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Belle FN, Hunziker S, Fluss J, Grunt S, Juenemann S, Kuenzle C, Meyer-Heim A, Newman CJ, Ramelli GP, Weber P, Claudia E K, Tscherter A. Cohort profile: the Swiss Cerebral Palsy Registry (Swiss-CP-Reg) cohort study. Swiss Med Wkly 2022; 152:w30139. [PMID: 35230014 DOI: 10.4414/smw.2022.w30139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cerebral Palsy (CP) is a group of permanent disorders of movement and posture that follow injuries to the developing brain. It results in motor dysfunction and a wide variety of comorbidities like epilepsy; pain; speech, hearing and vision disorders; cognitive dysfunction; and eating and digestive difficulties. Central data collection is essential to the study of the epidemiology, clinical presentations, care, and quality of life of patients affected by CP. CP specialists founded the Swiss Cerebral Palsy Registry (Swiss-CP-Reg) in 2017. This paper describes the design, structure, aims and achievements of Swiss-CP-Reg and presents its first results. METHODS Swiss-CP-Reg records patients of any age diagnosed with CP who are born, are treated, or live in Switzerland. It collects data from medical records and reports, from questionnaires answered by patients and their families, and from data linkage with routine statistics and other registries. The registry contains information on diagnosis, clinical presentation, comorbidities, therapies, personal information, family history, and quality of life. RESULTS From August 2017 to August 2021, 546 participants (55% male, mean age at registration 8 years [interquartile range IQR: 5-12]), were enrolled in Swiss-CP-Reg. Most had been born at term (56%), were less than two years old at diagnosis (73%, median 18 months, IQR: 9-25), and were diagnosed with spastic CP (76%). Most (59%) live with a mild motor impairment (Gross Motor Function Classification System [GMFCS] level I or II), 12% with a moderate motor impairment (GMFCS level III), and 29% with a severe motor impairment (GMFCS level IV or V). In a subset of 170 participants, we measured intelligence quotient (IQ) and saw lower IQs with increasing GMFCS level. Swiss-CP-Reg has a strong interest in research, with four nested projects running currently, and many more planned. CONCLUSIONS Swiss-CP-Reg collects and exchanges national data on people living with CP to answer clinically relevant questions. Its structure enables retrospective and prospective data collection and knowledge exchange between experts to optimise and standardise treatment and to improve the health and quality of life of those diagnosed with CP in Switzerland.
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Affiliation(s)
- Fabiën N Belle
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Sandra Hunziker
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Joël Fluss
- Paediatric Neurology Unit, University Children's Hospital Geneva, Geneva, Switzerland
| | - Sebastian Grunt
- Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital Bern, University Hospital, University of Bern, Switzerland
| | - Stephanie Juenemann
- Division of Neuropaediatric and Developmental Medicine, University Children's Hospital of Basel (UKBB), University of Basel, Basel, Switzerland
| | | | - Andreas Meyer-Heim
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland
| | - Christopher J Newman
- Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,University of Lausanne (UNIL), Lausanne, Switzerland
| | - Gian Paolo Ramelli
- Neuropaediatric Unit, Paediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Peter Weber
- Division of Neuropaediatric and Developmental Medicine, University Children's Hospital of Basel (UKBB), University of Basel, Basel, Switzerland
| | - Kuehni Claudia E
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Children's University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Anne Tscherter
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Brunner AL, Rutz E, Juenemann S, Brunner R. Continuous vs. blocks of physiotherapy for motor development in children with cerebral palsy and similar syndromes: A prospective randomized study. Dev Neurorehabil 2014; 17:426-32. [PMID: 24866273 DOI: 10.3109/17518423.2014.923057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine whether physiotherapy is more effective when applied in blocks or continuously in children with cerebral palsy (CP). METHODS A prospective randomized cross-over design study compared the effect of regular physiotherapy (baseline) with blocks of physiotherapy alternating with no physiotherapy over one year. Thirty-nine institutionalized children with CP and clinically similar syndromes (6-16 years old, Gross Motor Function Classification Scale II-IV) were included. During the first scholastic year, group A received regular physiotherapy, group B blocks of physiotherapy and vice versa in the second year. The Gross Motor Function Measure 66 (GMFM-66) was the outcome measure. RESULTS Thirteen children in each group completed the study. GMFM-66 improved (p < 0.05) over the study period in both groups in total; changes (p < 0.05) were seen only in dimension D (group B) and E (both groups) during regular therapy. CONCLUSION Physiotherapy may be more effective when provided regularly rather than in blocks.
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Juenemann S, Hasler C, Brunner R. Digital imaging data on CD-R: a time trap for orthopaedic surgeons in outpatient clinics. J Child Orthop 2009; 3:59-62. [PMID: 19308614 PMCID: PMC2656835 DOI: 10.1007/s11832-008-0150-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Accepted: 11/18/2008] [Indexed: 02/03/2023] Open
Abstract
PURPOSE X-rays are presented on CD-Rs in a digital format with increasing frequency. This technique is potentially more time-consuming for the clinician compared to conventional pictures. METHODS Ten sets of six X-rays for each case were prepared in both the conventional way and in digital format on CD-R. The order was randomised. Time in seconds was measured for six experienced orthopaedic residents to present the most recent a.p. view out of a given set. As a precondition, the computer was turned on and the same viewing software was used for all digital sets. The results were compared using a non-linked Student's t-test (significance level P = 0.05). RESULTS The presentation of conventional X-rays required 21 s (+/-7.5 s) and of digital X-rays 90 s (+/-27 s), respectively (P < 0.001). CONCLUSION In spite of ideal conditions, digital X-rays on CD-R need significantly more time in the orthopaedic clinic. In major centres, patients present with different software and software in other languages, which increase the required time even further. This latter problem will be assessed in another study. This increase of preparation time required by a highly qualified staff member has implications on the economics and logistics and has a negative impact on daily clinical practice. One of the solutions might be that the CD-Rs be given to the registration desk and the data being already prepared when the patient sees the doctor. This can also include it being implemented in the digital system used in the inpatient part of the hospital and, therefore, making any other consultations or second opinions easily accessible.
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Affiliation(s)
- Stephanie Juenemann
- Department of Pediatric Orthopaedics, University Children's Hospital Basel, Postfach, 4005, Basel, Switzerland,
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