Effect of Intrathecal Baclofen Pump on Scoliosis in Children With Cerebral Palsy: A Meta-Analysis.

OBJECTIVE: To systematically review the effect of intrathecal baclofen pump insertion in children with cerebral palsy (CP) with respect to scoliosis. METHODS: A systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Google Scholar databases up to June 2022. The inclusion criteria were as follows: (1) studies with a quantitative study design; (2) studies with a study group of children with CP; (3) studies comparing scoliosis in children with and without an intrathecal baclofen pump; and (4) studies with Cobb's angle as a parameter. RESULTS: Of the 183 studies found, four studies, all of which were retrospective comparative studies, met the aforementioned inclusion criteria. All studies were homogeneous (I2=0%, p=0.53) and intrathecal baclofen pump insertion accelerated the progression of scoliosis (standard mean difference=0.27; 95% confidence interval=0.07-0.48). CONCLUSION: Intrathecal baclofen pumps have been used to alleviate spasticity in children with CP, thus aiding their daily activities and movements. However, their advantages and disadvantages should be reviewed after sufficient time considering the pumps' negative effect on the course of scoliosis.

The Short-term Effects of Hippotherapy and Therapeutic Horseback Riding on Spasticity in Children With Cerebral Palsy: A Meta-analysis.

PURPOSE: We systematically reviewed the short-term effects of hippotherapy and therapeutic horseback riding (THR) on lower-limb muscle spasticity in children with cerebral palsy (CP). METHODS: PubMed, EMBASE, Cochrane Library, and Google Scholar databases were searched for relevant quantitative studies. Treatment effects were coded using the Ashworth scale (AS) or modified Ashworth scale (MAS) in pre- and posttreatment evaluations. Of the 73 studies identified initially, 7 met the inclusion criteria. RESULTS: Treatment was associated with positive effects on lower-limb muscle spasticity, as supported by the AS or MAS scores. However, repeated trials did not show a statistically significant difference from a single trial (Q = 2.95, P = .086). CONCLUSION: Hippotherapy and THR can be used to treat lower-limb muscle spasticity in children with CP. However, repeated sessions did not show a better effect in reducing spasticity. WHAT THIS ADDS TO THE EVIDENCE: This is the first meta-analysis to confirm that hippotherapy or THR can reduce lower-limb muscle spasticity in children with CP in the short term, but long-term effects on function still require further studies.

Quantitative evaluation of the consciousness level of patients in a vegetative state using virtual reality and an eye-tracking system: A single-case experimental design study.

ABSTRACTIt is important to distinguish patients in a minimally conscious state (MCS) from patients in a vegetative state (VS) when assessing disorders of consciousness (DOC) as prognosis, selection of therapy, and drug treatment could differ accordingly. Clinical evaluation of a patient's eye movements, such as visual startle, visual fixation, and visual pursuit, provides valuable evidence but is often subject to misdiagnosis. To minimize such misdiagnosis caused by human judgment, a virtual reality (VR) technology-based quantitative assessment method with an eye-tracking system is proposed in this study. The new VR system presented 3 stimuli to 20 healthy participants, and visual response data were recorded to define valid responses to each stimulus. Further, the newly defined stimuli were presented to five chronic patients in VS, and the system classified three of them as showing visual fixations that could not be verified through clinical assessment beforehand. The proposed system, as verified through such experimentation, suggests quantitative and objective evaluation methods for examining three visual functions of patients with DOC.

Reliability and validity of the Korean version of the Caregiver Burden Inventory.

The purpose of this study was to demonstrate the reliability and validity of the Korean version of the Caregiver Burden Inventory (CBI). The study was conducted as a multicenter cross-sectional survey for caregivers caring for patients with disabilities in outpatient or inpatient rehabilitation clinics. Sociodemographic characteristics and health-related quality of life were collected via questionnaires. The CBI and Burden Interview (BI) were administered, after which internal consistency and factor analysis of the CBI and correlation between the CBI and BI were explored. A total of 151 caregivers participated. The mean age of caregivers was 53.7 ± 12.4 years, and 80.8 % were women. The majority of caregivers were the main caregivers of stroke, spinal cord injury or traumatic brain injury. The factor analysis confirmed its five factorial structure. The time-dependence and physical burden scores of CBI were higher than those of other factors. All five-dimensional and total scores of CBI showed high internal consistency and were well correlated with BI. In conclusion, the CBI has proven its reliability, construct validity and concurrent validity for caregivers of disabled people and has shown its advantage as a multidimensional measure.