scholarly journals The Level of Children’s Independence with Cerebral Palsy in Several Regions in Java and Sumatra

2020 ◽  
Vol 5 (1) ◽  
pp. 1-12
Author(s):  
Bambang Trisnowiyanto
Keyword(s):  
Cerebral Palsy ◽  
Health Workers ◽  
Brain Lesion ◽  
Clinical Manifestations ◽  
Total Sample ◽  
Body Parts ◽  
Research Subjects ◽  
Cross Sectional ◽  
Children With Cerebral Palsy ◽  
Gmfcs Level

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.

scholarly journals Association of Motor Function and Neuroimaging in Cerebral Palsy: A Cross-sectional Study

2021 ◽  
Author(s):  
Dhirendra Kumar Singh ◽  
Nonica Laisram ◽  
Amita Malik ◽  
Vinay Kanaujia ◽  
Suman Badhal ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Classification System ◽  
Brain Lesion ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Age Group ◽  
Cross Sectional ◽  
Gmfcs Level

Introduction: Cerebral Palsy (CP) is one of the most common causes of disability in children. Neuroimaging is useful in determining structural or functional relationships in children with CP. It provides an opportunity to link various CP types to the localisation of the brain maldevelopment or lesion. Aim: To study association of motor function and brain structure on neuroimaging Magnetic Resonance Imaging (MRI) in CP children. Materials and Methods: This cross-sectional observational study was conducted in a tertiary care hospital from August 2015 to December 2016. A total of 50 diagnosed cases of CP were included after satisfying inclusion and exclusion criteria. After detailed history and clinical examination, MRI of brain was advised. All parameters were assessed in terms of Gross Motor Functional Classification System (GMFCS), Manual Ability Classification System (MACS) and MRI Grading. Categorical variables were presented as numbers and percentage and association was checked using Chi-square test or Fischer’s-exact test. A p-value of <0.05 was considered statistically significant. Results: Patients with CP in the study ranged from 2-12 years with mean age of 5.43 (±2.58) years. Out of 50 cases, 30 (60%) were in the age group of 2-5 years, 17 (34%) were in the age group of 6-10 years and three (6%) were in the age group of 11-12 years. Out of 50 enrolled cases, maximum cases were having GMFCS level 3 (n=14) and MACS level 2 (n=15). There was significant positive association (p-value <0.05) between GMFCS level and grading of MRI. Similar significant association was observed for analysis of association of MACS level and MRI Grading. Conclusion: The present study highlighted that there was a significant association between extent and type of brain lesion and motor functions (GMFCS and MACS levels). Type and extent of brain lesion helps clinician to understand prognosis of functional motor outcome in CP children.

scholarly journals Guidelines and practices on feeding children with cerebral palsy

2020 ◽  
Vol 30 (1) ◽  
pp. 65-74
Author(s):  
Luiza Maggioni ◽  
Cláudia Marina Tavares de Araújo
Keyword(s):  
Cerebral Palsy ◽  
Developmental Disorders ◽  
Daily Practice ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Cross Sectional ◽  
Children With Cerebral Palsy ◽  
Safe Food

Introduction: Cerebral palsy refers to developmental disorders with direct repercussions on posture control and motricity. Its  non-progressive  and  happens by damage  of the  brain still in development. Children with Cerebral Palsy (CP) present alterations in the oral functions, which makes feeding difficult and can bring serious health consequences, such as malnutrition and pneumonia. The caregiver plays an  essential role  of these children's diet, so they need to know the implementation of best  practices  to provide safe food. Guidelines for food practices and care are essential and need to be satisfactory and effective  to avoid complications and reduce stress for the caregiver and child. The speech therapist is the skilled professional in assisting and intervening in children's eating difficulties and in guiding the caregiver. However, the guidance provided is not always incorporated into daily practice, and it is key  to know  and understand it appropriately. Objective: To analyze the quality of the guidelines received and the feeding practices of caregivers of children with cerebral palsy. Methods: This is an exploratory, cross-sectional study, involving 59 main caregivers of children with CP from 1 to 10 years of age, classified as level IV or V in the Gross Motor Function Classification System (GMFCS), with absent cervical control or compensation and fed orally. Data collection carried out through interviews with questions related to the characterization of the sample, quality of the guidelines received regarding feeding and care. The data were entered, pre-coded and processed by the Epi-info 3.5.4 program, using Fisher's exact test to compare categorical variables. RESULTS: Of the total sample, 52 participants had already received speech-language guidance regarding feeding care. Of these, 76.9% were classified as satisfactory guidelines. The most emphasized aspect is related to posture, while signs of risk of bronchoaspiration were the least oriented.The quality of the guidelines was related to safe food consistency, inadequate utensils and facilitating maneuvers during children's feeding. Conclusion: The findings reveal that most of the caregivers receive the feeding guidelines for children with CP  , however, there is no periodic and systematic monitoring of what  is actually incorporated into the feeding . This  may  indicate    a potential  gap between the guidelines received  by the caregivers and  the effectiveness of  their daily practice, especially  concerning  protective measures of the lower respiratory tract.

A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Income ◽  
Classification System ◽  
West African ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Common Cause ◽  
Low Income Country ◽  
Children With Cerebral Palsy

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.

scholarly journals Risk factors for hip dislocation in dyskinetic cerebral palsy

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110011
Author(s):  
Kyoko Okuno ◽  
Yukihiro Kitai ◽  
Toru Shibata ◽  
Hiroshi Arai
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Birth Weight ◽  
Gestational Age ◽  
Brain Mri ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Lesion Location ◽  
Hip Displacement ◽  
Gmfcs Level

Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP). Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions. Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions. Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.

Effect of an interval rehabilitation program with home-based, vibration-assisted training on the development of muscle and bone in children with cerebral palsy – an observational study

2020 ◽  
Vol 33 (8) ◽  
pp. 1083-1092 ◽  
Author(s):  
Ibrahim Duran ◽  
Kyriakos Martakis ◽  
Christina Stark ◽  
Leonie Schafmeyer ◽  
Mirko Rehberg ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Bone Growth ◽  
Muscle Growth ◽  
Rehabilitation Program ◽  
Whole Body ◽  
Cross Sectional ◽  
Home Based ◽  
Children With Cerebral Palsy ◽  
One Year ◽  
Intensive Rehabilitation

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.

A Cross-Sectional Study to Evaluate the Quality of Life of Caregivers for Children with Cerebral Palsy in Saudi Arabia, Jeddah

2021 ◽  
Author(s):  
Alanoud Akram Aman ◽  
Bashaer Baharoon ◽  
Haifa Jamal Idrees ◽  
Ahad Mohammedyusuf Taj ◽  
Bassmah Ali Alzahrani ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Saudi Arabia ◽  
Cerebral Palsy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Children With Cerebral Palsy

scholarly journals Effects of Task Constraints on Kinematic Characteristics of Body Segments in Children with Cerebral Palsy and Children with Typical Development during Hand-Reaching

2021 ◽  
Vol 11 (23) ◽  
pp. 11140
Author(s):  
Yun-Huei Ju ◽  
Rong-Ju Cherng
Keyword(s):  
Cerebral Palsy ◽  
Postural Control ◽  
Task Demands ◽  
Typical Development ◽  
Typically Developing ◽  
Typically Developing Children ◽  
Cross Sectional ◽  
Postural Alignment ◽  
Reaching Tasks ◽  
Children With Cerebral Palsy

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.

scholarly journals Distal rectus femoris surgery in children with cerebral palsy: results of a Delphi consensus project

2021 ◽  
pp. 1-9
Author(s):  
Robert M. Kay ◽  
Kristan Pierz ◽  
James McCarthy ◽  
H. Kerr Graham ◽  
Henry Chambers ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Rectus Femoris ◽  
Delphi Consensus ◽  
Level Of Evidence ◽  
Modified Delphi ◽  
International Panel ◽  
Children With Cerebral Palsy ◽  
Stiff Knee ◽  
Paediatric Orthopaedic ◽  
Gmfcs Level

Purpose The purpose of this study was for an international panel of experts to establish consensus indications for distal rectus femoris surgery in children with cerebral palsy (CP) using a modified Delphi method. Methods The panel used a five-level Likert scale to record agreement or disagreement with 33 statements regarding distal rectus femoris surgery. The panel responded to statements regarding general characteristics, clinical indications, computerized gait data, intraoperative techniques and outcome measures. Consensus was defined as at least 80% of responses being in the highest or lowest two of the five Likert ratings, and general agreement as 60% to 79% falling into the highest or lowest two ratings. There was no agreement if neither threshold was reached. Results Consensus or general agreement was reached for 17 of 33 statements (52%). There was general consensus that distal rectus femoris surgery is better for stiff knee gait than is proximal rectus femoris release. There was no consensus about whether the results of distal rectus femoris release were comparable to those following distal rectus femoris transfer. Gross Motor Function Classification System (GMFCS) level was an important factor for the panel, with the best outcomes expected in children functioning at GMFCS levels I and II. The panel also reached consensus that they do distal rectus femoris surgery less frequently than earlier in their careers, in large part reflecting the narrowing of indications for this surgery over the last decade. Conclusion This study can help paediatric orthopaedic surgeons optimize decision-making for, and outcomes of, distal rectus femoris surgery in children with CP. Level of evidence V

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