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

Children ◽  
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.

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

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.

scholarly journals Faktor Risiko Prenatal Perinatal Dan Postnatal Pada Kejadian Cerebral Palsy

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.

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

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.

scholarly journals Effect of Action Observation Training on Spasticity, Gross Motor Function, and Balance in Children with Diplegia Cerebral Palsy

Children ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. 64
Author(s):  
Young-a Jeong ◽  
Byoung-Hee Lee
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Action Observation ◽  
Training Group ◽  
Control Group ◽  
Spastic Diplegia ◽  
Post Intervention ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Observation Training

This study evaluated the effect of action observation training on spasticity, gross motor function, and balance in children with spastic diplegia cerebral palsy. Eighteen children with cerebral palsy participated in this study. The participants were randomized into the action observation training group (n = 9) and a control group (n = 9). The action observation training group repeatedly practiced the action with their motor skills, while the control group practiced conventional physical therapy. Both groups received 30 min sessions, 3 days a week, for 6 weeks. To confirm the effects of intervention, the spasticity, gross motor function measurement (GMFM), and pediatric reaching test (PRT) were evaluated. The results showed that in the plantar flexor contracture test of both sides, the Modified Tardieu Scale (MTS) of the right side of knee joints, GMFM-B, C, and D were significantly increased between pre- and post-intervention within both groups (p < 0.05). PRT was significantly increased between pre- and post-intervention within the both groups (p < 0.05), and there was a significant difference between the two groups (p < 0.05). These results suggest that action observation training is both feasible and beneficial for improving spasticity, gross motor function, and balance in children with spastic diplegia cerebral palsy.

scholarly journals Intrathecal baclofen infusion and subsequent orthopedic surgery in patients with spastic cerebral palsy

1998 ◽  
Vol 4 (1) ◽  
pp. E7 ◽  
Author(s):  
Peter C. Gerszten ◽  
A. Leland Albright ◽  
Graham F. Johnstone
Keyword(s):  
Cerebral Palsy ◽  
Lower Extremity ◽  
Orthopedic Surgery ◽  
Intrathecal Baclofen ◽  
Orthopedic Procedures ◽  
Spastic Cerebral Palsy ◽  
Spastic Diplegia ◽  
Spastic Quadriplegia ◽  
Orthopedic Operation ◽  
The Mean

Intrathecal baclofen infusion (IBI) is an effective treatment for spasticity secondary to cerebral palsy (CP). The authors retrospectively reviewed the need for orthopedic surgery of the lower extremities in 48 patients with spastic CP who were treated with IBI. Forty pumps were placed in patients suffering from spastic quadriplegia (84%) and eight (16%) in patients with spastic diplegia. The patients' ages ranged from 5 to 43 years (mean 15 years). The mean follow-up period was 53 months (range 22-94 months). The mean baclofen dosage was 306 μg/day (range 25-1350 μg/day). At the time of pump placement, subsequent orthopedic surgery was planned in 28 patients (58%); however, only 10 (21%) underwent orthopedic surgery after IBI therapy. In all 10 cases, the surgical procedure was planned at the time of initial evaluation for IBI therapy. In the remaining 18 patients, who did not subsequently undergo their planned orthopedic operation, it was believed that their lower-extremity spasticity had improved to the degree that orthopedic intervention was no longer indicated. In addition, although six patients had undergone multiple orthopedic operations before their spasticity was treated, no patient required more than one orthopedic operation after IBI treatment for their spasticity. The authors conclude that IBI for treatment of spastic CP reduces the need for subsequent orthopedic surgery for the effects of lower-extremity spasticity. In patients with spastic CP and lower-extremity contractures, spasticity should be treated before orthopedic procedures are performed.

Review of Cerebral Palsy Cases in the University Of Nigeria Teaching Hospital Ituku-Ozalla, Enugu

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Chikamso Samuel Atuh ◽  
N Otti-Agha ◽  
B Eneje ◽  
V Ezema ◽  
A Okonkwo ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Teaching Hospital ◽  
Birth Asphyxia ◽  
Data Retrieval ◽  
Motor Disorder ◽  
Childhood Disability ◽  
Chi Square ◽  
Nigeria Teaching Hospital ◽  
Type Motor ◽  
The University

Background: Cerebral palsy (CP) is a major cause of childhood disability. The objective of this study was to review the causes, types, complications, demographic and clinical characteristics of children with CP over a period of ten years as seen in the physiotherapy (PT) department of the University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, Nigeria.Methods: A retrospective study that reviewed a total of 497 case folders of children with CP. Ethical clearance was obtained from the Health Research Ethics Committee of the University of Nigeria Teaching Hospital, Enugu. The case records were randomly selected, a data retrieval form developed through a two-stage process was used to obtain the required information. Data was analyzed using descriptive statistics and Chi-square tests. Level of significance was set at 0.05.Results: Four hundred and ninety-seven cases of children with CP were reviewed. Birth asphyxia (29.9%) and jaundice (28.7%) were the leading causes of CP while spastic CP (56.7%) was the most common type. Motor disorder (67.0%) was the predominant clinical presentation. There was a significant association between type of CP and each of cause (X2 =28.303, p = 0.001), and duration of PT treatment (X2 =31.784, p < 0.0001).Conclusion: It was concluded that Birth asphyxia and jaundice are the major cause of CP in this environment. There is a significant association between type of CP and the cause of CP as well as the duration of PT treatment received.Keywords: Review; Cerebral Palsy; Hospital

scholarly journals Intrauterine cytomegalovirus infection: a possible risk for cerebral palsy and related to its clinical features, neuroimaging findings: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
H Xu ◽  
L Zhang ◽  
XY Xuan ◽  
M Zhu ◽  
J Tang ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Development ◽  
Clinical Symptoms ◽  
Control Group ◽  
Cmv Infection ◽  
Gross Motor ◽  
Rehabilitation Treatment ◽  
Intrauterine Exposure ◽  
Increased Risk ◽  
Spastic Quadriplegia

Abstract Background Abundant clinical evidences indicate that the increased risk of cerebral palsy (CP) may be associated with the intrauterine exposure to maternal infection. Cytomegalovirus (CMV) is a common cause of CP. However, little is known about the relationship between the intrauterine exposure of the fetus to CMV infection and CP. This study aims to explore the relationships between intrauterine CMV infection and clinical symptoms, classification, intelligence development and brain neuroimaging findings in children with CP. Methods In this study, 147 children with CP in recent 6 years were retrospectively analyzed (average age: 14.76 ± 3.07months; sex (M/F): 103/44). 148 children had CMV IgG and IgM positive sera identified by TORCH examination were selected as the control group (average age: 15.10 ± 3.21months; sex (M/F): 102/46), which also undergo the examination of CMV-DNA in urine. The age and sex of children in the control group were matched with those in the CP group. CMV-DNA in urine was detected by CMV fluorescence quantitative PCR, and t-test was performed to analyze the number of copies. For the CP group, standardized rehabilitation treatment was performed and the function of gross motor was evaluated by GMFM scale before and after treatment. The Gesell developmental scale (GDS) was used to assess the level of intellectual development. The classification of CP was conducted and the results of magnetic resonance imaging were analyzed. Finally, the correlations between the copy number of CMV-DNA and the clinical characteristics of children with CP were evaluated by the method of Pearson and Spearman correlation analysis. Results The level of CMV infection was negatively correlated with the developmental quotient (DQ) of children with CP. Negative association was found between the level of CMV infection and the level of the gross motor development. The level of CMV infection was positively related with the occurrence probability of spastic quadriplegia. However, no associations were found between the abnormalities of brain tissue and the number of CMV copies. Moreover, CMV infection might add the difficulty of the rehabilitation treatment. Conclusions CMV infection is a risk factor for the occurrence of CP in children. Pregnancy examination should be strengthened. Early detection and control of CMV infection may contribute to the rehabilitation of children with CP and reduce the disability and social burden.

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

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.

scholarly journals Acupuncture treatment on the motor area of the scalp for motor dysfunction in children with cerebral palsy: study protocol for a multicenter randomized controlled trial

2019 ◽  
Author(s):  
Jun Wang ◽  
Wei Shi ◽  
Dhiaedin Khiati ◽  
Bingpei Shi ◽  
Xiaojuan Shi ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Acupuncture Treatment ◽  
Controlled Trial ◽  
Scalp Acupuncture ◽  
Motor Dysfunction ◽  
Control Group ◽  
Rehabilitation Treatment ◽  
Randomized Controlled ◽  
Children With Cerebral Palsy ◽  
Function Measure

Abstract Background: Scalp acupuncture has been widely used as treatment for motor dysfunction in children with cerebral palsy in China. Previous studies have failed to provide high quality evidence to demonstrate the effectiveness of this treatment in children with cerebral palsy. No high quality randomized controlled trials on scalp acupuncture have been published. The aim of this study is to evaluate the effectiveness of jiao’ scalp acupuncture when combined with routine rehabilitation treatment versus routine rehabilitation treatment alone for motor dysfunction in children with cerebral palsy. Methods/design: This is a four-centred randomized controlled trial. One hundred cerebral palsy patients with motor dysfunction were enrolled. Patients will be allocated in a 1:1 ratio into either an acupuncture treatment group or a control group. Cerebral palsy patients in the control group will receive conventional rehabilitation treatment, whereas patients in the acupuncture group will receive a combination of scalp acupuncture and conventional rehabilitation treatment. Thirty-six treatment sessions will be performed over a 12-week period. The Gross Motor Function Measure and the Fine Motor Function Measure Scale will be assessed as the primary outcome measure. The Pediatric Evaluation of Disability Inventory, and the Cerebral Palsy Quality of Life Questionnaire for Children will be selected as secondary outcome measures. All assessments will be conducted at baseline, week 4 (treatment 12), week 8 ( treatment 24 ), week 12 (treatment 36), and week 24 (follow-up). Discussion: This is the first trial evaluating the efficacy and safety of scalp acupuncture as a treatment for motor dysfunction in children with cerebral palsy. The results of this trial are expected to provide relevant evidence demonstrating that scalp acupuncture can be used as an effective rehabilitation treatment method for improving motor dysfunction in children with cerebral palsy.

scholarly journals Scalp acupuncture treatment for motor dysfunction in children with cerebral palsy: study protocol for a multicenter randomized controlled Trial

2019 ◽  
Author(s):  
Jun Wang ◽  
Wei Shi ◽  
Dhiaedin Khiati ◽  
Bingpei Shi ◽  
Xiaojuan Shi ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Acupuncture Treatment ◽  
Controlled Trial ◽  
Scalp Acupuncture ◽  
Motor Dysfunction ◽  
Control Group ◽  
Rehabilitation Treatment ◽  
Randomized Controlled ◽  
Children With Cerebral Palsy ◽  
Function Measure

Abstract Abstract Background: Scalp acupuncture has shown a remarkable treatment efficacy on motor dysfunction in children with cerebral palsy, especially when performed on the motor area of Jiao’s scalp acupuncture, which is the most widely used treatment. However, previous studies have summarized that the clinical curative effect of acupuncture treatment for children with cerebral palsy remains uncertain. Meanwhile, no randomized controlled trials on scalp acupuncture have been performed. The aim of this study is to evaluate the efficacy and safety of scalp acupuncture for motor dysfunction in children with cerebral palsy. Methods/design: This is an assessor and analyst blinded, randomized controlled trial. One hundred cerebral palsy patients with motor dysfunction meeting the inclusion criteria will be allocated by a 1:1 ratio into either an acupuncture treatment group or a control group. Cerebral palsy in the control group will receive conventional rehabilitation treatment, whereas a combination of scalp acupuncture and conventional rehabilitation treatment will be applied to the acupuncture group. Thirty-six treatment sessions will be performed over a 12-week period. The Gross Motor Function Measure and the Fine Motor Function Measure Scale will be assessed as the primary outcome measure. The Pediatric Evaluation of Disability Inventory, and the Cerebral Palsy Quality of Life Questionnaire for Children will be selected as secondary outcome measurements. All assessments will be conducted at baseline, week 4 (treatment 12), week 8 (treatment 24), week 12 (treatment 36), and week 24 (follow-up). Discussion: This is the first trial evaluating the efficacy and safety of scalp acupuncture for motor dysfunction in children with cerebral palsy. The results of this trial are expected to provide relevant evidence demonstrating that scalp acupuncture can be used as an effective rehabilitation treatment method for improving motor dysfunction in children with cerebral palsy.

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