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Bharti N, Dwivedi AK, Gupta S, Singh AK, Sharma B, Khan IA. A Cross-Sectional Study Examining the Relationship Between Malnutrition and Gross Motor Function in Cerebral Palsy. Cureus 2024; 16:e55753. [PMID: 38586741 PMCID: PMC10999170 DOI: 10.7759/cureus.55753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Cerebral palsy (CP) characterizes a range of permanent, nonprogressive symptoms of postural and motor dysfunction caused by an insult to the developing central nervous system in a fetus or an infant. CP manifests early in life, often within the first two to three years of age. CP is associated with poor growth, that is the deviation from the normal growth parameters. The prevalence of CP ranges from 2.0 to 3.5 per 1000 live births in high-income countries which is comparable to the estimates from low-income countries. Antenatal and perinatal insults are among the most commonly reported causes of CP; however, a large number of cases do not have an identifiable etiology of CP. The current study aims to examine the relationship between malnutrition and gross motor function in children with CP. Materials and Methods This study was conducted at the Department of Pediatrics and Neonatology, Nehru Hospital, Baba Raghav Das (BRD) Medical College, Gorakhpur (UP) over a period of one year (August 2020 to July 2021) after obtaining ethical clearance from the College Research Council. Children of age 1-15 years with CP attending the pediatric outpatient and inpatient departments were enrolled as the study participants after obtaining informed consent from a legal guardian. Assessment of motor function was done using the gross motor function classification system (GMFCS). Associations of malnutrition across levels of gross motor function were tested using Chi-square or Fisher's exact test whichever was applicable. Statistical significance was set at p < 0.05 as significant. Data was analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). Result We analyzed 110 children with a diagnosis of CP (median age 6.5 years, interquartile range (IQR) 4.4-9.0 years). The majority (65/110; 59%) of the patients were male, and 68 (61.8%) delivered at term gestation. The most common presenting symptom among children with CP was seizures (79/110; 72.3%), the second most common being delayed milestones among 73 (66.8%), followed by difficulty in breathing among 63 (57.5%). The association between the anthropometric index of participants and GMFCS was found to be highly significant. Conclusion Most CP patients were facing gross motor disturbances. Spastic type of CP was most frequent, and more than half of the patients experienced feeding difficulty. A statistically significant association was found between gross motor functioning and the prevalence of malnutrition and stunting.
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Affiliation(s)
- Namrata Bharti
- Pediatrics, Baba Raghav Das Medical College, Gorakhpur, IND
| | | | - Shikha Gupta
- Physical Medicine and Rehabilitation, Baba Raghav Das Medical College, Gorakhpur, IND
| | | | | | - Imran Ahmed Khan
- Community Medicine, Baba Raghav Das Medical College, Gorakhpur, IND
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Sadeghian Afarani R, Fatorehchy S, Rassafiani M, Vahedi M, Azadi H, Akbarfahimi N. Psychometric Evaluation of the Persian Version of the Functional Mobility Scale: Assessing Validity and Reliability. Phys Occup Ther Pediatr 2024; 44:721-732. [PMID: 38317376 DOI: 10.1080/01942638.2024.2314489] [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: 08/04/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/07/2024]
Abstract
AIM This study aimed to assess the content, concurrent validity, test-retest, and intra-rater reliability of the Persian version of the Functional Mobility Scale (FMS) for evaluating functional mobility in children and adolescents with cerebral palsy (CP). METHODS Following international standards for measurement translation, we developed a Persian version of the FMS. A total of 160 participants took part in this study. Concurrent validity was assessed using Spearman's coefficient to correlate with the Gross Motor Function Classification System (GMFCS). Test-retest (n = 30) and intra-rater (n = 30) reliability of the FMS were also examined by Cohen's weighted kappa coefficient. RESULTS Concurrent validity ranged from -0.912 to -0.941 for children and -0.912 to -0.936 for adolescents. Test-retest ranged from 0.902 to 1. Intra-rater ranged from 0.933 to 0.987. CONCLUSION The Persian version of the FMS demonstrates very strong validity and almost perfect reliability for assessing and classifying functional mobility in children and adolescents with CP. These findings suggest that this tool could be a useful addition to clinical practice and research for the Persian-speaking population.
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Affiliation(s)
- Razieh Sadeghian Afarani
- Department of Occupational Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Saeid Fatorehchy
- Department of Occupational Therapy, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Rassafiani
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Australia
| | - Mohsen Vahedi
- Department of Biostatistics and Epidemiology, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamidreza Azadi
- Department of Occupational Therapy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazila Akbarfahimi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Rofeideh Rehabilitation Hospital, University of Social Welfare and Rehabilitation Sciences, Iran
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Lidbeck C, Häbel H, Martinsson C, Pettersson K, Löwing K. Motor Development in Children with Cerebral Palsy in Sweden-A Population-Based Longitudinal Register Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1864. [PMID: 38136066 PMCID: PMC10741609 DOI: 10.3390/children10121864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023]
Abstract
The aim was to explore longitudinal motor development in children with cerebral palsy (CP) in Sweden with respect to the Gross Motor Function Classification System (GMFCS). In this national CP registry-based study, 2138 children aged 0.5-19 years participated (42% girls). The distribution with respect to GMFCS was I: 49%, II: 16%, III: 10%, IV: 14%, and V: 11%. In total, 5538 assessments (mean 2.7, min-max: 1-9) with the Gross Motor Function Measure-66 were included. Data were analysed using non-linear mixed-effects regression models, and the Stable Limit Model was selected to fit data. Five distinct curves of predicted gross motor development with respect to GMFCS levels were obtained. The achieved motor development was maintained over time. The estimated average GMFM-66 limit and the average age when 90% of the expected limits were reached were at GMFCS I: 88 at age 4.5; GMFCS II: 71 at age 4.2; GMFCS III: 54 at age 3.1; GMFCS IV: 38 at age 2.6, and at GMFCS V: 18 at age 0.9. In conclusion, this is the first national population-based study following motor development in CP. Five distinct curves reported in previous controlled research studies were confirmed. Our study adds knowledge about motor development captured in children's everyday context.
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Affiliation(s)
- Cecilia Lidbeck
- Division of Paediatric Neurology, Department of Women’s and Children’s Health, Karolinska Institutet, 171 76 Stockholm, Sweden;
- Astrid Lindgren Childrens Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Henrike Häbel
- Medical Statistics Unit, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden;
| | | | - Katina Pettersson
- Centre for Clinical Research, Uppsala University—Region Västmanland, 721 89 Västerås, Sweden;
| | - Kristina Löwing
- Division of Paediatric Neurology, Department of Women’s and Children’s Health, Karolinska Institutet, 171 76 Stockholm, Sweden;
- Astrid Lindgren Childrens Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden
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Wang X, Teh SH, Du XG, Wang XH. Acupuncture and Tuina Treatment for Gross Motor Function in Children with Spastic Cerebral Palsy: A Monocentric Clinical Study. Neuropsychiatr Dis Treat 2023; 19:1875-1886. [PMID: 37667737 PMCID: PMC10475301 DOI: 10.2147/ndt.s424102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Abstract
Objective Cerebral palsy (CP) is a condition characterized by abnormal pronunciation, posture, and movement, particularly spastic CP, which involves Gross motor dysfunction due to increased muscle tone and stiffness. This monocentric clinical study aims to evaluate the effectiveness of acupuncture and tuina (AT) in improving gross motor function and alleviating associated symptoms in children diagnosed with spastic CP. Methods A total of 83 eligible patients received AT treatment, while 85 patients received conventional rehabilitation treatment. Both groups underwent a 12-week treatment period following the research protocol. Pre- and post-treatment assessments included the Modified Ashworth Muscle Tension Scale (MAS), Gross Motor Function Measure (GMFM-D and GMFM-E), 6-min walking distance measurement (6MWD), and Modified Children's Functional Independence Rating Scale (WeeFIM). Results After 12 weeks of treatment, when compared with baseline, the scores of MAS in both AT group and control group are decreased (p<0.01, p<0.01), the scores of GMFM-D, GMFME, 6MWD, WeeFIM in both group are increased (p<0.01 in all indicators). When compared with control group, AT group had significantly lower MAS scores compared to the control group (p<0.01), indicating reduced muscle tension. Moreover, AT group showed significantly higher scores in GMFM-D, GMFM-E, 6MWD, and WeeFIM compared to the control group (p<0.01 in all indicators), indicating improved gross motor function and functional independence. The study also revealed an inverse correlation between the children's age and treatment efficacy (r= -0.496, p<0.01 in AT group, r=-0.540, p<0.01 in control group), highlighting the importance of early intervention in the management of CP in children. Conclusion These findings suggest that AT may effectively enhance gross motor function and alleviate associated symptoms in children diagnosed with spastic CP. Moreover, early initiation of treatment is crucial to maximize therapeutic efficacy in children with spastic CP. Trial Registration Chinese Clinical Trial Registry, ChiCTR2200059823. Registered on 12 May 2022.
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Affiliation(s)
- Xing Wang
- M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, SGR, Malaysia
- Famous TCM Expert Heritage Studio, Xi’an Encephalopathy Hospital Affiliated to Shaanxi University of Chinese Medicine, Xi’an, Shaanxi, People’s Republic of China
| | - Siew Hoon Teh
- M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, SGR, Malaysia
| | - Xiao-Gang Du
- Famous TCM Expert Heritage Studio, Xi’an Encephalopathy Hospital Affiliated to Shaanxi University of Chinese Medicine, Xi’an, Shaanxi, People’s Republic of China
| | - Xing-Hua Wang
- M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, SGR, Malaysia
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Davis TJ, Salazar R, Beenders S, Boehme A, LaMarca NM, Bain JM. A Prospective, Longitudinal Study of Caregiver-Reported Adaptive Skills and Function of Individuals with HNRNPH2-related Neurodevelopmental Disorder. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2023; 8:445-456. [PMID: 39220267 PMCID: PMC11358239 DOI: 10.1007/s41252-023-00346-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 09/04/2024]
Abstract
Objectives This study presents a cohort of individuals in a natural history study with de novo pathogenic missense variants in HNRNPH2 causative of HNRNPH2-related neurodevelopmental disorder (NDD) to describe individuals' adaptive functional abilities. Methods We measured adaptive function using the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) and the Vineland Adaptive Behavior Scale (VABS-III). Results were compared using inferential statistics and regression analysis. Results Sixty-seven individuals carried known pathogenic or likely pathogenic variants in HNRNPH2. Thirty-five participants (2.89-42.04 years, 83% female) and caregivers completed PEDI-CAT assessments with 25 of these participants completing the VABS-III. Sixteen, three and two participants completed a follow-up PEDI-CAT assessment at one, two and three years respectively. Individuals had mean normative scores less than age-matched peers across all domains on both PEDI-CAT and VABS-III measures, with 91% participants < 5th percentile on both the PEDI- CAT and VABS-III. Verbal and ambulatory participants had significantly higher PEDI-CAT scores across all domains, using both raw and normative data. There was no significant change in PEDI-CAT scores over 3 years. Conclusions Overall scores, both raw and normative, are low across all individuals with HNRNPH2-related NDD using both the PEDI-CAT and VABS-III. PEDI-CAT normative scores do not likely represent the clinical variability, but raw scores may be able to capture functional variability. In a small sample, longitudinal data from the PEDI-CAT domain scores demonstrate stability in performance at 3 years.Trial Registration: ClinicalTrials.gov NCT03492060.
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Affiliation(s)
- Thomas J. Davis
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
| | - Rachel Salazar
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
- Department of Interprofessional Health Sciences and Health Administration, Seton Hall University, Nutley, NJ United States
| | - Sarah Beenders
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, PA Philadelphia, United States
| | - Amelia Boehme
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
| | - Nicole M. LaMarca
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
| | - Jennifer M. Bain
- Department of Neurology, Columbia University Irving Medical Center and NewYork Presbyterian Morgan Stanley Children’s Hospital, New York, NY USA
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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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Akkaya KU, Bezgin S, Field D, Elbasan B. Turkish validity and reliability of the level of sitting scale in children with cerebral palsy. Turk J Med Sci 2023; 53:603-609. [PMID: 37476883 PMCID: PMC10387952 DOI: 10.55730/1300-0144.5621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/15/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The Level of Sitting Scale (LSS) is a valid and reliable classification index that categorizes sitting ability. The aim of this study is to establish the Turkish validity and reliability of the LSS in children with cerebral palsy (CP). METHODS In total, 165 children (75 girls and 90 boys) between the ages of 4 and 18 years who were diagnosed with CP were included in the study. All children were evaluated by two independent physiotherapists for the interrater reliability analysis of the LSS and were reevaluated 1 week later by the same physiotherapist for the intrarater reliability analysis. The Gross Motor Function Classification System (GMFCS) was used for validity analysis. RESULTS The intrarater reliability analyses of the LSS showed an intraclass correlation coefficient of 0.999 (ICC 95% CI [0.999-1]),and the interrater reliability analyses showed an intraclass correlation coefficient of 0.998 (ICC 95% CI [0.998-0.999]). A statistically significant, negative, and strong correlation was found between the GMFCS and the LSS (p < 0.001, r = -0.770). DISCUSSION The Turkish version of the LSS in children with CP is a valid and reliable scale. The Turkish LSS can be used by researchersand clinicians in research and to determine the sitting level of children with CP.
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Affiliation(s)
- Kamile Uzun Akkaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Sabiha Bezgin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Debra Field
- Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada
| | - Bülent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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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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De Beukelaer N, Vandekerckhove I, Huyghe E, Molenberghs G, Peeters N, Hanssen B, Ortibus E, Van Campenhout A, Desloovere K. Morphological Medial Gastrocnemius Muscle Growth in Ambulant Children with Spastic Cerebral Palsy: A Prospective Longitudinal Study. J Clin Med 2023; 12:jcm12041564. [PMID: 36836099 PMCID: PMC9963346 DOI: 10.3390/jcm12041564] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
Only cross-sectional studies have demonstrated muscle deficits in children with spastic cerebral palsy (SCP). The impact of gross motor functional limitations on altered muscle growth remains unclear. This prospective longitudinal study modelled morphological muscle growth in 87 children with SCP (age range 6 months to 11 years, Gross Motor Function Classification System [GMFCS] level I/II/III = 47/22/18). Ultrasound assessments were performed during 2-year follow-up and repeated for a minimal interval of 6 months. Three-dimensional freehand ultrasound was applied to assess medial gastrocnemius muscle volume (MV), mid-belly cross-sectional area (CSA) and muscle belly length (ML). Non-linear mixed models compared trajectories of (normalized) muscle growth between GMFCS-I and GMFCS-II&III. MV and CSA growth trajectories showed a piecewise model with two breakpoints, with the highest growth before 2 years and negative growth rates after 6-9 years. Before 2 years, children with GMFCS-II&III already showed lower growth rates compared to GMFCS-I. From 2 to 9 years, the growth rates did not differ between GMFCS levels. After 9 years, a more pronounced reduction in normalized CSA was observed in GMFCS-II&III. Different trajectories in ML growth were shown between the GMFCS level subgroups. These longitudinal trajectories highlight monitoring of SCP muscle pathology from early ages and related to motor mobility. Treatment planning and goals should stimulate muscle growth.
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Affiliation(s)
- Nathalie De Beukelaer
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-474033110
| | | | - Ester Huyghe
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Geert Molenberghs
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), KU Leuven, 3000 Leuven, Belgium
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), Data Science Institute, Hasselt University, 3590 Diepenbeek, Belgium
| | - Nicky Peeters
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, 9000 Gent, Belgium
| | - Britta Hanssen
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, 9000 Gent, Belgium
| | - Els Ortibus
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Anja Van Campenhout
- Department of Orthopedics, University Hospitals Leuven, 3000 Leuven, Belgium
- Clinical Motion Analysis Laboratory, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium
- Clinical Motion Analysis Laboratory, University Hospitals Leuven, 3000 Leuven, Belgium
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10
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Moon I, An Y, Min S, Park C. Therapeutic Effects of Metaverse Rehabilitation for Cerebral Palsy: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1578. [PMID: 36674332 PMCID: PMC9864535 DOI: 10.3390/ijerph20021578] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/04/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Metaverse physical therapy (MPT), an adjuvant technology for the rehabilitation of children with cerebral palsy (CP), has gained notoriety in the clinical field owing to its accessibility and because it provides motivation for rehabilitation. The aim is to compare the gross motor function and cardiopulmonary function, the activities of daily living, quality of life (QOL), and the perceived risk of coronavirus disease (COVID)-19 transmission between MPT and conventional physical therapy (CPT). A convenience sample of 26 children with CP (mean age, 11.23 ± 3.24 years, 14 females) were randomized into either the MPT or CPT group and received therapy three days/week for four weeks. Clinical outcomes included gross-motor-function measure 66 (GMFM-66), heart rate (HR), Borg-rating perceived exertion (BRPE), functional independence measure (FIM), pediatric QOL, and the risk of COVID-19 transmission. An analysis of variance showed that compared with CPT, MPT exerted positive effects on GMFM, HR, and BRPE. An independent t-test showed that compared with CPT, MPT exerted positive effects on the perceived transmission risk of COVID-19 but not on FIM and QOL. Our results provide promising therapeutic evidence that MPT improves gross motor function, cardiopulmonary function, and the risk of COVID-19 in children with CP.
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Affiliation(s)
- Ilyoung Moon
- Department of Physical Therapy, Yonsei University, Wonju 26493, Republic of Korea
| | - Yeongsang An
- Funrehab Co., Ltd., Daejeon 35229, Republic of Korea
| | - Seunghwa Min
- Funrehab Co., Ltd., Daejeon 35229, Republic of Korea
| | - Chanhee Park
- Department of Physical Therapy, Yonsei University, Wonju 26493, Republic of Korea
- Funrehab Co., Ltd., Daejeon 35229, Republic of Korea
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11
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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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12
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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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