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Seyhan-Bıyık K, Erdem S, Kerem Günel M. The effects of postural control and upper extremity functional capacity on functional Independence in preschool-age children with spastic cerebral palsy: a path model. Physiother Theory Pract 2024; 40:1054-1063. [PMID: 36380714 DOI: 10.1080/09593985.2022.2148227] [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: 07/16/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate the effects of postural control and upper extremity functional capacity on functional independence and identify whether quality of upper extremity skills mediates the effects of postural control on functional independence in preschool-age children with spastic cerebral palsy (CP). METHODS 106 children with CP -mean age 43.4 ± 11.3 (24-71 months)- were included in this cross-sectional study. Postural control, upper extremity functional capacity, and functional independence in activities of daily living were evaluated using the Early Clinical Assessment of Balance (ECAB), Quality of Upper Extremity Skills Test (QUEST), and the Functional Independence Measure of Children (WeeFIM), respectively. A path model was used to evaluate the total, direct, and indirect effects. RESULTS According to the path model, ECAB (direct effect; r = 0.391, p < 0.01, indirect effect; r = 0.398) and QUEST (direct effect; r = 0.493, p < 0.01) had an impact on WeeFIM. In addition, QUEST had mediating effects on the relationship between ECAB and WeeFIM. The path model explained 71% of the variation in functional independence of the participants. CONCLUSION In the management of CP in preschool-age children, the focus should be on improving not only upper extremity capacity but also postural control to help improve functional independence in activities of daily living.
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Affiliation(s)
- Kübra Seyhan-Bıyık
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
| | - Sabri Erdem
- Faculty of Business, Dokuz Eylül University, Buca, Turkey
| | - Mintaze Kerem Günel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
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Calvo-Fuente V, Soto-Vidal C, Ramón-Corcoba A, Cerezo-Téllez E, Pérez-Martín Y, Pacheco-da-Costa S. Efficacy of Kinesiotape to Improve Upper-Extremity Function in Children and Adolescents with Cerebral Palsy: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:480. [PMID: 38671697 PMCID: PMC11049093 DOI: 10.3390/children11040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Cerebral palsy (CP) is one of the primary causes of physical disabilities in children that affects posture and movement. Upper-extremity (UE) function is frequently impaired, which may result in activity and participation limitations in people with CP. The use of kinesiotape (KT) has increased in the treatment of CP for various purposes. The aim of this systematic review was to assess the efficacy of KT for improving UE function in children and adolescents with CP. METHODS The literature search was carried out in PubMed, Cochrane, PEDro, Web of Science and SCOPUS databases. The methodological quality was analyzed with the PEDro scale. Review Manager (RevMan 5.4.1) was used for data extraction and risk of bias assessment. RESULTS A total of five randomized clinical trials were included. The use of KT showed improvement in UE functionality in three studies, with significant outcomes for range of motion (ROM) (three studies), fine motor skills (two studies), grip strength (one study) and manual dexterity (one study). Moreover, it also showed significant improvements in spasticity and gross motor function (one study). Overall, methodological quality was moderate, and the risk of bias was high in the domains related to blinding. CONCLUSION The use of KT showed improvement in UE function in children and adolescents with CP. However, further research is needed to reinforce the conclusions on the efficacy of KT as a therapeutic tool.
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Affiliation(s)
- Victoria Calvo-Fuente
- Neuromusculoskeletal Physical Therapy in Stages of Life Research Group (FINEMEV), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain; (V.C.-F.); (E.C.-T.); (S.P.-d.-C.)
| | - Concepción Soto-Vidal
- Neuromusculoskeletal Physical Therapy in Stages of Life Research Group (FINEMEV), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain; (V.C.-F.); (E.C.-T.); (S.P.-d.-C.)
| | | | - Ester Cerezo-Téllez
- Neuromusculoskeletal Physical Therapy in Stages of Life Research Group (FINEMEV), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain; (V.C.-F.); (E.C.-T.); (S.P.-d.-C.)
| | - Yolanda Pérez-Martín
- Humanization in the Intervention of Physiotherapy for the Integral Attention to the People (HIPATIA), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain;
| | - Soraya Pacheco-da-Costa
- Neuromusculoskeletal Physical Therapy in Stages of Life Research Group (FINEMEV), Department of Nursing and Physical Therapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, Autovía A2, km 33.200, Alcalá de Henares, 28805 Madrid, Spain; (V.C.-F.); (E.C.-T.); (S.P.-d.-C.)
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Bonden H, Jahnsen RB, Klevberg GL. Self-care and hand function in preschool children with unilateral or bilateral cerebral palsy: A cross-sectional study. Child Care Health Dev 2024; 50:e13208. [PMID: 38083836 DOI: 10.1111/cch.13208] [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: 12/16/2022] [Revised: 08/24/2023] [Accepted: 11/19/2023] [Indexed: 01/25/2024]
Abstract
AIMS To describe self-care capabilities among children with cerebral palsy (CP) and explore associations between self-care and hand function for children with unilateral cerebral palsy (UCP) and children with bilateral cerebral palsy (BCP) separately. METHOD Cross-sectional data on self-care capabilities (Pediatric Evaluation of Disability Inventory, PEDI), manual abilities (Manual Ability Classification System, MACS) and hand use during bimanual performance (Assisting Hand Assessment, AHA; Both Hands Assessment, BoHA) were retrieved from the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP). Eighty-seven children with CP (UCP, n = 61, mean age 4 years 1 month, SD 1 year 3 months, range 56) or BCP (n = 26, mean age 4 years 4 months, SD 1 year, range 41), classified at MACS level I (n = 26), II (n = 40) or III (n = 21), were included. RESULTS No significant differences in self-care capabilities were found between children with UCP and children with BCP. Analysis of variance showed significant differences in self-care between MACS levels for the whole group. No significant differences in self-care between MACS levels were observed for children with UCP (p = 0.36), but significant differences were found for those with BCP (p < 0.001). Whereas a small correlation (r = 0.3) between PEDI and AHA scores was found for children with UCP, a large correlation (r = 0.6) was found for those with BCP. Children with BCP with symmetric hand use during bimanual performance (BoHA) had higher PEDI scores than children with asymmetric hand use. CONCLUSION Though children with UCP and children with BCP who were classified at MACS I-III exhibited similar self-care capabilities, the limited hand use seems to contribute differently between the two groups. The two different measures of hand use exhibit different associations with self-care capabilities for young children with UCP and BCP, respectively, and illustrate the need to treat UCP and BCP as two distinct groups, each requiring tailored interventions according to their specific needs.
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Affiliation(s)
- Hilde Bonden
- Children's and Youth Rehabilitation Section, Sarpsborg Clinic, Østfold Hospital Trust, Grålum, Norway
| | - Reidun Birgitta Jahnsen
- Department of Neurosciences in Children, Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP), Oslo University Hospital, Oslo, Norway
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Gunvor Lilleholt Klevberg
- Department of Neurosciences in Children, Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP), Oslo University Hospital, Oslo, Norway
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Bueno SA, Mancini MC, Oliveira RHS, Airoldi MJ, Vieira BS, Gordon AM, Brandão MB. Bimanual hand use in children and adolescents with unilateral spastic cerebral palsy: an exploratory study. Braz J Phys Ther 2023; 27:100561. [PMID: 37979248 PMCID: PMC10692658 DOI: 10.1016/j.bjpt.2023.100561] [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: 11/21/2022] [Revised: 10/05/2023] [Accepted: 10/25/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND Individuals with unilateral spastic cerebral palsy (USCP) often show difficulties using their hands during activities of daily living. OBJECTIVE To investigate the factors that interfere with hand use during bimanual activities in children and adolescents with USCP. METHODS We conducted a cross-sectional study with 102 children and adolescents with USCP, aged 6 to 18 years. We collected information with the caregivers about the classification of the child's manual ability, according to the Manual Ability Classification System (MACS); child's age; side of the involvement; Children's Hand-Use Experience Questionnaire- CHEQ2.0. Cluster analysis identified groups of children and adolescents who performed CHEQ activities with or without assistance. Multiple linear regression analyses identified the contribution of the factors: age, sex, MACS level, side of hemiparesis, and clusters of assistance, on the outcomes of efficacy, time, and feeling bothered. RESULTS MACS and clusters of assistance explained the variance in efficacy (p<0.05; R2=0.31) and time (p<0.05; R2=0.37). MACS explained 22% of the variance in feeling bothered. Children and adolescents with increased difficulty to perform activities that involve hand use (i.e., MACS III) and who receive assistance during most bimanual activities showed less efficacy of use, were slower in their performance, and presented greater feeling of being bothered. CONCLUSION Assistance in bimanual activities and MACS level contributed to explain the efficacy of use, time, and feeling bothered in performing bimanual activities. Intervention strategies aimed at promoting the performance of bimanual activities in the daily routine of children with USCP should consider these outcomes.
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Affiliation(s)
- Simone A Bueno
- Graduate Program in Rehabilitation Sciences, Escola de Educação Física, Fisioterapia e Terapia Ocupacional- Av. Antônio Carlos, 6627, Cep: 31270-901 Belo Horizonte, MG, Brazil
| | - Marisa C Mancini
- Graduate Program in Rehabilitation Sciences, Escola de Educação Física, Fisioterapia e Terapia Ocupacional- Av. Antônio Carlos, 6627, Cep: 31270-901 Belo Horizonte, MG, Brazil
| | - Rachel H S Oliveira
- Graduate Program in Rehabilitation Sciences, Escola de Educação Física, Fisioterapia e Terapia Ocupacional- Av. Antônio Carlos, 6627, Cep: 31270-901 Belo Horizonte, MG, Brazil
| | - Marina J Airoldi
- Graduate Program in Rehabilitation Sciences, Escola de Educação Física, Fisioterapia e Terapia Ocupacional- Av. Antônio Carlos, 6627, Cep: 31270-901 Belo Horizonte, MG, Brazil; Instituto Nossa Casa, Rua Cumaru, 98, Campinas, SP Cep: 13098-324, Brazil
| | - Beatriz S Vieira
- Instituto Nossa Casa, Rua Cumaru, 98, Campinas, SP Cep: 13098-324, Brazil
| | - Andrew M Gordon
- Teacher's College, Columbia University, 525 West 120th Street, NY10027 New York, NY, USA
| | - Marina B Brandão
- Graduate Program in Rehabilitation Sciences, Escola de Educação Física, Fisioterapia e Terapia Ocupacional- Av. Antônio Carlos, 6627, Cep: 31270-901 Belo Horizonte, MG, Brazil.
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Brandão MB, Coster WJ, Figueiredo PRP, Amaral MF, Gordon AM, Mancini MC. Assisting hand use and self-care bimanual performance of children with unilateral spastic cerebral palsy. Dev Med Child Neurol 2023; 65:385-392. [PMID: 35866562 DOI: 10.1111/dmcn.15362] [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] [Received: 08/24/2021] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
AIM To examine the relationship between assisting hand use in bimanual activities and children's self-care activities and task performance. METHOD We retrospectively analysed daily functioning (Pediatric Evaluation of Disability Inventory [PEDI]) and bimanual performance (Assisting Hand Assessment [AHA]) data from the assessment of 112 children (mean age: 8 years 10 months [SD 2 years 1 month], range 3 years 7 months-17 years 4 months; 66 males, 46 females) with unilateral spastic cerebral palsy (CP). We used Rasch analysis to examine the relationship between individual item scores from the AHA and the self-care items (functional skills, caregiver assistance) from the PEDI. RESULTS Most self-care functional skills and caregiver-assisted tasks were located on the middle of the unidimensional continuum. These items showed similar levels of difficulty as the items from the AHA related to the effective coordination of two hands, appropriate pace, and use of the assisting hand to stabilize and release objects, as well as variations in arm movements. INTERPRETATION The distribution of the PEDI self-care and AHA items along the unidimensional continuum illustrates the relationship between assisting hand use and self-care bimanual performance. Interpretation of the items' locations on the hierarchical unidimensional continuum may be helpful to therapists' clinical reasoning and suggest intervention goals to improve the hand function and daily functioning of children with unilateral spastic CP. Such an application needs further investigation.
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Affiliation(s)
- Marina B Brandão
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Wendy J Coster
- Department of Occupational Therapy, College of Health and Rehabilitation Sciences: Sargent, Boston University, Boston, MA, USA
| | - Priscilla R P Figueiredo
- Universidade Federal de Minas Gerais; Associação Mineira de Reabilitação, Belo Horizonte, Brazil
| | - Maíra F Amaral
- Department of Occupational Therapy, Universidade Federal do Triângulo Mineiro, Uberaba, Brazil
| | - Andrew M Gordon
- Movement Science Program, Columbia University, New York, NY, USA
| | - Marisa C Mancini
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Eliasson AC, Nordstrand L, Backheden M, Holmefur M. Longitudinal development of hand use in children with unilateral spastic cerebral palsy from 18 months to 18 years. Dev Med Child Neurol 2023; 65:376-384. [PMID: 35899928 PMCID: PMC10087588 DOI: 10.1111/dmcn.15370] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/28/2022]
Abstract
AIM To describe the development of the use of the affected hand in bimanual tasks in children with unilateral cerebral palsy (CP) from 18 months to 18 years. Specifically, whether early development can be confirmed in a larger cohort and how development progresses during adolescence. METHOD In total, 171 participants (95 males, 76 females; mean age 3 years 1 month [SD 3 years 8 months], range 18 months-16 years at inclusion) were classified in Manual Ability Classification System (MACS) levels I (n = 41), II (n = 91), and III (n = 39). Children were assessed repeatedly (median 7, range 2-16 times) with the Assisting Hand Assessment: in total 1197 assessments. Developmental trajectories were estimated using a nonlinear mixed effects model. To further analyse the adolescent period, a linear mixed model was applied. RESULTS The developmental trajectories were different between participants in MACS levels (MACS I-II, II-III) in both rate (0.019, 95% confidence interval [CI] 0.006-0.031, p = 0.034; 0.025, 95% CI 0.015-0.037, p < 0.001) and limit (19.9, 95% CI 16.6-23.3, p = 0.001; 7.2, 95% CI 3.3-11.2, p < 0.003). The individual variations were large within each level. The developmental trajectories were stable over time for all MACS levels between 7 and 18 years (p > 0.05). INTERPRETATION Children and adolescents with unilateral CP have considerable development at an early age and a stable ability to use their affected hand in bimanual activities from 7 to 18 years in all MACS levels.
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Affiliation(s)
- Ann-Christin Eliasson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Linda Nordstrand
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Backheden
- Department of Leaning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Marie Holmefur
- School of Health Sciences, Örebro University, Örebro, Sweden
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Brandão MB, Coster WJ, Figueiredo PRP, Amaral MF, Gordon AM, Mancini MC. Uso da mão de assistência e o desempenho bimanual no autocuidado de crianças com paralisia cerebral unilateral espástica. Dev Med Child Neurol 2023; 65:e1-e8. [PMID: 35903015 DOI: 10.1111/dmcn.15368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Marina B Brandão
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Wendy J Coster
- Department of Occupational Therapy, College of Health and Rehabilitation Sciences: Sargent, Boston University, Boston, MA, USA
| | - Priscilla R P Figueiredo
- Universidade Federal de Minas Gerais; Associação Mineira de Reabilitação, Belo Horizonte, Brasil
| | - Maíra F Amaral
- Departamento de Terapia Ocupacional, Universidade Federal do Triângulo Mineiro, Uberaba, Brasil
| | - Andrew M Gordon
- Movement Science Program, Columbia University, New York, NY, USA
| | - Marisa C Mancini
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Boyd RN, Novak I, Morgan C, Bora S, Sakzewski L, Ware RS, Comans T, Fahey MC, Whittingham K, Trost S, Pannek K, Pagnozzi A, Mcintyre S, Badawi N, Smithers Sheedy H, Palmer KR, Burgess A, Keramat A, Bell K, Hines A, Benfer K, Gascoigne-Pees L, Leishman S, Oftedal S. School readiness of children at high risk of cerebral palsy randomised to early neuroprotection and neurorehabilitation: protocol for a follow-up study of participants from four randomised clinical trials. BMJ Open 2023; 13:e068675. [PMID: 36849209 PMCID: PMC9972445 DOI: 10.1136/bmjopen-2022-068675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
INTRODUCTION School readiness includes cognitive, socio-emotional, language and physical growth and development domains which share strong associations with life-course opportunities. Children with cerebral palsy (CP) are at increased risk of poor school readiness compared with their typically developing peers. Recently, earlier diagnosis of CP has allowed interventions to commence sooner, harnessing neuroplasticity. First, we hypothesise that early referral to intervention for children at-risk of CP will lead to improved school readiness at 4-6 years relative to placebo or care as usual. Second, we hypothesise that receipt of early diagnosis and early intervention will lead to cost-savings in the form of reduced healthcare utilisation. METHODS AND ANALYSIS Infants identified as at-risk of CP ≤6 months corrected age (n=425) recruited to four randomised trials of neuroprotectants (n=1), early neurorehabilitation (n=2) or early parenting support (n=1) will be re-recruited to one overarching follow-up study at age 4-6 years 3 months. A comprehensive battery of standardised assessments and questionnaires will be administered to assess all domains of school readiness and associated risk factors. Participants will be compared with a historical control group of children (n=245) who were diagnosed with CP in their second year of life. Mixed-effects regression models will be used to compare school readiness outcomes between those referred for early intervention versus placebo/care-as-usual. We will also compare health-resource use associated with early diagnosis and intervention versus later diagnosis and intervention. ETHICS AND DISSEMINATION The Children's Health Queensland Hospital and Health Service, The University of Queensland, University of Sydney, Monash University and Curtin University Human Research Ethics Committees have approved this study. Informed consent will be sought from the parent or legal guardian of every child invited to participate. Results will be disseminated in peer-reviewed journals, scientific conferences and professional organisations, and to people with lived experience of CP and their families. TRIAL REGISTRATION NUMBER ACTRN12621001253897.
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Affiliation(s)
- 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
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Samudragupta Bora
- Case Western Reserve University School of Medicine, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio, USA
- Faculty of Medicine, Mater Research Institute, The University of Queensland, South Brisbane, Queensland, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, 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
| | - Michael Collingwood Fahey
- Paediatric Neurology, Monash Medical Centre Clayton, Clayton, Victoria, Australia
- Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Stewart Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Kerstin Pannek
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Canberra, Australian Capital Territory, Australia
| | - Alex Pagnozzi
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Canberra, Australian Capital Territory, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Hayley Smithers Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kirsten Rebecca Palmer
- Obstetrics and Gynaecology, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia
| | - Andrea Burgess
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Afroz Keramat
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Kristie Bell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
- Dietetics and Food Services, Children's Health Queensland, South Brisbane, Queensland, Australia
| | - Ashleigh Hines
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Katherine Benfer
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Laura Gascoigne-Pees
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Shaneen Leishman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Stina Oftedal
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
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Wang J, Yue L, Chen Z, Bai B, Chen C. Effect of Hospital-Family Rehabilitation Intervention on Walking Function and Lower Limb Surface Electromyography in Children with Cerebral Palsy. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7034670. [PMID: 35720026 PMCID: PMC9200566 DOI: 10.1155/2022/7034670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/06/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022]
Abstract
Objective To explore the effect of hospital-family rehabilitation intervention on walking function and lower limb surface electromyography in children with cerebral palsy (CP). Methods About 100 children with CP treated in our hospital from February 2019 to April 2021 were enrolled. The patients were randomly assigned into control group and study group. The control group received routine intervention, and the study group received hospital-family rehabilitation intervention. The intervention effect, GMFM88 scale score, IMMG value, CR value, lower limb surface EMG value, and compliance of gastrocnemius muscle and tibialis anterior muscle were compared. Results First of all, we compared the intervention effects. In the study group, 43 cases were markedly effective, 5 cases were effective, 1 case was improved, 1 case was ineffective, and the effective rate was 98.00%. In the control group, 22 cases were markedly effective, 14 cases were effective, 7 cases were improved, 7 cases were ineffective, and the effective rate of 86.00%. The intervention effect of the study group was better compared to the control group (P < 0.05). Secondly, we compared the scores of the GMFM88 scale. The scores of D area and E area and total score of the study group were higher compared to the control group (P < 0.05). The IEMG values of gastrocnemius muscle and tibialis anterior muscle were compared, and the IMMG values of passive and active gastrocnemius muscle and tibialis anterior muscle in the study group were higher compared to the control group (P < 0.05). There exhibited no significant difference in CR value before intervention (P > 0.05). After intervention, the CR values of gastrocnemius muscle and tibialis anterior muscle in the study group were significantly lower compared to the control group (P < 0.05). In terms of the surface EMG of lower limbs, the EMG value of passive activity (gastrocnemius muscle, tibialis anterior muscle) in the study group was higher compared to the control group, and the EMG value of active activity was significantly lower compared to the control group (P < 0.05). Finally, we compared the compliance. In the study group, there were 43 cases of complete compliance, 7 cases of compliance, and 0 cases of noncompliance, with a compliance rate of 100.00%. In the control group, there were 32 cases of complete compliance, 11 cases of compliance, and 7 cases of noncompliance with a compliance rate of 86.00%. The compliance rate of the study group was better compared to the control group (P < 0.05). Conclusion The intervention of hospital-family rehabilitation model is helpful to improve the self-care ability, cognitive function, and daily activities of children with CP, enhance the walking function and lower limb surface electromyography of children with SCP, and strengthen their qualities of life.
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Affiliation(s)
- Jing Wang
- Department of Neurorehabilitation, Hebei Children's Hospital, China
| | - Ling Yue
- Department of Neurorehabilitation, Hebei Children's Hospital, China
| | - Zhihong Chen
- Nursing Department, Hebei Children's Hospital, China
| | - Bing Bai
- Department of Neurorehabilitation, Hebei Children's Hospital, China
| | - Cuiying Chen
- Department of Neurorehabilitation, Hebei Children's Hospital, China
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Elvrum AKG, Johansen GO, Vik T, Krumlinde-Sundholm L. External validity of the Both Hands Assessment for evaluating bimanual performance in children with bilateral cerebral palsy. Dev Med Child Neurol 2022; 64:586-592. [PMID: 34907525 DOI: 10.1111/dmcn.15127] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 09/11/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
AIM To investigate the external validity of the Both Hands Assessment (BoHA), a new test evaluating bimanual performance in children with bilateral cerebral palsy (CP), by analysing its relationship to established measurements of hand function and self-care skills. METHOD In this cross-sectional study, we recruited children with bilateral CP and manual ability corresponding to Manual Ability Classification System (MACS) levels I to III attending three habilitation units in Norway. All participants completed the BoHA. Unimanual capacity was assessed using the Bimanual Fine Motor Function (BFMF) classification, the Box and Block Test (BBT), and the Melbourne Assessment 2 (MA2). Self-care skills were assessed with the Pediatric Evaluation of Disability Inventory (PEDI). RESULTS Thirty-nine children (19 males, 20 females; mean age 8y 2mo, SD 2y 8mo; age range 2y 8mo-12y 6mo) were included. Spearman's correlation coefficient (ρ) suggested high correlation between the BoHA and MACS (p=0.89; 95% confidence interval [CI] 0.79-0.94), BFMF classification (p=0.84; 95% CI 0.71-0.91), and BBT for the non-dominant (p=0.85; 95% CI 0.68-0.95) and dominant hand (p=0.72; 95% CI 0.53-0.85). The Spearman's ρ between the BoHA and the MA2 subscales varied between 0.48 and 0.83, while the PEDI's ρ was 0.51 (95% CI 0.33-0.67). INTERPRETATION The BoHA provides valid measures of hand use as suggested by its high correlation with other activity-based measures of hand function.
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Affiliation(s)
- Ann-Kristin G Elvrum
- Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gøril Okkenhaug Johansen
- Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torstein Vik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lena Krumlinde-Sundholm
- Neuropediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Park H, Choi JY, Yi SH, Park ES, Shim D, Choi TY, Rha DW. Relationship between the more-affected upper limb function and daily activity performance in children with cerebral palsy: a cross-sectional study. BMC Pediatr 2021; 21:459. [PMID: 34666730 PMCID: PMC8524797 DOI: 10.1186/s12887-021-02927-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background There are differences in roles between the more-affected and less-affected upper limb of children with cerebral palsy (CP). However, there is a lack of studies of the relationship between the more-affected limb function and activities of daily living (ADL) in children with CP. Thus, the aim of this prospective cross-sectional study was to investigate the relationship between more-affected upper limb function and ADL in children with CP. Methods Children with spastic CP (unilateral CP n = 28, bilateral CP n = 31; 34 males, 25 females; mean age ± SD, 6.8 ± 3.1y [range, 3-14y]) participated in this study. Function of the more-affected upper limb was measured using the Melbourne Assessment of Unilateral Upper limb Function, version 2 (MA2) and the Upper Limb Physician’s Rating Scale (ULPRS). Performance of daily living activities was measured using the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT). Results The range, accuracy and fluency dimension of MA2 and ULPRS total scores were moderately correlated with the daily activity domain (r = 0.47, 0.47, 0.56 for MA2 and r = 0.50 for ULPRS, respectively; P < 0.001) rather than the mobility, social/cognitive, and responsibility domains of the PEDI-CAT. ULPRS scores for elbow extension, supination in extension, supination in flexion, and two-handed function were moderately correlated with the PEDI-CAT daily activity domain (r = 0.44, 0.43, 0.41, and 0.49, respectively; P < 0.01). Finger opening and thumb-in-palm deformity of the ULPRS did not correlate with any PEDI-CAT domain. Conclusions The MA2 range, accuracy, and fluency domains (rather than dexterity) had the strongest correlations with the PEDI-CAT daily activity domain. Elbow extension, forearm supination, and two-handed function (rather than wrist and finger movements) of the ULPRS had the strongest correlations with the PEDI-CAT daily activity domain. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02927-2.
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Affiliation(s)
- Hyerin Park
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50-1, Yonsei‑ro, Seodaemun‑gu, Seoul, Republic of Korea
| | - Ja Young Choi
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Sook-Hee Yi
- Department of Rehabilitation Medicine, Seoul Rehabilitation Hospital, 30, Galhyeon-ro 11-gil, Eunpyeong-gu, Seoul, Republic of Korea
| | - Eun Sook Park
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50-1, Yonsei‑ro, Seodaemun‑gu, Seoul, Republic of Korea
| | - Dain Shim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50-1, Yonsei‑ro, Seodaemun‑gu, Seoul, Republic of Korea
| | - Tae Young Choi
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50-1, Yonsei‑ro, Seodaemun‑gu, Seoul, Republic of Korea
| | - Dong-Wook Rha
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50-1, Yonsei‑ro, Seodaemun‑gu, Seoul, Republic of Korea.
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