Evaluation of the effectiveness of screening and monitoring program for early prevention of orthopedic complications in children with cerebral palsy

Hip instability and following hip luxation and subluxations remain common and serious problem among children with cerebral palsy (CP). The hip luxation and subluxations can be avoided using timely monitoring and early preventive treatment. However, standard scheme for patients’ management in children with CP is not adopted so far in Russian Federation. In 2014 on the territory of Tyumen region the Europe surveillance program for children with CP (CPUP) was introduced.Research purpose. To analyze the effectiveness of the early orthopedic complications prevention program in children with CP. Material and methods. The study included children with CP of the «Child psychoneurological medical-rehabilitation center «Nadezhda» register born in 2010 and earlier (n=176), undergoing surveillance under the European Program (main group); the comparison group consisted of children with CP which were treated before the adoption of the program (n=642). Group comparability was achieved by selecting children with one level of motor impairment according to the GMFCS classification. The presence of expressed orthopedic complications was exposed at the value of Reimers Index (RI) above 40%, and the effectiveness of the program was determined by a reduction in the frequency of such RI.Results. It was found that overall incidence of hip dislocation in control group decreased by 70%: in children with GMFCS II by 100%, GMFCS III – by 78%, GMFCS IV – by 62% and GMFCS V – by 74%.Conclusion. Due to the introduction of the Europe surveillance program on the territory of Tyumen region there is a significant decrease in orthopedic complications incidence in children with CP.

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Cost-effectiveness analysis of a surveillance program to prevent hip dislocation in children with cerebral palsy

Gaceta Sanitaria ◽

10.1016/j.gaceta.2019.05.005 ◽

2020 ◽

Vol 34 (4) ◽

pp. 377-384 ◽

Cited By ~ 2

Author(s):

Laura Vallejo-Torres ◽

Amado Rivero-Santana ◽

Carlos Martin-Saborido ◽

David Epstein ◽

Lilisbeth Perestelo-Pérez ◽

...

Keyword(s):

Cerebral Palsy ◽

Cost Effectiveness ◽

Hip Dislocation ◽

Cost Effectiveness Analysis ◽

Surveillance Program ◽

Effectiveness Analysis ◽

Children With Cerebral Palsy

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Influence of Rehabilitation measures on the state of static and motor functions in Children with Cerebral palsy

Acta Balneologica ◽

10.36740/abal202103103 ◽

2021 ◽

Vol 64 (3) ◽

pp. 149-154

Author(s):

Yevhen Yu. Strashko ◽

Valeriy O. Zhamardiy ◽

Viktoriia I. Donchenko ◽

Olena M. Shkola ◽

Natalia A. Lyakhova ◽

...

Keyword(s):

Cerebral Palsy ◽

Integrated Approach ◽

The State ◽

Medical Rehabilitation ◽

Control Group ◽

Study Group ◽

Motor Functions ◽

Children With Cerebral Palsy ◽

Rehabilitation Measures ◽

The Difference

Aim: The article experimentally tests the influence of rehabilitation measures on the state of static and motor functions in children with cerebral palsy (CP). It was found that medical rehabilitation of children with cerebral palsy requires the development of adequate strategies and tactics, integrated approach, application, if possible, of non-drug methods (physiotherapy, kinesitherapy). materials and methods: During the study, the effectiveness of a set of rehabilitation measures was evaluated in 168 children aged 3 to 7 years, with spastic forms of cerebral palsy. All children were divided into two observation groups: the main group, which conducted the proposed rehabilitation course (n = 98) and the control group, which underwent a course of generally accepted rehabilitation content (n = 70). Results: As a result of experimental work, the increase in indicators in the experimental group was higher. And although in the blocks “lying on your back”, “sitting on the floor”, “sideways turns”, “lying on your stomach”, “on your knees” and “standing and getting up” the difference between the indicators of the groups was insignificant (P> 0.05), we observed the best tendency to recovery in children of the study group in the blocks “crawling”, “sitting”, “walking”. The average increase in testing scores using the scale for assessing large motor functions in the study group was much higher than in the control. Conclusions: A comparative evaluation of the effectiveness of comprehensive rehabilitation of children with spastic forms of cerebral palsy, found that the use of the developed program allows to achieve a clear therapeutic effect to improve the results of rehabilitation.

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Primary surgery to prevent hip dislocation in children with cerebral palsy in Sweden: a minimum 5-year follow-up by the national surveillance program (CPUP)

Acta Orthopaedica ◽

10.1080/17453674.2019.1627116 ◽

2019 ◽

Vol 90 (5) ◽

pp. 495-500 ◽

Cited By ~ 2

Author(s):

Nikolaos Kiapekos ◽

Eva Broström ◽

Gunnar Hägglund ◽

Per Åstrand

Keyword(s):

Cerebral Palsy ◽

Hip Dislocation ◽

Surveillance Program ◽

National Surveillance ◽

Primary Surgery ◽

Children With Cerebral Palsy

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Hip surgery and radiology reporting for children with cerebral palsy prior to initiation of a hip surveillance program

Journal of Pediatric Rehabilitation Medicine ◽

10.3233/prm-201506 ◽

2021 ◽

pp. 1-7

Author(s):

Kyra Kane ◽

Marshall Siemens ◽

Shane Wunder ◽

Jacqueline Kraushaar ◽

J. Alexandra Mortimer ◽

...

Keyword(s):

Cerebral Palsy ◽

Retrospective Chart Review ◽

Surveillance Program ◽

Radiology Reporting ◽

Reporting Practices ◽

Hip Displacement ◽

Primary Surgery ◽

Radiology Reports ◽

Children With Cerebral Palsy ◽

Surveillance Programs

PURPOSE: Hip displacement impacts quality of life for many children with cerebral palsy (CP). While early detection can help avoid dislocation and late-stage surgery, formalized surveillance programs are not ubiquitous. This study aimed to examine: 1) surgical practices around pediatric hip displacement for children with CP in a region without formalized hip surveillance; and 2) utility of MP compared to traditional radiology reporting for quantifying displacement. METHODS: A retrospective chart review examined hip displacement surgeries performed on children with CP between 2007–2016. Surgeries were classified as preventative, reconstructive, or salvage. Pre- and post-operative migration percentage (MP) was calculated for available radiographs using a mobile application and compared using Wilcoxon Signed Ranks test. MPs were also compared with descriptions in the corresponding radiology reports using directed and conventional content analyses. RESULTS: Data from 67 children (115 surgical hips) was included. Primary surgery types included preventative (63.5% hips), reconstructive (36.5%), or salvage (0%). For the 92 hips with both radiology reports and radiographs available, reports contained a range of descriptors that inconsistently reflected the retrospectively-calculated MPs. CONCLUSION: Current radiology reporting practices do not appear to effectively describe hip displacement for children with CP. Therefore, standardized reporting of MP is recommended.

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Bone metabolism biomarkers in walking children with cerebral palsy

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors7479-86 ◽

2020 ◽

Vol 7 (4) ◽

pp. 79-86

Author(s):

Vladimir M. Kenis ◽

Svetlana L. Bogdanova ◽

Tatyana N. Prokopenko ◽

Andrei V. Sapogovskiy ◽

Tatyana I. Kiseleva

Keyword(s):

Vitamin D ◽

Alkaline Phosphatase ◽

Cerebral Palsy ◽

Bone Metabolism ◽

Control Group ◽

Study Group ◽

Flat Feet ◽

Children With Cerebral Palsy ◽

Calcium Phosphorus ◽

Orthopedic Patients

Backgrоund. Osteoporosis is an important factor in the pathogenesis of orthopedic manifestations in children with cerebral palsy. It was previously demonstrated that children with cerebral palsy have specific changes in bone metabolism, which can cause changes in laboratory parameters compared with other orthopedic patients without neurological backgrounds. Aim. The aim of this study was to assess bone metabolism biomarkers in children with cerebral palsy, identifying distinguishing characteristic patterns in comparison with patients with orthopedic pathology without neurological backgrounds. Materials and methods. This study evaluated the concentrations of calcium, phosphorus, -cross laps, osteocalcin, vitamin D, CICP, and alkaline phosphatase in the blood serum of 50 children with cerebral palsy aged between 6 to 12 years with GMFCS levels IIII. The control group consisted of 50 patients with plano-valgus deformities of the feet. Results. The alkaline phosphatase activity in the group of children with cerebral palsy was 170.25 59.35 u/L, while in the control group it was 145.58 46.29 u/L; the CICP concentration in the study group was higher than in the control group (324.01 174.10 and 269.68 240.98, respectively). The concentration of -cross laps, osteocalcin, calcium, and vitamin D in the study group was lower than in children with flat feet. Conclusions. This study demonstrated multidirectional changes in the biomarkers of bone metabolism that are characteristic of walking children with cerebral palsy. These changes are characterized by a corresponding increase in the activity of osteoresorption and osteoreparation. This makes it possible to justify the combined use of metabolites and metabolic activators (calcium and vitamin D) and drugs that suppress osteoresorption (bisphosphonates) for the prevention and treatment of osteoporosis in children with cerebral palsy.

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Effectiveness of Virtual Reality and Visual Feedback on Balance and Leg Function in Children with Cerebral Palsy

Reabilitacijos mokslai slauga kineziterapija ergoterapija ◽

10.33607/rmske.v1i18.748 ◽

2019 ◽

Vol 1 (18) ◽

Author(s):

Arūnė Dūdaitė ◽

Vilma Juodžbalienė

Keyword(s):

Virtual Reality ◽

Cerebral Palsy ◽

Postural Control ◽

Range Of Motion ◽

Visual Feedback ◽

Lower Limb ◽

Dynamic Balance ◽

Control Group ◽

Children With Cerebral Palsy ◽

Stretching Exercises

Research background. Virtual reality and visual feedback improve motor performance, motor function and balance, so we want to fnd if it aﬀects the function of legs and balance of children with spastic hemiplegia. Research aim was to establish if the use of virtual reality and visual feedback with traditional physiotherapy improve the function of legs and balance of children with cerebral palsy. Methods. Nine children with cerebral palsy participated in the research. Participants were randomly divided into two groups – virtual reality group (n = 6) and control (n = 3). Virtual reality group practised exergaming and stretching exercises for 10 weeks, twice a week. Control group practiced conventional physiotherapy and stretching exercises for 6 weeks, twice a week. We measured the range of motion of the lower limb, spasticity of the lower limb using Modifed Ashworth’o Scale, static, dynamic balance, trunk coordination using Trunk Impairment Scale at the start and the end of the research, and balance using Pediatric Balance Scale. Results. Virtual reality and visual feedback reduced the spasticity of the lower limb, improved balance and postural control for children with cerebral palsy, but it did not improve the range of motion of the lower limb of children with cerebral palsy. Conclusions. Virtual reality and visual feedback did not improve the range of motion of the lower limb of children with cerebral palsy. Virtual reality and visual feedback reduced spasticity of the lower limb, improved balance and postural control for children with cerebral palsy.Keywords. Cerebral palsy, virtual reality, visual feedback, postural control, muscle architecture.

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A DYNAMIC SEATING SYSTEM FOR CHILDREN WITH CEREBRAL PALSY

Journal of Musculoskeletal Research ◽

10.1142/s0218957709002158 ◽

2009 ◽

Vol 12 (01) ◽

pp. 21-30 ◽

Cited By ~ 3

Author(s):

Michael E. Hahn ◽

Sheri L. Simkins ◽

Jacob K. Gardner ◽

Gaurav Kaushik

Keyword(s):

Cerebral Palsy ◽

Range Of Motion ◽

Motor Function ◽

Control Group ◽

Significant Group ◽

Gross Motor ◽

Gross Motor Function ◽

Muscle Spasticity ◽

Children With Cerebral Palsy ◽

Dynamic Seating

The study's aim was to determine the initial effects of a dynamic seating system as a therapeutic intervention in children with cerebral palsy. A two-factor, repeated-measures design was used. Twelve children with neuromuscular dysfunction (mean age 6.0, SD 2.7 years) were included in the study, randomly assigned to an experimental or a control group. At study initiation the experimental group received a wheelchair with dynamic seating components that allows limited range of motion in the hip and knee, and the control group received a static setting wheelchair. Participants were evaluated for range of motion, muscle spasticity (Modified Ashworth Scale), motor function (Gross Motor Function Measure), and level of disability (Pediatric Evaluation of Disability Inventory) at study initiation, 3-months, and 6-months post intervention. Both groups improved in motor function over time, particularly in the categories of Sitting and Crawl/Kneel. Measures of disability improved in both groups for the categories of self-care, mobility, and social function. A larger, more homogeneous sample would likely show significant group differences in measures of muscle spasticity, gross motor function and disability.

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Development of a wearable orthotic device pattern to prevent hip dislocation in children with cerebral palsy

International Journal of Clothing Science and Technology ◽

10.1108/ijcst-09-2020-0142 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Hyunjung Han ◽

Jeong Ha Kim

Keyword(s):

Cerebral Palsy ◽

Great Trochanter ◽

Hip Dislocation ◽

Virtual Model ◽

Persons With Disabilities ◽

Content Type ◽

Final Version ◽

Orthotic Device ◽

Children With Cerebral Palsy ◽

Child Patient

PurposeThis study suggest the development of a wearable orthotic device pattern that can reduce pain and deformation, and help in the normal development of children with cerebral palsy. Such a pattern enables daily wear before hip subluxation occurs, to prevent hip dislocation and subluxation.Design/methodology/approachThis study set the design line by carrying out cell work on the actual model, then proceeded with the first pattern design. The final version of the second orthotic device was designed by conducting discussions with experts and the patient's guardian, with the device fitted to the child patient. The evaluation of the second orthotic device used the virtual model to check the pressure area and level through virtual fitting. An evaluation was then conducted with the device fitted to the child patient, to verify the functionality and suitability of the final pattern.FindingsFollowing the initial fitting evaluation, the second pattern was presented after modifying and supplementing issues such as movement suitability with posture change, position change of the great trochanter when wearing a diaper, pressure control of the X-shaped band on the genital area and thigh abduction. The master pattern of the final version of the second orthotic device was proposed after confirming that the femoral head of the hip joint was stably fixed, and the compression was applied through a verification based on the virtual fitting using the virtual model, and with the device fitted to the child patient.Originality/valueWith this study, it is expected that the process and design plan for the development of wearable orthotic device patterns for the persons with disabilities impaired mobility can be used as a basic resource to create devices that merge the clothing and medical fields.

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