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1.
Rev Lat Am Enfermagem ; 28: e3300, 2020.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-32609264

RESUMO

METHOD: to assess the quality of life (QOL) of adolescents with cerebral palsy (CP) by self-report and by the caregiver's report, and to analyze the agreement between these reports.cross-sectional study conducted with 101 adolescents with CP and 101 caregivers. Both answered the Pediatric Quality of Life Inventory (PedsQL), module 4.0 - Generic (PedsQL 4.0) and module 3.0 - PC (PedsQL 3.0). Agreement between reports was analyzed using the Mann-Whitney test and the intra-class correlation coefficient (ICC) (p<0.05). RESULTS: the lowest scores were in physical health, school activities and fatigue in the self-report. The lowest scores were in physical health and daily activities, in the caregivers' report. Perceptions among adolescents and caregivers differed in physical health, movement and equilibrium, daily and school activities, with a lower score for caregivers in all of them. The agreement between the self-report and the caregivers' report was poor (ICC<0.44) and in both instruments, the caregivers' report was less optimistic. CONCLUSION: physical health is the most impaired domain of the QOL of adolescents with CP, both in the self-report and in the caregivers' report. However, there is poor agreement between these reports, emphasizing that the use of the caregivers' report should be cautious.


Assuntos
Cuidadores , Paralisia Cerebral , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Qualidade de Vida , Autorrelato , Inquéritos e Questionários
2.
Artigo em Russo | MEDLINE | ID: mdl-32678546

RESUMO

Spastic muscles in the pathological motor patterns may change at different ages that leads to the changes in anti-spastic treatment. OBJECTIVE: To study the specific patterns of spasticity in CP patients with level III according to the Gross Motor Function Classification System (GMFCS) in different age periods. MATERIAL AND METHODS: A retrospective analysis of injection protocols of Abobotulinum toxin A for 99 patients with bilateral spastic CP GMFCS III at the age of 2 to 12 years was performed. Spasticity patterns were evaluated according to the frequency of target muscle selection for the botulinum toxin A (Abobotulinum toxin A) injections. RESULTS: The equinus foot deformity (89.7%, 95%CI 72.8-97.2) and its combination with internal hip rotation (79.3%, 95% CI 61.3-90.5) and/or hip adduction (65.5%, 95% CI 47.3-80.2) were the main lower extremity spasticity pattern for the patients aged 2 to 4 years. Between 4 and 6 years, there was the decrease in injections to the gastrocnemius muscle (75%, 95% CI 52.8-89.2), and less to the m. gracilis (70%, 95% CI 47.9-85.7) and hip adductors (55% 95 CI 34.2-74.2). In the 6-12 year old patients, the predominant spasticity patterns were internal hip rotation (80%, 95% CI 66.8-88.9), adduction (54%, 95% CI 40.4-67.0) and knee flexion (66%, 95% CI 52.1-77.6). The leading upper extremity patterns at all observed ages were forearm pronation (70.7%, 95% CI 61.1-78.8) and elbow flexion (47.5%, 95% CI 37.9-57.2). The frequency of injections to these muscles slightly decreased in elder groups. CONCLUSIONS: CP GMFCS III patients demonstrate age-related changes of the spasticity patterns both in lower and upper extremities. These changes and typical spastic muscles should be taken into account during the rehabilitation and botulinum toxin treatment planning, as well as in the detection and prevention of the orthopaedic complications.


Assuntos
Paralisia Cerebral , Toxinas Botulínicas Tipo A , Criança , Pré-Escolar , Humanos , Espasticidade Muscular , Músculo Esquelético , Fármacos Neuromusculares , Estudos Retrospectivos
3.
Artigo em Russo | MEDLINE | ID: mdl-32678553

RESUMO

OBJECTIVE: To evaluate the results of traditional and high-tech physical rehabilitation in cerebral palsy and in modeling of rehabilitation prognosis. MATERIAL AND METHODS: One hundred and twenty-six patients with cerebral palsy (spastic diplegia); mean age 7.0±1.3 years, the duration of inpatient treatment 28 days, were studied. Forty patients received conventional treatment, 86 - a high-tech physical rehabilitation (robotic mechanic therapy with «Lokomat¼, «Armeo¼ and electric stimulation of the brain with «Brain-port¼ device). RESULTS AND CONCLUSION: The advantage of more significant therapeutic effects of high-tech physical rehabilitation over traditional treatment is established. This effect consists in improving coordination and independent movement. On the basis of the regression analysis, mathematical models of the prognosis of the rehabilitation potential are constructed. High-tech physical rehabilitation has a significantly more pronounced therapeutic effect than traditional treatment.


Assuntos
Paralisia Cerebral , Encéfalo , Criança , Pré-Escolar , Humanos , Movimento , Prognóstico , Robótica
4.
Spec Care Dentist ; 40(4): 335-343, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32488889

RESUMO

AIM: To assess the effectiveness of different parenting interventions for improving oral hygiene of cerebral palsy (CP) children aged 4-12 years. METHODOLOGY AND RESULTS: A randomized controlled trial was done among 60 CP children and parents visiting a tertiary care center in New Delhi. The study population was randomly assigned to experimental or control group (30 in each group). Parents/caregivers in the experimental group (Group 1) received video-based dental health education (DHE) and the control group (Group 2) received conventional DHE. Each group also received two telephonic reinforcements at fourth and eighth week after the first intervention at baseline. The groups were assessed for sociodemographic, familial factors, medical history, oral hygiene practices, and oral hygiene status. At 3-month follow-up, the mean reduction in simplified oral hygiene index (OHI-S), plaque index (PI), and gingival index (GI) scores was 0.27, 0.17, and 0.09, respectively, in Group 1 (P-value < .05). The mean reductions seen in Group 2 were 0.03 in OHI-S, 0.14 in PI, and 0.04 in GI index (P-value < .05, except for GI score: P-value = .6). CONCLUSION: Video-based DHE is effective and brings about significant improvement in oral hygiene status and oral health among CP children.


Assuntos
Paralisia Cerebral , Higiene Bucal , Criança , Pré-Escolar , Índice de Placa Dentária , Humanos , Índice de Higiene Oral , Poder Familiar
5.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(6): 567-572, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32571453

RESUMO

OBJECTIVE: To study the effect of functional chewing training (FuCT) on masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy. METHODS: A prospective study was performed for 48 children who were diagnosed with oral motor dysfunction from January 2019 to January 2020, and they were randomly divided into an FuCT group and an oral motor training group, with 24 children in each group. Both groups received FuCT or oral motor training for 12 weeks, and then they were evaluated in terms of the changes in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling. RESULTS: There were no significant differences between the two groups in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling before treatment (P>0.05). After the 12-week training, the FuCT group showed significant improvements in the masticatory function and the severity of tongue thrust and drooling (P<0.05), but with no improvement in the frequency of drooling (P>0.05), while the oral motor training group had no improvements in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling (P>0.05). After the 12-week training, the FuCT group had more significantly improvements in the severity of tongue thrust and the severity and frequency of drooling than the oral motor training group (P<0.05). CONCLUSIONS: FuCT can effectively improve the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy.


Assuntos
Paralisia Cerebral , Sialorreia , Criança , Humanos , Mastigação , Estudos Prospectivos
6.
J Clin Pediatr Dent ; 44(3): 161-167, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32552449

RESUMO

Objectives: The aim of the present study was to compare the perception of caregivers regarding the oral health status of children and adolescents with cerebral palsy (CP) and those with typical development. Study Design: Study group (SG) was composed of 35 children and adolescents with a clinical diagnosis of CP and their caregivers. Control group (CG) was composed of 35 individuals with typical development (matched with the SG for age, sex and caries activity) and their caregivers. Questionnaire was administered to caregivers addressing the oral health of individuals under their care. Caries activity, dmft/DMFT index, visible plaque index (VPI) and occlusal characteristics were determined. Results: Statistically significant differences were found in the perceptions of dental problems (p = 0.004) and gingival bleeding (p = 0.013). Individuals in SG whose caregivers perceived dental problems had a higher mean VPI (50.84 ± 5.11%) than those in CG (27.97 ± 6.50%). The mean dmft/DMFT in the SG was 2.77 ± 3.20. Class II molar relationship, overjet and anterior open bite were more prevalent in the SG. Conclusion: Caregivers of children/adolescents with CP perceive more oral problems, such as visible plaque, gingival bleeding and malocclusion, than caregivers of children/ adolescents with typical development.


Assuntos
Paralisia Cerebral , Cárie Dentária , Adolescente , Cuidadores , Criança , Estudos Transversais , Nível de Saúde , Humanos , Saúde Bucal
7.
Zhongguo Gu Shang ; 33(5): 489-92, 2020 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-32452192

RESUMO

Cerebral palsy is a common clinical syndrome of neurological disability in childhood, which seriously affects the quality of life of children and their families, and brings a heavy economic burden to the society. Domestic and foreign scholars had a long history of the application of selective posterior rhizotomy for the treatment of spastic cerebral palsy or mixed cerebral palsy with limb paralysis. It is effective in improving the lower extremity spasm of patients with cerebral palsy, and there are few cases with recurrences. After rehabilitation therapy, the muscle strength of patients with cerebral palsy was significantly improved compared with the previous one. The range of motion was significantly improved after operation, and there is no rebounded in aspect of joint activety in the long-term follow-up. The overall gait of the patient was significant improved. The author thought that selective posterior rhizotomy is effective in improving the motor function of lower limbs in patients with cerebral palsy, and it is worth being spread. However, it has to follow the principle of selecting appropriate cases before surgery, precise operation during operation, and timely and effective rehabilitation treatment after surgery, in order to achieve a better curative effect.


Assuntos
Paralisia Cerebral , Rizotomia , Humanos , Extremidade Inferior , Espasticidade Muscular , Qualidade de Vida , Resultado do Tratamento
8.
N Z Med J ; 133(1514): 63-70, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32379740

RESUMO

BACKGROUND: Preterm infants have a high risk of neurodevelopmental disability, including cerebral palsy (CP). Often, CP is not diagnosed until after 12 months, leading to delay in targeted interventions. The General Movements assessment (GM) evaluates the spontaneous movements of high-risk infants from birth to 20 weeks corrected postnatal age (CPA), and accurately predicts the risk of CP. This allows for earlier diagnosis and intervention, potentially changing the trajectory of disability, yet routine use of GM is not well established in New Zealand. AIM: To describe the process of setting up GM in a tertiary neonatal unit. METHODS: We reviewed the process and progress made to date setting up GM in our service. RESULTS: Challenges and potential solutions for the implementation of GM were identified. Key areas of development included staff training and support, IT services, resources, medical documentation, inter-departmental communication and establishing clinical pathways. CONCLUSION: GM has become successfully integrated into the assessment of high-risk infants in our neonatal unit, with the aim to provide valuable information to health professionals and families to optimise intervention and improve outcomes. Efforts will continue to ensure there is robust and sustainable system for using GM in our service.


Assuntos
Paralisia Cerebral/diagnóstico , Movimento , Avaliação de Sintomas/métodos , Paralisia Cerebral/fisiopatologia , Procedimentos Clínicos , Diagnóstico Precoce , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/organização & administração , Nova Zelândia , Seleção de Pacientes , Desenvolvimento de Programas , Fatores de Risco , Centros de Atenção Terciária , Gravação de Videoteipe
9.
Orv Hetil ; 161(21): 873-880, 2020 05.
Artigo em Húngaro | MEDLINE | ID: mdl-32427572

RESUMO

Introduction, aim: Quality control of patient documentation for cerebral palsy (CP) at Semmelweis University. METHOD: In our retrospective audit, we revised patient records for all children born between 2005 and 2015, with suspected CP, registering 673 cases with confirmed CP. Based on the available patient data, we assessed clinical and etiological classification of CP and data availability. RESULTS: Patient records of 86% of children were suitable for clinical classification. Among them, 90.5% were spastic, 7.8% hypotonic, 1.2% dyskinetic and 0.5% ataxic. Among the classifiable spastic cases (98% of all spastic cases), 51% presented with tetraparetic/tetraplegic, 26% diparetic/diplegic and 23% hemiparetic/hemiplegic localization; in the remaining 2%, sufficient data for topological classification was unavailable. Severity assessed on Gross Motor Function Classification System was definable in 82% of cases, 43% showing grade I-II, 28% grade III and 29% grade IV-V impairment. Patient history was specified in 91% of cases. Prematurity was documented in 55%, perinatal asphyxia/hypoxic-ischemic encephalopathy in 31%, intraventricular/intracranial haemorrhage in 27%, multiple births in 19%, intrauterine growth restriction in 18%, intrauterine/perinatal/infancy infection in 15%, congenital malformation in 12%, in vitro fertilisation in 5%, stroke in 3% and CP-associated genetic mutation in 3% of cases. Negative patient history was determined in 16% of children. CONCLUSIONS: Our audit established that clinical documentation of CP is performed based on uniform criteria, detecting missing data primarily in clinical classification and patient history. We propose a patient documentation standard in the clinical care of affected children, which is a prerequisite for unified data recording and a future national CP registry. Orv Hetil. 2020; 161(21): 873-880.


Assuntos
Paralisia Cerebral/epidemiologia , Auditoria Clínica , Confiabilidade dos Dados , Documentação/normas , Criança , Feminino , Humanos , Recém-Nascido , Gravidez , Prevalência , Estudos Retrospectivos , Universidades
10.
J Rehabil Med ; 52(5): jrm00059, 2020 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-32301499

RESUMO

BACKGROUND: A cost-effectiveness trial (the Space Bop study) on the added value of botulinum toxin injections (BoNT-A) in the leg muscles, as part of a multimodal intervention for ambulatory children with spastic cerebral palsy in the context of a single distinct cycle of care was performed recently by our group. For a broad set of effect outcomes, we found that BoNT-A had no added value if children received comprehensive rehabilitation. However, this counterintuitive finding was met with scepticism. OBJECTIVE: Since several noteworthy facts and experiences were recorded during the course of the trial and the dissemination phase, the aim of this paper was to describe and discuss some crucial aspects of, and barriers to, the Space Bop study, related to context and perspective, design and results, as well as publication and implementation. METHODS: This paper discusses 5 issues: (i) the design, interpretation and presentation of previous research; (ii) the role of one's own clinical experience and interpretation; (iii) the aims of (BoNT-A) treatment; (iv) conflict of interest, role of industry, and the role of history; (v) optimal treatment modalities and dose-response relationships. CONCLUSION: Despite the unambiguous findings from the Space Bop study, several factors hindered acceptance of the results. Awareness of these factors is important when performing rehabilitation research and disseminating and implementing research findings.


Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Paralisia Cerebral/tratamento farmacológico , Terapia Combinada/métodos , Análise Custo-Benefício/métodos , Fármacos Neuromusculares/uso terapêutico , Toxinas Botulínicas Tipo A/farmacologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Fármacos Neuromusculares/farmacologia , Resultado do Tratamento
11.
J Rehabil Med ; 52(5): jrm00060, 2020 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-32318745

RESUMO

INTRODUCTION: The development of efficient resistance exercise protocols to counteract muscle dysfunction in cerebral palsy is warranted. Whether individuals with cerebral palsy are able to perform iso-inertial resistance (flywheel) exercise in a comparable manner to typically developed subjects has never been experimentally tested. DESIGN: A comparative, controlled study. SUBJECTS: Eight young ambulatory adults with cerebral palsy (mean age 19 years; Gross Motor Function Classification System (GMFCS) I-III) and 8 typically developed control subjects (mean age 21 years). METHODS: Subjects performed acute bouts on the weight-stack and flywheel leg-press device, respectively. Range of motion, electromyography, power, work and muscle thickness (ultrasound) data were collected. RESULTS: Subjects with cerebral palsy were able to produce a greater eccentric/concentric peak power ratio on the flywheel (p < 0.05 vs ratio in weight-stack), however absolute values were lower (p < 0.05 vs weight-stack). Typically developed subjects produced more power per mm of thigh muscle than the cerebral palsy group, independent of leg, device and action. DISCUSSION: Subjects with cerebral palsy could not elicit the eccentric overload seen in typically developed subjects. Furthermore, peak power production per mm muscle was markedly reduced in both legs in subjects with cerebral palsy. In conclusion, this comparative study of weight-stack and flywheel exercise does not support the implementation of the current iso-inertial protocol for young adults with cerebral palsy.


Assuntos
Paralisia Cerebral/terapia , Exercício Físico/fisiologia , Força Muscular/fisiologia , Treinamento de Resistência/métodos , Adulto , Feminino , Humanos , Masculino , Músculo Esquelético/fisiologia , Adulto Jovem
12.
Arq Gastroenterol ; 57(1): 3-7, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294728

RESUMO

BACKGROUND: Cerebral palsy is the most common cause of physical disability in childhood. Caregivers of patients presenting tetraparesis cerebral palsy (TCP) and gastrostomy tube feeding (GTF) were selected for this study because both conditions represent a great demand for their caregivers. OBJECTIVE: To describe the quality of life related to the state of health of caregivers of patients with TCP who were fed by gastrostomy, to assess the results linked to the mental health of these caregivers, to compare our data with data from other studies on children with cerebral palsy without gastrostomy and to evaluate the possible interference of gastrostomy in the quality of life. METHODS: A number of 30 major caregivers were interviewed and assessed. Quality of life and mental health tools applied and analyzed only for caregivers were: Medical Outcomes Study (MOS) 36-item Short Form Health Survey (SF-36), WHOQOL-BREF and Beck scales. Other information (age, gender, marital status, number of residents per household and psychological support) was evaluated. The Spearman's rank correlation coefficient was used to analyze. A 5% significance level was adopted. RESULTS: Results obtained through questionnaires are as follows: moderate hopelessness in 20% of caregivers (the higher the number of residents per household the higher the level of caregiver's hopelessness); moderate and severe anxiety in 33.33% of the sample studied; moderate and severe depression identified in 46.67% of interviewed caregivers; health-related quality of life of caregivers of patients with TCP were found to be below world averages; no significant figures for suicide potential were noted for the population under this study. CONCLUSION: The HRQOL of caregivers of TCP patients who were fed by gastrostomy is below the average of the general population. Our results are very similar to those found in other studies that evaluated caregivers of patients with cerebral palsy with different degrees of neurological impairment and no report of using GTF, suggesting that the presence of gastrostomy did not negatively interfere with the caregiver's HRQOL.


Assuntos
Cuidadores/psicologia , Paralisia Cerebral/enfermagem , Nutrição Enteral , Gastrostomia , Qualidade de Vida/psicologia , Adolescente , Adulto , Paralisia Cerebral/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Inquéritos e Questionários , Adulto Jovem
14.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32269135

RESUMO

BACKGROUND AND OBJECTIVES: Early diagnosis of cerebral palsy (CP) is critical in obtaining evidence-based interventions when plasticity is greatest. In 2017, international guidelines for early detection of CP were published on the basis of a systematic review of evidence. Our study aim was to reduce the age at CP diagnosis throughout a network of 5 diverse US high-risk infant follow-up programs through consistent implementation of these guidelines. METHODS: The study leveraged plan-do-study-act and Lean methodologies. The primary outcome was age at CP diagnosis. Data were acquired during the corresponding 9-month baseline and quarterly throughout study. Balancing measures were clinic no-show rates and parent perception of the diagnosis visit. Clinic teams conducted strengths, weaknesses, opportunities, and threats analyses, process flow evaluations, standardized assessments training, and parent questionnaires. Performance of a 3- to 4-month clinic visit was a critical process step because it included a Hammersmith Infant Neurologic Examination, a General Movements Assessment, and standardized assessments of motor function. RESULTS: The age at CP diagnosis decreased from a weighted average of 19.5 (95% confidence interval 16.2 to 22.8) to 9.5 months (95% confidence interval 4.5 to 14.6), with P = .008; 3- to 4-month visits per site increased from the median (interquartile range) 14 (5.2-73.7) to 54 (34.5-152.0), with P < .001; and no-show rates were not different. Parent questionnaires revealed positive provider perception with improvement opportunities for information content and understandability. CONCLUSIONS: Large-scale implementation of international guidelines for early detection of CP is feasible in diverse high-risk infant follow-up clinics. The initiative was received positively by families and without adversely affecting clinic operational flow. Additional parent support and education are necessary.


Assuntos
Paralisia Cerebral/diagnóstico , Redes Comunitárias/normas , Exame Neurológico/normas , Guias de Prática Clínica como Assunto/normas , Melhoria de Qualidade/normas , Fatores Etários , Paralisia Cerebral/terapia , Diagnóstico Precoce , Feminino , Humanos , Lactente , Masculino , Exame Neurológico/métodos
15.
PLoS One ; 15(4): e0232064, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330162

RESUMO

Clinical gait analysis is widely used in clinical routine to assess the function of patients with motor disorders. The proper assessment of the patient's function relies greatly on the repeatability between the measurements. Marker misplacement has been reported as the largest source of variability between measurements and its impact on kinematics is not fully understood. Thus, the purpose of this study was: 1) to evaluate the impact of the misplacement of the lateral femoral epicondyle marker on lower limb kinematics, and 2) evaluate if such impact can be predicted. The kinematic data of 10 children with cerebral palsy and 10 aged-match typical developing children were included. The lateral femoral epicondyle marker was virtually misplaced around its measured position at different magnitudes and directions. The outcome to represent the impact of each marker misplacement on the lower limb was the root mean square deviations between the resultant kinematics from each simulated misplacement and the originally calculated kinematics. Correlation and regression equations were estimated between the root mean square deviation and the magnitude of the misplacement expressed in percentage of leg length. Results indicated that the lower-limb kinematics is highly sensitive to the lateral femoral epicondyle marker misplacement in the anterior-posterior direction. The joint angles most impacted by the anterior-posterior misplacement were the hip internal-external rotation (5.3° per 10 mm), the ankle internal-external rotation (4.4° per 10 mm) and the knee flexion-extension (4.2° per 10 mm). Finally, it was observed that the lower the leg length, the higher the impact of misplacement on kinematics. This impact was predicted by regression equations using the magnitude of misplacement expressed in percentage of leg length. An error below 5° on all joints requires a marker placement repeatability under 1.2% of the leg length. In conclusion, the placement of the lateral femoral epicondyle marker in the antero-posterior direction plays a crucial role on the reliability of gait measurements with the Conventional Gait Model.


Assuntos
Fenômenos Biomecânicos/fisiologia , Análise da Marcha/métodos , Joelho/fisiopatologia , Adolescente , Algoritmos , Articulação do Tornozelo/fisiopatologia , Paralisia Cerebral/fisiopatologia , Criança , Feminino , Fêmur/fisiopatologia , Marcha/fisiologia , Articulação do Quadril/fisiopatologia , Humanos , Articulação do Joelho/fisiopatologia , Extremidade Inferior/fisiopatologia , Masculino , Amplitude de Movimento Articular/fisiologia , Reprodutibilidade dos Testes
17.
J Rehabil Med ; 52(4): jrm00049, 2020 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-32313963

RESUMO

OBJECTIVE: To identify areas of functioning in adults with cerebral palsy that are considered relevant by experts, in order to develop an International Classification of Functioning, Disability and Health (ICF) Core Set for adults with cerebral palsy. PARTICIPANTS: Experts from various professional backgrounds worldwide who had experience working with adults with cerebral palsy for ≥2 years and were able to complete the survey in the English language. METHODS: A cross-sectional study using an international internet-based survey. The experts were asked to address relevant areas of functioning in adults with cerebral palsy. These areas of functioning were then linked to the ICF and the frequencies analysed. RESULTS: A total of 126 experts from 32 countries completed the survey. From the responses, 217 unique second-level ICF categories were identified. The three most frequently mentioned categories were "design, construction and building products and technology of buildings for public use (e150, 77%) and private use" (e155, 67%), followed by "sensation of pain" (b280, 62%). CONCLUSION: The broad diversity of ICF categories reported by the experts emphasize the known heterogeneity of cerebral palsy and the variety of func-tioning in adulthood. They also reported on many environmental factors, illustrating the importance of person-environment interactions. These findings provide information about relevant issues for use in developing an ICF Core Set for adults with cerebral palsy.


Assuntos
Paralisia Cerebral/epidemiologia , Classificação Internacional de Funcionalidade, Incapacidade e Saúde/normas , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários
18.
AJR Am J Roentgenol ; 214(6): 1389-1397, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32228327

RESUMO

OBJECTIVE. Any combination of abnormal positioning of the ankle, hindfoot, midfoot, and forefoot is possible in the context of cerebral palsy, but some patterns are more common than others. The purpose of this article is to discuss the radiographic manifestations and surgical management of the following common conditions: equinus, equinoplanovalgus, equinocavovarus, vertical talus, oblique talus, hallux valgus, and ankle valgus. CONCLUSION. CP is defined by abnormalities of the developing fetal or infant brain that result in permanent central motor dysfunction. Foot and ankle deformities are very common in the patients with CP, occurring in up to 93% of such patients as a result of underlying abnormal muscle tone, impaired motor control, and dynamic muscle imbalance. Radiologists must develop knowledge of the most common changes in alignment and basic techniques for correction to better recognize abnormalities and improve communication with orthopedic colleagues.


Assuntos
Paralisia Cerebral/complicações , Deformidades do Pé/diagnóstico por imagem , Deformidades do Pé/etiologia , Criança , Humanos
19.
Am J Occup Ther ; 74(2): 7402180060p1-7402180060p40, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32204777

RESUMO

IMPORTANCE: Occupational therapy practitioners need updated information about which interventions may improve motor skills for young children. OBJECTIVE: To identify the effectiveness of occupational therapy interventions to promote motor development and prevent delay for children ages 0-5 yr. DATA SOURCES: Six databases (CINAHL, MEDLINE, PsycINFO, ERIC, Cochrane, and OTseeker) were searched for articles published from January 2010 to March 2017. STUDY SELECTION AND DATA COLLECTION: The search yielded 4,488 articles that were reviewed for inclusion. Fifty-six studies were entered into both evidence and risk-of-bias tables. Included studies used Level I-III designs, were within occupational therapy's scope of practice, included participants with a mean age younger than 6 yr, and addressed motor skills. FINDINGS: Three intervention themes emerged: early intervention for children younger than age 3 yr, interventions for preschool children ages 3-5 yr, and interventions for children with or at risk for cerebral palsy. CONCLUSIONS AND RELEVANCE: Occupational therapy practitioners should consider use of interventions with moderate or strong evidence as described in this review. Limitations include high risk of bias and limited evidence for several interventions. WHAT THIS ARTICLE ADDS: This article provides occupational therapy practitioners with updated information on evidence-based practices for children age 5 and younger who have motor delays.


Assuntos
Paralisia Cerebral , Transtornos das Habilidades Motoras , Terapia Ocupacional , Pré-Escolar , Intervenção Educacional Precoce , Humanos , Recém-Nascido , Destreza Motora , Terapia Ocupacional/métodos , Terapia Ocupacional/normas
20.
Am J Occup Ther ; 74(2): 7402205090p1-7402205090p9, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32204787

RESUMO

IMPORTANCE: Children with hemiplegic cerebral palsy (CP) demonstrate spatial attention disregard, but the rehabilitation approach to CP is traditionally motor oriented. OBJECTIVE: To explore spatial attention disregard in children with hemiplegic CP and its relationship to their motor performance in daily activities. DESIGN: Cross-sectional study. SETTING: Community. PARTICIPANTS: Twenty-five children with hemiplegic CP and 25 age-matched typically developing children. OUTCOMES AND MEASURES: For spatial attention performance, the Random Visual Stimuli Detection Task; for developmental disregard, the Observatory Test of Capacity, Performance, and Developmental Disregard; and for motor performance, the Melbourne Assessment 2. RESULTS: Children with hemiplegic CP evidenced spatial attention disregard on their more affected sides, and this phenomenon was correlated with developmental disregard. CONCLUSIONS AND RELEVANCE: Children with hemiplegic CP demonstrate developmental disregard in both the motor and the visual-spatial attention domains. Including evaluation of and intervention for visual-spatial attention for children with hemiplegic CP in the traditionally motor-oriented rehabilitation approach is recommended. WHAT THIS ARTICLE ADDS: This research provides evidence that children with hemiplegic CP demonstrate disregard in the domain of visual-spatial attention. The findings suggest that evaluation of and intervention for visual-spatial attention should be included in CP rehabilitation in addition to the traditionally motor-oriented approach.


Assuntos
Paralisia Cerebral , Hemiplegia/fisiopatologia , Atenção/fisiologia , Estudos de Casos e Controles , Criança , Estudos Transversais , Humanos
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