life in individuals with cerebral palsy: a multicenter longitudinal study. Arch Phys Med Rehabil 2014; 95:2029-39. [PMID: 24929026 DOI: 10.1016/j.apmr.2014.04.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 04/28/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To (1) determine the long-term trajectory of health-related quality of life (HRQOL) for the dimensions of physical complaints and motor, psychological, and social functioning for groups of individuals with cerebral palsy (CP) aged 1 to 24 years; (2) assess the variability in HRQOL within individuals with CP over time; (3) assess the variability in HRQOL between individuals with CP; and (4) compare the HRQOL in individuals with CP to reference data of typically developing individuals. DESIGN Multicenter prospective longitudinal study. SETTING Rehabilitation departments of 3 university medical centers and various rehabilitation centers in The Netherlands. PARTICIPANTS Dutch individuals with CP (N=424; age, 1-24y). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The HRQOL dimensions of physical complaints and motor, psychological, and social functioning. Each individual visited the rehabilitation department for 3 or 4 measurements. The time between measurements was 1 or 2 years. RESULTS Individuals with CP experience an HRQOL that, on average, remains fairly stable over time. Variability in HRQOL within individuals with CP was similar to that within typically developing individuals. Variability between individuals with CP could be explained by type of CP (motor functioning), Gross Motor Function Classification System level (physical complaints and motor and social functioning), and intellectual disability (physical complaints and social functioning). Finally, individuals with CP experienced a lower HRQOL than did typically developing individuals, especially for the dimensions of motor and social functioning. CONCLUSIONS Many changes take place in the psychosocial development of the individual with CP, which accordingly change their expectations and those of their caregivers, peers, and professionals. As a result, perceived physical complaints and motor, psychological, and social functioning remain fairly stable over many years.
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Affiliation(s)
- Siok Swan Tan
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Jetty van Meeteren
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Rijndam Rehabilitation Center, Rotterdam, The Netherlands
| | - Marjolijn Ketelaar
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; Partner of NetChild, Network for Childhood Disability Research, Utrecht, The Netherlands
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies, VU University, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Heleen A Reinders-Messelink
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands; Rehabilitation Center Revalidatie Friesland, Beetsterzwaag, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Annet J Dallmeijer
- EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands; Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Rijndam Rehabilitation Center, Rotterdam, The Netherlands
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How do changes in motor capacity, motor capability, and motor performance relate in children and adolescents with cerebral palsy? Arch Phys Med Rehabil 2014; 95:1577-84. [PMID: 24792140 DOI: 10.1016/j.apmr.2014.04.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 03/21/2014] [Accepted: 04/01/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the relations between changes in motor capacity (can do, in standardized environment), motor capability (can do, in daily environment), and motor performance (does do, in daily environment) among children with cerebral palsy (CP). DESIGN Prospective longitudinal study. After baseline measurements (at the age of 18 mo, 30 mo, 5 y, 7 y, 9 y, 11 y, or 13 y), 2-year follow-up measurements were performed. Change scores were calculated, and Pearson correlations were used for change score relations. SETTING Outpatient clinic. PARTICIPANTS Toddlers, school-age children, and adolescents with CP (N=321; 200 boys, 121 girls). Levels of severity according to the Gross Motor Function Classification System included level I (42%), level II (15%), level III (17%), level IV (13%), and level V (13%). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Change in motor capacity was assessed with the Gross Motor Function Measure-66. Changes in motor capability and motor performance were assessed with the Pediatric Evaluation of Disability Inventory using the Functional Skills Scale and Caregiver Assistance Scale, respectively. RESULTS Within the total group, change score correlations were moderate (.52-.67) and significant (P<.001). For age groups, correlations were significantly higher in toddlers than school-age children and adolescents. For severity levels, correlations were significantly higher in children at level III than level I, IV, and V. CONCLUSIONS Results imply that change in motor capacity does not automatically translate to change in motor capability and change in motor capability does not automatically translate to change in motor performance. Results also show different relations for clinically relevant subgroups. These are important insights for clinical practice because they can guide evidence-based interventions with a focus on activities.
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