scholarly journals Growth in Infants, Children and Adolescents with Unilateral and Bilateral Cerebral Palsy

2021 ◽  
Author(s):  
Maria de las Mercedes Ruiz Brunner ◽  
Eduardo Cuestas ◽  
Florian Heinen ◽  
Andreas Sebastian Schroeder
Keyword(s):  
Cerebral Palsy ◽  
Gestational Age ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Motor Impairment ◽  
Growth Patterns ◽  
Childhood And Adolescence ◽  
Gross Motor ◽  
Severe Impairment ◽  
Z Scores

Abstract PURPOSE: To compare growth patterns during infancy, childhood and adolescence in children with unilateral and bilateral cerebral palsy (CP) phenotype and to assess the association with gross motor impairment, dysphagia and gestational age. METHODS: We retrospectively studied 389 children with CP from a single center population in Munich, Germany. 1536 measurements of height and weight were tabulated and z-scored from 6 to 180 months of age. Generalized linear mixed model were used to examine the association between growth, GMFCS, dysphagia and gestational age by CP phenotype. RESULTS: Children with unilateral CP tend to grow similarly to their typically developed peers. In the main effect model, bilateral CP phenotype was significantly associated with decreased mean z-scores for height (β[95% CI] = -0.953 [-1.145, -0.761], p < 0.001), weight (−0.999 [−1.176, −0.807], p < 0.001) and BMI (β[95% CI] = −0.437 [−0.799, −0.075]), compared with unilateral CP phenotype.This association remained significant in the interaction models. The height-for-age z-scores, weight-for-age decreased z-scores and BMI-for-age z-scores of children with bilateral CP and GMFCS III–V or dysphagia decreased more significantly than those of children with unilateral CP. Preterm birth was not significantly associated with decreased growth in height, weight and BMI.CONCLUSION: Reduced growth in children with bilateral CP was strongly associated with moderate to severe impairment in gross motor function (GMFCS III–V) and dysphagia.

Growth rate of coeliac children is compromised before the onset of the disease

2020 ◽  
Vol 105 (10) ◽  
pp. 964-968 ◽  
Author(s):  
Renata Auricchio ◽  
Pio Stellato ◽  
Dario Bruzzese ◽  
Donatella Cielo ◽  
Alfredo Chiurazzi ◽  
...  
Keyword(s):  
Growth Rate ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Growth Failure ◽  
Growth Patterns ◽  
First Year ◽  
Z Score ◽  
Lower Growth ◽  
Z Scores ◽  
Lower Growth Rate

IntroductionGrowth impairment has often been described in children who develop coeliac disease (CD). Based on data from the multicentre, longitudinal PreventCD study, we analysed the growth patterns of infants at genetic risk of CD, comparing those who developed CD by 6 years of age (CD ‘cases’, 113 infants) versus those who did not develop CD by 6 years (no CD ‘controls’, 831 infants).MethodsWeight and length/height were measured using a longitudinal protocol. Raw measurements were standardised, computing z-scores for length/height and weight; a linear mixed model was fitted to the data in order to compare the rate of growth in the two cohorts.ResultsNeither cases nor controls had significant growth failure. However, when the mean z-scores for weight and height were analysed, there was a difference between the two groups starting at fourth month of life. When the growth pattern in the first year was analysed longitudinally using mixed models, it emerged that children who develop CD had a significantly lower growth rate in weight z-score (−0.028/month; 95% CI −0.038 to −0.017; p<0.001) and in length/height z-score (−0.018/month; 95% CI −0.031 to −0.005; p=0.008) than those who do not develop CD. When the whole follow-up period was analysed (0–6 years), differences between groups in both weight and length/height z-scores were confirmed.ConclusionThe growth of children at risk of CD rarely fell below ‘clinical standards’. However, growth rate was significantly lower in cases than in controls. Our data suggest that peculiar pathways of growth are present in children who develop CD, long before any clinical or serological signs of the disease appear.

Prevalence of Speech Problems and the Use of Augmentative and Alternative Communication in Children With Cerebral Palsy: A Registry-Based Study in Norway

2010 ◽  
Vol 19 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Guro Andersen ◽  
Tone R. Mjøen ◽  
Torstein Vik
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gestational Age ◽  
Augmentative And Alternative Communication ◽  
Alternative Communication ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Children With Cerebral Palsy ◽  
Communicative Abilities ◽  
Normal Speech

Abstract This study describes the prevalence of speech problems and the use of augmentative and alternative communication (AAC) in children with cerebral palsy (CP) in Norway. Information on the communicative abilities of 564 children with CP born 1996–2003, recorded in the Norwegian CP Registry, was collected. A total of 270 children (48%) had normal speech, 90 (16%) had slightly indistinct speech, 52 (9%) had indistinct speech, 35 (6%) had very indistinct speech, 110 children (19%) had no speech, and 7 (1%) were unknown. Speech problems were most common in children with dyskinetic CP (92 %), in children with the most severe gross motor function impairments and among children being totally dependent on assistance in feeding or tube-fed children. A higher proportion of children born at term had speech problems when compared with children born before 32 weeks of gestational age 32 (p > 0.001). Among the 197 children with speech problems only, 106 (54%) used AAC in some form. Approximately 20% of children had no verbal speech, whereas ~15% had significant speech problems. Among children with either significant speech problems or no speech, only 54% used AAC in any form.

scholarly journals Bi-directional prospective associations between objectively measured physical activity and fundamental motor skills in children: a two-year follow-up

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Ada Kristine Ofrim Nilsen ◽  
Sigmund Alfred Anderssen ◽  
Kjersti Johannessen ◽  
Katrine Nyvoll Aadland ◽  
Einar Ylvisaaker ◽  
...  
Keyword(s):  
Physical Activity ◽  
Young Children ◽  
Motor Skills ◽  
Motor Development ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Gross Motor ◽  
Object Control ◽  
Fundamental Motor Skills

Abstract Background The direction of the longitudinal relationship between physical activity (PA) and fundamental motor skills (FMS) remains unclear. We evaluated the bi-directional, prospective relationships between intensity-specific physical activity (PA) and domain-specific fundamental motor skills (FMS) over 2 years in children attending preschool at baseline. Methods A sample of 230 children (mean age at baseline 4.7 yr, 52% boys) from the 'Sogn og Fjordane Preschool Physical Activity Study' was measured 2 years apart. PA was assessed using ActiGraph accelerometers (GT3X+). FMS were evaluated by a test battery guided by the 'Test of Gross Motor Development 3' and the 'Preschooler Gross Motor Quality Scale'. PA outcomes were total PA (TPA [counts per minute]) and intensity specific PA and sedentary behaviour (SED) (min/day). FMS outcomes were locomotor, object control, and balance skills. Linear mixed model adjusting for potential co-variates was used to evaluate the bi-directional prospective associations between these variables, including the moderating effect of sex and age. Results Baseline total PA, moderate-to-vigorous PA (MVPA), and vigorous PA predicted higher locomotor, object control, and balance skills at follow-up (standardized regression coefficient (β): 0.17 to 0.26, p = 0.002–0.017). Baseline SED predicted lower locomotor skills at follow-up (β: − 0.27, p = 0.012). Baseline light PA did not predict FMS at follow-up. Baseline FMS were not associated with PA or SED at follow-up. Conclusions MVPA was positively associated with development of FMS in young children. In contrast, FMS were not related to future PA levels. Our results suggest promotion of MVPA is important for FMS development in young children.

scholarly journals Tree Growth and Wood Quality in Pure Vs. Mixed-Species Stands of European Beech and Calabrian Pine in Mediterranean Mountain Forests

Forests ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 6 ◽  
Author(s):  
Diego Russo ◽  
Pasquale A. Marziliano ◽  
Giorgio Macrì ◽  
Giuseppe Zimbalatti ◽  
Roberto Tognetti ◽  
...  
Keyword(s):  
Tree Growth ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Wood Quality ◽  
European Beech ◽  
Growth Patterns ◽  
Mixed Species ◽  
Area Index ◽  
Mixture Effect ◽  
Calabrian Pine

Mixed-species forests may deliver more forest functions and services than monocultures, as being considered more resistant to disturbances than pure stands. However, information on wood quality in mixed-species vs. corresponding pure forests is poor. In this study, nine plots grouped into three triplets of pure and mixed-species stands of European beech and Calabrian pine (three dominated by European beech, three dominated by Calabrian pine, and three mixed-species plots) were analysed. We evaluated tree growth and wood quality through dendrochronological approaches and non-destructive technologies (acoustic detection), respectively, hypothesizing that the mixture might improve the fitness of each species and its wood quality. A linear mixed model was applied to test the effects of exogenous influences on the basal area index (BAI) and the dynamic modulus of elasticity (MOEd). The recruitment period (Rp) was studied to verify whether wood quality was independent from stem radial growth patterns. Results showed that the mixture effect influenced both wood quality and BAI. In the mixed-species plots, for each species, MOEd values were significantly higher than in the corresponding pure stands. The mixture effect aligned MOEd values, making wood quality uniform across the different diameter classes. In the mixed-species plots, a significant positive relationship between MOEd and Rp, but also significantly higher BAI values than in the pure plots, were found for European beech, but not for Calabrian pine. The results suggest the promotion of mixing of European beech and Calabrian pine in this harsh environment to potentially improve both tree growth and wood quality.

scholarly journals Whole genome methylation and transcriptome analyses to identify risk for cerebral palsy (CP) in extremely low gestational age neonates (ELGAN)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
An N. Massaro ◽  
Theo K. Bammler ◽  
James W. MacDonald ◽  
Krystle M. Perez ◽  
Bryan Comstock ◽  
...  
Keyword(s):  
Gene Expression ◽  
Cerebral Palsy ◽  
Gestational Age ◽  
Motor Impairment ◽  
Peripheral Blood Cell ◽  
Differentially Methylated Region ◽  
Identifiable Risk Factor ◽  
Transcriptome Analyses ◽  
Whole Transcriptome ◽  
Extremely Low Gestational Age

AbstractPreterm birth remains the leading identifiable risk factor for cerebral palsy (CP), a devastating form of motor impairment due to developmental brain injury occurring around the time of birth. We performed genome wide methylation and whole transcriptome analyses to elucidate the early pathogenesis of CP in extremely low gestational age neonates (ELGANs). We evaluated peripheral blood cell specimens collected during a randomized trial of erythropoietin for neuroprotection in the ELGAN (PENUT Trial, NCT# 01378273). DNA methylation data were generated from 94 PENUT subjects (n = 47 CP vs. n = 47 Control) on day 1 and 14 of life. Gene expression data were generated from a subset of 56 subjects. Only one differentially methylated region was identified for the day 1 to 14 change between CP versus no CP, without evidence for differential gene expression of the associated gene RNA Pseudouridine Synthase Domain Containing 2. iPathwayGuide meta-analyses identified a relevant upregulation of JAK1 expression in the setting of decreased methylation that was observed in control subjects but not CP subjects. Evaluation of whole transcriptome data identified several top pathways of potential clinical relevance including thermogenesis, ferroptossis, ribosomal activity and other neurodegenerative conditions that differentiated CP from controls.

scholarly journals Cerebral palsy in preterm infants

2016 ◽  
Vol 73 (4) ◽  
pp. 343-348 ◽  
Author(s):  
Cila Demesi-Drljan ◽  
Aleksandra Mikov ◽  
Karmela Filipovic ◽  
Snezana Tomasevic-Todorovic ◽  
Aleksandar Knezevic ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Preterm Birth ◽  
Motor Function ◽  
Gestational Age ◽  
Significant Risk ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Extremely Preterm ◽  
Significant Difference ◽  
Associated Conditions

Background/Aim. Cerebral palsy (CP) is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods. The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE) and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS). Results. More than half of the children with CP were born prematurely (54.4%). Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001). In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049), children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0%) affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032). Conclusion. The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy.

scholarly journals A Retrospective Longitudinal Study in a Cohort of Children With Dyskinetic Cerebral Palsy Treated With Tetrabenazine

2021 ◽  
Vol 12 ◽  
Author(s):  
Roberta Scalise ◽  
Giuseppina Sgandurra ◽  
Valentina Menici ◽  
Nicola Capodagli ◽  
Roberta Di Pietro ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Longitudinal Study ◽  
Movement Disorders ◽  
Mixed Model ◽  
Randomized Clinical Trials ◽  
Linear Mixed Model ◽  
Rating Scale ◽  
Random Effect ◽  
Empirical Literature ◽  
Significant Clinical Improvement

Tetrabenazine has been studied with a variety of hyperkinetic movement disorders, but there is limited and empirical literature on the potential efficacy of tetrabenazine in children with dyskinetic cerebral palsy (DCP). The purpose of this study was to evaluate the efficacy of tetrabenazine in a sample of children with DCP using the Movement Disorders—Childhood Rating Scale 4–18 Revised (MD-CRS 4–18 R). The study is a multicenter retrospective longitudinal study in which the participants were selected from the databases of each Center involved, according to detailed inclusion criteria. The study was performed on 23 children and adolescents (19 male and 4 females; mean age 8.28 years, SD 3.59) with DCP having been evaluated before starting the treatment (baseline), after 6 and 12 months of treatment and in a sub-cohort after &gt;2 years follow-up. A linear mixed model was used to evaluate the effects of the different timings on each MD-CRS 4–18 R Index (Index I, Index II, and Global Index) adding age and type of movement disorder as random effect. A significant clinical improvement related to a reduction of MD-CRS 4-18 R Indexes was detected between the baseline and after 6 and 12 months of treatment. Findings support the efficacy of tetrabenazine in children with DCP through a standardized outcome measure (MD-CRS 4–18 R) and confirm the use of this scale as a suitable tool to detect changes in further randomized clinical trials.

scholarly journals Association between oral health status and type of motor function in children and adolescents with cerebral palsy

2021 ◽  
Vol 10 (16) ◽  
pp. e06101622515
Author(s):  
Gabriele Groehs Guerreiro ◽  
Cristiana Pereira Malta ◽  
Clandio Timm Marques ◽  
Juliana Saibt Martins ◽  
Letícia Westphalen Bento
Keyword(s):  
Cerebral Palsy ◽  
Health Status ◽  
Oral Health ◽  
Children And Adolescents ◽  
Motor Function ◽  
Motor Impairment ◽  
Oral Health Status ◽  
Dental Age ◽  
Cross Sectional ◽  
Gross Motor

Objectives: The aim of the present study was to evaluate oral health and motor function in children and adolescents with cerebral palsy (CP) and determine the perception of caregivers regarding the oral health status of these individuals. Study Design: A cross-sectional study was conducted with 35 children/adolescents with CP and their caregivers. A questionnaire was administered to the caregivers addressing the oral health of the individuals with CP. The dmft/DMFT index, visible plaque index, malocclusion, dental age, pH, buffering capacity and flow salivary were determined. Motor function was evaluated using the GMFCS and GMFM-88 instruments. Results: A significant association was found between the GMFCS category and malocclusion. The GMFM-88 index was significantly lower in individuals with malocclusion and an altered dental age. Caregivers of quadriplegic individuals (57.1%), wheelchair users (42.9%) and those with more severe gross motor impairment (GMFM-88) reported more oral problems. Conclusion: Malocclusion and dental age were associated with motor function in children/adolescents with cerebral palsy. The caregivers of children and adolescents who are quadriplegic, use a wheelchair and have greater impairment regarding gross motor function reported more oral problems.

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