scholarly journals PredictMed: A logistic regression–based model to predict health conditions in cerebral palsy

2020 ◽  
Vol 26 (3) ◽  
pp. 2105-2118 ◽  
Author(s):  
Carlo M Bertoncelli ◽  
Paola Altamura ◽  
Edgar Ramos Vieira ◽  
Sundaraja Sitharama Iyengar ◽  
Federico Solla ◽  
...  

Logistic regression–based predictive models are widely used in the healthcare field but just recently are used to predict comorbidities in children with cerebral palsy. This article presents a logistic regression approach to predict health conditions in children with cerebral palsy and a few examples from recent research. The model named PredictMed was trained, tested, and validated for predicting the development of scoliosis, intellectual disabilities, autistic features, and in the present study, feeding disorders needing gastrostomy. This was a multinational, cross-sectional descriptive study. Data of 130 children (aged 12–18 years) with cerebral palsy were collected between June 2005 and June 2015. The logistic regression–based model uses an algorithm implemented in R programming language. After splitting the patients in training and testing sets, logistic regressions are performed on every possible subset (tuple) of independent variables. The tuple that shows the best predictive performance in terms of accuracy, sensitivity, and specificity is chosen as a set of independent variables in another logistic regression to calculate the probability to develop the specific health condition (e.g. the need for gastrostomy). The average of accuracy, sensitivity, and specificity score was 90%. Our model represents a novelty in the field of some cerebral palsy–related health outcomes treatment, and it should significantly help doctors’ decision-making process regarding patient prognosis.

2013 ◽  
Vol 04 (S 01) ◽  
pp. S40-S44 ◽  
Author(s):  
Thekkumkara Surendran Nair Anish ◽  
Reshmi Ramachandran ◽  
P Sivaram ◽  
Seetha Mohandas ◽  
Archana Sasidharan ◽  
...  

ABSTRACT Context: There is enough documented evidence to prove the benefits of early and appropriate initiation of education among children with cerebral palsy (CP). Aim: To find out the proportion of children with CP who are enrolled for some kind of formal education and to study the determinants of the same. Setting and Design: This cross sectional study was done among children, attending the special clinics at government medical college, Thiruvananthapuram. Materials and Methods: Children between 3 and 12 years of age diagnosed with CP were subjects for the study. Statistical Analysis Used: Enrollment for any form of formal education was the major outcome variable. The factors associated with initiation of formal education were tested using Chi-square test or Fischer′s exact test. Independent association of each factor was evaluated through binary logistic Regression analysis. Results and Conclusions: The mean (SD) age of the children (n = 86) was 5.7 (2.3) years with forty-six (53.5%) of them being girls. Diplegia was the commonest limb abnormality found. Fifty-two (60.5%) children were undergoing some kind of schooling. Those children who were less dependent physically and those who had achieved better language development were regular school goers. After binary logistic regression the ability of a child to speak in sentences (P = 0.008) and ambulatory level of the child (P = 0.019) were factors which favored, whereas delay in attaining the adaptive developmental milestone of transferring objects from one hand to another (P = 0.014) was found to be detrimental for school enrollment.


2021 ◽  
Vol 26 (3) ◽  
pp. 575-583
Author(s):  
Damla Cankurtaran ◽  
Nihan Abidin ◽  
Ece Unlu Akyuz ◽  
Nihal Tezel

Background & Objective: This study aimed to examine the factors affecting sitting function in non- ambulatory children with cerebral palsy (CP) who spend most of their daily life in a sitting position. Methods: Thirty- five non-ambulatory children with CP were included in this cross sectional study. Data included demographics, socio-economic features, examination findings, personal and family history, and accompanying problems of patients. The participants’ lower extremity spasticity was evaluated using the Modified Ashworth scale (MAS); manual ability was evaluated using the Manual Ability Classification System (MACS); sitting function using the Gross Motor Functional Measure (GMFM)-sitting subscale; and trunk control using the Trunk Impairment Scale (TIS). The relationship between sitting function and the other evaluation parameters was analyzed. Results: Children with scoliosis had significantly lower scores in TIS-static and TIS-total (p<0.05). Hip problems negatively affected the GMFM-sitting subscale, TIS-static, and TIS-total (p<0.05). Strong positive correlations were found between GMFM- B (sitting subscale) scores and TIS-static, dynamic, coordination, and TIS-total scores (p<0.05). Duration of hospitalization in neonatal intensive care and MACS were correlated with GMFM-B (p<0.05). Multivariate analyses showed that trunk control and upper extremity function were independent risk factors on sitting function. Conclusion: More attention should be paid to rehabilitation programs which incorporate trunk control exercises and upper extremity functions in order to improve sitting function. Preventing hip dislocation may be an option to increase sitting function of non-ambulatory children with CP.


2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.


2020 ◽  
Vol 33 (8) ◽  
pp. 1083-1092 ◽  
Author(s):  
Ibrahim Duran ◽  
Kyriakos Martakis ◽  
Christina Stark ◽  
Leonie Schafmeyer ◽  
Mirko Rehberg ◽  
...  

AbstractObjectivesIn children with cerebral palsy (CP), the most common cause of physical impairment in childhood, less muscle and bone growth has been reported, when compared with typically developing children. The aim of this study was to evaluate the effect of an intensive rehabilitation program including physiotherapy in combination with 6 months of home-based, vibration-assisted training on muscle and bone growth in children with CP.MethodsWe included children with CP, who participated in a rehabilitation program utilizing whole-body vibration (WBV). Muscle mass was quantified by appendicular lean mass index (App-LMI) and bone mass by total-body-less-head bone mineral content (TBLH-BMC) assessed by Dual-energy X-ray absorptiometry (DXA) at the beginning of rehabilitation and one year later. To assess the functional muscle-bone unit, the relation of TBLH-BMC to TBLH lean body mass (TBLH-LBM) was used.ResultsThe study population included 128 children (52 females, mean age 11.9 ± 2.7). App-LMI assessed in kg/m2 increased significantly after rehabilitation. The age-adjusted Z-score for App-LMI showed no significant change. TBLH-BMC assessed in gram increased significantly. The Z-scores for TBLH-BMC decreased lesser than expected by the evaluation of the cross-sectional data at the beginning of rehabilitation. The parameter $\frac{TBLH-BMC}{TBLH-LBM}$ did not change relevantly after 12 months.ConclusionsMuscle growth and to a lesser extent bone growth could be increased in children with CP. The intensive rehabilitation program including WBV seemed to have no direct effect on the bone, but the observed anabolic effect on the bone, may only been mediated through the muscle.


2021 ◽  
Author(s):  
Alanoud Akram Aman ◽  
Bashaer Baharoon ◽  
Haifa Jamal Idrees ◽  
Ahad Mohammedyusuf Taj ◽  
Bassmah Ali Alzahrani ◽  
...  

2021 ◽  
pp. 140349482110454
Author(s):  
Amanda M.S. Christesen ◽  
Camilla K. Knudsen ◽  
Kirsten Fonager ◽  
Martin N. Johansen ◽  
Signe Heuckendorff

Aim: Parental mental health conditions adversely affect the children. Information on the prevalence of parental mental health conditions is needed to help policymakers allocate resources appropriately. Therefore, the aim of this study was to estimate the prevalence of children with parental mental health conditions in Denmark and further estimate the age-specific prevalence and geographical variation. Methods: In this nationwide register-based cross-sectional study, we included all children born between 2000 and 2016 if they resided in Denmark on 31 December 2016. Information on both maternal and paternal mental health conditions was retrieved from primary and secondary healthcare registers. Parental mental health conditions were categorised in three severity groups: minor, moderate, and severe. We estimated the proportion of children with parental mental health conditions on 31 December 2016. Results: Of the 1,106,459 children aged 0–16 years, 39.1% had at least one parent with a mental health condition. The prevalence increased with age of the children until the age of six years. Geographical variation in the prevalence ranged from 29.0% to 48.3% in the 98 municipalities. Minor parental mental health conditions (23.5%) were more common than moderate (13.5%) and severe parental mental health conditions (2.2%). Hospital-diagnosed parental mental health conditions were prevalent in 12.8% of the children. Conclusions: Two in five children aged 0–16 years in Denmark have parents with a mental health condition and geographical variation exists. The high prevalence of children with parental mental health conditions is an important public health challenge, which calls for attention.


2021 ◽  
Vol 11 (23) ◽  
pp. 11140
Author(s):  
Yun-Huei Ju ◽  
Rong-Ju Cherng

Background: Children with cerebral palsy (CP) have difficulty in managing postural control during functional reaching tasks, although children with different postural control ability are able to come up with different motor solutions to cope with different task demands. This study examined the effect of task constraint on postural control performance in children with cerebral palsy and typical development (TD) in terms of different postural control abilities. Methods: A cross-sectional research design was used. Twelve children with spastic diplegic cerebral palsy (mean age: 107.8 months) and 16 typically developing children (mean age: 110.9 months) participated in this study. Individually, all subjects were seated in a height-adjusted chair and were requested to reach for target(s) located at three different directions (medial, anterior, and lateral). A six-camera Qualisys Motion Capture System was used to capture motion data. Kinematic data in terms of body alignment and angular changes were analyzed. Results: Children with cerebral palsy demonstrated different postural control strategies to complete different reaching tasks compared to typically developing children by preparing postural alignment in advance, coordinating different body orientation movements during reaching after showing difficulty in managing reach medially. Conclusions: Children with cerebral palsy perceive their insufficient ability and prepare their alignment in advance to adapt to the task demanded and decrease the postural challenges of the task. Even though children with cerebral palsy self-generate different motor solutions to reach without falling, these alternative strategies might not be the most efficient adaptation.


2020 ◽  
Vol 5 (1) ◽  
pp. 1-12
Author(s):  
Bambang Trisnowiyanto

Background:  The most common disorder or disability in childhood is cerebral palsy, obtained during the antenatal, perinatal or early postnatal period. Cerebral palsy is a non-progressive injury or brain lesion with very variable clinical manifestations. children with cerebral palsy have impaired movement, ability levels and functional limitations and affected body parts. Therefore, to find out the level of independence in children with cerebral palsy, it is necessary to have an examination carried out by health workers, especially physiotherapy. In this case, an examination using the Gross Motor Function Classification System (GMFCS). The purpose of this study was to determine the degree of independence of children with cerebral palsy in several regions in Java and Sumatra. Methods: A total of 315 children with cerebral palsy (mean ± SD)  participated in this cross-sectional study design. The research was conducted in March-June 2019. GMFCS data was collected from children with cerebral palsy in the parent community of cerebral palsy in 10 cities. The Kolmogorov-Smirnov test used for data normality test. Result: Overall research subjects from 10 cerebral palsy communities with a total sample of 315 children, most cerebral palsy with GMFCS level 4 as many as 117 children (37.1%), then GMFCS level 3 as many as 84 children (26.7%), GMFCS level 5 is 67 children (21.3%), level 2 GMFCS is 24 children (7.6%), and at least children with level 1 GMFCS are 23 children (7.3%). Conclusion: The conclusion is from a total of 315 children with cerebral palsy, the level of Indonesian children's independence based on GMFCS most of them are less independent.


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