scholarly journals Physical Therapists' Perceptions of Factors Influencing the Acquisition of Motor Abilities of Children With Cerebral Palsy: Implications for Clinical Reasoning

2002 ◽  
Vol 82 (3) ◽  
pp. 237-248 ◽  
Author(s):  
Doreen J Bartlett ◽  
Robert J Palisano
Keyword(s):  
Cerebral Palsy ◽  
Focus Groups ◽  
Clinical Reasoning ◽  
Physical Therapists ◽  
Muscle Tone ◽  
Survey Methods ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Motor Abilities ◽  
Children With Cerebral Palsy

Abstract Background and Purpose. Evidence supporting factors predicting motor change for children with cerebral palsy is minimal. A consensus exercise using focus groups and survey methods was conducted to identify factors perceived to affect the acquisition of basic motor abilities among children with cerebral palsy from the time of diagnosis to 7 years of age. Subjects. Fifty-seven physical therapists participated in one of 12 focus groups, and 60 physical therapists participated in a follow-up questionnaire survey via mail. Methods. The nominal group technique was used to conduct the focus groups. Results. Participants reached consensus about 12 factors in 4 constructs, which we called: (1) primary impairments (muscle tone/movement patterns, distribution of involvement, balance, and sensory impairment), (2) secondary impairments (range of motion/joint alignment, force production, health, and endurance), (3) personality characteristics (motivation), and (4) family factors (support to child, family expectations, and support to family). Discussion and Conclusion. The recognition of potential determinants of motor change could assist in the clinical reasoning that physical therapists use when planning interventions for children with cerebral palsy. Participants identified a set of variables, some of which are found in the literature, that can provide foundation knowledge for decision making and research on factors that bring about change in motor ability among children with cerebral palsy.

scholarly journals Evaluation of Individualized Functional Electrical Stimulation-Induced Acute Changes during Walking: A Case Series in Children with Cerebral Palsy

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4452
Author(s):  
Nicole Zahradka ◽  
Ahad Behboodi ◽  
Ashwini Sansare ◽  
Samuel C. K. Lee
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Case Series ◽  
Phase Detection ◽  
Lower Extremity Muscle ◽  
Children With Cerebral Palsy ◽  
Muscle Groups

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

scholarly journals A series of case studies on the effect of a midfoot control ankle foot orthosis in the prevention of unresolved pressure areas in children with cerebral palsy

2001 ◽  
Vol 25 (3) ◽  
pp. 246-250 ◽  
Author(s):  
M. Bill ◽  
R. McIntosh ◽  
P. Myers
Keyword(s):  
Cerebral Palsy ◽  
Case Studies ◽  
Muscle Tone ◽  
Evidence Base ◽  
Triceps Surae ◽  
Orthotic Devices ◽  
Ankle Foot Orthosis ◽  
Children With Cerebral Palsy ◽  
Foot Position ◽  
Foot Orthosis

This paper reports on a series of case studies where improvements were sought in muscle tone and gait in children with cerebral palsy. A Midfoot Control Ankle Foot Orthosis (AFO) was developed to control foot position in a cohort of patients with cerebral palsy (CP). The concept of controlling midfoot and hindfoot with an encapsulated internal Supra-Malleolar AFO that fitted into an external AFO was shown to be effective in ambulant children with CP. Some initial problems of compliance were noted and postulated to be due to difficulties associated with previous orthotic devices. Evidence from the case studies suggest that the developed Supra-Malleolar AFO orthoses enables children with CP to maintain mobility without skin tissue damage, delays the need for surgery and at the same time maintains the length of the Triceps Surae (Gastrocnemius and Soleus) complex. Plans for further research are discussed which will contribute to the evidence base for this particular orthotic device.

scholarly journals The Nominal Group Technique (NGT) as a Tool for Facilitating Pan-Disability Focus Groups and as a New Method for Quantifying Changes in Qualitative Data

2019 ◽  
Vol 18 ◽  
pp. 160940691986604 ◽  
Author(s):  
Jason Olsen
Keyword(s):  
Focus Groups ◽  
Qualitative Data ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Disabled People ◽  
Full Inclusion ◽  
New Methods ◽  
Pertinent Data ◽  
Qualitative Focus Groups ◽  
Group Technique

This article reaffirms the value and flexibility of the nominal group technique (NGT) when conducting qualitative focus groups (QFGs). In the project that will be discussed, the methods used expanded the application of the NGT into the realm of pan-disability (i.e., individuals with differing impairments) research. It provides requirements and recommendations for the full inclusion and participation of disabled people into projects where the pertinent source of qualitative data is obtained from QFGs. Furthermore, this article describes innovative additional steps to the NGT that are beneficial to researchers. This includes a method of evaluating the data that is often lost between the NGTs’ stages of initial and final rankings. These new methods ensure pertinent data are not overlooked.

The use of botulinum toxin therapy for lower-extremity spasticity in children with cerebral palsy

2006 ◽  
Vol 21 (2) ◽  
pp. E1 ◽  
Author(s):  
Susan R. Criswell ◽  
Beth E. Crowner ◽  
Brad A. Racette
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Lower Extremity ◽  
Muscle Tone ◽  
Botulinum Toxin A ◽  
Multidisciplinary Treatment ◽  
Safety Margin ◽  
Technical Information ◽  
Botulinum Toxin Therapy ◽  
Children With Cerebral Palsy

✓ Hypertonicity is a leading cause of disability for children with cerebral palsy (CP). Botulinum toxin A (BTA) chemically denervates muscle tissue and is commonly used in the management of lower-extremity hypertonicity in children with CP because of its focal effects and wide safety margin. Randomized controlled trials have demonstrated that BTA injections in the ankle flexors, hamstrings, and adductors reduce spasticity and result in improved passive and active range of motion. In other studies, improvements in gait and measurements of functional outcome were found in appropriately selected children who had been injected with BTA. A multidisciplinary treatment approach that includes physical therapists, occupational therapists, orthotists, neurologists, physicians with expertise in performing botulinum toxin injections, orthopedic surgeons, and neurosurgeons is critical to optimize care in children with lower-extremity tone due to CP. In this paper, the authors propose treatment algorithms based on clinical presentation, detailed dosing, and technical information to optimize the treatment of these children. With a multidisciplinary approach, children with lower-extremity hypertonicity due to CP can experience improvements in muscle tone and function.

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