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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46968

RESUMO

Paralisia Cerebral (PC), a deficiência mais comum na infância, é caracterizada por alterações neurológicas permanentes que afetam o desenvolvimento motor e cognitivo, envolvendo o movimento e a postura do corpo.


Assuntos
Paralisia Cerebral
2.
Mymensingh Med J ; 29(1): 121-128, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915347

RESUMO

Cerebral palsy (CP) is a non- progressive disorder of movement and posture due to a lesion of the developing brain. It is the commonest physical disability in childhood that affects function and development. Neuro imaging is currently recommended as a standard evaluation in children with cerebral palsy. This hospital based cross-sectional study was conducted in Paediatric Neurology out-patient department of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2015 to December 2015 to see the frequency and pattern of neuro-imaging findings in children with cerebral palsy. A total of 130 cases those who were attended and diagnosed as cerebral palsy based on history, clinical examination and neuro developmental assessment included in this study. All patients were sent to radiology & imaging department of same hospital for CT scan of brain. Among total 130 cerebral palsy patients male were more affected than female (88 boys and 42 girls) with male to female ratio 2.09: 1. Their ages ranged between 6-72 months with a mean age 25.6 months. The commonest age group was 6-24 months (46.9%). Common mode of delivery was normal vaginal delivery (62.3%) & Perinatal asphyxia (PNA) occurred in 66.9% cases. The commonest type of cerebral palsy was spastic form. Among them most cases were quadriplegic type, 64 cases (53.3%). Other cases were hemiplegic 27(20.7%) diplegic 13(10.0%). Total 84.7% had documented cerebral neuroimaging abnormalities; among them, diffuse cortical atrophy (46.9%), encephalomalacic change (19.9%), malformation (6.1%), and calcification (5.3%). CT scan was normal in 15.3% cases of cerebral palsy. The commonest co morbidity was speech delay (50%). Most of the patient with CP had abnormal CT scan finding though some patient had normal CT scan. Diffuse cerebral atrophy and encephalomalacic changes constitute frequent CT neuroimaging findings and commonly found in quadriplegic type of cerebral pulsy patients. Though diagnosis of cerebral palsy is essentially clinical, neuro imaging improves the understanding of the neuro-anatomical basis for function in CP. Etiology, type of CP and extent of motor impairments can easily be identified by the neuro imaging.


Assuntos
Encéfalo/fisiopatologia , Paralisia Cerebral/diagnóstico por imagem , Neuroimagem/métodos , Bangladesh , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Neurologia
3.
Medicine (Baltimore) ; 99(2): e18609, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914039

RESUMO

BACKGROUND: Cerebral palsy (CP) is a common disability in children featured with pathological gait and limb function limitation due to muscle weakness. Improving limb function and quality of life is currently considered to be highlighted. Physiotherapy is a chief component of rehabilitation for children with CP, correcting gait and improve walking capacity through muscle strength training. Standard rehabilitation programs for CP have not been determined. Core stability training (CST), which coordinates limb balance via trunk control, is widely used in sports competition. And it is gradually introduced into the rehabilitation of children with cerebral palsy with a positive impact on the patients' gait performance. By screening published literatures, this study aims to conduct a meta-analysis to systematically evaluate the effectiveness and safety of CST in gait of children with CP. METHODS: Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on CST in the treatment of children with CP were searched from 6 databases. Moreover, the reference lists of conference papers and included literatures will be manually searched to avoid omissions. Literature screening and data extraction were performed independently by 2 researchers. RCTs carry out the risk of bias analysis evaluation from seven aspects through the Cochrane Collaboration's risk of bias tool. Fixed or random effect model will be performed to analyze the outcomes. When higher heterogeneity occurs (I > 50%), the sensitivity or subgroup analysis will also be conducted to find potential factors. And the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is used for assessing the quality of evidence. RESULTS: The study will evaluate the effect of CST on gait of children with CP from multiple outcomes, including walking speed, endurance, stride length, and safety. CONCLUSION: Based on evidence-based medicine, the conclusion of this study can demonstrate the effectiveness and safety of CST in gait correction for children with CP. PROSPERO REGISTRATION NUMBER: PROSPERO CRD 42019134094.


Assuntos
Paralisia Cerebral/reabilitação , Terapia por Exercício/métodos , Fenômenos Biomecânicos , Criança , Ensaios Clínicos como Assunto , Feminino , Humanos , Masculino , Metiltiouracila , Força Muscular , Projetos de Pesquisa
4.
Spec Care Dentist ; 40(1): 62-70, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31774579

RESUMO

AIMS: To investigate the oral health and nutritional status of children with cerebral palsy (CP). METHODS AND RESULTS: Oral health assessment included dental caries and dental plaque maturity scores (DPMS) while the nutritional assessment included children's height-for-age Z-score (HAZ), body mass index-for-age Z-score (BAZ), mid-upper-arm circumference (MUAC), nutrient intake, cariogenic food frequency (CFF) and daily sugar exposure (DSE). Ninety-three CP children were recruited. The prevalence of caries was 81.7% (95% CI: 72.7%-88.3%). The median (IQR) of the DMFT and dft scores were 0.5(4.0) and 3.0(8.0), respectively. Most of the participants had acid-producing plaque (90.3%), severely stunted (81.4%), and 45% were severely thin with acute malnutrition. Intakes of calcium, iron, zinc, vitamin A, vitamin D and total fat were below 77% of the Recommended Nutrient Intakes for Malaysian children (RNI 2017). Nine types of cariogenic foods/drinks were consumed moderately, and DSE indicated that 45% of the children were at moderate risk of dental caries. CONCLUSION: Untreated dental caries, severe stunting and thinness were prevalent, and cariogenic foods/drinks were consumed moderately suggesting a moderate risk of caries. Therefore, controlling cariogenic food intake is crucial, but monitoring daily nutrient intake is needed for the optimum growth of children with CP.


Assuntos
Paralisia Cerebral , Cárie Dentária , Criança , Dieta , Humanos , Malásia , Estado Nutricional , Saúde Bucal
5.
Spec Care Dentist ; 40(1): 35-40, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31697430

RESUMO

AIMS: Cerebral palsy (CP) is a chronic, nonprogressive disorder affecting movement, posture, and tone, caused by injuries in the central nervous system during the early stages of life. Patients with CP have swallowing disorders, which make oral feeding difficult and necessitate the use of external feeding devices. The objective of this research was to study the oral health status of pediatric patients affected with CP fed by either oral or enteral route. METHODS: A cross-sectional observational clinical study of the oral health of two groups of patients with CP, fed either orally or enterally (via percutaneous endoscopic gastrostomy, PEG). RESULTS: Patients fed by enteral route via PEG presented lower caries scores (DMFT: PEG: 1.09, non-PEG: 2.81) and higher percentages of supragingival dental calculus than the oral feeding group (PEG: 86%, non-PEG: 57.6%). CONCLUSION: Oral health status differed in pediatric patients with CP fed enterally via PEG and those fed orally. Specific preventive measures in both groups will be required to minimize the risk of complications.


Assuntos
Paralisia Cerebral , Gastrostomia , Criança , Estudos Transversais , Nutrição Enteral , Humanos , Saúde Bucal
6.
Spec Care Dentist ; 40(1): 26-34, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31697453

RESUMO

AIM: To evaluate the impact of an oral health program for institutionalized individuals with cerebral palsy (CP) and their caregivers, after 2 and 6 months. METHODS: Sixty-two CP individuals in four homes were selected for intervention group (n = 31) and control group (n = 31). An oral hygiene practices questionnaire was applied to all caregivers at the baseline. Both groups received awareness sessions, practical demonstration of toothbrushing and adaptive techniques with role-play. In the study group, individual oral hygiene monitoring was also performed in the first 2 months. A gingival and an oral hygiene indexes were performed at the beginning, after 2 and 6 months of intervention. RESULTS: There was a significant reduction of gingival (p < 0.001) and oral hygiene (p < 0.001) indexes at 2 and 6 months in the intervention group with the most significant reductions at 2 months. Caregivers reported opening the mouth (84.6%) and swallowing toothpaste (61.5%) as the most important difficulties in performing toothbrushing. CONCLUSION: It was found that frequent and individualized monitoring of plaque control was essential to reduce dental plaque and gingivitis levels and that awareness sessions were not enough to produce clinically significant result.


Assuntos
Paralisia Cerebral , Gengivite , Adulto , Índice de Placa Dentária , Humanos , Saúde Bucal , Higiene Bucal , Escovação Dentária
7.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1048303

RESUMO

Objetivo: compreender as percepções de mães de crianças com paralisia cerebral acerca dos cuidados realizados e aprendizados vividos a partir desse diagnóstico. Método: utilizou-se Inventário Sociodemográfico, Sistema de Classificação da Função Motora Grossa e Roteiro de Entrevista. Participaram 13 mães de crianças entre 0 e 12 anos com diagnóstico de paralisia cerebral atendidas em um centro de referência especializado nas áreas de crescimento e desenvolvimento infantil da capital Belém-PA. Resultados: as mães relataram a importância dos aprendizados adquiridos, o processo de amadurecimento, os sofrimentos experimentados, as percepções acerca da felicidade e os desafios a serem vencidos. Conclusão: constatou-se que apesar das dificuldades, as mães percebiam-se realizadas com a construção dos intensos aprendizados acerca dos cuidados exigidos na paralisia cerebral


Objective: this study aimed to understand the perceptions of mothers of children with cerebral palsy about the care and learning they have experienced since this diagnosis. Method: sociodemographic Inventory, Gross Motor Function Classification System and Interview were used. Participants: 13 mothers of children between 0 and 12 years old with diagnosis of cerebral palsy attended at a specialized referral center in the areas of growth and child development in BelémPará. Results: The mothers reported the importance of acquired learning, the maturation process, the suffering experienced, the perceptions about happiness and the challenges to be overcome. Conclusion: it was observed that despite the difficulties, the mothers perceived themselves accomplished with the construction of intense learning about the care required in cerebral palsy


Objetivo: comprender las percepciones de madres de niños con parálisis cerebral acerca de los cuidados realizados y aprendidos vividos a partir de ese diagnóstico. Método: se utilizó Inventario Sociodemográfico, Sistema de Clasificación de la Función Motora Grossa y Ruta de Entrevista. Participaron 13 madres de niños entre 0 y 12 años con diagnóstico de parálisis cerebral atendidas en un centro de referencia especializado en las áreas de crecimiento y desarrollo infantil de la capital Belém-PA. Resultados: las madres relataron la importancia de los aprendizajes adquiridos, el proceso de maduración, los sufrimientos experimentados, las percepciones acerca de la felicidad y los desafíos a ser vencidos. Conclusión: se constató que a pesar de las dificultades, las madres se percibían realizadas con la construcción de los intensos aprendizajes acerca de los cuidados exigidos en la parálisis cerebral


Assuntos
Humanos , Feminino , Paralisia Cerebral , Aprendizagem Baseada em Problemas , Relações Mãe-Filho , Brasil , Cuidadores
8.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(12): 1584-1588, 2019 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-31823563

RESUMO

Objective: To summarize the advancement of precise diagnosis and treatment for spastic cerebral palsy in recent years. Methods: The literature and own experiences were reviewed, and the surgical method, precise diagnosis, and personalized treatment of spastic cerebral palsy based on the classification of spastic cerebral palsy were summarized and analyzed. Results: The common classification of spastic cerebral palsy are gross motor function classification system (GMFCS) and manual ability classification system (MACS). The surgical methods of spastic cerebral palsy can be divided into soft tissue surgery, nerve surgery, and bone and joint surgery. The precise diagnosis of spastic cerebral palsy includes qualitative diagnosis, localization diagnosis, and quantitative diagnosis. Based on precise diagnosis and classification, one or more corresponding surgical methods are selected for treatment. Conclusion: The manifestations of spastic cerebral palsy are so diverse that it is necessary to select rational surgeries based on precise diagnosis to achieve individualized treatment.


Assuntos
Paralisia Cerebral , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/terapia , Avaliação da Deficiência , Humanos , Destreza Motora
9.
Rev. méd. Urug ; 35(4): 281-288, dic. 2019. tab, fig
Artigo em Espanhol | LILACS | ID: biblio-1026148

RESUMO

Introducción: la luxación de cadera es una complicación severa en pacientes con parálisis cerebral (PC), sobre todo en pacientes incluidos en el sistema de clasificación de la función motora gruesa (GMFCS, por su sigla en inglés) III-V. Para su identificación son necesarias radiografías de pelvis. Objetivos: evaluar el seguimiento radiográfico en estos pacientes y la detección precoz de esta complicación en nuestro hospital. Material y método: se revisaron historias clínicas y radiografías de 17 pacientes GMFCS III-V, entre 2 y 8 años de edad al momento de la radiografía de pelvis índice, midiendo el porcentaje de migración (PM) de cadera de acuerdo al índice de Reimer, el ángulo cérvico-diafisiario y calculando el CPUP Score de cada cadera. Evaluamos el control radiográfico al año o posteriormente a esa fecha, y de no haber sido así, se citaría a los pacientes a control radiológico para detectar las caderas con riesgo migratorio elevado. Resultados: de los 17 pacientes evaluados, 3 (18%) tuvieron una nueva radiografía de pelvis al año; 6 (35%) pacientes la tuvieron posteriormente al año, y antes de la fecha de control designada, 7 (41%) pacientes nunca fueron controlados, citándose para nueva radiografía en 2018. Un paciente (6%) se perdió en el seguimiento. Un paciente presentó una cadera con riesgo alto (CPUP Score 50%-60%), el resto tuvo PM dentro de rangos normales. Conclusiones: pocos pacientes con PC GMFCS III-V tuvieron un seguimiento radiográfico anual. Los monitoreados posteriormente no mostraron progresión de esta condición. El resultado de este estudio y la literatura respaldan la introducción de un programa de vigilancia en nuestro hospital.


Introduction: hip luxation is a severe complication in patients with cerebral palsy (CP), especially in gross motor functional classification system (GMFCS) III-V patients. Pelvic x-rays are necessary to identify this condition. Objectives: to assess the x-ray follow-up in these patients and the early detection of this complication in our hospital. Method: the medical records and x-rays of 17 GMFCS III-V patients who were between 2 and 8 years old at the time of index pelvic x-ray were reviewed, measurement of the hip migration percentage according to Reimer´s index, the cervical-diaphyseal angle and calculation of the CPUP hip score for each hip. We assessed the follow-up x-ray a year later or later than that date, and in the even this had not happened, we would call the patients in for a control x-ray to identify the hips with an increase migration risk. Results: 3 (18%) out of 17 patients assessed underwent a new pelvic x-ray a year later. 6 patients (35%) underwent one later than one year after and prior to the control visit planned, 7 (41%) patients were never controlled and they were called for a new x-ray in 2018. One patient (6%) was lost during follow-up. One patient had an increased risk hip (CPUP Score 50-60%), the rest had normal migration percentages. Conclusions: few patients with PC GMFCS III-V underwent annual follow-up. Those monitored did not evidence progression of this condition. This study and the relevant literature back up the introduction of a surveillance program in our hospital.


Introdução: a luxação de quadril é uma complicação grave nos pacientes com paralisia cerebral (PC), principalmente nos pacientes "Gross motor funcional classificativo system (GMFCS) III-V". Para sua identificação é necessário realizar radiografias de pélvis. Objetivos: avaliar o seguimento radiográfico nesses pacientes e realizar a detecção precoce desta complicação no hospital. Material e método: foram estudados os prontuários e radiografias de 17 pacientes GMFCS III-V, com idades entre 2 e 8 anos no momento da radiografia de pélvis índice, medindo a porcentagem de migração (PM) de quadril de acordo com o índice de Reimer, o ângulo cervico-diafisiario e calculando o CPUP Score de cada quadril. Foi feito o controle radiográfico um ano ou mais depois da data da realização da radiografia; quando não foi possível os pacientes foram convocados para a realização de controle radiológico para detectar os quadris com risco migratório elevado. Resultados: dos 17 pacientes avaliados, 3 (18%) realizaram uma nova radiografia de pélvis um ano depois da primeira, 6 (35%) pacientes depois de um ano mas antes de ser convocados para controle, 7 (41%) pacientes nunca foram controlados, sendo convocados para uma nova radiografia em 2018. Um paciente (6%) foi perdido. Um paciente apresentou um quadril com risco alto (CPUP Score 50-60%), os demais tinham PM dentro de intervalos normais. Conclusões: poucos pacientes com PC GMFCS III-V tiveram um seguimento radiográfico anual. Os que foram monitorados posteriormente não mostraram progressão desta condição. O resultado deste estudo e a literatura respaldam a introdução de um programa de vigilância no nosso hospital.


Assuntos
Humanos , Pré-Escolar , Criança , Paralisia Cerebral/complicações , Seguimentos , Luxação do Quadril/diagnóstico por imagem , Radiografia/instrumentação
10.
Croat Med J ; 60(5): 414-420, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31686455

RESUMO

AIM: To evaluate visual impairment (VI) in children with cerebral palsy (CP). METHODS: This population-based study included 419 children from the Surveillance of Cerebral Palsy in Europe (SCPE) C28 RCP-HR - Register of Cerebral Palsy of Croatia born 2003-2008. Vision in children with CP (according to SCPE) was classified as normal or impaired, with the subcategory of severe VI. The proportion of children with VI was assessed in groups with different CP type/subtype, gross and fine motor function, and gestational age (GA). RESULTS: A total of 266 children had some degree of VI (266/400; 66.5%), 134 had normal vision, and data on VI were unknown for 19 children. Severe VI was present in 44 children (44/400; 11%). The proportion of children with VI and severe VI increased with the Gross Motor Function Classification System and Bimanual Fine Motor Function levels. Children with bilateral spastic CP had the highest frequency of severe VI (14.9%). The percentage of severe VI in children with bilateral spastic CP was 53.8% in the group born <28 weeks of GA, 13.3% in the group born 28-31 weeks of GA, 11.1% in the group born 32-36 weeks of GA, and 24.4% in the group born >36 weeks of GA (λ2=4.95; df=6; P<0.001). CONCLUSION: Children with CP have a high prevalence of VI and severe VI, which is increasing with the level of motor impairment. Severe VI is significantly more common in children with bilateral spastic CP, especially among extremely premature infants.


Assuntos
Paralisia Cerebral , Transtornos da Visão , Paralisia Cerebral/complicações , Paralisia Cerebral/epidemiologia , Criança , Croácia/epidemiologia , Humanos , Transtornos da Visão/complicações , Transtornos da Visão/epidemiologia
11.
Stomatologiia (Mosk) ; 98(5): 78-86, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31701934

RESUMO

AIM: To study the morphological state of the maxillofacial system in children with cerebral palsy. MATERIAL AND METHODS: The frequency and prevalence of dental anomalies was studied in 30 9-15 years old children with cerebral palsy. For the registration of maxillofacial anomalies, the Bjork assessment method was used. The severity of sagittal incisive disocclusion and the reverse sagittal incisal disocclusion was measured by the magnitude of the sagittal slit. RESULTS: The study revealed no age-dependent correlation of lower canines and second premolars roots growth. The parameters of the cerebral part of the skull measured on the CT-bases lateral cephalograms were significantly less than normal rates except for the length of the posterior part of the skull. CONCLUSION: The morphological changes that determined the formation of sagittal and vertical incisive disocclusions were defined: the reduction of total anterior morphological face height (N-Me) and anterior upper morphological face height (N-SpP) and the increase in the anterior lower morphological face height (SpP-Me) which are characteristic features for patients with incisive sagittal and vertical diocclusion.


Assuntos
Paralisia Cerebral , Anormalidades Maxilofaciais , Adolescente , Cefalometria , Criança , Humanos , Mandíbula , Crânio , Raiz Dentária
12.
Isr Med Assoc J ; 21(11): 752-755, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31713365

RESUMO

BACKGROUND: In non-ambulatory patients with cerebral palsy, the presence of scoliosis has a major impact on health and quality of life. The aim of this review is to raise awareness of caregivers from various professions to the extent of the problem, to explain the natural history of neuromuscular scoliosis and its pathophysiology, and to describe up-to-date optional conservative and surgical treatments.


Assuntos
Paralisia Cerebral/complicações , Paralisia Cerebral/fisiopatologia , Escoliose/complicações , Escoliose/fisiopatologia , Pessoas com Deficiência , Humanos , Limitação da Mobilidade , Qualidade de Vida
13.
Sleep Health ; 5(6): 555-571, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31740377

RESUMO

BACKGROUND: Up to 85% of children with neurodevelopmental disorders have sleep problems, compared with 25% of typically developing children. Children with cerebral palsy (CP)may have risk factors (brain injury, physical disability, and comorbidities) that make them more likely to have sleep problems compared with typically developing children. OBJECTIVE: To determine prevalence of sleep problems in children with CP. METHODS: We conducted a systematic review and meta-analysis to report on the prevalence of sleep problems in children with CP, within subgroups (age, CP phenotype, presence of impairments [auditory, visual, and cognitive], and presence of epilepsy) and compared with control groups of healthy children. We searched eight relevant electronic databases from their respective start dates until September 2018. RESULTS: 23 full-text articles (n=2,908 children with CP) were included in the review. All studies were cross-sectional and examined caregiver-reported sleep measures. The Sleep Disturbance Scale for Children (SDSC) was the most commonly used questionnaire. No study met all Joanna Briggs Institute quality assessment criteria for prevalence studies; selection, coverage, classification, and/or confounding biases were present in all studies. Using a random effects model with a Freeman-Tukey double arcsine transformation, the pooled prevalence was 23.4% (95% confidence interval [CI] 18.8-28.4%; n=9 studies) for an abnormal total score on the SDSC and 26.9% (95% CI 21.5-32.7%; n=9 studies) for disorders of initiation and maintenance of sleep, the most prevalent sleep problem reported. For the studies that reported prevalence for control groups of healthy children (n=4 studies), sleep problems were generally more prevalent in the CP group. CONCLUSION: The prevalence of sleep problems in children with CP is high. There is notable variability in the prevalence of sleep problems between subgroups of children with CP. Future studies using questionnaires validated in children with CP and objective measures (such as polysomnography or actigraphy) in well-described, large, broadly recruited samples are recommended.


Assuntos
Paralisia Cerebral/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Criança , Estudos Transversais , Humanos , Prevalência
14.
Klin Padiatr ; 231(6): 304-312, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31724139

RESUMO

BACKGROUND: Physiotherapy, including vibration-assisted therapy, has been proven to be effective for patients with ataxic cerebral palsy. Herewith, we studied the effect of a functional, goal-oriented interval rehabilitation program, including vibration-assisted home-training on the motor function of children with congenital ataxias. PATIENTS: 45 children (mean age 7.7 years, SD 4.70) with ataxia, having received a 6-month home-based side-alternating vibration-assisted therapy combined with intensive, goal-oriented, functional rehabilitation intervals, were included in the study, classified according to the progressive or non-progressive ataxia character. METHOD: Retrospective analysis of the prospectively collected data of the registry of the Cologne rehabilitation program "Auf die Beine". Motor abilities have been assessed prior to the intervention (M0), after 6 months of home-training (M6) as well as in a follow-up 6 months later (M12). We performed a gait analysis, a 1-minute walking test (1-MWT), and the Gross Motor Function Measure (GMFM-66). RESULTS: The GMFM-66 improvement (M6-M0 vs. M12-M6) was statistically significant with median improvement of 2.4 points (non-progressive) and 2.9 points (progressive) respectively, and clinically relevant. The 1-MWT improvement was statistically significant and clinically relevant for non-progressive ataxia. CONCLUSION: The intensive training, including vibration-assisted therapy significantly improved the motor function of children with ataxia. Six months later the skills were preserved in children with progressive ataxia and could be further developed in non-progressive forms.


Assuntos
Ataxia/reabilitação , Paralisia Cerebral/reabilitação , Modalidades de Fisioterapia , Vibração/uso terapêutico , Criança , Feminino , Humanos , Masculino , Destreza Motora , Estudos Retrospectivos , Resultado do Tratamento
15.
Medicine (Baltimore) ; 98(48): e18062, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770222

RESUMO

BACKGROUND: Cerebral palsy (CP) describes a group of permanent disorders of movement and posture causing activity limitations, leading the most common movement disorder to children. Scalp acupuncture (SA) is one of several specialized acupuncture techniques, and it has been used widely in China to alleviate several CP symptoms, despite the deficiency of high-quality evidence related to this practice. Therefore, we plan to conduct a protocol of systematic review aimed at systematically reviewing all the clinical evidence on the effectiveness of scalp acupuncture for treating CP in children. METHODS: The following electronic databases will be searched from inception to May 1, 2019 MEDLINE, PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials (Cochrane Library), Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wan-fang Database, and Chinese Biomedical Literature Database (CBM). All published English and Chinese articles randomized controlled trials (RTCs) will be included. All types of CP of children in the trials will be included in this study and these individuals will be involved as core searchers to evaluate the efficacy of scalp acupuncture. Rev Man V.5.3 software will be implemented for the assessment of bias risk, data synthesis, subgroup analysis, and meta-analyses if inclusion conditions are met. Continuous outcomes will be presented as mean difference (MD) or standard mean difference (SMD), while dichotomous data will be expressed as a relative risk. RESULTS: The systematic review will synthesize the available knowledge surrounding scalp acupuncture for children with CP. The findings will be synthesized to determine the efficacy and safety of scalp acupuncture for children with CP. CONCLUSION: This protocol will present the evidence of whether scalp acupuncture is an effective intervention for children with CP.


Assuntos
Terapia por Acupuntura/métodos , Paralisia Cerebral/terapia , Criança , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Couro Cabeludo , Revisão Sistemática como Assunto , Resultado do Tratamento
16.
Zhongguo Gu Shang ; 32(9): 815-819, 2019 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-31615177

RESUMO

OBJECTIVE: To explore the effect of selective lumbosacral posterior rhizotomy(SPR) on lower limb spasticity and gross motor function in patients with cerebral palsy. METHODS: From January 2018 to October 2018, 47 patients with cerebral palsy were treated with rehabilitation alone and SPR combined with rehabilitation. According to whether SPR was performed, the patients were divided into group A and group B. Group A was treated with rehabilitation combined with SPR at lumbosacral level, and group B was treated with rehabilitation alone. There were 23 cases in group A, including 15 males and 8 females, with an average age of (7.30±3.25) years old; 24 cases in group B, 13 males and 11 females, with an average age of (7.00±3.09) years old. Forty-seven patients were assessed with modified Ashworth(MAS) and Gross Motor Function Scale(GMFM-88 items) before and after treatment. The changes of MAS and GMFM-88 scores before and after treatment were compared to evaluate the degree of spasm and the improvement of gross motor function in the two groups. RESULTS: All 47 patients were followed up. At 6 months after treatment, the MAS classification of the two groups was significantly improved(P<0.05), and the improvement of group A was more obvious than that of group B(P<0.05). Six months after treatment, the D, E and total scores of GMFM-88 between two groups were significantly improved compared with those before operation(P<0.05). The improvement of D and total scores in group A was more obvious than that in group B. There was no significant difference in the improvement of area E between two groups. CONCLUSIONS: Selective posterior rhizotomy combined with rehabilitation can significantly improve the spastic state and gross motor function of lower limbs in children with cerebral palsy, and can effectively promote the reconstruction and recovery of motor function of lower limbs in children with cerebral palsy.


Assuntos
Paralisia Cerebral , Rizotomia , Paralisia Cerebral/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Extremidade Inferior , Masculino , Movimento , Espasticidade Muscular
17.
Spine (Phila Pa 1976) ; 44(21): E1256-E1263, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31634301

RESUMO

STUDY DESIGN: Retrospective review of a multicenter, prospective database. OBJECTIVE: Our aim was to compare complication rates and maintenance of radiographic correction at 2 years after posterior spinal fusion (PSF) with or without cross-links in patients with cerebral palsy (CP)-related scoliosis. SUMMARY OF BACKGROUND DATA: Cross-links are frequently used in PSF to correct scoliosis in patients with CP because they are thought to increase the stiffness and torsional rigidity of the construct. METHODS: We reviewed the records of patients with CP who underwent primary PSF with or without cross-links between August 2008 and April 2015. Inclusion criteria were minimum follow-up of 2 years, availability of complications data (implant failure, surgical site infection, revision), and pre- and postoperative measurements of the major curve (measured using the Cobb method). The 256 patients included in this analysis had a mean age of 14.1 ±â€Š2.7 years. Ninety-four patients had cross-links (57% using one cross-link; 43% using two cross-links) and 162 patients did not have cross-links. P < 0.05 was considered statistically significant. RESULTS: The two groups did not differ significantly with regard to sex, age at surgery, preoperative menarche status, Gross Motor Function Classification System level, major curve magnitude, pelvic obliquity, kyphosis, and lordosis angles. There were no significant differences between groups in the correction achieved or the maintenance of correction at 2 years for the major curve, pelvic obliquity, kyphosis, or lordosis (all P > 0.05). Complication rates were similar between the cross-link group (16%, N = 15) and the non-cross-link group (14%, N = 22). CONCLUSION: At 2 years after PSF to treat CP-related scoliosis, patients had no significant differences in the degree of correction achieved, the maintenance of correction, or the rate of complications between those whose fusion constructs used cross-links and those whose constructs did not. LEVEL OF EVIDENCE: 3.


Assuntos
Paralisia Cerebral/complicações , Escoliose/etiologia , Escoliose/cirurgia , Fusão Vertebral/métodos , Adolescente , Criança , Feminino , Humanos , Cifose/patologia , Lordose/patologia , Masculino , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Escoliose/patologia , Fusão Vertebral/efeitos adversos , Vértebras Torácicas/cirurgia , Resultado do Tratamento
18.
Eklem Hastalik Cerrahisi ; 30(3): 217-23, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31650917

RESUMO

OBJECTIVES: This study aims to compare patients treated with single event multilevel surgery (SEMS) and multiple surgical events (MSE) for disorders of the lower extremities due to cerebral palsy (CP). PATIENTS AND METHODS: The study included 130 patients (74 males, 56 females; mean age 7.7±4 years; range, 4 to 13 years) who were retrospectively staged preoperatively and at the final follow-up with the Gross Motor Function Classification System (GMFCS). The patients were divided into two groups as group 1 (MSE) and group 2 (SEMS). Gross Motor Function Measure-88 (GMFM-88) was used as evaluation criteria and visual analog scale was used to measure family satisfaction. RESULTS: In the final follow-up, group 2 had better GMFM-88 D and E scores (p=0.037 and p=0.045, respectively). Similarly, family satisfaction was better in group 2 (p=0.047). There was a difference between preoperative and final follow-up GMFCS stages (I, II, III) of all patients (21÷53÷56 and 53÷49÷28; respectively, p<0.001). A total of 3.8 (range, 2-7) operations were performed per child. CONCLUSION: In this study, SEMS contributed significantly to movement, posture and independence of children with CP compared to MSE. Single event multilevel surgery also increased family satisfaction.


Assuntos
Paralisia Cerebral/cirurgia , Contratura/cirurgia , Extremidade Inferior/cirurgia , Procedimentos Ortopédicos/estatística & dados numéricos , Paralisia Cerebral/fisiopatologia , Criança , Pré-Escolar , Contratura/fisiopatologia , Avaliação da Deficiência , Feminino , Humanos , Extremidade Inferior/fisiopatologia , Masculino , Satisfação do Paciente , Estudos Retrospectivos , Escala Visual Analógica
19.
Zhen Ci Yan Jiu ; 44(10): 757-61, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31657167

RESUMO

OBJECTIVE: To investigate the clinical effect of acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of children with spastic cerebral palsy with spleen-kidney deficiency, as well as its effect in improving cerebral hemodynamics. METHODS: A total of 220 children with spastic cerebral palsy were divided into observation group and control group using a random number table, with 110 children in each group. The children in the control group were given rehabilitation training and repetitive transcranial magnetic stimulation, and those in the observation group were given acupuncture in addition to the treatment in the control group. Acupuncture was performed at Zusanli (ST36), Xuanzhong (GB39), Sanyinjiao (SP6), Pishu (BL20), Shenshu (BL23), Qihai (CV6), Quchi (LI11), Neiguan (PC6), Hegu (LI4) and Tianshu (ST25) once every other day, three times a week for 3 consecutive months. The two groups were compared in terms of Gross Motor Function Measure (GMFM), Fine Motor Function Measure (FMFM), comprehensive function score for children with cerebral palsy, clinical outcome, and related cerebral hemodynamic parameters (mean blood flow velocity [Vm], systolic peak velocity [Vs], and resistance index [RI] of the cerebral artery). RESULTS: After treatment, both groups had significant increases in the scores of GMFM, FMFM and comprehensive function (cognitive function, speech function, motor ability, self-care, and social adaptability,P<0.01), and the observation group had significantly better improvements in the scores of GMFM (domains A, B and C), FMFM (domains B, C, D and E), and comprehensive function than those of the control group (P<0.01). The therapeutic effect of the observation group (93/110, 84.55%)was superior to that of the control group (80/110, 72.73%, P<0.05). The observation group had significantly higher Vs and Vm and a significantly lower RI than the control group (P<0.01). CONCLUSION: In the treatment of children with spasmodic cerebral palsy with spleen-kidney deficiency, acupuncture combined with repeated transcranial magnetic stimulation can significantly improve their motor function, comprehensive function, and clinical outcome, which may be associated with the regulation of cerebral hemodynamics.


Assuntos
Terapia por Acupuntura , Paralisia Cerebral , Criança , Hemodinâmica , Humanos , Baço , Estimulação Magnética Transcraniana
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