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Spasticity AND Cerebral Palsy

Rafael Krätschmer, Harald Böhm, Leonhard Döderlein
BACKGROUND: Classification of sagittal gait patterns in unilateral spastic cerebral palsy (CP) provides direct implication for treatment. Five types are described: type 0 has minor gait deviation; type 1 has inadequate ankle dorsiflexion in swing; type 2 has inadequate ankle dorsiflexion throughout the gait cycle; types 3 and 4 have abnormal function of the knee and hip joint respectively. During gait analysis of children with unilateral spastic CP we observed frequently that a knee flexion deficit disappeared during running...
October 3, 2018: Gait & Posture
K K Wang, M E Munger, B P-J Chen, T F Novacheck
Background: Selective dorsal rhizotomy (SDR) is a surgical procedure for treating spasticity in ambulant children with cerebral palsy (CP). However, controversies remain regarding indications, techniques and outcomes. Current evidence summary: Because SDR is an irreversible procedure, careful patient selection, a multi-disciplinary approach in assessment and management and division of the appropriate proportion of dorsal rootlets are felt to be paramount for maximizing safety...
October 1, 2018: Journal of Children's Orthopaedics
Duangporn Suriyaamarit, Sujitra Boonyong
BACKGROUND: Sit-to-stand (STS) is one of the most common fundamental activity in daily life. The pathology of the neuromuscular control system in children with spastic diplegic cerebral palsy (SDCP) could contribute to atypical movement patterns leading to the inefficiency performance including the STS task. However, there was also a lack of evidence about kinematics, kinetics, and especially mechanical work during the STS task in children with SDCP aged 7-12 years old. RESEARCH QUESTION: What were the differences in mechanical work, kinematics and kinetics during STS task between children with SDCP and typically developing (TD) children? METHODS: Eleven children with SDCP (GMFCS I-II) and eleven age and gender-matched control TD children with an age range of 7-12 years were enrolled...
October 1, 2018: Gait & Posture
Janese Petuchowksi, Kaitlin Kieras, Kristina Stein
Upper motor neuron injuries that occur in cases such as cerebral palsy, cerebrovascular accidents, and traumatic brain injury often have resulting upper extremity deformity and dysfunction. Multiple surgical options are available to improve upper extremity positioning, and, in some cases, motor control. Postoperative therapeutic management is imperative to assist the patient/caregiver in maximizing potential functional gains. This article provides an overview of postoperative guidelines for commonly performed surgeries to manage upper extremity dysfunction caused by spasticity and discusses acute management as well as therapeutic techniques for functional training and improved motor control...
November 2018: Hand Clinics
Stephen P Duquette, Joshua M Adkinson
Upper extremity spasticity may result from a variety of types of brain injury, including cerebral palsy, stroke, or traumatic brain injury. These conditions lead to a predictable pattern of forearm and wrist deformities caused by opposing spasticity and flaccid paralysis. Upper extremity spasticity affects all ages and sociodemographics and is a complex clinical problem with a variety of treatment options depending on the patient, the underlying disease process, and postoperative expectations. This article discusses the cause, diagnosis, operative planning, operative techniques, postoperative outcomes, and rehabilitation protocols for the spastic wrist and forearm...
November 2018: Hand Clinics
Michael S Gart, Joshua M Adkinson
Spasticity is a movement disorder characterized by a velocity-dependent increase in muscle tone and a hyperexcitable stretch reflex. Common causes of spasticity include cerebral palsy, spinal cord injury, and stroke. Surgical treatment plans for spasticity must be highly individualized and based on the characteristics of patients and the spasticity in order to maximize functional gains. Candidates for surgery must be carefully selected. In this article, the authors review the pathophysiology of spasticity and discuss general considerations for surgical management with an emphasis on patient factors and spasticity characteristics...
November 2018: Hand Clinics
Francisco J Angulo-Parker, Joshua M Adkinson
Spasticity is a motor disorder that manifests as a component of the upper motor neuron syndrome. It is associated with paralysis and can cause significant disability. The most common causes leading to spasticity include stroke, traumatic brain injury, multiple sclerosis, spinal cord injury, and cerebral palsy. This article discusses the pathophysiology and clinical findings associated with each of the most common etiologies of upper extremity spasticity.
November 2018: Hand Clinics
Judith M Burnfield, Guilherme M Cesar, Thad W Buster, Sonya L Irons, Chase M Pfeifer
PURPOSE: To quantify effects of motor-assisted elliptical (Intelligently Controlled Assistive Rehabilitation Elliptical [ICARE]) training on walking and fitness of a child with cerebral palsy (CP). KEY POINTS: A 12-year-old boy with walking limitations due to spastic diplegic CP (Gross Motor Function Classification System II) participated in 24 sessions of primarily moderate- to vigorous-intensity ICARE exercise. Fitness improvements were evidenced clinically across sessions by the child's capacity to train for longer periods, at faster speeds, and while overriding motor's assistance...
October 2018: Pediatric Physical Therapy
Luca Puce, Lucio Marinelli, Emanuela Pierantozzi, Laura Mori, Ilaria Pallecchi, Marco Bonifazi, Marco Bove, Emerson Franchini, Carlo Trompetto
Training methods for Paralympic swimmers must take into account different pathologies, competitions classes, athlete's individual circumstances and peculiar physical adaptation mechanisms, hence general guidelines cannot be found in literature. In this study we present a training program, implemented for the physical preparation of a top level Paralympic swimmer. The athlete under study, affected by infantile cerebral palsy within a clinical picture of a spastic tetraparesis, by the end of 2016 was holder of Italian, European, world and Paralympic titles in the 400-m freestyle competition, S6 class...
August 2018: Journal of Exercise Rehabilitation
Ronit Aviram, Netta Harries, Anat Shkedy Rabani, Akram Amro, Ibtisam Nammourah, Muhammed Al-Jarrah, Yoav Raanan, Yeshayahu Hutzler, Simona Bar-Haim
PURPOSE: The comparison of habitual physical activity and sedentary time in teenagers and young adults with cerebral palsy (CP) with typically developed (TD) peers can serve to quantify activity shortcomings. METHODS: Patterns of sedentary, upright, standing, and walking components of habitual physical activity were compared in age-matched (16.8 y) groups of 54 youths with bilateral spastic CP (38 who walk with limitations and 16 who require mobility devices) and 41 TD youths in the Middle East...
October 1, 2018: Pediatric Exercise Science
Indar K Sharawat, Lesa Dawman
Glutaric aciduria type 1 (GA-1) is an autosomal-recessive disorder caused by the deficiency of the mitochondrial enzyme glutaryl-CoA dehydrogenase. A 13-month-old boy presented with microcephaly, developmental delay, and progressive spasticity and was being treated as spastic cerebral palsy, later on had loss of developmental milestones after acute episode of illness at 12 months of age. The magnetic resonance imaging of brain revealed widened Sylvian fissure, hyperintensities in bilateral globus pallidus, and bilateral frontoparietal atrophy along with white matter loss...
July 2018: Journal of Pediatric Neurosciences
Feriha Hadžagić Ćatibušić, Sajra Užičanin, Deniz Bulja, Emira Gasal Gvozdenović
Aim To assess hand function and explore the relationship between hand function and neuroimaging findings in children with unilateral spastic cerebral palsy (US CP). Methods Hand function was assessed using Manual Ability Classification System (MACS, I-V). Brain lesions were divided into five groups: brain maldevelopment (MAL), periventricular white matter lesions (PV WM), cortical/subcortical gray matter lesions (C/SC GM), nonspecific and normal findings. Results Of 114 children with US CP (77 boys and 37 girls), 56 were with right-sided and 58 with left-sided involvement...
February 1, 2019: Medicinski Glasnik
Nicoletta Battisti, David Milletti, Marco Miceli, Corrado Zenesini, Antonella Cersosimo
Ultrasound is increasingly used for the evaluation of spastic muscles in cerebral palsy. Increased echo intensity is considered indicative of a muscle fibrous involution. The aim of this study was to highlight any correlation between increased echo intensity of the gastrocnemius-soleus complex and clinical tests for stiffness evaluation, age and functional level measured with the Gross Motor Function Classification System. We used the qualitative echo intensity grading system of the Heckmatt scale (HS) and tested its inter-rater reliability...
September 22, 2018: Ultrasound in Medicine & Biology
Chia-Hsieh Chang, Kuo-Hsiang Lu, Wei-Tso Lin, Shih-Ching Chen, Wen-Pin Shih, Chii-Wann Lin
OBJECTIVES: Radiofrequency has been used to suppress spasticity affecting motion in patients with cerebral palsy and spinal cord injury. This study tested spasticity suppression and locomotion change after pulsed radiofrequency (PRF) at the dorsal root ganglion of rats with spasticity. MATERIALS AND METHODS: Twenty-four rats that survived for 28 days after thoracic spinal cord injury and showed spasticity in the right hind limb were separated randomly to a PRF group or Sham operation group...
September 25, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Walaa Abd El-Hakiem Abd El-Nabie, Marwa Shafiek Mustafa Saleh
BACKGROUND: Trunk pelvic mal-alignment and postural control deficit are common problems facing children with cerebral palsy. OBJECTIVE: The aim of this study was to investigate the relation of trunk and pelvic alignment with postural control in children with diplegic cerebral palsy. METHODS: Seventy seven children with spastic diplegic cerebral palsy (CP), aged 6 to 8 years with level II on Gross Motor Function Classification System, participated in this study...
September 14, 2018: Journal of Back and Musculoskeletal Rehabilitation
Sébastien Ratel, Eric Doré, Pascale Duché
No abstract text is available yet for this article.
September 23, 2018: Developmental Medicine and Child Neurology
Christina Engel Hoei-Hansen, Bjarne Laursen, Jens Langhoff-Roos, Gija Rackauskaite, Peter Uldall
AIM: To analyse trends in prevalence and severity of cerebral palsy (CP) in Denmark in birth years 1999-2007 and compare with previous periods. METHOD: Data has been collected uniformly in the Danish cerebral palsy national register nationwide since 1995. Rates in the time periods 1999-2001, 2002-2004 and 2005-2007 covering 585,393 births were analysed by gestational age and subtypes. RESULTS: Total number of CP cases in the period was 1165...
September 6, 2018: European Journal of Paediatric Neurology: EJPN
Daniela Medeiros Dos Santos, Renata Valdívia Lucisano, Luzia Iara Pfeifer
BACKGROUND: Cerebral palsy (CP) describes a group of permanent disorders in the development of movement and posture due to non-progressive disturbances during foetal or infant brain development that can result in activity limitations, including engagement in pretend play. METHODS: Twenty children aged four to seven years with spastic CP participated in this descriptive qualitative study. The Child-Initiated Pretend Play Assessment (ChIPPA) clinical observations were analysed from five categories: Time, Interaction with the examiner, Imitation, Theme and Story...
September 21, 2018: Australian Occupational Therapy Journal
Oleh Kachmar, Anna Kushnir, Oles Matiushenko, Marko Hasiuk
Objectives: The aim of this study was to investigate the short-term effects of spinal manipulation (SM) on wrist muscle spasticity and manual dexterity in participants with cerebral palsy (CP). Methods: After baseline examination, 78 participants with spastic CP (7-18 years) without contractures or hyperkinetic syndrome were randomly allocated into 2 groups. The experimental group underwent SM to the cervical, thoracic, and lumbar spine, and the control group received sham SM...
September 2018: Journal of Chiropractic Medicine
Alessandro Picelli, Andrea Santamato, Elena Chemello, Nicoletta Cinone, Carlo Cisari, Marialuisa Gandolfi, Maurizio Ranieri, Nicola Smania, Alessio Baricich
BACKGROUND AND OBJECTIVE: A wide range of adjunct therapies after botulinum toxin administration have been proposed. The aim of the present paper is to provide an overview of major writings dealing with adjuvant (non-pharmacological) treatments associated with botulinum toxin for managing spasticity in order to provide some up-to-date information about the usefulness of the most commonly used procedures. METHODS: The literature in PubMed was searched with the MeSH terms botulinum toxins, muscle spasticity, physical therapy modalities, and rehabilitation...
September 13, 2018: Annals of Physical and Rehabilitation Medicine
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