Cerebral Palsy in Children With Congenital Zika Syndrome: A 2-Year Neurodevelopmental Follow-up

2019 ◽  
Vol 35 (3) ◽  
pp. 202-207 ◽  
Author(s):  
Alessandra Lemos de Carvalho ◽  
Paloma Ventura ◽  
Tânia Taguchi ◽  
Ivar Brandi ◽  
Carlos Brites ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Neurological Examination ◽  
Head Circumference ◽  
Classification System ◽  
Test Scores ◽  
Examination Score ◽  
Children With Cerebral Palsy ◽  
Toddler Development

Objective: To describe the 2-year neurodevelopmental outcome in children with cerebral palsy associated with congenital Zika (CZ) and explore variables associated with a more severe presentation. Methods: Data on 69 children with cerebral palsy associated with CZ, followed in a neurorehabilitation hospital, who consecutively attended the neurodevelopmental assessment at 2 years of age, were collected. Bayley III Scales of Infant and Toddler Development, Hammersmith Infant Neurological Examination, and Gross Motor Function Classification System were used for the outcome evaluation. Descriptive and inferential statistical analysis were performed. Results: The median age at follow-up was of 24.0 (23-32) months. Only 3 (4.3%) children were not microcephalic. The majority presented with bilateral (94.2%), spastic (100.0%), Gross Motor Function Classification System grade IV or V (92.8%) cerebral palsy, epilepsy (73.1%), extremely low performances on cognitive (94.2%), language (95.7%), and motor (95.7%) Bayley-III Scales of Infant and Toddler Development Test scores. The median Hammersmith Infant Neurological Examination score was of 21.0 (range 9-75). There was a correlation between birth head circumference with the cognitive ( r = 0.3, P < .01), language ( r = 0.3, P < .01), and motor ( r = 0.3, P < .01) Bayley-III Scales of Infant and Toddler Development Test scores, as well as with the Hammersmith Infant Neurological Examination score ( r = 0.2, P < .03). An association was observed between an inferior median Hammersmith Infant Neurological Examination score with congenital microcephaly ( P = .04), arthrogryposis ( P = .02), and epilepsy in the first year ( P < .01). Conclusion: Cerebral palsy related to CZ presents with a severe global impairment at a 2-year follow-up. Birth head circumference, arthrogryposis, and early epilepsy are associated with a worse outcome and may be considered as prognostic markers. These findings are important for the neurorehabilitation planning, parents’ guiding, and future prognostic studies.

scholarly journals GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM (GMFCS) FOR CHILDREN WITH CEREBRAL PALSY

2019 ◽  
Vol 7 (7) ◽  
pp. 3281-3286
Author(s):  
Mst. Rabea Begum ◽  
◽  
Mohammad Anwar Hossain ◽  
Shahnaj Sultana ◽  
◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Classification System ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Children With Cerebral Palsy

scholarly journals Access to Intrathecal Baclofen Treatment for Children with Cerebral Palsy in European Countries: An SCPE Survey Reveals Important Differences

2020 ◽  
Vol 51 (02) ◽  
pp. 129-134
Author(s):  
Kate Himmelmann ◽  
Magnus Påhlman ◽  
Guro L. Andersen ◽  
Torstein Vik ◽  
Daniel Virella ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Gross Domestic Product ◽  
Sex Difference ◽  
Motor Function ◽  
Classification System ◽  
Intrathecal Baclofen ◽  
Population Based ◽  
Treatment Access ◽  
Significant Difference ◽  
Children With Cerebral Palsy

Abstract Aim The aim is to study access to intrathecal baclofen (ITB) for children with cerebral palsy (CP) in Europe, as an indicator of access to advanced care. Methods Surveys were sent to CP registers, clinical networks, and pump manufacturers. Enquiries were made about ITB treatment in children born in 1990 to 2005 by sex, CP type, level of gross motor function classification system (GMFCS) and age at the start of treatment. Access to ITB was related to the country's gross domestic product (GDP) and % GDP spent on health. Results In 2011 population-based data from Sweden, Norway, England, Portugal, Slovenia, and Denmark showed that 114 (3.4%) of 3,398 children with CP were treated with ITB, varying from 0.4 to 4.7% between centers. The majority of the children were at GMFCS levels IV-V and had bilateral spastic CP. In Sweden, dyskinetic CP was the most commonly treated subtype. Boys were more often treated with ITB than girls (p = 0.014). ITB was reported to be available for children with CP in 25 of 43 countries. Access to ITB was associated with a higher GDP and %GDP spent on health (p < 0.01). Updated information from 2019 showed remaining differences between countries in ITB treatment and sex difference in treated children was maintained. Conclusion There is a significant difference in access to ITB for children with CP across Europe. More boys than girls are treated. Access to ITB for children with CP is associated with GDP and percent of GDP spent on health in the country.

scholarly journals The Effect of Robot-Assisted Gait Training on Locomotor Function and Functional Capability for Daily Activities in Children with Cerebral Palsy: A Single-Blinded, Randomized Cross-Over Trial

2020 ◽  
Vol 10 (11) ◽  
pp. 801
Author(s):  
Li Hua Jin ◽  
Shin-seung Yang ◽  
Ja Young Choi ◽  
Min Kyun Sohn
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gait Training ◽  
Daily Activities ◽  
Robot Assisted ◽  
Functional Capability ◽  
Gross Motor ◽  
Children With Cerebral Palsy ◽  
Carry Over

Purpose: The effectiveness of robot-assisted gait training (RAGT) in children with cerebral palsy (CP), especially in terms of improving the performance of daily activities, remains unclear. Therefore, we aimed to investigate the effectiveness of RAGT in children with CP. Methods: In this single-center, single-blinded, randomized cross-over trial, we enrolled 20 children with CP with Gross Motor Function Classification System (GMFCS) levels II–IV (13 males; age range, 6.75 ± 2.15 years). The participants were randomized into the RAGT/standard care (SC) (n = 10) and SC/RAGT/SC sequence groups (n = 10). Using a Walkbot-K system, the RAGT program comprised 3 × 30-min sessions/week for 6 weeks with a continued SC program. The SC program comprised 2–4 conventional physiotherapy sessions/week for 6 weeks. The Gross Motor Function Measure-88 (GMFM-88), the pediatric functional independence measure (WeeFIM), and the Canadian occupational performance measure (COPM) scores were assessed pre- and post-RAGT or SC periods and treatment, period, follow-up, and carry-over effects were analyzed. Energy expenditure and body composition were measured pre- and post-RAGT. Results: Significant treatment effects were observed in dimensions D and E of the GMFM (D: p = 0.018; E: p = 0.021) scores, WeeFIM mobility subtotal (p = 0.007), and COPM performance (p < 0.001) and satisfaction (p = 0.001) measure scores. The period, follow-up, and carry-over effects were not statistically significant. The gross energy cost significantly decreased (p = 0.041) and the skeletal muscle mass increased (p = 0.014) at post-RAGT assessment. The factors associated with functional outcomes showed significant improvements in the GMFM D scores and were mainly observed in children with GMFCS levels II–III compared to those classified at level IV (p = 0.038). Conclusion: RAGT had training benefits for children with CP. Specifically, it improved locomotor function and functional capability for daily activities. These effects were better in ambulatory children with CP. However, as SC interventions continued during the RAGT period, these improvements may be also related to multiple treatment effects.

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