Problems and management of the rearfoot in neuromuscular disease. A report of ten cases

Neuromuscular disease commonly affects the rearfoot as equinus, equinovarus, and equinovalgus deformity. Spastic hemiplegia caused by stroke, head injury, and cerebral palsy results in equinovarus deformity of the rearfoot. Spastic diplegia, most frequently caused by cerebral palsy, results in equinovalgus rearfoot deformity. Problems in ambulation, footwear, and bracing, as well as their orthopedic management, in patients with neuromuscular disease are discussed in a case-report format.

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Standardized Outcomes Measures in Physical Therapy Practice for Treatment and Rehabilitation of Cerebral PALSY: A Systematic Review

Journal of Personalized Medicine ◽

10.3390/jpm11070604 ◽

2021 ◽

Vol 11 (7) ◽

pp. 604

Author(s):

Maria Dolores Apolo-Arenas ◽

Aline Ferreira de Araújo Jerônimo ◽

Alejandro Caña-Pino ◽

Orlando Fernandes ◽

Joana Alegrete ◽

...

Keyword(s):

Cerebral Palsy ◽

Physical Therapy ◽

Gait Training ◽

Physical Therapy Modalities ◽

Spastic Diplegia ◽

Evaluation Procedures ◽

Outcomes Measures ◽

Prisma Statement ◽

Spastic Hemiplegia

Cerebral palsy (CP) treatment includes physical therapy and various complementary therapies to the standard clinical treatment. However, there are not many reviews that focus on the methods used and evaluation procedures. This study aims to analyze which tools are most suitable for the evaluation and methodology of patients with CP treated with physical therapy. Following the PRISMA statement, through a PICOS strategy, PubMed/MEDLINE, Web of Science (WOS), Scopus, Science Direct, and Scielo were searched with the following terms: cerebral palsy AND (physical therapy modalities OR therapeutics) AND outcome assessment. The methodological quality of the RCTs was assessed with the Evidence Project risk of bias tool. Thirty-seven RCTs and six RCT protocols, comprising 1359 participants with different types of CP: spastic hemiplegia/paresis, spastic diplegia/paresis, and spastic CP, met the inclusion criteria, uncovering 21 variables measured through 77 different instruments and several interventions. The therapies most widely used in CP are gaming or technology-assisted therapies, aerobic training, hippotherapy, music therapy, gait training, and aquatic exercises. This study provides an overview of what the authors used in the neurorehabilitation field through procedure evaluation and checking the technological advance that began to be used.

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Faktor Risiko Prenatal Perinatal Dan Postnatal Pada Kejadian Cerebral Palsy

Interest : Jurnal Ilmu Kesehatan ◽

10.37341/interest.v8i2.177 ◽

2019 ◽

Vol 8 (2) ◽

pp. 204-209

Author(s):

Bambang Trisnowiyanto ◽

Yohanes Purwanto

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cerebral Palsy ◽

Postnatal Period ◽

Spastic Diplegia ◽

Prenatal Risk ◽

Prenatal Risk Factors ◽

Spastic Hemiplegia ◽

Postnatal Risk Factors ◽

Observational Descriptive Study

Background: Cerebral Palsy (CP) is a disability disorder motor motorization is most common in children with a prevalence of 2-3 per 1000 live births. The term CP is explained as a group of movement and posture disorders that are often accompanied by impaired sensation, perception, cognition, communication, behavior, epilepsy, and secondary disorders of the musculoskeletal system. Disorders of CP occur in the immature central nervous system with non-progressive traits occurring in the prenatal, perinatal, and postnatal period. Methods: The purpose of this study is to determine how much prenatal risk factors, perinatal, and postnatal events in CP at the Kitty Center Clinic in Jakarta for 5 year (2013 - 2017). Result: An observational descriptive study, which described prenatal perinatal, and postnatal risk factors for CP events at the Kitty Center Clinic in Jakarta for a period of 5 years (2013-2017) with a total of 523 study subjects. Based on the analysis of data obtained, based on the type of CP 35% quadripelgia spastic, 36% spastic diplegia, 6% spastic hemiplegia, 9% athetosis, and 14% hypotonia. Based on sex 62% are men, and 38% are women with a ratio of 1.6: 1.0. Based on the age of the child 11% <2 years, 34% 3-6 years, 33% 7-12 years, and 22%13-18 years. Conclusion: Based on risk factors of 62% prenatal, 25% perinatal, and 12% postnatal. Prenatal risk factor is the biggest risk factor as much as 62% which causes Cerebral Palsy at the Kitty Center Clinic in Jakarta.

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Anthropometrical Features of Para-Footballers According to Their Cerebral Palsy Profiles and Compared to Controls

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17239071 ◽

2020 ◽

Vol 17 (23) ◽

pp. 9071

Author(s):

José M. Sarabia ◽

Carmen Doménech ◽

Enrique Roche ◽

Néstor Vicente-Salar ◽

Raul Reina

Keyword(s):

Body Composition ◽

Cerebral Palsy ◽

Spastic Diplegia ◽

Football Players ◽

International Level ◽

Anthropometric Measures ◽

Physical Impairments ◽

Spastic Hemiplegia ◽

Composition Profiles ◽

Sports Coaches

Cerebral palsy (CP) football is a team para-sport practiced by para-athletes with eligible impairments of hypertonia, athetosis, and ataxia. This study aimed: (1) to describe the anthropometrical and body composition profiles of international CP para-footballers with different CP profiles (i.e., spastic diplegia, athetosis/ataxia, spastic hemiplegia, and minimum impairment); (2) to analyze the differences between both affected/nondominant and nonaffected/dominant sides; and (3) to compare the sample of international-level CP para-footballers (n = 141) with a sample of highly trained able-bodied footballers (n = 39). Anthropometric measures included four breadths, nine girths, and six skinfolds, while body composition was measured through fat mass (including Carter’s, Faulkner’s, and Withers’ equations), muscle mass (Lee’s equation), and bone mass (Rocha’s and Martin’s equations). This study found differences between the able-bodied footballers and the following impairment profiles: spastic diplegia (skinfolds); ataxia/athetosis (corrected calf of the nondominant side, and calf skinfolds for both sides); and spastic hemiplegia (all measurements excepting femur breadth, and thigh and ankle girths). No differences were found between para-athletes with minimum impairment and the able-bodied footballers. This study demonstrates that football players with or without physical impairments of hypertonia athetosis or ataxia may be considered homogeneous in shape when dominant size is compared. Besides, the study provides reference scores on anthropometric measures and body composition of international-level CP para-footballers that can help sports coaches and physical trainers to monitor physical fitness of their para-athletes.

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Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity

Children ◽

10.3390/children8010016 ◽

2020 ◽

Vol 8 (1) ◽

pp. 16

Author(s):

Piero Pavone ◽

Carmela Gulizia ◽

Alice Le Pira ◽

Filippo Greco ◽

Pasquale Parisi ◽

...

Keyword(s):

Cerebral Palsy ◽

Epileptic Seizures ◽

Motor Dysfunction ◽

Clinical Aspects ◽

Control Group ◽

Spastic Diplegia ◽

Childhood Disability ◽

Spastic Quadriplegia ◽

Spastic Hemiplegia ◽

The University

Cerebral palsy (CP) is a frequent cause of childhood disability often associated with a complex group of disorders, including epilepsy, which is reported to impact approximately 40% of affected individuals. This retrospective study involved a group of children affected by CP, some of whom also had comorbid epilepsy. The aim of this study was to report our experience of analyzing, in particular, (a) some of the clinical aspects of the different type of CP, and (b) the relationship between the clinical data of children affected by CP plus epilepsy and each type of CP. Methods: This retrospective single-center study was performed with 93 children admitted to the Pediatric Department of the University of Catania, Italy, affected by CP and distinguished according to the type of motor clinical presentation, with 46 showing epileptic seizures, compared to a control group of 136 children affected by epilepsy without other neurologic disorders. Results: Among the 93 CP children, 25 (27%) had spastic quadriplegia (plus one patient with dystonic quadriplegia), 39 (42%) had spastic hemiplegia, 11 (12%) had spastic diplegia (plus two with ataxia and one with dyskinetic CP), and 14 (15%) did not have a well-defined type of CP. The frequency of epilepsy was higher in affected CP children who showed major motor dysfunction (GMFCS IV–V types). As regards the 46 children with CP plus epilepsy, compared to the group of the control, the age of epilepsy onset was found to be statistically significant: 21 ± 35.1 months vs. 67 ± 39.7. Conclusions: Epilepsy represents one of the most frequent comorbidities of cerebral palsy. In children with CP, particular attention should be paid to the early identification and treatment of comorbid epilepsy.

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Using Decision Trees to Support Classifiers’ Decision-Making about Activity Limitation of Cerebral Palsy Footballers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084320 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4320

Author(s):

José M. Sarabia ◽

Alba Roldan ◽

Matías Henríquez ◽

Raul Reina

Keyword(s):

Cerebral Palsy ◽

Decision Trees ◽

Activity Limitation ◽

Step Test ◽

Spastic Diplegia ◽

Final Sample ◽

Spastic Hemiplegia ◽

Classification Tool ◽

Functional Profiles ◽

The Impact

This study aimed (1) to determine the appropriateness of using decision trees as a classification tool for determining the allocation of sport classes of para-footballers with “moderate vs. mild” cerebral palsy (CP) profiles of spastic diplegia/hemiplegia and ataxia/athetosis based on observational outcomes by international classifiers, and (2) to identify what key observational features were relevant to discriminating among different impairment levels. A sample of 16 experienced international classifiers from five world regions participated in this study, observing activity limitation of a final sample of 21 international CP footballers when performing 16 gross-motor and sports-specific tests for balance (n = 3), coordination (n = 5), running, accelerations and decelerations (n = 3), jumping (n = 4), and change of direction ability (n = 1). For the overall sample (336 observations), the model included eight decision nodes and 24 branches with 17 leaves, including side-step, side-stepping, and triple hop as the tests with the best sensitivity (precision = 67.0%). For those with spastic diplegia (64 observations: Two nodes, six branches with five leaves), the range of motion in the side-step test and the balance in the tandem walk tests correctly classified 89.1% of the observations. In those with athetosis and ataxia (96 observations), the model included five nodes, 15 branches, and 11 leaves (176 observations, precision = 86.5%). For those with spastic hemiplegia, a model containing two nodes, six branches, and five leaves had 90.9% accuracy, including observational features of balance in the side-step test and symmetry in the side-stepping test. The observational tool used in this study, based on the impact of specific impairment measurements of hypertonia, athetosis, and ataxia, can be used to determine which assessments are more appropriate for discriminating between functional profiles in para-footballers with CP.

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