scholarly journals A Patient-Reported Measure of Locomotor Function Derived from the Functional Assessment Questionnaire

2021 ◽  
Author(s):  
Michael H Schwartz ◽  
Nanette Aldahondo ◽  
Bruce MacWilliams
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Functional Assessment ◽  
External Validity ◽  
System Level ◽  
Gross Motor ◽  
Locomotor Function ◽  
Gross Motor Function ◽  
Assessment Questionnaire ◽  
Functional Assessment Questionnaire

Background Locomotor function is often impaired in children diagnosed with cerebral palsy (CP). Improving locomotor function is a common goal of treatment. The current gold standard for assessing locomotor function in CP is the gross motor function measure (GMFM-66). The GMFM-66 requires an in-person assessment by a trained clinician. It would be useful to have a measure of function that is like the GMFM-66 but can be assessed through patient report. Methods We queried the clinical databases of two motion analysis centers (Gillette Children's Specialty Healthcare and Shriners Hospital - Salt Lake City) for individuals with a diagnosis of cerebral palsy (CP) who were 18 years old or younger and had undergone instrumented clinical gait analysis that included the functional assessment questionnaire (FAQ). We computed the transformed FAQ (FAQt) as the weighted sum of the skills an individual was able to perform, where the weighting was the difficulty of the skills. We assessed concurrent and external validity of the FAQt by comparing it to the GMFM-66. Results The FAQt exhibited strong concurrent and external validity. Linear regression showed that the GMFM-66 explained 54% of the variance in FAQt, and the linear fit was independent of center. The FAQt evolved with age in a manner similar to the GMFM-66, with higher functioning individuals, as measured by gross motor function classification system level, achieving higher levels of function at a higher rate and an earlier age compared to their lower functioning peers. The findings with respect to GMFM-66 did not depend on the center at which the data was acquired. Conclusions The FAQt demonstrates strong concurrent and external validity, making it a useful measure of locomotor function

scholarly journals Acute Response to One Bout of Dynamic Standing Exercise on Blood Glucose and Blood Lactate Among Children and Adolescents With Cerebral Palsy Who are Nonambulant

2021 ◽  
pp. 1-6
Author(s):  
Åsa Andersson ◽  
Petra Lundström ◽  
Katarina Lauruschkus ◽  
Åsa B. Tornberg
Keyword(s):  
Cerebral Palsy ◽  
Blood Glucose ◽  
Children And Adolescents ◽  
Blood Lactate ◽  
Motor Function ◽  
System Level ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Lactate Levels ◽  
Blood Lactate Levels

Purpose: To investigate the acute exercise effects of dynamic standing exercise on blood glucose and blood lactate among children and adolescents with cerebral palsy who are nonambulant. Methods: Twenty-four participants with cerebral palsy who are nonambulant performed 30 minutes of dynamic standing exercise using a motorized device enabling assisted passive movements in an upright weight-bearing position. Capillary blood samples were taken from the fingertip for measurement of blood glucose and blood lactate at rest and at the end of exercise. Results: At rest, the participants had hyperlactatemia that was unaffected after exercise, presented as median and interquartile range at rest 1.8 (1.3:2.7) mmol/L, and after exercise 2.0 (1.1:2.5) mmol/L. Children and adolescents with Gross Motor Function Classification System, level V, had higher lactate levels at rest (2.5 [1.8:2.9] vs 1.4 [1.0:2.0]; P = .030) and after exercise (2.3 [2.0:2.6] vs 1.2 [0.9:2.2]; P = .032) compared with children and adolescents with Gross Motor Function Classification System, level IV, respectively. A statistically significant larger decrease in blood lactate levels after exercise was observed in children and adolescents with higher resting blood lactate levels (ρ = .56; P = .004). There were no statistically significant changes in blood glucose. Conclusions: Forty percentage of the participants had mild hyperlactatemia at rest and participants with the highest blood lactate levels at rest had the greatest decrease in blood lactate levels after one bout of exercise. Children and adolescents who were classified with the highest level of the Gross Motor Function Classification Scale had higher blood lactate levels. More studies are needed on how to prevent chronically high resting levels of lactate with exercise in children with cerebral palsy who are nonambulant.

Effect of position on gross motor function and spasticity in spastic cerebral palsy children

2021 ◽  
pp. 1-14
Author(s):  
Wardah Rauf ◽  
Samia Sarmad ◽  
Iqra Khan ◽  
Muhammad Jawad ◽  
Admin
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
System Level ◽  
Spastic Cerebral Palsy ◽  
Sitting Position ◽  
Gross Motor ◽  
Motor Functioning ◽  
Five Dimensions ◽  
Gross Motor Function ◽  
Quasi Experimental

Abstract Objective: To evaluate the effect of positioning on gross motor function and spasticity in spastic quadriplegic cerebral palsy children with Gross Motor Function Classification System level IV and V. Methods: A quasi-experimental study was conducted at two Paediatric Physical Therapy Centres from November 2018 to July 2019. The study was comprised of seventy four children with quadriplegic cerebral palsy aged between 3 to 8 years. Data was obtained and gross motor functional abilities and spasticity were assessed by GMFM-88 and Modified Ashworth Scale respectively. Twenty four-hour positioning in specific seats, night positioning and standing frames for six months. The child was being positioned in 24 hours according to his challenges for the period of six months. Semi reclined positioning was performed to manage aspiration, oral leak and to develop retention. Prone positioning was done to develop righting reactions, functional sitting position was used in the treatment regime to attain better upright position and neutral pelvic standing using standing frames. SPSS 24 was used to analyse the data. Results: Paired t-test reported significant improvement in the test scores in lying position, rolling, sitting position, crawling, kneeling, standing, walking or running. n=59 subjects exhibited improvement in the spasticity before and after interventional procedures, while n=15 showed no improvement as the value of p<0.05. Conclusion: Twenty-Four-hour proper body positioning and postural techniques improved gross motor functioning in all of the five dimensions of functioning. The overall spasticity in quadriplegic cerebral palsy children was also reduced due to appropriate positioning techniques.  Continuous....

Effects of granulocyte colony-stimulating factor treatment in children and patients with cerebral palsy: a preliminary report

2017 ◽  
Vol 7 (1) ◽  
pp. 78-82
Author(s):  
G. Paszko-Patej ◽  
W. Kułak ◽  
B. Okurowska-Zawada ◽  
D. Sienkiewicz ◽  
J. Wojtkowski ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Preliminary Report ◽  
Speech Development ◽  
System Level ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Stimulating Factor

neuroinflammation and apoptosis in brains affected by cerebral palsy could be therapeutic targets. Granulocyte colony-stimulating factor (G-CSF) exerts anti-inflammatory and antiapoptosis effects and stimulates the proliferation of neural stem and progenitor cells in the brain. Purpose: To assess the efficacy and safety of G-CSF treatment in children and adolescents with CP. Materials and methods: Six patients with spastic tetraplegia CP aged 3-15 years were enrolled in this study. Five patients had GMFCS (Gross Motor Function Classification System) level at V, three children had epilepsy, and three had severe mental retardation. We used the gross motor function measure-66 (GMFM-66) to assess motor function.GCSF (5μg/kg/body/day) was administered subcutaneously for five consecutive days during the four months. The parents also evaluated the physical and mental development of their children. Results: We observed improvement in motor function in patients with CP on the GMFM-66 scale. Parents reported improvement in behavior, speech development, and a decrease in spasticity in children with CP. G-CSF therapy was well-tolerated. No side effects were observed during the study. Conclusions: Our preliminary report suggests that G-CSF treatment improves motor and mental function in patients with CP. Further studies are needed to confirm these observations

scholarly journals Integrated Rehabilitation for Children with Cerebral palsy: A Prospective Observational Study

2021 ◽  
Vol 42 (4) ◽  
pp. 60-74
Author(s):  
Hye-Yoon Lee ◽  
Young-Ju Yun ◽  
Yong-Beom Shin ◽  
Soo-Yeon Kim ◽  
Jun-hee Han ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Observational Study ◽  
Motor Function ◽  
Prospective Observational Study ◽  
Health Problems ◽  
System Level ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Treatment Type ◽  
Children With Cerebral Palsy

Objectives: This study aimed to analyse: 1) the clinical effectiveness and safety of traditional Korean Medicine (TKM) and frequency of TKM therapies used and their relationship with conventional treatments.Methods: This prospective observational study enrolled children with cerebral palsy (CP) aged 6-78 months (n=126). The children who used herbal medication for >30 days or acupuncture treatment >12 sessions within 6 months were defined as the integrated rehabilitation (IR) group; the remaining participants were included in the conventional rehabilitation (CR) group.Results: Changes in the Gross Motor Function Measure-66 (GMFM-66) were greater in the IR group (6.4±6.1) than in the CR group (4.6±5.8). The reduction in the number of other health problems was greater in the IR group than in the CR group. The GMFM-66 improvement was greatest in gross motor function classification system level 1. There was no between-group difference in the frequency of rehabilitation therapy (10.9±6.6 and 12.0±9.9 in the IR and CR groups, respectively).Conclusion: TKM may offer additional benefits in terms of the GMFM-66 score and other health problems. However, there is a need for further randomized controlled trials involving a restricted CP type and a controlled treatment type and intensity to confirm these findings.

scholarly journals Neuromuscular Electrical Stimulation to Immobilized Lower Extremities Directly Following Orthopaedic Surgery in Three Children with Cerebral Palsy: A Case Series

Sensors ◽  
2021 ◽  
Vol 21 (22) ◽  
pp. 7661
Author(s):  
Kelly Greve ◽  
Caroline Colvin
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Motor Function ◽  
Orthopaedic Surgery ◽  
Neuromuscular Electrical Stimulation ◽  
Case Series ◽  
System Level ◽  
Electrode Placement ◽  
Gross Motor ◽  
Gross Motor Function

Cerebral palsy (CP) is a non-progressive, neurological disorder often resulting in secondary musculoskeletal impairments affecting alignment and function which can result in orthopaedic surgery. Neuromuscular electrical stimulation (NMES) is a modality that can be used for rehabilitation; however, NMES immediately following orthopaedic surgery in children with CP using surface electrodes has not been previously reported. The purpose of this case series is to describe the novel use of NMES in the acute rehabilitation phase directly after orthopaedic surgery. This case series included three children with spastic diplegia CP, Gross Motor Function Classification System level II who underwent Single Event Multi-Level orthopaedic Surgery. Each long leg cast contained window cast cut-outs to allow for surface electrode placement for daily NMES intervention to the quadriceps muscles while immobilized. Children were assessed pre- and post-operatively using the Functional Mobility Scale (FMS), Gross Motor Function Measure (GMFM-66), and 6-Minute Walk Test (6MWT). All children demonstrated no adverse effects using NMES intervention and had improvements in the 6MWT. Most children demonstrated gains in the FMS and GMFM-66. Use of NMES through window cast-cuts in a long leg cast is a novel practice approach for delivery of early rehabilitation following lower extremity orthopaedic surgery.

Sign in / Sign up

Export Citation Format

Share Document