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Spasticity AND Cerebral Palsy

T S Park, Brandon A Miller, Junsang Cho
BACKGROUND: Intrathecal baclofen (ITB) administration via an implanted programmable pump and selective dorsal rhizotomy (SDR) are both used for the treatment of cerebral palsy (CP) spasticity. OBJECTIVE: To examine whether SDR can improve ambulation in children who have been receiving ITB therapy for spastic cerebral palsy. METHODS: We reviewed 13 patients who received prior ITB placement with subsequent simultaneous SDR and ITB removal...
June 12, 2018: Curēus
Thanh Liem Nguyen, Hoang Phuong Nguyen, Trung Kien Nguyen
BACKGROUND: Quality of life (QOL) is an important factor in evaluating the effectiveness of treatment in children with cerebral palsy (CP). The aim of this study was to evaluate the effects of autologous bone marrow mononuclear cells (BM MNCs) on the QOL of children with CP. METHODS: From December 2015 to December 2016, 30 children with CP aged from 2 to 15 years received two intrathecal infusions of BM MNCs, one at baseline and the other 3 months later, at Vinmec International Hospital...
August 14, 2018: Health and Quality of Life Outcomes
In Soo Kim, Donghwi Park, Jin Young Ko, Ju Seok Ryu
OBJECTIVE: To evaluate whether medial knee support in seating systems aggravates hip displacement in children with cerebral palsy. DESIGN: Retrospective chart review SETTING: Rehabilitation department of tertiary university hospital PARTICIPANTS: Children with cerebral palsy using seating systems (Intervention group, n=42; mean age 6.86y) and using regular wheelchairs (Control group, n=34; mean age 8.15y). INTERVENTIONS: The intervention group was provided with a seating system with medial knee support...
August 10, 2018: Archives of Physical Medicine and Rehabilitation
Sarah J Holmes, Anita J Mudge, Elizabeth A Wojciechowski, Matthias W Axt, Joshua Burns
BACKGROUND: Children with cerebral palsy are at risk of developing muscle contractures, often contributing to pain, structural deformities and mobility limitations. With the increasing use of gait indices to summarise the findings of three dimensional gait analysis (3DGA), the purpose of this study is to determine whether there is a relationship between multilevel joint contractures and the Gait Profile Score in children with cerebral palsy. METHODS: The Gait Profile Score, calculated from 3D gait analysis, and passive range of motion, strength and spasticity of the hips, knees and ankles in the sagittal plane were measured in 145 children with cerebral palsy (mean age:11 years,4 months; SD:2 years,10 months) (83 males) enrolled in the NSW Paediatric Gait Analysis Service Research Registry from 2011 to 2016...
August 8, 2018: Clinical Biomechanics
Sibel Çağlar Okur, Mahir Uğur, Kazım Şenel
PURPOSE: The purpose of the study is to assess the change in their ambulatory capacity and spasticity in children with cerebral palsy (CP) who received botulinum toxin A (BoNT-A) injection and underwent rehabilitation therapy. METHODS: Thirty patients with CP, 3-13 years who had varied functional levels and lower extremity spasticity, were randomized in two groups. In Group 1(n = 15), BoNT-A was administered to the affected extremity and underwent rehabilitation...
August 10, 2018: Developmental Neurorehabilitation
Avinash Mishra, Georgia A Malandraki, Justine J Sheppard, Andrew M Gordon, Erika S Levy, Michelle S Troche
Dysphagia and resulting pulmonary sequelae are frequently observed in children with spastic cerebral palsy (SCP). However, physiological evidence regarding airway protective behaviors (specifically swallowing and cough function) in these children is sparse. The aim of this investigation was to quantify specific feeding, swallowing, and cough impairments in children with SCP compared to controls. Eleven children with SCP (mean age: 7 ± 2 years; GMFCS: I-V; MACS: I-V) and 10 age-matched controls participated...
August 7, 2018: Dysphagia
Ingrid Skaaret, Harald Steen, Terje Terjesen, Inger Holm
BACKGROUND: Different types of ankle-foot orthoses are commonly used following lower limb surgery in children with bilateral spastic cerebral palsy. After three-dimensional gait analysis 1 year postoperatively, many children are recommended continued use of ankle-foot orthoses. OBJECTIVES: Our aims were to quantify the impact of ankle-foot orthoses on gait 1 year postoperatively and evaluate predictors for clinically important improvement. STUDY DESIGN: Prospective cohort study...
August 7, 2018: Prosthetics and Orthotics International
Fabienne Schasfoort, Robert Pangalila, Emiel M Sneekes, Coriene Catsman, Jules Becher, Herwin Horemans, Henk J Stam, Annet J Dallmeijer, Johannes B J Bussmann
OBJECTIVE: Botulinum toxin (BoNT-A) is widely used in combined treatment for spastic cerebral palsy, but its added value preceding comprehensive rehabilitation for motor impairments, gait, and goal attainment has not been studied. DESIGN: A comparative multi-centre trial, in which two groups underwent comprehensive rehabilitation (i.e. high-intensive functional physiotherapy, and indicated casting/orthoses). One group received intramuscular BoNT-A prior to rehabilitation, and the other group did not receive BoNT-A...
August 6, 2018: Journal of Rehabilitation Medicine
Kishore Mulpuri, Emily K Schaeffer, James Sanders, Ira Zaltz, Mininder S Kocher
BACKGROUND: The evidence-based approach to guide clinical practice has gained great importance in the medical field. High-quality evidence is of paramount importance to inform clinical decision-making and optimize patient outcomes. The generation of high-quality evidence relies on sound methodology and study design to facilitate appropriate interpretation and subsequent application of the clinical findings. The purpose of this review is to objectively critique the methodological design and clinical findings of 2 pediatric orthopaedic studies on children with cerebral palsy (CP) to assess their potential to impact clinical practice...
August 1, 2018: Journal of Pediatric Orthopedics
Utsana Tonmukayakul, Long Khanh-Dao Le, Shalika Bohingamu Mudiyanselage, Lidia Engel, Jessica Bucholc, Brendan Mulhern, Rob Carter, Cathrine Mihalopoulos
PURPOSE: Project aims include the following: (i) to identify reported utility values associated with CP in children aged ≤ 18 years; (ii) to explore utility value elicitation techniques in published studies; and (iii) to examine performance of the measures and/or elicitation approaches. METHODS: Peer-reviewed studies published prior to March 2017 were identified from six electronic databases. Construct validity, convergent validity, responsiveness, and reliability of instruments were assessed...
August 2, 2018: Quality of Life Research
L Mathevon, I Bonan, J-L Barnais, F Boyer, M Dinomais
BACKGROUND: Botulinum toxin (BTX) injection alone is not sufficient to treat spasticity in children, notably those with cerebral palsy; thus, there is an emerging trend for adjunct therapies to offer greater outcomes than BTX alone. OBJECTIVE: The aim of this systematic review was to evaluate the general effectiveness of adjunct therapies regardless of their nature in children with spasticity. METHODS: MEDLINE, Cochrane and Embase databases were searched from January 1980 to March 15, 2018 for reports of parallel-group trials (randomized controlled trials [RCTs] and non-RCTs) assessing adjunct therapies after BTX injection for treating spasticity in children...
July 28, 2018: Annals of Physical and Rehabilitation Medicine
Indre Bakaniene, Gintare Urbonaviciene, Kristina Janaviciute, Audrone Prasauskiene
AIM OF THE STUDY: To investigate the effect of the Inerventions method on gross motor function in children with spastic cerebral palsy (CP). CLINICAL RATIONALE FOR THE STUDY: The Inerventions method is the type of transcutaneous electrical nerve stimulation (TENS) delivered through a full-body garment (Mollii suit) that aims to prompt reciprocal inhibition via the antagonist to reduce spasticity in selected muscle groups. Although Mollii is approved by the European Union as a medical device, independent clinical tests have not yet been performed...
July 20, 2018: Neurologia i Neurochirurgia Polska
Anna Mirska, Wojciech Kułak, Bożena Okurowska-Zawada, Elżbieta Dmitruk
PURPOSE: The aim of this study was to assess the effectiveness of long-term therapy with multiply botulinum neurotoxin (BoNT) injections. METHODS: In 2004-2010, 60 children with spastic cerebral palsy aged 2-16 were treated multiple botulinum toxin sessions (injections in gastrocnemius muscle and soleus muscles). In each patient, we rated muscle tone by Modified Ashworth Scale, passive range of motion in ankle joint with extended, and flexed knee joint and gait using the Physician Rating Scale...
July 30, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Bruno Dohin
The hip is the joint most exposed to orthopaedic complications in cerebral palsy (CP) which is the main cause of spasticity in paediatric patients. The initial immaturity of the hip allows the forces applied by the spastic and retracted muscles to displace the femoral head, eventually causing it to dislocate. The risk of hip dislocation increases with the severity and extent of CP, exceeding 70% in the most severe cases. Hip dislocation causes pain in up to 30% of cases, carries a risk of orthopaedic and cutaneous complications, and hinders patient installation and nursing care...
July 26, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
M Ahmed, E Waly
No abstract text is available yet for this article.
July 11, 2018: Gait & Posture
M A Berge, S M Brændvik, K Roeleveld, T Goihl
No abstract text is available yet for this article.
July 17, 2018: Gait & Posture
Matthias Hösl, Harald Böhm, Justine Eck, Leonhard Döderlein, Adamantios Arampatzis
BACKGROUND: Patients with spastic Cerebral Palsy are prone to equinus deformities, likely affected by short and inextensible plantarflexor muscles. Manual stretching is a popular treatment but its effectiveness concerning joint mobility, muscle-tendon morphometrics and walking function is debated. Eccentric exercise by backward-downhill treadmill training could be a therapeutic alternative for ambulatory patients improving gait and muscle function. RESEARCH QUESTION: What are the effects of eccentric training by backward-downhill treadmill training and plantarflexor stretching concerning gait and muscle function in patients with spastic Cerebral Palsy? METHODS: 10 independent ambulators with spastic Cerebral Palsy (12 [SD 4] years old, 2 uni- and 8 bilaterally affected) participated in a randomized crossover-study...
July 22, 2018: Gait & Posture
Tomofumi Yamaguchi, Tue Hvass Petersen, Henrik Kirk, Christian Forman, Christian Svane, Mathilde Kofoed-Hansen, Finn Boesen, Jakob Lorentzen
OBJECTIVE: The present study evaluated ankle stiffness in adults with and without neurological disorders and investigated the accuracy and reproducibility of a clinically applicable method using a dynamometer. METHODS: Measurements were obtained from 8 healthy subjects (age 39.3), 9 subjects with spastic cerebral palsy (CP) (age 39.8) and 8 subjects with multiple sclerosis (MS) (age 49.9). Slow and fast dorsiflexion stretches of the ankle joint were performed to evaluate passive muscle-tendon-joint stiffness, reflex mediated stiffness and range of movement (ROM), respectively...
September 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Margaret A Fox, Rita Ayyangar, Rebecca Parten, Heidi J Haapala, Stephen G Schilling, Claire Z Kalpakjian
AIM: People with cerebral palsy (CP) are often unable to express pain owing to cognitive or speech impairments. Reports that rely on observation can be inaccurate, because behaviours such as grimacing, common in people with spastic CP, resemble pain expressions. We examined preliminary validity and reliability of the revised Face, Legs, Activity, Cry, and Consolability (r-FLACC) scale in people with spastic CP. METHOD: Forty-eight young people and adults (35 females, 13 males; mean [SD] age 29y 2mo [13y]) were video-recorded during a standard examination, rating their pain (0-10) afterwards...
July 27, 2018: Developmental Medicine and Child Neurology
Valerie Critten, Emma Campbell, Emily Farran, David Messer
BACKGROUND: Previous research suggests that children with cerebral palsy (CP) have impairments in visual-spatial and mathematics abilities, although we know very little about the association between these two domains. AIMS: To investigate the extent of visual-spatial and mathematical impairments in children with CP and the associations between these two domains. METHOD AND PROCEDURE: Thirty-two children with predominantly quadriplegic spastic and/or athetoid (dyskinetic) CP (13 years 7 months) and a group of typically developing (TD) children (8 years 6 months) matched by receptive vocabulary were given a battery of visual-spatial and mathematics tasks...
September 2018: Research in Developmental Disabilities
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