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Shahid J, Kashif A, Shahid MK. Enhancing Post-Operative Recovery in Spastic Diplegia through Physical Therapy Rehabilitation following Selective Dorsal Rhizotomy: A Case Report and Thorough Literature Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050842. [PMID: 37238390 DOI: 10.3390/children10050842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
Spasticity is a common issue among children, especially those with bilateral spastic cerebral palsy (CP). Selective dorsal rhizotomy (SDR) is a surgical procedure that is often used to decrease lower limb rigidity, alongside other treatment options such as intrathecal medication, peripheral nerve surgery, and deep brain stimulation (DBS). The objective of these therapies is to improve the standard of living for young individuals. This article intends to explain the motor deficits observed in spastic diplegia and a rehabilitation program using physical therapy after SDR. The information can help with counseling parents about the prognosis and developing a clinical treatment plan. The article presents a case study of a 12-year-old girl who recently underwent L3, L4, and L5 nerve root rhizotomy in the physical therapy department. It highlights the importance of long-term physical therapy follow-up and orthotic usage in the management of spastic diplegia.
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Affiliation(s)
- Jawaria Shahid
- Department of Physical Therapy, Ikram Hospital, Gujrat 50700, Pakistan
- Center of Physical Therapy, Rayan Medical Center, Gujrat 50700, Pakistan
| | - Ayesha Kashif
- Department of Senior Health Care, Eulji University, Uijeongbu-si 11759, Republic of Korea
| | - Muhammad Kashif Shahid
- Research Institute of Environment & Biosystem, Chungnam National University, Daejeon 34134, Republic of Korea
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Ferreira de Andrade A, dos Santos Guimarães GK, Ferreira da Silva J, Moura de Sousa BM, Honorato MM, de Carvalho Cremaschi RM, Santos Coelho FM. Neurodegeneration with brain iron accumulation: a differential diagnosis of cerebral palsy. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2023. [DOI: 10.1186/s41983-023-00639-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Abstract
Background
Brain iron accumulation neurodegeneration (NBIA) comprises a group of rare diseases characterized by deposits of this metal in brain structures. It presents a great variability of progression, which can be fast enough to lead the patient to death in the first years of life, or slow enough to be confused with non-progressive diseases.
Case presentation
Female, 19-year-old patient, cesarean delivery at 38 weeks of gestation. History of multiple sclerosis in a second-degree paternal aunt. Normal neuropsychomotor growth and development up to 11 months, when changes in gait began. After that, it got worse, with decreased muscle strength and falls, but it progressed so slowly that she was diagnosed with cerebral palsy, a non-progressive condition. At the age of 16, she underwent molecular analysis by exome sequencing, being diagnosed with the NBIA Phospholipase A2 (PLAN) variant. Currently doing physical therapy, hydrotherapy, occupational therapy and sertraline.
Conclusions
The report draws attention to the variability of the disease and the possibility of confusion with other diagnoses, which may delay proper management.
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Whitney DG. 5-year fracture risk among children with cerebral palsy. Pediatr Res 2023; 93:996-1002. [PMID: 35854092 DOI: 10.1038/s41390-022-02207-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/10/2022] [Accepted: 06/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Epidemiologic evidence documenting fracture risk as children with cerebral palsy (CP) age throughout growth is lacking to inform on when to implement fracture prevention strategies. The objective was to characterize the 5-year risk of fractures by each year of age among <1-13 year olds with CP and effects by patient-level factors. METHODS This retrospective cohort study used commercial administrative claims from 01/01/2001 to 12/31/2018 from children <1-13 years old with ≥5 years of insurance enrollment. Fractures were examined during the 5-year follow-up. For the CP cohort, the association between 5-year fracture rate and patient-level factors was assessed using Cox regression. RESULTS Children with (n = 5559) vs. without (n = 2.3 million) CP had a higher 5-year fracture risk at the vertebral column, hip, and lower extremities at almost each year of age, but lower 5-year fracture risk at the upper extremities after 6 years old (all P < 0.05). Among children with CP, the 5-year fracture rate was elevated for co-occurring neurological conditions and non-ambulatory status at the vertebral column, hip, and lower extremities (hazard ratio [HR] range, 1.44-2.39), and higher for males at the upper extremities (HR = 1.29) (all P < 0.05). CONCLUSIONS This study provides novel epidemiologic evidence of 5-year fracture risk for each year of age for children with CP. IMPACT This study provides novel epidemiologic evidence of 5-year fracture risk for each year of age across important developmental stages for children with vs. without cerebral palsy (CP). Children with vs. without CP were more likely to fracture at the vertebral column, hip, lower extremities, and humerus and less likely to fracture at the forearm and hands. The age-related 5-year fracture risk was associated with clinically relevant patient-level factors, but in different ways by fracture region. Study findings may be used to enhance clinical detection of at-risk children and strategize when to implement fracture prevention efforts for children with CP.
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Affiliation(s)
- Daniel G Whitney
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
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Friedman JM, van Essen P, van Karnebeek CDM. Cerebral palsy and related neuromotor disorders: Overview of genetic and genomic studies. Mol Genet Metab 2022; 137:399-419. [PMID: 34872807 DOI: 10.1016/j.ymgme.2021.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 12/14/2022]
Abstract
Cerebral palsy (CP) is a debilitating condition characterized by abnormal movement or posture, beginning early in development. Early family and twin studies and more recent genomic investigations clearly demonstrate that genetic factors of major effect contribute to the etiology of CP. Most copy number variants and small alterations of nucleotide sequence that cause CP arise as a result of de novo mutations, so studies that estimate heritability on basis of recurrence frequency within families substantially underestimate genetic contributions to the etiology. At least 4% of patients with typical CP have disease-causing CNVs, and at least 14% have disease-causing single nucleotide variants or indels. The rate of pathogenic genomic lesions is probably more than twice as high among patients who have atypical CP, i.e., neuromotor dysfunction with additional neurodevelopmental abnormalities or malformations, or with MRI findings and medical history that are not characteristic of a perinatal insult. Mutations of many different genetic loci can produce a CP-like phenotype. The importance of genetic variants of minor effect and of epigenetic modifications in producing a multifactorial predisposition to CP is less clear. Recognizing the specific cause of CP in an affected individual is essential to providing optimal clinical management. An etiological diagnosis provides families an "enhanced compass" that improves overall well-being, facilitates access to educational and social services, permits accurate genetic counseling, and, for a subset of patients such as those with underlying inherited metabolic disorders, may make precision therapy that targets the pathophysiology available. Trio exome sequencing with assessment of copy number or trio genome sequencing with bioinformatics analysis for single nucleotide variants, indels, and copy number variants is clinically indicated in the initial workup of CP patients, especially those with additional malformations or neurodevelopmental abnormalities.
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Affiliation(s)
- Jan M Friedman
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada
| | - Peter van Essen
- Department of Pediatrics, Amalia Children's Hospital, Radboud Centre for Mitochondrial Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Clara D M van Karnebeek
- Department of Pediatrics, Amalia Children's Hospital, Radboud Centre for Mitochondrial Diseases, Radboud University Medical Center, Nijmegen, the Netherlands; Departments of Human Genetics and Pediatrics, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, the Netherlands; Department of Pediatrics, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, Canada.
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Whitney DG. 5-year risk of “adult-onset” chronic diseases during childhood and adolescent transitioning for individuals with cerebral palsy. Prev Med Rep 2022; 29:101933. [PMID: 35928595 PMCID: PMC9344024 DOI: 10.1016/j.pmedr.2022.101933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 12/01/2022] Open
Abstract
“Adult-onset” chronic diseases may begin in childhood for individuals with CP. 5-year disease risk was < 64.3-fold higher for < 1–13 year olds with vs without CP. 5-year chronic disease risks were elevated for CP across all developmental stages. Patient factors impacted disease risk variably for children with CP. Findings may inform when to implement prevention efforts and who is more at-risk.
Epidemiologic evidence documenting risk of chronic diseases as children with cerebral palsy age throughout growth is lacking to inform prevention strategies. The objective was to characterize the 5-year risk of chronic diseases that are typically associated with advanced aging among < 1–13 year olds with cerebral palsy and effects by patient-level factors. This retrospective cohort study used nationwide commercial administrative claims from 01/01/2001–12/31/2018 from children < 1–13 years old with ≥ 5 years of mostly continuous insurance enrollment. The 5-year risk of chronic diseases was examined for the entire cohort with and without cerebral palsy and then by baseline age group (<1–2, 3–5, 6–8, 9–11, 12–13 years old), including cardiorespiratory, metabolic, kidney, and liver diseases, cancer, depression, and osteoarthritis. For cerebral palsy, the association between 5-year chronic disease rate and patient-level factors was assessed using Cox regression. Children with (n = 5,559) vs without (n = 2.3 million) cerebral palsy had a higher 5-year risk of all chronic diseases when comparing the entire cohorts (relative risk, 1.19 to 64.26, all P < 0.05) and most chronic diseases when comparing cohorts for each age group. Among children with cerebral palsy, there were effects by gender, co-occurring intellectual disabilities and/or epilepsy, and wheelchair use for some chronic diseases, which can help to identify at-risk children. This study provides novel epidemiologic evidence of 5-year risk of “adult-onset” chronic diseases for children with cerebral palsy during important developmental stages, and associated patient-level factors (to enhance clinical detection). Findings may inform when to implement prevention strategies and who may be more at risk.
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Elnaggar RK, Alhowimel A, Alotaibi M, Abdrabo MS, Elshafey MA. Accommodating variable-resistance exercise enhance weight-bearing/gait symmetry and balance capability in children with hemiparetic cerebral palsy: a parallel-group, single-blinded randomized clinical trial. Eur J Phys Rehabil Med 2022; 58:378-386. [PMID: 34870387 PMCID: PMC9980524 DOI: 10.23736/s1973-9087.21.07324-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/06/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Children with hemiparetic cerebral palsy (HCP) tend preferentially to bear their body weight on the non-paretic side, which leads to the emergence of asymmetrical walking patterns and limited ability to maintain balance. Therefore, improved and clearly effective intervention strategies to remedy these impairments are needed. AIM This study endeavored to evaluate the efficacy of an accommodating variable-resistance exercise (AVr-Ex) program on weight-bearing symmetry, gait symmetry, and dynamic balance in children with HCP. DESIGN This study employed a parallel-group, single-blinded randomized controlled design. SETTINGS Physical Therapy Outpatient Clinic and University Hospital, and a tertiary referral hospital. POPULATION Thirty-six children with HCP aged between eight and 16 years were assigned randomly to the AVr-Ex group (N.=18) or control group (N.=18). METHODS Children in the AVr-Ex group undergone an AVr-Ex program, three sessions/week over eight consecutive weeks, besides the usual physical therapy while children in the Control group received the usual physical therapy alone. Outcome measures were evaluated before and after intervention and included weight-bearing symmetry indices [rearfoot (RF-WbSI), and forefoot (FF-WbSI)], gait symmetry indices (spatial [GSIspatial], and temporal [GSItemporal]), and dynamic balance. RESULTS The post-treatment RF-WbSI (P<0.001; ηp2=0.41), GSIspatial (P<0.001; ηp2=0.42), GSItemporal (P<0.001; ηp2=0.52), and dynamic balance variables (all P<0.05; ηp2 ranged from 0.21 to 0.51) improved significantly in the AVr-Ex group compared to the control group, when controlled for the pre-treatment scores. CONCLUSIONS This study suggests that AVr-Ex can improve weight-bearing symmetry, gait symmetry, and dynamic balance in children with HCP when incorporated into the usual physical rehabilitation program. CLINICAL REHABILITATION IMPACT AVr-Ex is likely an effective training paradigm to address weight-bearing/gait asymmetry and balance issues in children with HCP, which provides the basis for its incorporation in rehabilitation programs for such a patient population.
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Affiliation(s)
- Ragab K Elnaggar
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia -
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt -
| | - Ahmed Alhowimel
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mazyad Alotaibi
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohamed S Abdrabo
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Mohammed A Elshafey
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Che Y, Shi Y. Screening of differentially expressed genes in children with cerebral palsy and the construction of a network of the effective components of traditional Chinese medicine. Transl Pediatr 2022; 11:757-765. [PMID: 35685065 PMCID: PMC9173875 DOI: 10.21037/tp-22-171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/07/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The study sought to construct a network of the effective components of traditional Chinese medicine (TCM) and potential therapeutic target genes of cerebral palsy based on data sets from high-throughput sequencing and the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). METHODS A transcriptome sequencing data set (GSE183021) of blood samples from children with cerebral palsy was downloaded from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) between the cerebral palsy blood samples and control blood samples were screened. The TCM active components and target genes were identified from the TCMSP. We constructed a network of the active ingredients of TCM and the cerebral palsy DEGs. RESULTS Using a |log2 fold change| ≥1 and a false discovery rate <0.05 as the screening criteria for the blood samples of 5 children with cerebral palsy and 5 control participants, 399 DEGs were identified. In the cerebral palsy blood samples, 209 genes were upregulated, and 190 genes were downregulated. The effective components of Angelica sinensis, Shenjincao, and Achyranthes bidentata, targeted 158 genes, and 49 genes crossed with the cerebral palsy DEGs. A network was constructed with the active ingredients of Angelica sinensis, Shenjincao, and Achyranthes bidentata and the DEGs of the cerebral palsy as nodes. Interleukin (IL)-1β, IL-6, prostaglandin-endoperoxide synthase 1, tumor necrosis factor, estrogen receptor 1, and nitric oxide synthase 2 had a wide range of effects on the effective components of Angelica sinensis, Shenjincao, and Achyranthes bidentata. CONCLUSIONS The effective components of Angelica sinensis, Shenjincao, Achyranthes sinensis, and interact closely with the cerebral palsy DEGs. Based on the interaction network, the pharmacological mechanism of TCM in the treatment of cerebral palsy can be elucidated and new therapeutic targets discovered.
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Affiliation(s)
- Yueping Che
- Department of Pediatric Rehabilitation, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Yan Shi
- Department of Children's Rehabilitation, The Third Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, China
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Tamura A, Yamaguchi K, Yanagida R, Miyata R, Tohara H. At-Home Orthodontic Treatment for Severe Teeth Arch Malalignment and Severe Obstructive Sleep Apnea Syndrome in a Child with Cerebral Palsy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095333. [PMID: 35564726 PMCID: PMC9099996 DOI: 10.3390/ijerph19095333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 02/06/2023]
Abstract
Children with cerebral palsy typically have severe teeth arch malalignment, causing swallowing and respiration dysfunction. Malalignment in cerebral palsy, especially in children, worsens dysphagia and respiratory disorders; sometimes, it is also noted with obstructive sleep apnea. However, no study has reported on the improvement in obstructive sleep apnea after at-home orthodontic treatment in children with cerebral palsy. We herein present a pediatric case of cerebral palsy wherein obstructive sleep apnea improved with at-home orthodontic treatment for malalignment. We administered at-home orthodontic treatment to a 15-year-old boy with quadriplegia, due to spastic-type cerebral palsy, having no oral intake, obstructive sleep apnea, and teeth arch malalignment. After treatment, a decline in the severity of sleep apnea was observed. Perioral muscle hypertension and oral intake difficulties cause maxillary protrusion, narrowed teeth arch, and tilting of teeth in children with cerebral palsy. We expanded the oral cavity volume by orthodontic treatment to relieve muscle hypertension and correct the tongue position, thereby remarkably improving obstructive sleep apnea. Our findings suggest that at-home orthodontic treatment for malalignment effectively improves perioral muscle hypertension, glossoptosis, and obstructive sleep apnea.
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Affiliation(s)
- Atsuko Tamura
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (A.T.); (R.Y.); (H.T.)
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (A.T.); (R.Y.); (H.T.)
- Correspondence: ; Tel.: +81-3-5803-5587
| | - Ryosuke Yanagida
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (A.T.); (R.Y.); (H.T.)
| | - Rie Miyata
- Department of Pediatrics, Tokyo Kita-Medical Center, Tokyo 115-0053, Japan;
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (A.T.); (R.Y.); (H.T.)
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Elnaggar RK, Diab RH, Alghadier M, Azab AR. Block-sequence of plyometric and balance training is superior to the alternating-sequence for enhancing motor function in children with hemiplegic cerebral palsy: A comparative randomized clinical trial. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-220005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND: Postural control deficits are prevalent in children with hemiplegic cerebral palsy (CwHCP). Therefore, the best rehabilitative strategies for remediating these deficits are warranted, which could then enhance function. OBJECTIVE: To examine effects of a block versus an alternating sequence of balance training (BT) and plyometric training (PT) on postural control in CwHCP. METHODS: Forty-eight CwHCP (812 years) were randomized to a block or an alternating BT/PT training. The block BT/PT group (n= 24) received a sixweek BT followed by a sixweek PT, twice/week over 12 consecutive weeks. The alternating BT/PT group (n= 24) received an interchanging sequence of BT and PT changed every two weeks for 12 weeks. Postural control [center-of-pressure reaction time (RT), movement velocity (MV), maximum excursion (ME), end-point excursion (EE), and directional control (DC)], functional balance (indicated by pediatric balance scale; PBS), and balance/risk-of-falls during walking (denoted by dynamic gait index; DGI) were assessed before and after training. RESULTS: The block BT/PT group showed greater enhancements in postural control variables [RT (P= 0.004), MV (P= 0.028), ME (P= 0.002), EE (P= 0.003), and DC (P= 0.012)] and functional balance (P= 0.006), and lesser risk-of-falls during walking (P= 0.018) when compared to the alternating BT/PT group. CONCLUSION: The block BT/PT sequence is more effective to enhance postural control than the alternating sequence in CwHCP.
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Affiliation(s)
- Ragab K. Elnaggar
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Reham H. Diab
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Physical Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madina, Saudi Arabia
| | - Mshari Alghadier
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Alshimaa R. Azab
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Bastos PAD, Barbosa R. A Newly Identified Int22h1/Int22h2‐Mediated Xq28 Duplication Syndrome Case Misdiagnosed as Cerebral Palsy. JOURNAL OF PEDIATRIC NEUROLOGY 2022. [DOI: 10.1055/s-0042-1743435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractCerebral palsy (CP) is a nonprogressive, early-onset neurodevelopmental disorder affecting ∼2 to 3/1,000 children worldwide. It is characterized by movement/postural disabilities accompanied by sensitive, perceptual, cognitive, communicational, behavioral, and musculoskeletal perturbations. Many CP patients are thought to have genetic etiologies overlapping those of other neurodevelopmental conditions. Herein, we reported a newly discovered case (the 36th case to date) of a female patient (misdiagnosed with CP until age 19) with the rare X-linked intellectual disability syndrome resulting from an int22h1/int22h2-mediated Xq28 duplication. A microarray analysis revealed a ∼0.4 Mb duplication within the 154.1 to 154.6 Mb subregion of Xq28 (hg19, CRCh37), confirming a diagnosis of the rare int22h1/int22h2-mediated Xq28 duplication intellectual disability syndrome. Atypical T2 hyperintensities were also observed. This case report builds upon the limited cohort of X-linked intellectual disability syndrome patients and reiterates the growing observations pertaining to the phenotypic overlap between genetic CP cases and other neurodevelopmental disorders.
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Affiliation(s)
- Paulo André Dias Bastos
- Chronic Diseases Research Centre, NOVA Medical School, Faculty of Medical Sciences, Universidade Nova de Lisboa, Lisbon, Portugal
- Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Raquel Barbosa
- Chronic Diseases Research Centre, NOVA Medical School, Faculty of Medical Sciences, Universidade Nova de Lisboa, Lisbon, Portugal
- Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
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Are COL4A1 and COL4A2 gene polymorphisms associated with cerebral palsy? Turk J Phys Med Rehabil 2021; 67:242-249. [PMID: 34396076 PMCID: PMC8343154 DOI: 10.5606/tftrd.2021.5481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/16/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate the association of COL4A1 and COL4A2 gene polymorphisms with susceptibility to risk of developing cerebral palsy (CP) and severity of CP. Patients and methods Between December 2016 and June 2017, a total of 176 patients with CP (101 males, 75 females; mean age 71.8±37.9 months; range, 24 to 184 months) and age-, sex-, and ethnically-matched 178 (90 males, 88 females; mean age 69.3±55.2 months; range, 24 to 214 months) controls were included. Two polymorphisms of COL4A1 (rs1961495) and COL4A2 (rs9521733) genes were typed from genomic deoxyribonucleic acid. Genotype distributions and allelic frequencies were compared between the patient and control groups. Gross Motor Function Classification System, the use of medical drugs, type of involvement, number of affected limbs, accompanying conditions, birth weight, gestational age, and magnetic resonance imaging (MRI) findings were used to evaluate the disease severity and their relationships with the COL4A1 and COL4A2 gene polymorphisms. Results There was no statistically significant difference between the groups in terms of genotype distribution and allele frequency of COL4A1 and COL4A2 gene polymorphisms (p>0.05). In addition, there was no relationship between severity of CP and two gene polymorphisms (p>0.05). A significant association was detected between the COL4A2 polymorphism and growth retardation in CP. The TT genotype (57.1%) and T allele (76.2%) were higher, compared to CC (4.8%) and CT genotypes (38.1%) and C allele (23.8%) in patients with CP with growth retardation (p=0.03 for genotype and p=0.01 for allele frequency). Conclusion These findings suggest that COL4A1 and COL4A2 gene polymorphisms are not associated with susceptibility to CP in a group of Turkish populations, although COL4A2 gene polymorphism may be associated with growth retardation in patients with CP.
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Elnaggar RK. Effects of plyometric exercises on muscle-activation strategies and response-capacity to balance threats in children with hemiplegic cerebral palsy. Physiother Theory Pract 2020; 38:1165-1173. [DOI: 10.1080/09593985.2020.1833389] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ragab K. Elnaggar
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Ebrahimi-Fakhari D, Teinert J, Behne R, Wimmer M, D'Amore A, Eberhardt K, Brechmann B, Ziegler M, Jensen DM, Nagabhyrava P, Geisel G, Carmody E, Shamshad U, Dies KA, Yuskaitis CJ, Salussolia CL, Ebrahimi-Fakhari D, Pearson TS, Saffari A, Ziegler A, Kölker S, Volkmann J, Wiesener A, Bearden DR, Lakhani S, Segal D, Udwadia-Hegde A, Martinuzzi A, Hirst J, Perlman S, Takiyama Y, Xiromerisiou G, Vill K, Walker WO, Shukla A, Dubey Gupta R, Dahl N, Aksoy A, Verhelst H, Delgado MR, Kremlikova Pourova R, Sadek AA, Elkhateeb NM, Blumkin L, Brea-Fernández AJ, Dacruz-Álvarez D, Smol T, Ghoumid J, Miguel D, Heine C, Schlump JU, Langen H, Baets J, Bulk S, Darvish H, Bakhtiari S, Kruer MC, Lim-Melia E, Aydinli N, Alanay Y, El-Rashidy O, Nampoothiri S, Patel C, Beetz C, Bauer P, Yoon G, Guillot M, Miller SP, Bourinaris T, Houlden H, Robelin L, Anheim M, Alamri AS, Mahmoud AAH, Inaloo S, Habibzadeh P, Faghihi MA, Jansen AC, Brock S, Roubertie A, Darras BT, Agrawal PB, Santorelli FM, Gleeson J, Zaki MS, Sheikh SI, Bennett JT, Sahin M. Defining the clinical, molecular and imaging spectrum of adaptor protein complex 4-associated hereditary spastic paraplegia. Brain 2020; 143:2929-2944. [PMID: 32979048 PMCID: PMC7780481 DOI: 10.1093/brain/awz307] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/25/2019] [Accepted: 08/16/2019] [Indexed: 12/21/2022] Open
Abstract
Bi-allelic loss-of-function variants in genes that encode subunits of the adaptor protein complex 4 (AP-4) lead to prototypical yet poorly understood forms of childhood-onset and complex hereditary spastic paraplegia: SPG47 (AP4B1), SPG50 (AP4M1), SPG51 (AP4E1) and SPG52 (AP4S1). Here, we report a detailed cross-sectional analysis of clinical, imaging and molecular data of 156 patients from 101 families. Enrolled patients were of diverse ethnic backgrounds and covered a wide age range (1.0-49.3 years). While the mean age at symptom onset was 0.8 ± 0.6 years [standard deviation (SD), range 0.2-5.0], the mean age at diagnosis was 10.2 ± 8.5 years (SD, range 0.1-46.3). We define a set of core features: early-onset developmental delay with delayed motor milestones and significant speech delay (50% non-verbal); intellectual disability in the moderate to severe range; mild hypotonia in infancy followed by spastic diplegia (mean age: 8.4 ± 5.1 years, SD) and later tetraplegia (mean age: 16.1 ± 9.8 years, SD); postnatal microcephaly (83%); foot deformities (69%); and epilepsy (66%) that is intractable in a subset. At last follow-up, 36% ambulated with assistance (mean age: 8.9 ± 6.4 years, SD) and 54% were wheelchair-dependent (mean age: 13.4 ± 9.8 years, SD). Episodes of stereotypic laughing, possibly consistent with a pseudobulbar affect, were found in 56% of patients. Key features on neuroimaging include a thin corpus callosum (90%), ventriculomegaly (65%) often with colpocephaly, and periventricular white-matter signal abnormalities (68%). Iron deposition and polymicrogyria were found in a subset of patients. AP4B1-associated SPG47 and AP4M1-associated SPG50 accounted for the majority of cases. About two-thirds of patients were born to consanguineous parents, and 82% carried homozygous variants. Over 70 unique variants were present, the majority of which are frameshift or nonsense mutations. To track disease progression across the age spectrum, we defined the relationship between disease severity as measured by several rating scales and disease duration. We found that the presence of epilepsy, which manifested before the age of 3 years in the majority of patients, was associated with worse motor outcomes. Exploring genotype-phenotype correlations, we found that disease severity and major phenotypes were equally distributed among the four subtypes, establishing that SPG47, SPG50, SPG51 and SPG52 share a common phenotype, an 'AP-4 deficiency syndrome'. By delineating the core clinical, imaging, and molecular features of AP-4-associated hereditary spastic paraplegia across the age spectrum our results will facilitate early diagnosis, enable counselling and anticipatory guidance of affected families and help define endpoints for future interventional trials.
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Affiliation(s)
- Darius Ebrahimi-Fakhari
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Julian Teinert
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Division of Child Neurology and Metabolic Medicine, Centre for Paediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Robert Behne
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Miriam Wimmer
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Angelica D'Amore
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Kathrin Eberhardt
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Barbara Brechmann
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marvin Ziegler
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dana M Jensen
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Premsai Nagabhyrava
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gregory Geisel
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Erin Carmody
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Uzma Shamshad
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kira A Dies
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Christopher J Yuskaitis
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Catherine L Salussolia
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel Ebrahimi-Fakhari
- Pediatric Neurology, Saarland University Medical Center, Homburg/Saar, Germany
- Department of General Pediatrics, University Children's Hospital Muenster, Muenster, Germany
| | - Toni S Pearson
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Afshin Saffari
- Division of Child Neurology and Metabolic Medicine, Centre for Paediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Ziegler
- Division of Child Neurology and Metabolic Medicine, Centre for Paediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan Kölker
- Division of Child Neurology and Metabolic Medicine, Centre for Paediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Antje Wiesener
- Institute of Human Genetics, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - David R Bearden
- Child Neurology, University of Rochester School of Medicine, Rochester, NY, USA
| | - Shenela Lakhani
- Center for Neurogenetics, Weill Cornell Medical College, New York, NY, USA
| | - Devorah Segal
- Center for Neurogenetics, Weill Cornell Medical College, New York, NY, USA
- Division of Child Neurology, Weill Cornell Medicine, New York City, NY, USA
| | - Anaita Udwadia-Hegde
- Department of Pediatric Neurology, Jaslok Hospital and Research Centre, Mumbai, India
| | - Andrea Martinuzzi
- Scientific Institute, IRCCS E. Medea, Unità Operativa Conegliano, Treviso, Italy
| | - Jennifer Hirst
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - Seth Perlman
- Division of Neurology, Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | | | | | - Katharina Vill
- Pediatric Neurology and Developmental Medicine, Dr. v. Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - William O Walker
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | | | - Niklas Dahl
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ayse Aksoy
- Pediatric Neurology, Dr. Sami Ulus Hospital, Ankara, Turkey
| | - Helene Verhelst
- Pediatric Neurology, Ghent University Hospital, Ghent, Belgium
| | - Mauricio R Delgado
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Radka Kremlikova Pourova
- Department of Biology and Medical Genetics, Second Medical Faculty, Charles University and UH Motol, Prague, Czech Republic
| | - Abdelrahim A Sadek
- Pediatric Neurology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | | | - Lubov Blumkin
- Movement Disorders Clinic, Pediatric Neurology Unit, Wolfson Medical Center, Holon, Sackler School of Medicine, Tel-Aviv University, Israel
| | | | - David Dacruz-Álvarez
- Neurología Pediátrica, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Thomas Smol
- CHU Lille, Institut de Génétique Médicale, RADEME, Lille, France
| | - Jamal Ghoumid
- CHU Lille, Institut de Génétique Médicale, RADEME, Lille, France
| | - Diego Miguel
- Serviço de Genética Médica, Universidade Federal da Bahia, Salvador, Brazil
| | - Constanze Heine
- Institute of Human Genetics, University Hospital Leipzig, Leipzig, Germany
| | | | | | - Jonathan Baets
- Neurogenetics Group and Neuromuscular Reference Center, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Saskia Bulk
- Medical Genetics, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Hossein Darvish
- Cancer Research Center and Department of Medical Genetics, Semnan University of Medical Sciences, Semnan, Iran
| | - Somayeh Bakhtiari
- Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Michael C Kruer
- Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Elizabeth Lim-Melia
- Pediatric Medical Genetics, Maria Fareri Children's Hospital, Valhalla, NY, USA
| | - Nur Aydinli
- Pediatric Genetics, Department of Pediatrics, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Yasemin Alanay
- Pediatric Neurology, Istanbul Medical Faculty, Istanbul, Turkey
| | | | | | - Chirag Patel
- Genetic Health Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | | | | | - Grace Yoon
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Mireille Guillot
- Department of Paediatrics, The Hospital for Sick Children and The University of Toronto, Toronto, Canada
| | - Steven P Miller
- Department of Paediatrics, The Hospital for Sick Children and The University of Toronto, Toronto, Canada
| | - Thomas Bourinaris
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Laura Robelin
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Abdullah S Alamri
- Pediatric Neurology, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Adel A H Mahmoud
- Pediatrics, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Soroor Inaloo
- Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parham Habibzadeh
- Persian BayanGene Research and Training Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali Faghihi
- Persian BayanGene Research and Training Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Center for Therapeutic Innovation and Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, USA
| | - Anna C Jansen
- Pediatric Neurology Unit, Department of Pediatrics, UZ Brussel, Brussels, Belgium
| | - Stefanie Brock
- Pediatric Neurology Unit, Department of Pediatrics, UZ Brussel, Brussels, Belgium
| | | | - Basil T Darras
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Pankaj B Agrawal
- Divisions of Newborn Medicine and Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Joseph Gleeson
- Rady Children's Institute for Genomic Medicine, Rady Children's Hospital, San Diego, CA, USA
| | - Maha S Zaki
- Clinical Genetics, Human Genetics and Genome Research Division, National Research Centre, Cairo, Egypt
| | | | - James T Bennett
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Mustafa Sahin
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Hu L, Xin X, Lin S, Luo M, Chen J, Qiu H, Ma L, Huang J. A child with a novel DDX3X variant mimicking cerebral palsy: a case report. Ital J Pediatr 2020; 46:88. [PMID: 32600431 PMCID: PMC7325255 DOI: 10.1186/s13052-020-00850-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 06/15/2020] [Indexed: 11/21/2022] Open
Abstract
Background Cerebral palsy (CP) is a non-progressive disorder of movement and posture due to a static insult to the brain. In CP, the depth of investigation is guided by the patients’ medical history and their clinical examination. Magnetic resonance imaging (MRI) has a high yield and is widely used for investigation in CP. Case presentation In this paper, we report a novel DDX3X variant in a girl afflicted with the X-linked mental retardation-102 (MRX102). The girl had been misdiagnosed with CP in her early life based on a comprehensive clinical evaluation and associated clinical features, such as developmental delay, reduced activities of the arms and legs, and abnormal brain MRI. Subsequently, whole-exome sequencing was applied to better distinguish between CP and actual MRX102 with similar characteristics. Conclusions We report on a de novo heterozygous DDX3X variant mimicking cerebral palsy and suggest a thorough and conscientious review during diagnosis of CP.
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Affiliation(s)
- Liqin Hu
- Department of Gynaecology and Obstetrics, Ganzhou Maternal and Child Health Hospital, Ganzhou, 341000, Jiangxi Province, China
| | - Xiaoqin Xin
- Department of Clinical Laboratory, Ganzhou People's Hospital, Ganzhou, 341000, Jiangxi Province, China
| | - Shaobin Lin
- Fetal Medicine Centre, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, Guangdong Province, China
| | - Min Luo
- Department of Pediatric Neurorehabilitation, Ganzhou Maternal and Child Health Hospital, Ganzhou, 341000, Jiangxi Province, China
| | - Junkun Chen
- Department of Medical Genetics, Ganzhou Maternal and Child Health Hospital, Ganzhou, 341000, Jiangxi Province, China
| | - Hongsheng Qiu
- Neonatology Department, Ganzhou Maternal and Child Health Hospital, Ganzhou, 341000, Jiangxi Province, China
| | - Li Ma
- Department of Gynaecology and Obstetrics, Ganzhou Maternal and Child Health Hospital, Ganzhou, 341000, Jiangxi Province, China
| | - Jungao Huang
- Department of Medical Genetics, Ganzhou Maternal and Child Health Hospital, Ganzhou, 341000, Jiangxi Province, China.
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15
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Elnaggar RK. Relationship Between Transverse-plane Kinematic Deviations of Lower Limbs and Gait Performance in Children with Unilateral Cerebral Palsy: A Descriptive Analysis. Gait Posture 2020; 79:224-228. [PMID: 32442898 DOI: 10.1016/j.gaitpost.2020.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/23/2020] [Accepted: 05/06/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Transverse-plane kinematic deviations of lower limbs are common in children with unilateral cerebral palsy (UCP), often with detrimental consequences for gait. RESEARCH QUESTION To identify the most important factor among rotational anomalies of lower limbs for gait in children with UCP. METHODS In a descriptive observational study, 42 children with UCP (age; 5-8 years) who had the ability of independent walking were included. Comprehensive gait analysis was performed and included assessment of the transverse-plane kinematic deviations of the lower limbs [pelvis, hip, and ankle rotation angles, and foot progression (FP) angle], and spatial-temporal gait features [velocity, step length (SL), single-limb support time (SLSt), temporal gait-symmetry index (T-GSI), and spatial gait-symmetry index (S-GSI)]. RESULTS AND SIGNIFICANCE The regression analysis indicated that hip rotation was the key determinant of gait velocity (R2 = 0.75, P < .001) and S-GSI (R2 = 0.24, P = .001). The FP angle was the most important factor for T-GSI (R2 = 0.22, P = .002). The ankle rotation explained in part the variance in T-GSI (R2 = 0.10, P = .001). CONCLUSION Gait velocity and spatial gait-symmetry are primarily affected by hip rotation anomalies. The temporal gait-symmetry is generally associated with the FP angle deviation and partly with ankle rotation deviation.
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Affiliation(s)
- Ragab K Elnaggar
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.
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16
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de Oliveira AMM, de Melo EGM, Mendes MLT, Dos Santos Oliveira SJG, Tavares CSS, Vaez AC, de Vasconcelos SJA, Santos HP, Santos VS, Martins-Filho PRS. Oral and maxillofacial conditions, dietary aspects, and nutritional status of children with congenital Zika syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:71-77. [PMID: 32493680 DOI: 10.1016/j.oooo.2020.02.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study was to investigate oral and maxillofacial outcomes in children with congenital Zika syndrome (CZS) and the presence of nonnutritive sucking habits, functional habits, and features related to breastfeeding and nutrition of these children. STUDY DESIGN We conducted a cross-sectional study with 45 children with CZS and 50 healthy controls in Sergipe state, Brazil, from February 2018 to June 2018. Demographic and clinical data, including breastfeeding and feeding data, were obtained for each child. Additionally, oral and maxillofacial evaluation was performed. RESULTS Low weight (prevalence rate [PR] 8.33; 95% confidence interval [CI] 2.02-34.45), nonexclusive breastfeeding up to 6 months (PR 1.56; 95% CI 1.18-2.08); mouth breathing (PR 3.46; 95% CI 1.83-6.52); difficulty in swallowing (PR 6.00; 95% CI 2.53-14.25); and excessive salivation (PR 4.81; 95% CI 2.18-10.62) were more frequent in children with CZS. Children with CZS were more likely to have abnormal insertion of the upper labial frenulum (PR 7.04; 95% CI 2.23-22.20); ogival palate (PR 3.70; 95% CI 1.63-8.40), dental enamel defects (PR 2.22; 95% CI 1.05-4.69); and delayed dental eruption (PR 8.89; 95% CI 1.16-68.32) compared with healthy children. CONCLUSIONS Children with CZS had a higher frequency of problems related to breastfeeding, low weight, and oral and maxillofacial abnormalities compared with healthy children.
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Affiliation(s)
- Ana Márcia Menezes de Oliveira
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil; Investigative Pathology Laboratory, Federal University of Sergipe, Sergipe, Brazil
| | - Elisama Gomes Magalhães de Melo
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil; Investigative Pathology Laboratory, Federal University of Sergipe, Sergipe, Brazil
| | | | - Sheila Jaqueline Gomes Dos Santos Oliveira
- Investigative Pathology Laboratory, Federal University of Sergipe, Sergipe, Brazil; Postgraduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
| | - Carolina Santos Souza Tavares
- Investigative Pathology Laboratory, Federal University of Sergipe, Sergipe, Brazil; Postgraduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
| | - Andreia Centenaro Vaez
- Investigative Pathology Laboratory, Federal University of Sergipe, Sergipe, Brazil; Postgraduate Program in Nursing, Federal University of Sergipe, Sergipe, Brazil
| | - Sara Juliana Abreu de Vasconcelos
- Investigative Pathology Laboratory, Federal University of Sergipe, Sergipe, Brazil; Postgraduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
| | - Hudson P Santos
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Victor Santana Santos
- Department of Nursing, Centre for Epidemiology and Public Health, Federal University of Alagoas, Arapiraca, Brazil
| | - Paulo Ricardo Saquete Martins-Filho
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil; Investigative Pathology Laboratory, Federal University of Sergipe, Sergipe, Brazil; Postgraduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil.
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17
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Developmental Delay with Intermittent Twisting of Neck. Indian Pediatr 2020. [DOI: 10.1007/s13312-020-1826-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Abstract
Cerebral palsy is a syndrome that encompasses a large group of childhood movement and posture disorders that result from a lesion occurring in the developing brain. The clinical presentation of many metabolic and genetic conditions, particularly in highly consanguineous populations, can mimic cerebral palsy particularly at early age. The aim of this review article is to identify the clinical features that should alert the physician to the possibility of disorders that resemble cerebral palsy, the clinical and neuroimaging red flags, and highlight some metabolic and genetic conditions which may present with spasticity, ataxia and dyskinesia. In the case of metabolic or genetic disorder, making a precise diagnosis is particularly important for the possibility of treatment, accurate prognosis and genetic counseling.
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Affiliation(s)
- Wejdan S Hakami
- Division of Pediatric Neurology, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
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19
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Huang C, Chen Y, Chen G, Xie Y, Mo J, Li K, Huang R, Pan G, Cai Y, Zhou L. Efficacy and safety of core stability training on gait of children with cerebral palsy: A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e18609. [PMID: 31914039 PMCID: PMC6959942 DOI: 10.1097/md.0000000000018609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/05/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is a common disability in children featured with pathological gait and limb function limitation due to muscle weakness. Improving limb function and quality of life is currently considered to be highlighted. Physiotherapy is a chief component of rehabilitation for children with CP, correcting gait and improve walking capacity through muscle strength training. Standard rehabilitation programs for CP have not been determined. Core stability training (CST), which coordinates limb balance via trunk control, is widely used in sports competition. And it is gradually introduced into the rehabilitation of children with cerebral palsy with a positive impact on the patients' gait performance. By screening published literatures, this study aims to conduct a meta-analysis to systematically evaluate the effectiveness and safety of CST in gait of children with CP. METHODS Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on CST in the treatment of children with CP were searched from 6 databases. Moreover, the reference lists of conference papers and included literatures will be manually searched to avoid omissions. Literature screening and data extraction were performed independently by 2 researchers. RCTs carry out the risk of bias analysis evaluation from seven aspects through the Cochrane Collaboration's risk of bias tool. Fixed or random effect model will be performed to analyze the outcomes. When higher heterogeneity occurs (I > 50%), the sensitivity or subgroup analysis will also be conducted to find potential factors. And the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is used for assessing the quality of evidence. RESULTS The study will evaluate the effect of CST on gait of children with CP from multiple outcomes, including walking speed, endurance, stride length, and safety. CONCLUSION Based on evidence-based medicine, the conclusion of this study can demonstrate the effectiveness and safety of CST in gait correction for children with CP. PROSPERO REGISTRATION NUMBER PROSPERO CRD 42019134094.
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Affiliation(s)
| | - Yijun Chen
- First Affiliated Hospital of Guangzhou Medical University
- National Clinical Research Center for Respiratory Disease
| | | | - Yaying Xie
- Guangzhou University of Chinese Medicine
| | - Jiahao Mo
- Guangzhou University of Chinese Medicine
| | - Keyi Li
- Guangzhou University of Chinese Medicine
| | | | - Guanghua Pan
- First Affiliated Hospital of Guangzhou Medical University
| | - Yong Cai
- First Affiliated Hospital of Guangzhou Medical University
| | - Lei Zhou
- Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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20
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Aguayo V, Verdugo MA, Arias VB, Guillen VM, Amor AM. Assessing support needs in children with intellectual disability and motor impairments: measurement invariance and group differences. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1413-1427. [PMID: 31486142 DOI: 10.1111/jir.12683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/18/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND This study assessed the equivalence of the measurement of support needs between children with intellectual disability (ID) and children with intellectual and motor disabilities (IMD) and compared both groups in the different domains of support. METHOD The Supports Intensity Scale-Children's Version was used to assess the support needs of 713 children with ID and 286 children with IMD, mainly associated with cerebral palsy. RESULTS The results supported measurement invariance between the group of ID and IMD, which allowed to conduct comparison between them. Children with IMD scored higher on support needs than did children without IMD, suggesting that children with IMD needed more support than their peers without motor impairments. Furthermore, the ID levels interacted with motor impairments: at the highest levels of ID, groups tended to be similar in support needs, with high scores and low variability. The greatest differences were found in the domains of Home and Community activities. CONCLUSIONS This study points to the across-condition of the construct of support needs in populations with intellectual and developmental disabilities. However, additional mobility impairments should be considered during the evaluation and planning of systems of support. In this regard, the Supports Intensity Scale-Children's Version might have limitations when discriminating between samples with high support needs.
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Affiliation(s)
- V Aguayo
- Institute on Community Integration, Department of Personality, Assessment, and Psychological Treatments, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - M A Verdugo
- Institute on Community Integration, Department of Personality, Assessment, and Psychological Treatments, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - V B Arias
- Institute on Community Integration, Department of Personality, Assessment, and Psychological Treatments, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - V M Guillen
- Institute on Community Integration, Department of Education, Faculty of Education, University of Cantabria, Santander, Spain
| | - A M Amor
- Institute on Community Integration, Department of Personality, Assessment, and Psychological Treatments, Faculty of Psychology, University of Salamanca, Salamanca, Spain
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Méneret A, Roze E. GLUT1 Deficiency in a Patient Diagnosed as Cerebral Palsy: Is NGS a Valuable Tool to Be Considered in All Cases of CP to Detect Underlying Genetic Disorders? Mov Disord Clin Pract 2019; 6:277-279. [PMID: 31061833 PMCID: PMC6476600 DOI: 10.1002/mdc3.12754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/04/2019] [Indexed: 02/02/2023] Open
Affiliation(s)
- Aurélie Méneret
- Department of NeurologyPitié‐Salpêtrière Hospital, APHPParisFrance
- Faculty of Medicine of Sorbonne UniversityInserm U 1127, CNRS UMR 7225, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F‐75013, ParisFrance
| | - Emmanuel Roze
- Department of NeurologyPitié‐Salpêtrière Hospital, APHPParisFrance
- Faculty of Medicine of Sorbonne UniversityInserm U 1127, CNRS UMR 7225, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F‐75013, ParisFrance
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