1
|
Blasco M, García-Galant M, Berenguer-González A, Caldú X, Arqué M, Laporta-Hoyos O, Ballester-Plané J, Miralbell J, Jurado MÁ, Roser Pueyo. Interventions with an Impact on Cognitive Functions in Cerebral Palsy: a Systematic Review. Neuropsychol Rev 2022; 33:551-577. [PMID: 35972712 DOI: 10.1007/s11065-022-09550-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/18/2022] [Indexed: 10/15/2022]
Abstract
This systematic review aimed at investigating those interventions that impact on cognitive functioning in children and adults with cerebral palsy (CP). A systematic database search was conducted and twenty-eight studies suitable for inclusion were identified, of which only nine were randomized controlled trials (RCTs). Among all the studies included, ten were multi-modal (cognitive and physical tasks), eleven physical, five cognitive, and two alternative and augmentative communication interventions. The evidence suggests that multi-modal and physical interventions improve general cognitive functioning. Multi-modal and cognitive interventions have an impact on visual perception. Both interventions, together with physical interventions have an effect on a specific executive function domain (inhibitory control), and only cognitive interventions improved other executive function domains such as working memory. However, no RCT assessed the effects of all executive function domains. Few studies have looked at interventions to improve memory and language, and there is a scarcity of long-term research. Future RCTs must be of higher quality and better account for age and sex differences, as well as the clinical heterogeneity of CP. To date, there is evidence that multi-modal, cognitive or physical interventions have an impact on general cognitive functioning, visual perception and executive functions in children with CP, which may support their cognitive development.The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO): CRD42020152616.
Collapse
Affiliation(s)
- Montse Blasco
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - María García-Galant
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Alba Berenguer-González
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Miquel Arqué
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Júlia Miralbell
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - María Ángeles Jurado
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain. .,Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain. .,Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain.
| |
Collapse
|
2
|
Sees JP, Miller F. The Foot in Cerebral Palsy. Foot Ankle Clin 2021; 26:639-653. [PMID: 34752232 DOI: 10.1016/j.fcl.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Children with cerebral palsy frequently develop foot deformities, most commonly equinus contractures, which can be managed with orthotics up to age 5 to 7 years. Plantar flexor lengthening, typically around this age, should be restricted to the offending muscle only, usually with a fascia release of the gastrocnemius. Equinovarus, mainly a problem in children with unilateral cerebral palsy, often responds to plantar flexor lengthening. If further tendon transfers are needed, they should be done when the child is older to avoid overcorrection. Planovalgus mostly improves spontaneously up to age 5 years. Surgical correction is best done in adolescence.
Collapse
Affiliation(s)
- Julieanne P Sees
- Department of Orthopedics, Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, USA
| | - Freeman Miller
- Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, BOX 269, Wilmington, DE 19899, USA.
| |
Collapse
|
3
|
Abstract
Health-related quality of life (HRQOL) is central to how clinicians and parents make choices about medical care for pediatric neurology patients. To provide parents with the information they need to make these decisions and plan for the future, it is necessary for parents and clinicians to understand how HRQOL is defined and measured in the setting of pediatric neurodevelopmental impairment. We review challenges that exist in measuring HRQOL in pediatric neurology, examine existing measures, and outline key principles to guide selection and interpretation of HRQOL measures in children with neurologic conditions.
Collapse
Affiliation(s)
- Monica E. Lemmon
- Department of Pediatrics, Duke University Medical Center, Durham, NC,Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD,Margolis Center for Health Policy, Duke University, Durham, NC
| | | | - Bryce B. Reeve
- Department of Pediatrics, Duke University Medical Center, Durham, NC,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC,Center for Health Measurement, Duke University School of Medicine, Durham, NC
| |
Collapse
|
4
|
Zwinkels M, Ketelaar M, Nijboer T, Verschuren O, Te Velde S, de Groot J, Takken T, Visser-Meily A. Effects of a school-based sports program on psychosocial health and attention in youth with physical disabilities. J Pediatr Rehabil Med 2020; 13:37-46. [PMID: 32176664 DOI: 10.3233/prm-180570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Youth with physical disabilities have lower psychosocial health and attention compared to their typically developing peers. Recent research has shown positive associations between sports participation and these outcomes. The purpose of the current study was to explore whether a school-based sports program affects psychosocial health and attention in youth with physical disabilities. METHODS Seventy children and adolescents (mean age (SD) 13.8 (2.9) years, aged 8-19 years, 54% boys) with physical disabilities were included in this quasi-experimental study from schools for special education. The sports group (n= 31) followed a school-based sports program (45 min/week) for six months. The control group followed the regular curriculum. Psychosocial health was assessed with self-perception (Self-Perception Profile for Children) and quality of life (DISABKIDS Chronic Generic Measure, DCGM-37). Attention was measured with experimental tasks on search efficiency, sustained attention, and distractibility. RESULTS Linear regression analyses revealed no differences between the sports and control group for self-perception, quality of life, and attention. CONCLUSION A school-based sports program seems to have no effect on psychosocial health and attention in youth with physical disabilities. Research into the important factors influencing these variables is needed before further resources can be given to improve sports participation for increasing psychosocial health and attention.
Collapse
Affiliation(s)
- Maremka Zwinkels
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Tanja Nijboer
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | | | - Janke de Groot
- HU University of Applied Sciences, Utrecht, The Netherlands
| | - Tim Takken
- Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anne Visser-Meily
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
5
|
Makris T, Dorstyn D, Crettenden A. Quality of life in children and adolescents with cerebral palsy: a systematic review with meta-analysis. Disabil Rehabil 2019; 43:299-308. [PMID: 31180733 DOI: 10.1080/09638288.2019.1623852] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cerebral palsy has been linked to decreased quality of life. However use of self- versus proxy-perspectives and norm-sample comparisons to examine quality of life impact may produce different results. AIMS To compare quality of life ratings in children and adolescents with cerebral palsy relative to typically developing peers in consideration of sample and methodological moderators on estimated effects. METHODS Eleven independent studies, comprising a pooled sample of 1475 families living with cerebral palsy and 42119 peers, were identified. Study reporting quality was evaluated with the QualSyst tool and standardised mean group differences (Hedges' g) with associated confidence intervals and p values calculated. Heterogeneity was examined using a random effects model. RESULTS All studies provided good to excellent methodological and statistical detail. Physical quality of life was significantly impaired among those with cerebral palsy (g range: -0.42 to -1.58). However, inconsistent findings were noted in relation to the effect of cerebral palsy on psychological (g range: 0.04 to -0.80) and social quality of life (g range: -0.80 to -0.51), depending on the measurement used. There was a trend for parents to evaluate their child's physical quality of life lower than child-reported scores. CONCLUSIONS Physical quality of life is, invariably, more affected in those with cerebral palsy. The connection between cerebral palsy and psychosocial quality of life is less clear. Noted parent-child discrepancies highlight the value of a multi-informant approach to child quality of life assessment. Implications for rehabilitation Quality of life is an important health-related outcome in cerebral palsy research and practice. Collecting both self-report and proxy data can help to highlight quality of life issues that are salient to the parent and to the child or adolescent with cerebral palsy. Selection of the appropriate quality of life instrument depends on the assessment purpose, with available measures varying in their focus on functionality, subjectivity and illness-specific items. Quality of life assessment of children with cerebral palsy should extend beyond functional abilities to include less obvious, but critical, psychological and social issues.
Collapse
Affiliation(s)
- Tina Makris
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, Australia
| | - Diana Dorstyn
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, Australia
| | - Angela Crettenden
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, Australia
| |
Collapse
|
6
|
Colquitt G, Walker AD, Alfonso ML, Olivas M, Ugwu B, Dipita T. Parent Perspectives on Health and Functioning of School-Aged Adolescents With Disabilities. THE JOURNAL OF SCHOOL HEALTH 2018; 88:676-684. [PMID: 30133774 DOI: 10.1111/josh.12668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/31/2017] [Accepted: 11/20/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Youth living with disabilities are at risk of experiencing poor health outcomes. Coordinated school health programs have an opportunity to help youth with disabilities and their families through health education, health services, and community engagement. The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) as a framework to analyze factors related to health conditions. We used the ICF to examine parental perceptions of health and function among students with disabilities living in rural and urban areas. METHODS We surveyed parents (N = 71) using the parent-report versions of the Pediatric Outcomes Data Collection Instrument and Child Health and Illness Profile. From this group, parents were asked to volunteer to participate in in-depth, individual interviews (N = 18). The interviews were audio-recorded and transcribed verbatim. Researchers used the ICF linking rules to analyze and code the transcriptions. Emergent themes were assigned numerical ICF codes. RESULTS There were more similarities than differences among rural and urban families. Children living with disabilities face significant environmental barriers regardless of context. CONCLUSIONS Schools can facilitate education to improve the quality of life of parents and families of children with disabilities. School authorities should consider the many environmental barriers both urban and rural these families face in the community. The ICF can be used as a framework for program planning for community-based, health education for this population.
Collapse
Affiliation(s)
- Gavin Colquitt
- Georgia Southern University, Department of Health Sciences and Kinesiology, PO Box 8076, Statesboro, GA 30460
| | - Ashley D Walker
- Community Health Education & Behavior, Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA 30460
| | - Moya L Alfonso
- Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA 30460
| | - Maria Olivas
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA 30460
| | - Bethrand Ugwu
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA 30460
| | - Theophile Dipita
- Biostatistics Team 1, HFV-163, Office of New Animal Drug Evaluation, Center for Veterinary Medicine, U.S. Food & Drug Administration, 7500 Standish Place, Rockville, MD 20855
| |
Collapse
|
7
|
Eriksson M, Jylli L, Villard L, Kroksmark AK, Bartonek Å. Health-related quality of life and orthosis use in a Swedish population with arthrogryposis. Prosthet Orthot Int 2018; 42:402-409. [PMID: 29775129 DOI: 10.1177/0309364618774059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Joint contractures are the main characteristics for children with arthrogryposis multiplex congenita. Orthoses are often used to enable or facilitate walking. OBJECTIVES To describe health-related quality of life in children with arthrogryposis multiplex congenita and satisfaction with orthoses in those using orthoses. STUDY DESIGN Cross-sectional study. METHODS A total of 33 children with arthrogryposis multiplex congenita participated in the study. Questionnaires were used which measured health-related quality of life (Child Health Questionnaire-Parent Form and EQ-5D youth), mobility and self-care (Paediatric Evaluation of Disability Inventory) and satisfaction with orthoses (Quebec User Evaluation of Satisfaction with Assistive Technology 2.0). Children were divided into groups based on the use of orthoses: Ort-D were dependent on orthoses for walking, Ort-ND used orthoses but were not dependent on them for walking and Non-Ort did not use orthoses. RESULTS Children with arthrogryposis multiplex congenita had significantly lower Child Health Questionnaire scores in 9 of 12 subscales compared to healthy controls. The children's reported perceived health with EQ-5D youth did not show any difference between children using orthoses or children using only shoes. Paediatric Evaluation of Disability Inventory showed less mobility in Ort-D than in Non-Ort. In total, both orthosis groups were 'quite satisfied' with their orthoses. CONCLUSION Child Health Questionnaire-physical functioning was lowest in children who were dependent on orthoses (Ort-D) for walking. Both Ort-D and Ort-ND were similar satisfied with their orthoses. Clinical relevance This study contributes to knowledge about health-related quality of life in a group of ambulatory children with arthrogryposis multiplex congenita. For children using orthoses, it is relevant to capture their opinion about their orthoses but a questionnaire specifically for children should be developed.
Collapse
Affiliation(s)
| | | | - Li Villard
- 1 Karolinska Institutet, Stockholm, Sweden
| | | | | |
Collapse
|
8
|
Borgestig M, Sandqvist J, Ahlsten G, Falkmer T, Hemmingsson H. Gaze-based assistive technology in daily activities in children with severe physical impairments-An intervention study. Dev Neurorehabil 2017; 20:129-141. [PMID: 26930111 DOI: 10.3109/17518423.2015.1132281] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents' satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention. METHODS Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1-15 years) participated in gaze-based AT intervention for 9-10 months, during which period the gaze-based AT was implemented in daily activities. RESULTS Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents' satisfaction with the AT and with services was high. DISCUSSION The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.
Collapse
Affiliation(s)
- Maria Borgestig
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden.,b Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health , Uppsala University , Uppsala , Sweden
| | - Jan Sandqvist
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
| | - Gunnar Ahlsten
- b Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health , Uppsala University , Uppsala , Sweden
| | - Torbjörn Falkmer
- c School of Occupational Therapy & Social Work, Curtin University , Perth , WA , Australia.,d School of Occupational Therapy, La Trobe University , Melbourne , Victoria , Australia.,e Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences , Linköping University & Pain and Rehabilitation Centre, UHL, County Council , Linköping , Sweden
| | - Helena Hemmingsson
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
| |
Collapse
|
9
|
Impact of a short walking exercise on gait kinematics in children with cerebral palsy who walk in a crouch gait. Clin Biomech (Bristol, Avon) 2016; 34:18-21. [PMID: 27038653 DOI: 10.1016/j.clinbiomech.2016.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 02/09/2016] [Accepted: 03/07/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Crouch gait results in an increase of the joint stress due to an excessive knee flexion. Daily walking exercises, even when performed at a self-selected speed, may result in a decrease of the extensor muscle strength which could lead to a more severe crouch gait pattern. The aim of this study was to assess the impact of a short walking exercise on gait kinematics in children with cerebral palsy who walk with a crouch gait. METHODS Seven children with cerebral palsy who walk with a crouch gait were asked to walk for 6min at a self-selected speed. The spatio-temporal and kinematic measures, as well as the center of mass position were compared before and after the exercise. FINDINGS There was no significant difference between walking speed before and after the walking exercise. Knee flexion and the maximal ankle dorsiflexion increased after the walking exercise. The vertical position of the center of mass decreased. No significant difference was found at the hip. INTERPRETATION Children with cerebral palsy who walk with a crouch gait were more crouched after a 6-min walking exercise performed at their self-selected speed. These gait modifications could be due to fatigue of the extensor muscle groups. This study highlighted that a short walking exercise, corresponding to daily mobility, results in gait pattern modifications. Since therapies in children with cerebral palsy aim to improve motor function in everyday life situations, it could be relevant to evaluate gait adaptation after a few minutes of walking exercise.
Collapse
|
10
|
Surender S, Gowda VK, Sanjay KS, Basavaraja GV, Benakappa N, Benakappa A. Caregiver-reported health-related quality of life of children with cerebral palsy and their families and its association with gross motor function: A South Indian study. J Neurosci Rural Pract 2016; 7:223-7. [PMID: 27114652 PMCID: PMC4821929 DOI: 10.4103/0976-3147.178657] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: In children, health-related quality of life (HRQOL) includes parental impact and family functioning along with concepts of illness, functional status, mental health, and comfort. We are focusing on the impact of cerebral palsy (CP) on children's HRQOL and their families, and its relationship with gross motor dysfunction. Subjects and Methods: CP children aged 3–10 years under regular neurology follow-up were enrolled. The HRQOL and motor severity were prospectively assessed using lifestyle assessment questionnaire-CP and gross motor function classification systems, respectively. Results: One hundred children participated in this study. Thirty-three percent of children had good, 22% had mildly affected, whereas 45% had moderately to severely affected HRQOL. A significant association is present between gross motor function classification system and HRQOL. Conclusion: HRQOL in CP and their caregivers is highly impaired. The degree of impairment is associated with physical independence, mobility, clinical burden, and social integration dimensions. Therapies targeting these dimensions and associated comorbidities will improve the HRQOL. Gross motor function classification system is a good indicator of HRQOL.
Collapse
Affiliation(s)
- S Surender
- Department of Paediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Vykuntaraju K Gowda
- Department of Paediatric Neurology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - K S Sanjay
- Department of Paediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - G V Basavaraja
- Department of Paediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Naveen Benakappa
- Department of Paediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Asha Benakappa
- Department of Paediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| |
Collapse
|
11
|
Badia M, Begoña Orgaz M, Gómez-Vela M, Verdugo MA, Ullán AM, Longo E. Do environmental barriers affect the parent-reported quality of life of children and adolescents with cerebral palsy? RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 49-50:312-321. [PMID: 26788697 DOI: 10.1016/j.ridd.2015.12.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 12/12/2015] [Accepted: 12/14/2015] [Indexed: 06/05/2023]
Abstract
Physical, social, and attitudinal environment may affect the quality of life (QoL) of children and adolescents with cerebral palsy (CP). Participants in this study included parents of 206 children and adolescents with CP (55.8% males) aged 8-18 years (M=11.96, SD=3). Distribution according to the Gross Motor Function Classification System (GMFCS) was 24.3% level I, 18% level II, 18% level III, 12.6% level IV, and 27.2 level V. Environmental barriers were assessed with the Spanish version of the European Child Environment Questionnaire (ECEQ), and QoL was assessed with the KIDSCREEN parents' version. The results of the correlation analysis revealed that GMFCS level, IQ, and type of schooling are significantly correlated with QoL. Barriers were also associated with QoL. A series of hierarchical regression analyses indicated that, after controlling for the effect of child and parent's variables, barriers at home and at school significantly contribute to QoL. These findings underscore the importance of providing interventions to produce environmental changes that contribute to the improvement of QoL.
Collapse
Affiliation(s)
- Marta Badia
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain.
| | - M Begoña Orgaz
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.
| | - María Gómez-Vela
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain.
| | - Miguel A Verdugo
- Institute on Community Integration (INICO), Faculty of Psychology, University of Salamanca, Salamanca, Spain.
| | - Ana M Ullán
- Department of Social Psychology, University of Salamanca, Spain.
| | | |
Collapse
|
12
|
Resch B, Mühlanger A, Maurer-Fellbaum U, Pichler-Stachl E, Resch E, Urlesberger B. Quality of Life of Children with Cystic Periventricular Leukomalacia - A Prospective Analysis with the Child Health Questionnaire-Parent Form 50. Front Pediatr 2016; 4:50. [PMID: 27242979 PMCID: PMC4869559 DOI: 10.3389/fped.2016.00050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/02/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Cystic periventricular leukomalacia (PVL) is associated with moderate to severe physical and mental handicaps in preterm infants. We hypothesized whether or not those handicaps were associated with a poorer quality of life (QOL) of affected children and their families compared to matched controls. PATIENTS AND METHODS All children with the diagnosis PVL collected from a local database of the Division of Neonatology of the Medical University of Graz, Austria, and born between 1997 and 2008 were included in the study group. Preterm infants matched for gestational age, birth weight, year of birth, and gender without PVL served as controls. Selected perinatal data and neurological outcome were documented. The interview of the parents was conducted using the Child Health Questionnaire-Parent Form 50 (CHQ-PF50), German version. The CHQ-PF50 consists of 50 items divided over 11 multi-item scales and 2 single-item questions. RESULTS The CHQ-PF50 was answered by 21 parents of the study (26%) and 44 of the control (39%) group. Cases were diagnosed as having developmental delay, dystonia, strabismus, central visual impairment, seizures, and cerebral palsy (81 vs. 7%, p < 0.001) more common than controls. Analysis of the CHQ-PF 50 revealed significantly poorer results for cases regarding physical health (physical functioning: p < 0.001, physical social limitations: p < 0.001, and physical summary score: p < 0.001). Several psychosocial categories (behavior, mental health, and self-esteem) and the psychosocial summary score did not differ between groups. Only two categories (parental impact concerning time p = 0.004 and family activities: p = 0.026) revealed significantly poorer results in the cases as it was for the global category for health (p = 0.009). CONCLUSION Children with PVL had an overall poorer QOL regarding physical aspects. However, PVL was not generally associated with a poorer QOL regarding psychosocial aspects.
Collapse
Affiliation(s)
- Bernhard Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria; Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria
| | - Anja Mühlanger
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz , Graz , Austria
| | - Ute Maurer-Fellbaum
- Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria; Outpatient Department of Developmental Follow-Up, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Pichler-Stachl
- Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria; Outpatient Department of Developmental Follow-Up, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz , Graz , Austria
| | - Berndt Urlesberger
- Division of Neonatology, Department of Pediatrics, Medical University of Graz , Graz , Austria
| |
Collapse
|
13
|
Löwing K, Arredondo YC, Tedroff M, Tedroff K. Introduction of the gross motor function classification system in Venezuela--a model for knowledge dissemination. BMC Pediatr 2015; 15:111. [PMID: 26341265 PMCID: PMC4560893 DOI: 10.1186/s12887-015-0433-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 08/21/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A current worldwide common goal is to optimize the health and well-being of children with cerebral palsy (CP). In order to reach that goal, for this heterogeneous group, a common language and classification systems are required to predict development and offer evidence based interventions. In most countries in Africa, South America, Asia and Eastern Europe the classification systems for CP are unfamiliar and rarely used. Education and implementation are required. The specific aims of this study were to examine a model in order to introduce the Gross Motor Function Classification System (GMFCS-E&R) in Venezuela, and to examine the validity and the reliability. METHODS Children with CP, registered at a National child rehabilitation centre in Venezuela, were invited to participate. The Spanish version of GMFCS-E&R was used. The Wilson mobility scale was translated and used to examine the concurrent validity. A structured questionnaire, comprising aspects of mobility and gross motor function, was constructed. In addition, each child was filmed. A paediatrician in Venezuela received supervised self-education in GMFCS-E&R and the Wilson mobility scale. A Swedish student was educated in GMFCS-E&R and the Wilson mobility scale prior to visiting Venezuela. In Venezuela, all children were classified and scored by the paediatrician and student independently. An experienced paediatric physiotherapist (PT) in Sweden made independent GMFCS-E&R classifications and Wilson mobility scale scorings, accomplished through merging data from the structured questionnaire with observations of the films. Descriptive statistics were used and reliability was presented with weighted Kappa (Kw). Spearman's correlation coefficient was calculated to explore the concurrent validity between GMFCS-E&R and Wilson mobility scale. RESULTS Eighty-eight children (56 boys), mean age 10 years (3-18), with CP participated. The inter-rater reliability of GMFCS-E&R between; the paediatrician and the PT was Kw = 0.85 (95% CI: 0.75-0.88), the PT and student was Kw = 0.91 (95% CI: 0.86-0.95) and the paediatrician and student was Kw = 0.85 (95 % CI: 0.79-0.90). The correlations between GMFCS-E&R and Wilson mobility scale were high rs =0.94-0.95 (p < 0.001). CONCLUSIONS In a setting with no previous knowledge of GMFCS-E&R, the model with education, supervised self-education and practice was efficient and resulted in very good reliability and validity.
Collapse
Affiliation(s)
- Kristina Löwing
- Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Q2:07, SE-171 76, Stockholm, Sweden.
| | - Ynes C Arredondo
- Child Rehabilitation Center Mundo de Sonrisas Alta Vista, Mundo De Sonrisas Building, Puerto Ordaz, 8050, Venezuela.
| | - Marika Tedroff
- Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Q2:07, SE-171 76, Stockholm, Sweden.
| | - Kristina Tedroff
- Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Q2:07, SE-171 76, Stockholm, Sweden.
| |
Collapse
|
14
|
Houben-van Herten M, Bai G, Hafkamp E, Landgraf JM, Raat H. Determinants of health-related quality of life in school-aged children: a general population study in the Netherlands. PLoS One 2015; 10:e0125083. [PMID: 25933361 PMCID: PMC4416795 DOI: 10.1371/journal.pone.0125083] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/20/2015] [Indexed: 11/19/2022] Open
Abstract
Background Health related quality of life is the functional effect of a medical condition and/or its therapy upon a patient, and as such is particularly suitable for describing the general health of children. The objective of this study was to identify and confirm potential determinants of health-related quality of life in children aged 4-11 years in the general population in the Netherlands. Understanding such determinants may provide insights into more targeted public health policy. Methods As part of a population based cross sectional study, the Child Health Questionnaire (CHQ) Parental Form 28 was used to measure health-related quality of life in school-aged children in a general population sample. Parents of 10,651 children aged 4-11 years were interviewed from January 2001 to December 2009. Results Multivariate and regression analyses demonstrated a declined CHQ Physical Summary score for children who had >1 conditions, disorders or acute health complaints and who were greater consumers of healthcare; children with a non-western immigrant background; and children whose parents did not work. Lower CHQ Psychosocial Summary score was reported for children who had >1 conditions, disorders or acute health complaints, boys, children of single parents and obese children. Conclusion The best predictors of health-related quality of life are variables that describe use of health care and the number of disorders and health complaints. Nonetheless, a number of demographic, socio-economic and family/environmental determinants contribute to a child’s health-related quality of life as well.
Collapse
Affiliation(s)
| | - Guannan Bai
- Department of Public Health, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Esther Hafkamp
- Department of Public Health, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | | | - Hein Raat
- Department of Public Health, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
15
|
Stadskleiv K, von Tetzchner S, Batorowicz B, van Balkom H, Dahlgren-Sandberg A, Renner G. Investigating executive functions in children with severe speech and movement disorders using structured tasks. Front Psychol 2014; 5:992. [PMID: 25249999 PMCID: PMC4157461 DOI: 10.3389/fpsyg.2014.00992] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 08/21/2014] [Indexed: 11/17/2022] Open
Abstract
Executive functions are the basis for goal-directed activity and include planning, monitoring, and inhibition, and language seems to play a role in the development of these functions. There is a tradition of studying executive function in both typical and atypical populations, and the present study investigates executive functions in children with severe speech and motor impairments who are communicating using communication aids with graphic symbols, letters, and/or words. There are few neuropsychological studies of children in this group and little is known about their cognitive functioning, including executive functions. It was hypothesized that aided communication would tax executive functions more than speech. Twenty-nine children using communication aids and 27 naturally speaking children participated. Structured tasks resembling everyday activities, where the action goals had to be reached through communication with a partner, were used to get information about executive functions. The children (a) directed the partner to perform actions like building a Lego tower from a model the partner could not see and (b) gave information about an object without naming it to a person who had to guess what object it was. The executive functions of planning, monitoring, and impulse control were coded from the children's on-task behavior. Both groups solved most of the tasks correctly, indicating that aided communicators are able to use language to direct another person to do a complex set of actions. Planning and lack of impulsivity was positively related to task success in both groups. The aided group completed significantly fewer tasks, spent longer time and showed more variation in performance than the comparison group. The aided communicators scored lower on planning and showed more impulsivity than the comparison group, while both groups showed an equal degree of monitoring of the work progress. The results are consistent with the hypothesis that aided language tax executive functions more than speech. The results may also indicate that aided communicators have less experience with these kinds of play activities. The findings broaden the perspective on executive functions and have implications for interventions for motor-impaired children developing aided communication.
Collapse
Affiliation(s)
- Kristine Stadskleiv
- Department of Psychology, University of OsloOslo, Norway
- Section of Paediatric Neuro-habilitation, Department of Clinical Neurosciences for Children, Oslo University HospitalOslo, Norway
| | | | - Beata Batorowicz
- CanChild Centre for Childhood Disability Research, McMaster UniversityHamilton, Canada
| | - Hans van Balkom
- Behavioural Science Institute, Radboud University NijmegenNijmegen, Netherlands
| | | | - Gregor Renner
- Catholic University of Applied SciencesFreiburg, Germany
| |
Collapse
|
16
|
Burström K, Bartonek Å, Broström EW, Sun S, Egmar AC. EQ-5D-Y as a health-related quality of life measure in children and adolescents with functional disability in Sweden: testing feasibility and validity. Acta Paediatr 2014; 103:426-35. [PMID: 24761459 DOI: 10.1111/apa.12557] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The EQ-5D-Y is a newly developed generic instrument measuring health-related quality of life in children and adolescents. The aim of the study was to test the feasibility and validity of the EQ-5D-Y in a Swedish patient sample of children and adolescents with functional motor, orthopaedic and medical disabilities and to compare the results with a general population sample. METHODS Two samples of children and adolescents answered the EQ-5D-Y and a core set of internationally standardised instruments, variables and socio-demographic questions. Patients with functional disability (n = 71, aged seven to 17 years) and individuals from the general population (n = 407, aged eight to 16 years) were included in this study. RESULTS There was a low number of missing answers. Significantly more problems were reported in all dimensions in the patient sample, and the mean visual analogue scale (VAS) score was significantly lower. Any problems were reported by 83% of the patients and by 37% of the general population. In the patient sample, 21% reported problems at the most severe level, compared with 1.5% in the general population sample. By subgroup analyses by diagnoses, the frequency of reported problems in the different dimensions varied. CONCLUSION Even though feasibility and discriminative validity of the EQ-5D-Y were supported in our study, further studies are needed including more patients and patient groups.
Collapse
Affiliation(s)
- K Burström
- Department of Learning Informatics Management and Ethics; Medical Management Centre; Karolinska Institutet; Stockholm Sweden
- Department of Public Health Sciences; Equity and Health Policy Research Group; Karolinska Institutet; Stockholm Sweden
- Stockholm County Council; Health Care Services; Stockholm Sweden
| | - Å Bartonek
- Department of Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
- Astrid Lindgren's Children's Hospital; Karolinska University Hospital; Stockholm Sweden
| | - EW Broström
- Department of Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
- Astrid Lindgren's Children's Hospital; Karolinska University Hospital; Stockholm Sweden
| | - S Sun
- Department of Learning Informatics Management and Ethics; Medical Management Centre; Karolinska Institutet; Stockholm Sweden
- Department of Public Health Sciences; Equity and Health Policy Research Group; Karolinska Institutet; Stockholm Sweden
- Stockholm County Council; Health Care Services; Stockholm Sweden
| | - A-C Egmar
- Department of Learning Informatics Management and Ethics; Medical Management Centre; Karolinska Institutet; Stockholm Sweden
- The Red Cross University College; Stockholm Sweden
| |
Collapse
|
17
|
Chen KL, Tseng MH, Shieh JY, Lu L, Huang CY. Determinants of quality of life in children with cerebral palsy: a comprehensive biopsychosocial approach. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:520-528. [PMID: 24374895 DOI: 10.1016/j.ridd.2013.12.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 12/02/2013] [Accepted: 12/04/2013] [Indexed: 06/03/2023]
Abstract
This study investigated the determinants of quality of life (QOL) of children with cerebral palsy (CP) considering possible variables comprehensively from a biopsychosocial perspective by adopting the International Classification of Functioning, Disability and Health (ICF) and using a CP-specific QOL questionnaire. A total of 167 children with CP (mean age 9.06 years, SD 2.61 years) and their caregivers participated in this study. Children's QOL was measured by the Cerebral Palsy Quality of Life for Children (CP QOL-Child) - primary caregiver proxy-report form. The potential determinants of QOL were collected based on all ICF dimensions. Results of seven multiple regression models showed that the determinants of QOL in children with CP were multidimensional and biopsychosocial in nature, i.e., encompassing the domains of health condition, body functions and structures, and contextual factors of the ICF. Children's behavioral and emotional problems as well as caregiver's psychological and family-related factors were important determinants of QOL in children with CP. Knowledge of the determinants of QOL could serve as a guide in a holistic approach to evaluation and intervention targeted at these determinants to improve the QOL of children with CP.
Collapse
Affiliation(s)
- Kuan-Lin Chen
- School of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Mei-Hui Tseng
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
| | - Jeng-Yi Shieh
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Lu Lu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Yu Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
18
|
Law M, Hanna S, Anaby D, Kertoy M, King G, Xu L. Health-related quality of life of children with physical disabilities: a longitudinal study. BMC Pediatr 2014; 14:26. [PMID: 24476085 PMCID: PMC3911963 DOI: 10.1186/1471-2431-14-26] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 01/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Outcomes of health and rehabilitation services for children and youth with disabilities increasingly include assessments of health-related quality of life (HRQoL). The purpose of this research was to 1) describe overall patterns of HRQoL, 2) examine changes in parent's perceptions of child's HRQoL across 18 months and 3) explore factors that predict these changes. METHODS Participants in this study included 427 parents of children (229 boys and 198 girls) with a physically-based disability between the ages of 6 to 14 years. The Child Health Questionnaire (CHQ) was administered three times, at nine month intervals. Comparisons to the CHQ normative data were analyzed at Time 1 using t-tests, and change over time was examined using linear mixed-effects models. Possible predictors were modeled: 1) child's factors measured by the Activities Scale for Kids, Strengths and Difficulties Questionnaire, and general health measured by SF-36, 2) family characteristics measured by the Impact on Family Scale and 3) environmental barriers measured by the Craig Hospital Inventory of Environmental Factors. RESULTS CHQ scores of the study's participants demonstrated significantly lower summary scores from the normative sample for both CHQ Physical and Psychosocial summary scores. On average, children did not change significantly over time for physical summary scores. There was an average increase in psychosocial health that was statistically significant, but small. However, there was evidence of heterogeneity among children. Environmental barriers, behavioral difficulties, family functioning/impact, general health and child physical functioning had negative and significant associations with physical QoL at baseline. Change in physical QoL scores over time was dependent on children's behavioral difficulties, family functioning and environmental barriers. Environmental barriers, behavioral difficulties, family functioning/impact and general health had significant associations with psychosocial scores at baseline, but none served as predictors of change over time. CONCLUSIONS Children with physical disabilities differ from the normative group on parent ratings of their physical and psychosocial health. While there was little average change in CHQ scores over 18 months, there is evidence of heterogeneity among children. Factors such as environmental barriers, family functioning/impact, child physical functioning and behavioral difficulties and general health significantly influence QoL scores as measured by the CHQ.
Collapse
Affiliation(s)
- Mary Law
- School of Rehabilitation Science, McMaster University, Hamilton, Canada.
| | | | | | | | | | | |
Collapse
|
19
|
Factors related to psychosocial quality of life for children with cerebral palsy. Int J Pediatr 2014; 2014:204386. [PMID: 24678321 PMCID: PMC3941960 DOI: 10.1155/2014/204386] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 11/08/2013] [Accepted: 11/15/2013] [Indexed: 11/17/2022] Open
Abstract
Background. Current health services interventions focus on the treatment of the musculoskeletal impairments of cerebral palsy (CP). The goal of this study was to explore whether the severity of physical symptoms correlates with psychosocial quality of life (QOL) among pediatric patients with CP. Methods. A sample of 53 caregivers of children with CP was surveyed and health status information was extracted from patient medical records. Descriptive analysis explored the association between the main outcome variable, psychosocial QOL (CP QOL-child), and patient demographics, comorbidity (e.g., visual, hearing and feeding impairments, language delays, and epilepsy), CP severity (GMFCS), and the receipt of family centered care (MPOC-20). Results. Child psychosocial QOL decreased with increasing comorbidity but was not associated with CP symptom severity or any measured demographic factors. Reporting high levels of family centered care (FCC) was associated with higher psychosocial QOL in univariate analysis but was not significant when controlling for comorbidities. Conclusion. There is no clear connection between symptom severity and psychosocial QOL in children with CP. Comorbidity however is strongly associated with psychosocial QOL. Focusing on reducing CP comorbidities could have a positive impact on psychosocial QOL.
Collapse
|
20
|
Sandstedt E, Fasth A, Eek MN, Beckung E. Muscle strength, physical fitness and well-being in children and adolescents with juvenile idiopathic arthritis and the effect of an exercise programme: a randomized controlled trial. Pediatr Rheumatol Online J 2013; 11:7. [PMID: 23432796 PMCID: PMC3614532 DOI: 10.1186/1546-0096-11-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 02/09/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Decreased muscle strength, fitness and well-being are common in children and adolescents with juvenile idiopathic arthritis (JIA) compared to healthy peers. Biological drugs have improved health in children with JIA, but despite this pain is still a major symptom and bone health is reported as decreased in the group. The improvement made by the biological drugs makes it possible to more demanding exercises. To jump is an exercise that can improve bone heath, fitness and muscle strength. The aim of the study was to see if an exercise programme with jumps had an effect on muscle strength, physical fitness and well-being and how it was tolerated. METHODS Muscle strength and well-being were studied before and after a 12-week exercise programme in 54 children and adolescents with JIA, 9-21 years old. The participants were randomized into an exercise and a control group. Muscle strength, fitness and well-being were documented before and after the training period and at follow-up after 6 months. Physical activity in leisure time was documented in diaries. The fitness/exercise programme was performed at home three times a week and included rope skipping and muscle strength training exercises.Assessment included measurement of muscle strength with a handheld device, and with Grip-it, step-test for fitness with documentation of heart rate and pain perception and two questionnaires (CHAQ, CHQ) on well-being. RESULTS There were no differences between exercise and control group regarding muscle strength, grip strength, fitness or well-being at base line. Muscle weakness was present in hip extensors, hip abductors and handgrip. For the exercise group muscle strength in hip and knee extensors increased after the 12-week exercise programme and was maintained in knee extensors at follow-up. There was no change in fitness tested with the individually adapted step-test. The CHQ questionnaire showed that pain was common in the exercise group and in the control group. There were only small changes in the CHAQ and CHQ after the training period. The fitness/exercise programme was well tolerated and pain did not increase during the study. CONCLUSIONS A weight bearing exercise programme, with muscle strength training with free weights and rope skipping was well tolerated without negative consequences on pain. It also improved muscle strength in the legs and can be recommended for children and adolescents with JIA.
Collapse
Affiliation(s)
- Eva Sandstedt
- Department of Paediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
| | - Anders Fasth
- Department of Paediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Meta Nyström Eek
- Department of Paediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Eva Beckung
- Department of Neuroscience and Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
21
|
Solomons N, Nortje N. Treating an intervention level 1 patient: futile or brave? SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2013. [DOI: 10.1080/16070658.2013.11734469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
22
|
Lauruschkus K, Westbom L, Hallström I, Wagner P, Nordmark E. Physical activity in a total population of children and adolescents with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:157-167. [PMID: 22940169 DOI: 10.1016/j.ridd.2012.07.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 07/06/2012] [Accepted: 07/06/2012] [Indexed: 06/01/2023]
Abstract
The aims of this study were to describe the participation in physical activity of children with cerebral palsy (CP) at school and during leisure time and to identify characteristics associated with physical activity. The frequency of receiving physiotherapeutic interventions were described as a variable of interest. A total population of 364 children with verified CP aged 7-17 years living in the Skåne region in Sweden was studied using cross-sectional data from the CP follow-up programme (CPUP). Proportional odds ratios showed the most severe gross motor limitations Gross Motor Function Classification System Expanded and Revised (GMFCS-E&R) to be a characteristic for low participation in physical education at school (PE) and GMFCS-E&R level III to be a characteristic for low participation in regular physical leisure activity. The age group of 7-11 years and obesity were characteristics associated with high participation in PE, whereas thinness was associated with low participation in regular physical leisure time activities. The highest proportion of children receiving physiotherapeutic interventions was found in GMFCS-E&R level III, while mental retardation, especially if moderate or severe, proved to be an independent characteristic associated with low frequency of physiotherapeutic interventions. Gender and epilepsy did not influence the odds for participation in physical activities. Special considerations are needed when planning interventions for increased physical activity in children with CP, as the individual prerequisites differ, even among children with the same gross motor function level according to the GMFCS-E&R.
Collapse
Affiliation(s)
- Katarina Lauruschkus
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | | | | | | | | |
Collapse
|
23
|
Genetic [corrected] insights into the causes and classification of [corrected] cerebral palsies. Lancet Neurol 2012; 11:283-92. [PMID: 22261432 DOI: 10.1016/s1474-4422(11)70287-3] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cerebral palsy-the most common physical disability of childhood-is a clinical diagnosis encompassing a heterogeneous group of neurodevelopmental disorders that cause impairments of movement and posture that persist throughout life. Despite being commonly attributed to a range of environmental factors, particularly birth asphyxia, the specific cause of cerebral palsy remains unknown in most individuals. A growing body of evidence suggests that cerebral palsy is probably caused by multiple genetic factors, similar to other neurodevelopmental disorders such as autism and intellectual disability. Recent advances in next-generation sequencing technologies have made possible rapid and cost-effective sequencing of the entire human genome. Novel cerebral palsy genes will probably be identified as more researchers and clinicians use this approach to study individuals with undiagnosed neurological disorders. As our knowledge of the underlying pathophysiological mechanisms of cerebral palsy increases, so will the possibility of developing genomically guided therapeutic interventions.
Collapse
|
24
|
Wong C, Bartlett DJ, Chiarello LA, Chang HJ, Stoskopf B. Comparison of the prevalence and impact of health problems of pre-school children with and without cerebral palsy. Child Care Health Dev 2012; 38:128-38. [PMID: 21443556 DOI: 10.1111/j.1365-2214.2011.01233.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The range of health problems associated with children with cerebral palsy (CP) is well documented in the literature; however, the existing data are often either reported for samples of children with all types of CP, or stratified by typology of motor disorder, rather than using the Gross Motor Function Classification System (GMFCS), which has been shown to be the most reliable way of classifying children with CP. Furthermore, availability of research on pre-school-aged children (under 5 years) is sparse. The aim of this study is to compare the prevalence and impact of health problems in pre-school children with and without CP, stratified by the GMFCS. METHODS Parents of 430 pre-school-aged children with CP (243 boys, 187 girls; mean age = 3 years 2 months, SD = 11 months) and 107 typically developing (TD) children (56 boys, 51 girls; mean age = 3 years 4 months, SD = 11 months) participated. Using the consensus definition of CP and the World Health Organization's International Classification of Functioning, Disability and Health, a parent survey was developed to assess the prevalence and impact of 16 health problems. The measure demonstrates good test-retest reliability (ICC > 0.80) and discriminant validity across GMFCS levels (P < 0.001). RESULTS Both the prevalence and impact of health problems is greater in children with CP compared with TD children (P < 0.001). The number and impact of health problems increase with ascending GMFCS level (P ≤ 0.01), except for the impact of health problems between groups GMFCS I and GMFCS II/III (P= 0.19). Children with CP have an average of between 3.4 and 6.7 health problems, compared with fewer than one in TD children. CONCLUSIONS Service providers working with pre-school-aged children with CP need to consider health problems and their impact when planning care.
Collapse
Affiliation(s)
- C Wong
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | | | | | | |
Collapse
|
25
|
Ballaz L, Plamondon S, Lemay M. Group aquatic training improves gait efficiency in adolescents with cerebral palsy. Disabil Rehabil 2011; 33:1616-24. [DOI: 10.3109/09638288.2010.541544] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
26
|
Bray P, Bundy AC, Ryan MM, North KN, Burns J. Health status of boys with Duchenne muscular dystrophy: a parent's perspective. J Paediatr Child Health 2011; 47:557-62. [PMID: 21392149 DOI: 10.1111/j.1440-1754.2011.02022.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AIM To investigate parent-reported health status of boys with Duchenne muscular dystrophy (DMD) compared with a large Australian normative population and a cohort of children with Charcot-Marie-Tooth disease type 1A (CMT1A). METHODS The Child Health Questionnaire parent form (CHQ-PF50) was completed by parents of 34 boys with confirmed DMD. Seventeen parents were followed up at 6 months. CHQ-PF50 data were compared with 2620 age-matched norms and 90 children with CMT1A. RESULTS All domains of the CHQ-PF50 for the DMD cohort were significantly lower than the general paediatric population, particularly for physical functioning (t = -17.2, P < 0.001) and the child's ability to fulfil school and social roles because of physical limitations (t = -9.4, P < 0.001). Parents experienced greatest emotional impact of their child's DMD around the time of loss of ambulation. Children with DMD had lower health status compared with children with CMT1A with the exception of the behaviour and pain domains. Physical functioning worsened during 6 months (P = 0.04); no other changes in health status were observed at follow-up. CONCLUSIONS Parents report the impact of DMD on health status to be considerably worse when compared with CMT1A. Interventions should target minimising the impact of physical limitations on role functioning.
Collapse
Affiliation(s)
- Paula Bray
- Institute for Neuroscience and Muscle Research, The Children’s Hospital at Westmead, Westmead, Sydney, NSW, Australia.
| | | | | | | | | |
Collapse
|
27
|
Smits DW, Ketelaar M, Gorter JW, van Schie PE, Becher JG, Lindeman E, Jongmans MJ. Development of non-verbal intellectual capacity in school-age children with cerebral palsy. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:550-562. [PMID: 21435067 DOI: 10.1111/j.1365-2788.2011.01409.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Children with cerebral palsy (CP) are at greater risk for a limited intellectual development than typically developing children. Little information is available which children with CP are most at risk. This study aimed to describe the development of non-verbal intellectual capacity of school-age children with CP and to examine the association between the development of non-verbal intellectual capacity and the severity of CP. METHODS A longitudinal analysis in a cohort study was performed with a clinic-based sample of children with CP. Forty-two children were assessed at 5, 6 and 7 years of age, and 49 children were assessed at 7, 8 and 9 years of age. Non-verbal intellectual capacity was assessed by Raven's Coloured Progressive Matrices (RCPM). Severity of CP was classified by the Gross Motor Function Classification System, type of motor impairment and limb distribution. manova for repeated measurements was used to analyse time effects and time × group effects on both RCPM raw scores and RCPM intelligence quotient scores. RESULTS The development of non-verbal intellectual capacity was characterised by a statistically significant increase in RCPM raw scores but no significant change in RCPM intelligence quotient scores. The development of RCPM raw scores was significantly associated with the severity of CP. Children with higher levels of gross motor functioning and children with spastic CP showed greater increase in raw scores than children with lower levels of gross motor functioning and children with dyskinetic CP. CONCLUSIONS Children with CP aged between 5 and 9 years show different developmental trajectories for non-verbal intellectual capacity, which are associated with the severity of CP. The development of non-verbal intellectual capacity in children with less severe CP seems to resemble that of typically developing children, while children with more severe CP show a limited intellectual development compared to typically developing children.
Collapse
Affiliation(s)
- D W Smits
- Centre of Excellence for Rehabilitation Medicine Utrecht, Rehabilitation Centre De Hoogstraat, Utrecht, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
28
|
Developmental profiles of preschool children with spastic diplegic and quadriplegic cerebral palsy. Kaohsiung J Med Sci 2010; 26:341-9. [PMID: 20638036 DOI: 10.1016/s1607-551x(10)70057-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Accepted: 01/27/2010] [Indexed: 10/19/2022] Open
Abstract
Cerebral palsy (CP) is a disorder of movement and posture control with multiple impairments. The clinical manifestations of CP vary among children. The aim of this study was to compare the developmental profiles of preschool children with either of two types of CP: spastic diplegic (SD) CP and spastic quadriplegic (SQ) CP. Relationships between the children's various developmental functions were also investigated. We recruited 137 children with spastic CP, aged 1-5 years (mean age = 3.7 +/- 2.1 years), and we classified them into two groups: SD (n = 59) and SQ (n = 78). The comparison group comprised 18 children with typical development. Developmental functions were assessed in all the children, using the Chinese Child Development Inventory with the updated norms. This scale addressed eight functional domains: gross motor ability, fine motor ability, expressive language ability, concept comprehension ability, situation comprehension ability, self-help ability, personal-social skills, and general development. A development quotient (DQ) was determined for each domain as a percentage of the developmental age divided by the chronological age. The developmental profiles of the CP subtypes were found to differ. Children with SQ were found to have lower DQs than those with SD (p < 0.01). There was also a difference in the distribution of DQs between the SD and SQ groups, although the lowest DQ in both groups was for the gross motor domain. An uneven delay in the development of gross motor function was found in both groups of children with CP. Motor functions, including gross motor and fine motor functions, were significantly related to self-help ability. Complex and significant correlations among developmental functions were also identified in children with CP. The findings in the present study may allow clinicians to anticipate the developmental profile of children with CP on the basis of whether they have the SD or SQ subtype. This, in turn, is likely to facilitate individual assessment, goal setting, and the planning of interventions in children with CP.
Collapse
|
29
|
Parkes J, McCullough N, Madden A. To what extent do children with cerebral palsy participate in everyday life situations? HEALTH & SOCIAL CARE IN THE COMMUNITY 2010; 18:304-315. [PMID: 20201974 DOI: 10.1111/j.1365-2524.2009.00908.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aims of the study are to describe participation of children with cerebral palsy in everyday life situations, to investigate the relationship between participation (primary outcome variable) with child and parent characteristics (independent variables) and to compare the frequency of participation (secondary outcome variable) of children with cerebral palsy with children without disabilities. A cross-sectional survey of parents of children with cerebral palsy in Northern Ireland was undertaken in families' homes using standard questionnaires. Children with cerebral palsy born between 31/8/1991 and 1/4/1997 were identified from a case register of people with the condition. A total of 102 parents opted in (51% response rate). Questionnaires included the Life Habits Questionnaire (Life-H) to measure difficulties in participation and The Frequency of Participation Questionnaire (FPQ), to measure frequency of participation with comparative data for children without disability. Overall, children with cerebral palsy participated less often than their non-disabled peers across a number of lifestyle and cultural pursuits. Among the 102 children with cerebral palsy, participation in 'relationships' was the least disrupted area of everyday life and aspects of 'school', 'personal care' and 'mobility' were the most disrupted. Children with cerebral palsy and severe co-impairments were significantly less likely to experience higher levels of participation in most areas of everyday life when compared to children with cerebral palsy and no severe co-impairments. Child physical and psychological well-being did not influence participation although higher parenting stress was significantly related to lower child participation in 'community activities'. Participation is an important health outcome for children with cerebral palsy and should be incorporated in routine clinical practice. Professionals have a role to play both at the level of addressing individual child and family needs as well as influencing legislation and policy to ensure improved access to services and local communities.
Collapse
Affiliation(s)
- Jackie Parkes
- Nursing-Midwifery Research Unit, School of Nursing & Midwifery, Queen's University Belfast, Belfast BT9 5BN, UK.
| | | | | |
Collapse
|
30
|
The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy. Eur J Paediatr Neurol 2010; 14:45-66. [PMID: 19914110 DOI: 10.1016/j.ejpn.2009.09.005] [Citation(s) in RCA: 157] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 09/15/2009] [Accepted: 09/17/2009] [Indexed: 12/20/2022]
Abstract
An interdisciplinary European group of clinical experts in the field of movement disorders and experienced Botulinum toxin users has updated the consensus for the use of Botulinum toxin in the treatment of children with cerebral palsy (CP). A problem-orientated approach was used focussing on both published and practice-based evidence. In part I of the consensus the authors have tabulated the supporting evidence to produce a concise but comprehensive information base, pooling data and experience from 36 institutions in 9 European countries which involves more than 10,000 patients and over 45,000 treatment sessions during a period of more than 280 treatment years. In part II of the consensus the Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) based Motor Development Curves have been expanded to provide a graphical framework on how to treat the motor disorders in children with CP. This graph is named "CP(Graph) Treatment Modalities - Gross Motor Function" and is intended to facilitate communication between parents, therapists and medical doctors concerning (1) achievable motor function, (2) realistic goal-setting and (3) treatment perspectives for children with CP. The updated European consensus 2009 summarises the current understanding regarding an integrated, multidisciplinary treatment approach using Botulinum toxin for the treatment of children with CP.
Collapse
|
31
|
Pakula AT, Van Naarden Braun K, Yeargin-Allsopp M. Cerebral Palsy: Classification and Epidemiology. Phys Med Rehabil Clin N Am 2009; 20:425-52. [DOI: 10.1016/j.pmr.2009.06.001] [Citation(s) in RCA: 143] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|