The effect of modified constraint-induced movement therapy in children with hemiparetic cerebral palsy. Consecutive or intermittent days?

PURPOSE: To investigate effect of modified constraint-induced movement therapy (mCIMT) administered on consecutive or intermittent days on upper limb function in children with hemiparetic cerebral palsy (CP). MATERIALS AND METHODS: Thirty-three children (age range 5-18 y) with hemiparetic CP separated into three groups: consecutive mCIMT group (n = 11), intermittent mCIMT group (n = 11), control group (n = 11). The outcome measures consist of Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Pediatric Balance Scale (PBS), Modified Tardieu Scale (MTS), Jebsen-Taylor Hand Function Test (JTHFT), Children's Hand Use Experience Questionnaire (CHEQ), Abilhand Kids Questionnaire, surface Electromyography (sEMG). The evaluations were made baseline, 10 days after, 5 weeks after the treatment. RESULTS: Improvements were achieved in all groups. The use of upper extremities in daily life activities (p < 0.01), speed of performing the activities (p < 0.001), grasping efficiency (p < 0.001), the amount of a decrease in the children's sense of discomfort while performing activities (p < 0.001) on the affected side in both mCIMT groups were better than the control group. The gain levels in mCIMT groups were similar (p > 0.05). CONCLUSIONS: Administration of mCIMT on intermittent days facilitate the adaptation of a child, it was concluded to be a more tolerable method and could be more effective.Implications for rehabilitationmCIMT is more effective than low-dose conventional therapeutic interventions in improving paretic upper limb functions in children with hemiparetic CP.The application of mCIMT in the child's natural environment increases the motivation to participate in the treatment.The application of mCIMT on intermittent days will be more easily tolerated in paediatric individuals and will increase participation in the treatment.

Examination of the relationship between body mass index (BMI) and functional independence level in children with spina bifida.

OBJECTIVE: The aim of this study is to examine the relationship between body mass index (BMI) and functional independence level in children with spina bifida (SB). METHODS: The study included 116 children between 5 and 18 years. Subjects' socio-demographic characteristics, BMI values and functional independence levels were recorded. RESULTS: There was negative correlation between BMI and communication and social cognition in girls (p < 0.05). No correlation was found between BMI and WeeFIM in boys (p > 0.05). CONCLUSION: The results indicated that body weight in children with SB affected functional independency and that precautions to control weight important in these children.

Comparison of Health-Related Quality of Life between children with cerebral palsy and spina bifida.

This study has two aims-the first is to compare the Health Related Quality of Life (HRQoL) between children with cerebral palsy (CP) and children with spina bifida (SB); the second is to investigate the relationship between HRQoL and age, sex, body mass index (BMI), level of ambulation, cooperation, family income and the mother's education level in both groups of children. The study included 96 children with CP and 70 children with SB (aged 5-18) who attended a physiotherapy and rehabilitation program at an institute of special training and rehabilitation. Socio-demographic information was obtained within the study. The Child Health Questionnaire (CHQ-PF50) was used to evaluate HRQoL. A significant difference was found in terms of age and BMI between children with CP and SB (p<0.05). HRQoL was lower for children with CP. There was a significant difference between the two groups in terms of role/social limitations - emotional behavioral, behavior, global behavior, parental impact-emotional and parental impact-time (p<0.05). A positive correlation was found between BMI and self-esteem in children with SB, unlike children with CP. The HRQoL of children with CP was lower than children with SB. The parameters of behavior and parental impact were particularly affected in the children with CP. Minimizing behavioral problems (which can improve with advancing age) of the children with CP and reducing parental impact are important for improving the HRQoL of both the child and parents. There is a need for further studies on this issue.