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Cerebral palsy treatment

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https://www.readbyqxmd.com/read/28436398/effects-of-dose-and-duration-of-robot-assisted-gait-training-on-walking-ability-of-children-affected-by-cerebral-palsy
#1
Elisabetta Peri, Anna Carla Turconi, Emilia Biffi, Cristina Maghini, Daniele Panzeri, Roberta Morganti, Alessandra Pedrocchi, Chiara Gagliardi
BACKGROUND: Robot-Assisted Gait Training (RAGT) is a widespread approach for locomotion rehabilitation but information about intervention frequency and duration is still lacking. OBJECTIVE: To evaluate the effect of frequency and duration of a RAGT on motor outcome of children affected by Cerebral Palsy (CP). METHODS: Forty-four CP children (age 4-17) underwent one among four different intensive trainings with equal dose of intervention, combining Task-Oriented Physiotherapy (TOP) and RAGT: 40 sessions (4 sessions/week) over 10 weeks of sole TOP (group1) or RAGT (group2) or RAGT and TOP (2 + 2 sessions/week; group3); 40 sessions in shorter period (4 weeks) of RAGT and TOP (5 + 5 sessions/week; group4)...
April 7, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28411552/reliability-of-four-models-for-clinical-gait-analysis
#2
Hans Kainz, David Graham, Julie Edwards, Henry P J Walsh, Sheanna Maine, Roslyn N Boyd, David G Lloyd, Luca Modenese, Christopher P Carty
Three-dimensional gait analysis (3DGA) has become a common clinical tool for treatment planning in children with cerebral palsy (CP). Many clinical gait laboratories use the conventional gait analysis model (e.g. Plug-in-Gait model), which uses Direct Kinematics (DK) for joint kinematic calculations, whereas, musculoskeletal models, mainly used for research, use Inverse Kinematics (IK). Musculoskeletal IK models have the advantage of enabling additional analyses which might improve the clinical decision-making in children with CP...
April 3, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28407718/perspectives-on-tactile-intervention-for-children-with-cerebral-palsy-a-framework-to-guide-clinical-reasoning-and-future-research
#3
Megan L Auld, Leanne M Johnston
PURPOSE: Many children with cerebral palsy (CP) are known to experience tactile impairments. Research evaluating specific interventions to manage this is, however, minimal. This paper seeks to consolidate current literature and provide a framework to help clinicians and researchers think strategically about tactile treatment selection and future research planning. METHOD: The framework is described via a novel analogy - "The Apartment Block Theory". The theory describes the relative effectiveness of three intervention strategies aimed at overcoming a poorly responsive tactile system: (1) Pressing the buzzer - providing repeated passive tactile stimulation at the periphery; (2) Sneaking in the door - providing active tactile-enhanced motor training that capitalises on the opportunity to provide high-dose tactile input during motor interventions; and (3) Connecting another way - providing visually enhanced touch strategies with the aim of enhancing tactile function, which can be compared to phoning the apartment as an alternative to using the buzzer...
April 14, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28405168/the-black-evil-affecting-patients-with-diabetes-a-case-of-rhino-orbito-cerebral-mucormycosis-causing-garcin-syndrome
#4
Santhosh Narayanan, Geetha Panarkandy, Gomathy Subramaniam, Chandni Radhakrishnan, N K Thulaseedharan, Neeraj Manikath, Sreejith Ramaswamy, Suma Radhakrishnan, Danish Ekkalayil
Mucormycosis is a life-threatening infection affecting patients with diabetes. It is an angioinvasive disease often resistant to treatment with a debilitating course and high mortality. Here, we report a case of a 45 year old woman with type 2 diabetes mellitus who presented to us with history of right-sided ptosis and facial palsy, and subsequently developed loss of vision and palatal palsy. She was in diabetic ketoacidosis. Nervous system examination revealed involvement of right second, third, fourth, sixth, seventh, ninth, and tenth cranial nerves, suggestive of Garcin syndrome...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28402971/implicating-receptor-activator-of-nf-%C3%AE%C2%BAb-rank-rank-ligand-signalling-in-microglial-responses-to-toll-like-receptor-stimuli
#5
Anton Kichev, Pascale Eede, Pierre Gressens, Claire Thornton, Henrik Hagberg
Inflammation in the perinatal brain caused by maternal or intrauterine fetal infection is now well established as an important contributor to the development of perinatal brain injury. Exposure to inflammatory products can impair perinatal brain development and act as a risk factor for neurological dysfunction, cognitive disorders, cerebral palsy, or preterm birth. Pre-exposure to inflammation significantly exacerbates brain injury caused by hypoxic/ischaemic insult. Tumour necrosis factor (TNF) is a family of cytokines largely involved in inflammation signalling...
April 13, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28401027/beneficial-effects-of-childhood-selective-dorsal-rhizotomy-in-adulthood
#6
T S Park, Caleb Edwards, Jenny L Liu, Deanna M Walter, Matthew B Dobbs
 Selective dorsal rhizotomy (SDR) has been used to treat children with spastic cerebral palsy (CP) for over three decades. However, little is known about the outcomes of childhood SDR in adults.  Objectives: 1) To study the effects of childhood SDR on the quality of life and ambulatory function in adult life. 2) To determine late side effects of SDR in adults.   Methods: Adults (> 17.9 years) who underwent SDR in childhood (2 - 17.9 years) between 1987 and 2013 were surveyed in 2015. Patients completed a survey, including questions on demographic information, quality of life, health, surgical outcomes, motor function, manual ability, pain, braces/orthotics, post-SDR treatment, living situation, education level, work status, and side effects of SDR...
March 5, 2017: Curēus
https://www.readbyqxmd.com/read/28399330/arginine-supplementation-for-prevention-of-necrotising-enterocolitis-in-preterm-infants
#7
REVIEW
Prakeshkumar S Shah, Vibhuti S Shah, Lauren E Kelly
BACKGROUND: Decreased concentration of nitric oxide has been proposed as one of the possible cellular mechanisms of necrotising enterocolitis (NEC). Arginine can act as a substrate for production of nitric oxide in the tissues, and arginine supplementation may help to prevent NEC. OBJECTIVES: To examine the effect of arginine supplementation (administered by any route) on the incidence of NEC in preterm neonates. To conduct subgroup analyses based on the dose of arginine and the gestational age of participants (≤ 32 weeks, > 32 weeks)...
April 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28399095/-modern-principles-of-integrated-diagnostics-and-rehabilitation-of-perinatal-lesions-of-the-nervous-system-and-their-consequences
#8
S A Nemkova
The article is devoted to the comprehensive diagnosis and treatment of perinatal lesions of the nervous system and their consequences in children. Reflects modern approaches to data classification conditions, taking into account ideas on the etiology and pathogenesis of the disease, the clinical manifestations of the main syndromes (excitation and depression, hypertensive, convulsive, movement disorders) as the neonatal period, and in the formation of long-term effects (motor and mental delay and speech development, hyperkinetic syndrome, cerebral palsy and others)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28398697/effects-of-targeting-lower-versus-higher-arterial-oxygen-saturations-on-death-or-disability-in-preterm-infants
#9
REVIEW
Lisa M Askie, Brian A Darlow, Peter G Davis, Neil Finer, Ben Stenson, Maximo Vento, Robin Whyte
BACKGROUND: The use of supplemental oxygen in the care of extremely preterm infants has been common practice since the 1940s. Despite this, there is little agreement regarding which oxygen saturation (SpO₂) ranges to target to maximise short- or long-term growth and development, while minimising harms. There are two opposing concerns. Lower oxygen levels (targeting SpO₂ at 90% or less) may impair neurodevelopment or result in death. Higher oxygen levels (targeting SpO₂ greater than 90%) may increase severe retinopathy of prematurity or chronic lung disease...
April 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28393669/serial-casting-as-an-adjunct-to-botulinum-toxin-type-a-treatment-in-children-with-cerebral-palsy-and-spastic-paraparesis-with-scissoring-of-the-lower-extremities
#10
Alper I Dai, Abdullah T Demiryürek
The purpose of this study was to examine whether combination therapy of serial casting and botulinum toxin type A injection can further enhance the effects of botulinum toxin type A in children with cerebral palsy with scissoring of both legs. This study was a prospective and randomized trial. The children were divided into 2 groups, one of which received serial casting after botulinum toxin type A (n = 40), and the other which only received botulinum toxin type A (n = 40). Serial casting started 3 weeks after the botulinum toxin type A...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28392287/blocked-delayed-or-obstructed-what-causes-poor-white-matter-development-in-intrauterine-growth-restricted-infants
#11
REVIEW
Mary Tolcos, Steven Petratos, Jonathan J Hirst, Flora Wong, Sarah J Spencer, Aminath Azhan, Ben Emery, David W Walker
Poor white matter development in intrauterine growth restricted (IUGR) babies remains a major, untreated problem in neonatology. New therapies, guided by an understanding of the mechanisms that underlie normal and abnormal oligodendrocyte development and myelin formation, are required. Much of our knowledge of the mechanisms that underlie impaired myelination come from studies in adult demyelinating disease, preterm brain injury, or experimental models of hypoxia-ischemia. However relatively less is known for IUGR which is surprising because IUGR is a leading cause of perinatal mortality and morbidity, second only to premature birth...
April 6, 2017: Progress in Neurobiology
https://www.readbyqxmd.com/read/28389939/cross-sectional-study-of-urinary-problems-in-adults-with-cerebral-palsy-awareness-and-impact-on-the-quality-of-life
#12
Necmettin Yıldız, Yeşim Akkoç, Murat Ersöz, Berrin Gündüz, Belgin Erhan, Hilal Yesil, Ayşe Nur Bardak, Senay Ozdolap, Hakan Tunç, Kurtulus Koklu, Ebru Alemdaroğlu, Ender Erden, Ulas Sungur, Ozlem Satır, Cagdaş Erdogan, Hakan Alkan
We aimed to assess the functional status, urinary problems, and awareness of these problems in adults with cerebral palsy (CP) and their relationship with the quality of life. One-hundred-seventeen adults with CP (53 women, 64 men) were included in this study. Subjects were asked to fill out a urological questionnaire which dealt with urinary symptoms, awareness of urinary problems, and pharmacological treatment they received. Subjects were also assessed with the Gross Motor Function Classification System (GMFCS), Functional Independence Measures (FIM), Functional Mobility Scale (FMS), and King's Health Questionnaire (KHQ)...
April 7, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28384984/management-of-traumatic-fibroma-in-a-patient-with-cerebral-palsy-using-810nm-diode-laser
#13
Raúl Vicente Perales-Garza, Gerardo Daniel Sierra-Garcia, Rosa Isela Sánchez Nájera, áRaúl Vicente Perales-Perez
There are several treatment options for hyperplastic gingival lesions. Among these, diode lasers have the advantages of less bleeding, which is an important characteristic in mucosal lesions, a shorter procedure time, better healing, and less complications. We present the case of a 48-year-old male patient with a history of cerebral palsy and a presumptive diagnosis of traumatic fibroma. The entire lesion was removed in one session with no complications. No recurrence was observed at 3 months follow up. This procedure can be considered a good modality especially for physically challenged patients...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28384828/association-between-early-low-dose-hydrocortisone-therapy-in-extremely-preterm-neonates-and-neurodevelopmental-outcomes-at-2-years-of-age
#14
Olivier Baud, Clémence Trousson, Valérie Biran, Emilie Leroy, Damir Mohamed, Corinne Alberti
Importance: Dexamethasone to prevent bronchopulmonary dysplasia in very preterm neonates was associated with adverse neurodevelopmental events. Early low-dose hydrocortisone treatment has been reported to improve survival without bronchopulmonary dysplasia but its safety with regard to neurodevelopment remains to be assessed. Objective: To assess whether early hydrocortisone therapy in extremely preterm infants is associated with neurodevelopmental impairment at 2 years of age...
April 4, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28384379/repeated-lumbar-or-ventricular-punctures-in-newborns-with-intraventricular-haemorrhage
#15
REVIEW
Andrew Whitelaw, Richard Lee-Kelland
BACKGROUND: Although in recent years the percentage of preterm infants who suffer intraventricular haemorrhage (IVH) has reduced, posthaemorrhagic hydrocephalus (PHH) remains a serious problem with a high rate of cerebral palsy and no evidence-based treatment. Survivors often have to undergo ventriculoperitoneal shunt (VPS) surgery, which makes the child permanently dependent on a valve and catheter system. This carries a significant risk of infection and the need for surgical revision of the shunt...
April 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28367118/neurologic-correlates-of-gait-abnormalities-in-cerebral-palsy-implications-for-treatment
#16
REVIEW
Joanne Zhou, Erin E Butler, Jessica Rose
Cerebral palsy (CP) is the most common movement disorder in children. A diagnosis of CP is often made based on abnormal muscle tone or posture, a delay in reaching motor milestones, or the presence of gait abnormalities in young children. Neuroimaging of high-risk neonates and of children diagnosed with CP have identified patterns of neurologic injury associated with CP, however, the neural underpinnings of common gait abnormalities remain largely uncharacterized. Here, we review the nature of the brain injury in CP, as well as the neuromuscular deficits and subsequent gait abnormalities common among children with CP...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28343216/susceptibility-weighted-imaging-identifies-iron-oxide-labeled-human-neural-stem-cells-automated-computational-detection
#17
Mohsen Baghchechi, Amy Plaia, Mary Hamer, Nirmalya Ghosh, Stephen Ashwal, Andre Obenaus
Neonatal hypoxic-ischemic brain injury (HII) can lead to devastating neurological outcomes such as cerebral palsy, epilepsy, and mental retardation. Human neural stem cell (hNSC) therapy provides new hope for the treatment of neonatal HII. These multipotent cells can aid in HII recovery by activating multiple reparative mechanisms including secretion of neurotrophic factors that enhance brain repair and plasticity. For clinical use of implanted hNSCs, methods are required to identify, quantify, track, and visualize migration and replication in an automated and reproducible fashion...
March 25, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28339409/practice-based-evidence-from-a-clinical-cohort-that-received-pediatric-constraint-induced-movement-therapy
#18
Stephanie C DeLuca, Mary Rebekah Trucks, Dorian A Wallace, Sharon L Ramey
PURPOSE: Constraint-Induced Movement Therapy (CIMT) is now designated a highly efficacious treatment for children with cerebral palsy, based on rigorous clinical trials. Yet virtually no evidence confirms that these moderate to large size effects can be replicated in clinical practice for a more heterogeneous clinical population. Thus there is a need to collect and report treatment outcome data based on actual clinical practice as a critical next step for implementation. METHODS: This study presents results from a prospective study conducted on a clinical cohort of 88 children, 18 months to 12 years old (M = 55 months, SD = 5 months), who received high-intensity CIMT known as ACQUIREc...
2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/28317070/lumbar-translaminar-fenestration-for-insertion-of-intrathecal-baclofen-catheter-a-novel-technique
#19
Manraj K S Heran, Hisham Al-Shikarchy, Carolyn Chowne
Intrathecal baclofen has long been known to be an efficacious treatment of spasticity in children with cerebral palsy. Test bolus administration is often necessary to ensure patients will benefit from this treatment. The introduction of a intrathecal catheter for test bolus administration can prove challenging in a subset of this population, particularly those who have received surgery with postoperative spinal fusion masses. We outline a novel technique of inserting a spinal catheter for test bolus administration in a patient with a postoperative fusion mass whereby a fenestration is created through the lamina using an osteotomy needle...
March 20, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28299509/symptom-recognition-and-diagnosis-of-cerebral-palsy-in-nepal
#20
Ritesh Thapa
Cerebral palsy (CP) is the most common movement disorder of childhood. Parents recognized the symptoms of CP at mean age of 13 months. However there was a mean delay of going to a doctor by 23 months and the mean age of diagnosis was 5½ years. Less than half of the CP children were diagnosed by a pediatrician and were receiving treatment methods with weak evidence base of efficacy. Delay in recognition of symptoms and help seeking due to lack of awareness and access to proper medical care and prevalent false beliefs were the leading reason for late diagnosis of CP in Nepal and thus children loose valuable time for intervention in their early developmental stage...
March 15, 2017: Journal of Autism and Developmental Disorders
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