MedWorm: Cerebral Palsy

New Approach To Improving Treatment For Multiple Sclerosis And Other Conditions

Health News from Medical News Today — Tue, 21 May 2013 07:00:00 +0100

Working with lab mice models of multiple sclerosis (MS), UC Davis scientists have detected a novel molecular target for the design of drugs that could be safer and more effective than current FDA-approved medications against MS. The findings of the research study, published online in the journal EMBO Molecular Medicine could have therapeutic applications for MS as well as cerebral palsy and leukodystrophies, all disorders associated with loss of white matter, which is the brain tissue that carries information between nerve cells in the brain and the spinal cord... (Source: Health News from Medical News Today)

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Peri‐operative pain management in children with cerebral palsy: comparative efficacy of epidural vs systemic analgesia protocols

Pediatric Anesthesia — Sat, 18 May 2013 04:00:00 +0100

ConclusionEpidural analgesia resulted in substantial improvements in pain control and safety. The data supports the superiority of a multimodal analgesia approach centered on epidural analgesia. A similar protocol should be considered following simple laminectomies or procedures associated with lower‐extremity muscle spasm. (Source: Pediatric Anesthesia)

Dexamethasone induces apoptosis of progenitor cells in the subventricular zone and dentate gyrus of developing rat brain

Journal of Neuroscience Research — Fri, 17 May 2013 04:00:00 +0100

The objective of this study was to confirm whether dexamethasone causes apoptosis in different regions of the developing rat brain. On postnatal day 2, pups in each litter were randomly divided into the dexamethasone‐treated (n = 91) or vehicle‐treated (n = 92) groups. Rat pups in the dexamethasone group received tapering doses of dexamethasone on postnatal days 3–6 (0.5, 0.25, 0.125, and 0.06 mg/kg/day, respectively). Dexamethasone treatment significantly decreased the gain of body and brain weight and increased brain caspase‐3 activity, DNA fragments, terminal deoxynucleotidyl transferase‐mediated dUTP nick end labeling, and cleaved caspse‐3‐positive cells at 24 hr after treatment. Dexamethasone increased cleaved caspse‐3‐positive cells in the cortex, thalamus, ...

Author's reply in response to letter to editor Indian J Orthop 2012;46:602 titled "Utility of combined abduction angle for hip surveillance in children with cerebral palsy"

Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) — Fri, 10 May 2013 04:00:00 +0100

Akshay Divecha, Atul BhaskarIndian Journal of Orthopaedics 2013 47(3):319-319 (Source: Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1))

Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions Pain in young people with CP is highly prevalent. Because pain causes immediate distress and is associated with lower subjective well-being and reduced participation, clinicians should routinely assess pain. Clinical interventions to reduce pain should be implemented and evaluated. The efficacy of medical and therapeutic interventions causing pain should be re-examined to establish if their benefit justifies the pain and fear of pain that accompany them. (Source: Archives of Disease in Childhood)

Development of neuromotor functions in very low birth weight children from six to 10 years of age: patterns of change

Acta Paediatrica — Wed, 08 May 2013 04:00:00 +0100

ConclusionNeuromotor functions improve in some children potentially reflecting catch up of maturational delay. However, the majority of neuromotor functions remain abnormal in a significant proportion of VLBW children. (Source: Acta Paediatrica)

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Oropharyngeal Dysphagia and Gross Motor Skills in Children With Cerebral Palsy

PEDIATRICS — Wed, 01 May 2013 04:00:00 +0100

Oropharyngeal dysphagia (OPD) prevalence is 19-99%. OPD based on parent-report is associated with gross motor skills in children with cerebral palsy (CP), however this underestimates prevalence. Almost all children with severe CP have dysphagia; little is known about mild CP. The prevalence of directly assessed OPD in preschool children with CP is 85% (70% in GMFCS I; 100% in GMFCS V). OPD was prevalent even in mild CP. Gross motor functional capacity is strongly related to dysphagia severity and prevalence. (Read the full article) (Source: PEDIATRICS)

Structural Neuroplastic Change After Constraint-Induced Movement Therapy in Children With Cerebral Palsy

PEDIATRICS — Wed, 01 May 2013 04:00:00 +0100

Research from the present laboratory with adult stroke patients showed that structural neuroplastic changes are correlated with clinical improvements due to constraint-induced movement (CI) therapy. This pilot study evaluated whether comparable changes occur in children receiving CI therapy. Ten children (6 boys) with congenital hemiparesis (mean age: 3 years, 3 months) underwent MRI scans 3 weeks before, immediately before, and immediately after receiving 3 weeks of CI therapy. Longitudinal voxel-based morphometry was performed on MRI scans to determine gray matter change. In addition, the Pediatric Motor Activity Log-Revised was administered at these time points to assess arm use in daily life before and after treatment. Children exhibited large improvements after CI therapy in spontaneo...

Yoga with Cerebral Palsy: Ryan McGraw's Story

U.S. News - Health — Tue, 30 Apr 2013 13:25:00 +0100

Ryan McGraw wants to make it clear yoga is for people of all abilities. (Source: U.S. News - Health)

The unseen force that drives Ouija boards and fake bomb detectors

Guardian Unlimited Science — Sat, 27 Apr 2013 06:30:00 +0100

The bomb detectors sold by James McCormick exploit a well known psychological phenomenon that can fool the unwaryThis week businessman James McCormick was convicted of fraud after making £50m selling fake bomb detectors to security forces in Iraq and many other countries around the world. The detectors were said to work in a similar way to dowsing rods and were claimed to detect explosives up to one kilometre below the ground. Even more incredibly, they could apparently be used to locate drugs, people, elephants – even $100 bills. They didn't work and, in all probability, hundreds of lives were lost as a result of misplaced trust in the phony devices.In February, a similar device was reported to be capable of detecting liver disease in patients sitting several feet away. The claims were...

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Functional performance of children with cerebral palsy from high and low socioeconomic status

Revista Paulista de Pediatria — Fri, 26 Apr 2013 19:26:08 +0100

CONCLUSIONS: Socioeconomic status may influence the development process of children with cerebral palsy and must be considered as a risk factor in educational and health practices aimed at this population.OBJETIVO: Investigar la influencia del nivel socioeconómico sobre el desempeño funcional de niños con parálisis cerebral. MÉTODOS: Estudio transversal, con acercamiento cuantitativo. Se seleccionaron 49 niños con diagnóstico clínico de parálisis cerebral de una muestra de conveniencia, con edades entre tres y siete años y medio, de ambos sexos, clasificadas conforme al nivel de gravedad de parálisis cerebral, con base en el Sistema de Clasificación de la Función Motora Grosera. Los participantes fueron distribuidos en dos grupos de niveles socioeconómicos, alto y bajo, confo...

MMR catch-up campaign targets a million children

NHS News Feed — Thu, 25 Apr 2013 09:54:00 +0100

The MMR vaccine should be given to all unvaccinated schoolchildren aged from 10 to 16 as part of a national catch-up campaign, the government has announced. This MMR vaccination catch-up campaign aims to prevent further measles outbreaks, following recent outbreaks in Wales. Speaking at the launch of the national MMR catch-up programme, Professor David Salisbury, director of immunisation at the Department of Health, said that the outbreaks in Wales had been "a wake-up call for parents", and warned that "what is happening in Swansea could happen anywhere in England". Professor Salisbury urged parents to get their children vaccinated with MMR if they were unsure whether they had previously had the jab. Why is a catch-up programme required? A catch-up programme is ...

Intra-partum fever and cerebral palsy in Khartoum, Sudan

BMC Research Notes — Wed, 24 Apr 2013 04:00:00 +0100

Conclusions: Fever during labor is a significant risk factor for developing CP in children. Further efforts are required for labor management to prevent CP in this setting. (Source: BMC Research Notes)

Introduction of Hypothermia for Neonates with Perinatal Asphyxia in the Netherlands and Flanders.

Neonatology — Tue, 23 Apr 2013 04:00:00 +0100

Conclusions: The introduction of therapeutic hypothermia for neonates with perinatal asphyxia in the Netherlands and Flanders has been rapid and successful, with results similar to findings in the randomised controlled trials. PMID: 23615314 [PubMed - as supplied by publisher] (Source: Neonatology)

Pioneering operation offers two-year-old with cerebral palsy the chance to keep up with his twin brother

the Mail online | Health — Mon, 22 Apr 2013 15:31:15 +0100

Callum Buchanan (left), was diagnosed with Spastic Diplegia Cerebral Palsy when he was eight-months-old. He will have surgery in June to help him walk. (Source: the Mail online | Health)

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Development of neuromotor functions in very low birth weight children from six to ten years of age: patterns of change

Acta Paediatrica — Fri, 19 Apr 2013 14:24:06 +0100

Magnesium Sulfate Increases Intracellular Magnesium Reducing Inflammatory Cytokine Release in Neonates

American Journal of Reproductive Immunology — Wed, 17 Apr 2013 04:00:00 +0100

ConclusionMgSO4 increases intracellular magnesium, reducing inflammatory cytokine production and release, potentially elucidating the mechanism by which MgSO4 prevents cerebral palsy, eclampsia, and preterm birth. (Source: American Journal of Reproductive Immunology)

Elevated temperature and 6‐ to 7‐year outcome of neonatal encephalopathy

Annals of Neurology — Wed, 17 Apr 2013 04:00:00 +0100

ObjectiveA study was undertaken to determine whether higher temperature after hypoxia–ischemia is associated with death or intelligence quotient (IQ)<70 at 6 to 7 years among infants treated with intensive care without hypothermia. MethodsControl infants (noncooled, n=106) of the National Institute of Child Health and Human Development Neonatal Research Network hypothermia trial had serial esophageal and skin temperatures over 72 hours. Each infant's temperature was ranked to derive an average of the upper and lower quartile, and median of each site. Temperatures were used in logistic regressions to determine adjusted associations with death or IQ<70 at 6 to 7 years. Secondary outcomes were death, IQ<70, and moderate/severe cerebral palsy (CP). IQ and motor function were assesse...

New Technique Holds Promise For The Treatment Of Multiple Sclerosis And Cerebral Palsy

Health News from Medical News Today — Mon, 15 Apr 2013 09:00:00 +0100

Researchers at Case Western Reserve School of Medicine have discovered a technique that directly converts skin cells to the type of brain cells destroyed in patients with multiple sclerosis, cerebral palsy and other so-called myelin disorders. This discovery appears in the journal Nature Biotechnology. This breakthrough now enables "on demand" production of myelinating cells, which provide a vital sheath of insulation that protects neurons and enables the delivery of brain impulses to the rest of the body... (Source: Health News from Medical News Today)

Deficits in anticipatory inhibition of postural muscle activity associated with load release while standing in individuals with spastic diplegic cerebral palsy

Journal of Neurophysiology — Mon, 15 Apr 2013 04:00:00 +0100

This study aimed to determine whether individuals with spastic diplegic cerebral palsy (SDCP) have deficits in anticipatory inhibition of postural muscle activity. Nine individuals with SDCP (SDCP group, 3 female and 6 male, 13–24 yr of age) and nine age- and sex-matched individuals without disability (control group) participated in this study. Participants stood on a force platform, which was used to measure the position of the center of pressure (CoP), while holding a light or heavy load in front of their bodies. They then released the load by abducting both shoulders. Surface electromyograms were recorded from the rectus abdominis, erector spinae (ES), rectus femoris (RF), medial hamstring (MH), tibialis anterior (TA), and gastrocnemius (GcM) muscles. In the control group, anticip...

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Ordinary skin cells morphed into functional brain cells

EurekAlert! - Biology — Sun, 14 Apr 2013 04:00:00 +0100

(Case Western Reserve University) Researchers at Case Western Reserve School of Medicine have discovered a technique that directly converts skin cells to the type of brain cells destroyed in patients with multiple sclerosis, cerebral palsy and other so-called myelin disorders. (Source: EurekAlert! - Biology)

Sex differences in cerebral palsy incidence and functional ability: a total population study

Acta Paediatrica — Fri, 12 Apr 2013 04:00:00 +0100

ConclusionNo equalization was detected in the incidence of CP between girls and boys during recent years in this total population. We could not confirm any consistent sex difference in motor function levels. Male sex is a risk factor for CP. (Source: Acta Paediatrica)

Vitamin D Status in Tasmanian Children with Cerebral Palsy

Journal of Paediatrics and Child Health — Thu, 11 Apr 2013 04:00:00 +0100

(Source: Journal of Paediatrics and Child Health)

Effect of treadmill gait training on static and functional balance in children with cerebral palsy: a randomized controlled trial

Revista Brasileira de Fisioterapia — Thu, 11 Apr 2013 03:10:16 +0100

CONCLUSIONS: Treadmill training had a greater effect on functional balance and mediolateral oscillation in comparison to over ground gait training in children with cerebral palsy. Trial registration: RBR-5v3kg9.(Brazilian Registry of Clinical Trials). (Source: Revista Brasileira de Fisioterapia)

Neurodevelopmental outcomes of extremely premature infants conceived after assisted conception: a population based cohort study

Archives of Disease in Childhood - Fetal and Neonatal Edition — Wed, 10 Apr 2013 04:00:00 +0100

Conclusions AC is associated with adverse neurodevelopmental outcome among high risk infants born at 22–26 weeks’ gestation. This finding warrants additional exploration. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)

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The longer-term health outcomes for children born as a result of IVF treatment. Part II-Mental health and development outcomes

Human Reproduction Update — Tue, 09 Apr 2013 04:00:00 +0100

CONCLUSIONS In general, the longer-term mental and emotional health outcome for children born from IVF treatment is reassuring, and is very similar to that of naturally conceived children; however, further studies are required to explore any association with depression, and its causality in more detail. (Source: Human Reproduction Update)

Magnesium sulphate at 30 to 34 weeks' gestational age: neuroprotection trial (MAGENTA) - study protocol

BMC Pregnancy and Childbirth - Latest articles — Tue, 09 Apr 2013 04:00:00 +0100

DiscussionGiven the magnitude of the protective effect in the systematic review, the ongoing uncertainty about benefits at later gestational ages, the serious health and cost consequences of cerebral palsy for the child, family and society, a trial of magnesium sulphate for women at risk of preterm birth between 30 to 34 weeks' gestation is both important and relevant for clinical practice globally.Trial registration: Australian New Zealand Clinical Trials Registry - ACTRN12611000491965 (Source: BMC Pregnancy and Childbirth - Latest articles)

Magnesium sulphate at 30 to 34 weeks¿ gestational age: neuroprotection trial (MAGENTA) - study protocol

BMC Pregnancy and Childbirth - Latest articles — Tue, 09 Apr 2013 04:00:00 +0100

DiscussionGiven the magnitude of the protective effect in the systematic review, the ongoing uncertainty about benefits at later gestational ages, the serious health and cost consequences of cerebral palsy for the child, family and society, a trial of magnesium sulphate for women at risk of preterm birth between 30 to 34 weeks’ gestation is both important and relevant for clinical practice globally.Trial registrationAustralian New Zealand Clinical Trials Registry - ACTRN12611000491965 (Source: BMC Pregnancy and Childbirth - Latest articles)

Differential Adaptations of Muscle Architecture to High-Velocity Versus Traditional Strength Training in Cerebral Palsy

Neurorehabilitation and Neural Repair — Mon, 08 Apr 2013 04:00:00 +0100

Conclusions. Muscle architecture in CP is capable of adapting differentially to the training stimulus. VT was equally effective as traditional ST in improving isokinetic strength of the knee extensors but more effective in improving velocity of movement, muscle power, and walking performance. Differences may be partially attributed to specificity of training effects on muscle architecture, such as the increase in fascicle length after VT. Strengthening interventions involving higher velocity movements should be incorporated into clinical practice. (Source: Neurorehabilitation and Neural Repair)

Muscle size, activation and coactivation in adults with cerebral palsy

Muscle and Nerve — Fri, 05 Apr 2013 04:00:00 +0100

Discussion. This demonstrates that in individuals with CP, muscle weakness in the paretic limb is attributed primarily to impaired neural activation and, to a lesser degree, ACSA. © 2013 Wiley Periodicals, Inc. (Source: Muscle and Nerve)

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Assessing salivary osmolality as a caries risk indicator in cerebral palsy children

International Journal of Paediatric Dentistry — Thu, 04 Apr 2013 04:00:00 +0100

ConclusionOsmolality exhibited a stronger association with caries occurrence than did salivary flow rate. This parameter, therefore, could be a potential caries risk indicator for spastic cerebral palsy children. (Source: International Journal of Paediatric Dentistry)

Labor induction by transcervical balloon catheter and cerebral palsy associated with umbilical cord prolapse

Journal of Obstetrics and Gynaecology Research — Wed, 03 Apr 2013 04:00:00 +0100

ConclusionUse of TCBC with a saline volume ≥ 80 mL was a significant risk factor for UCP‐CP; however, the absolute risk of UCP‐CP was estimated to be very low, approximately one in 7875 TCBC users. (Source: Journal of Obstetrics and Gynaecology Research)

Congenital Cytomegalovirus Infection: New Prospects for Prevention and Therapy

Pediatric Clinics of North America — Mon, 01 Apr 2013 04:00:00 +0100

Cytomegalovirus is the commonest congenital viral infection in the developed world, with an overall prevalence of approximately 0.6%. Approximately 10% of congenitally infected infants have signs and symptoms of disease at birth, and these symptomatic infants have a substantial risk of subsequent neurologic sequelae. These include sensorineural hearing loss, mental retardation, microcephaly, development delay, seizure disorders, and cerebral palsy. Antiviral therapy for children with symptomatic congenital cytomegalovirus infection is effective at reducing the risk of long-term disabilities and should be offered to families with affected newborns. An effective preconceptual vaccine against CMV could protect against long-term neurologic sequelae and other disabilities. (Source: Pediatric Cl...

Tongue base suspension in children with cerebral palsy and obstructive sleep apnea

International Journal of Pediatric Otorhinolaryngology — Mon, 01 Apr 2013 04:00:00 +0100

Conclusion: This study suggests that concomitant surgical approaches for OSA in children with CP are effective. Moderate to severe OSA in this population may safely benefit from the added technique of tongue base suspension. (Source: International Journal of Pediatric Otorhinolaryngology)

Limitations on the developing preterm brain: impact of periventricular white matter lesions on brain connectivity and cognition

Brain — Mon, 01 Apr 2013 04:00:00 +0100

Brain lesions to the white matter in peritrigonal regions, periventricular leukomalacia, in children who were born prematurely represent an important model for studying limitations on brain development. The lesional pattern is of early origin and bilateral, that constrains the compensatory potential of the brain. We suggest that (i) topography and severity of periventricular lesions may have a long-term predictive value for cognitive and social capabilities in preterm birth survivors; and (ii) periventricular lesions may impact cognitive and social functions by affecting brain connectivity, and thereby, the dissociable neural networks underpinning these functions. A further pathway to explore is the relationship between cerebral palsy and cognitive outcome. Restrictions caused by motor dis...

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Clinical Outcomes of Sacral Neuromodulation in Patients With Neurologic Conditions

Urology — Mon, 01 Apr 2013 04:00:00 +0100

Conclusion: Patients with neurogenic bladder dysfunction experience benefits after neuromodulation similar to the benefits experienced by those without coexisting neurologic conditions. (Source: Urology)

Antenatal and intrapartum risk factors for cerebral palsy in term and near-term newborns.

Archives of Iranian Medicine — Mon, 01 Apr 2013 04:00:00 +0100

CONCLUSIONS: Several maternal, antenatal and intrapartum factors increase the risk for CP. Identifying and avoiding risks for CP may lead to lower infant neurologic morbidity. PMID: 23496363 [PubMed - in process] (Source: Archives of Iranian Medicine)

Sex differences in cerebral palsy incidence and functional ability – a total population study

Acta Paediatrica — Thu, 28 Mar 2013 04:00:00 +0100

Brain Damage Can Be Averted In Oxygen-Starved Babies With Low-Cost 'Cooling Cure'

Health News from Medical News Today — Mon, 25 Mar 2013 08:00:00 +0100

When babies are deprived of oxygen before birth, brain damage and disorders such as cerebral palsy can occur. Extended cooling can prevent brain injuries, but this treatment is not always available in developing nations where advanced medical care is scarce. To address this need, Johns Hopkins undergraduates have devised a low-tech $40 unit to provide protective cooling in the absence of modern hospital equipment that can cost $12,000... (Source: Health News from Medical News Today)

Effectiveness of robot-assisted therapy on ankle rehabilitation -- a systematic review

Journal of NeuroEngineering and Rehabilitation — Thu, 21 Mar 2013 04:00:00 +0100

Conclusion: All the selected studies showed improvements in terms of ankle performance or gait function after a period of robot-assisted ankle rehabilitation training. The most effective robot-assisted intervention cannot be determined due to the lack of universal evaluation criteria for various devices and control strategies. Future research into the effects of robot-assisted ankle rehabilitation should be carried out based on universal evaluation criteria, which could determine the most effective method of intervention. It is also essential to conduct trials to analyse the differences among different devices or control strategies. (Source: Journal of NeuroEngineering and Rehabilitation)

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Finding a Partner for Children’s Health in Centralized Care

RWJF News Digest - Quality/Equality — Thu, 14 Mar 2013 04:00:00 +0100

It takes a team of medical specialists to care for Anna Barkhuizen, a 9-year-old with epilepsy, cerebral palsy and significant developmental delays. (Source: RWJF News Digest - Quality/Equality)

Signaling Molecule May Help Stem Cells Focus On Making Bone Despite Age, Disease

Health News from Medical News Today — Tue, 12 Mar 2013 08:00:00 +0100

A signaling molecule that helps stem cells survive in the naturally low-oxygen environment inside the bone marrow may hold clues to helping the cells survive when the going gets worse with age and disease, researchers report. They hope the findings, reported in PLOS ONE, will result in better therapies to prevent bone loss in aging and enhance success of stem cell transplants for a wide variety of conditions from heart disease to cerebral palsy and cancer... (Source: Health News from Medical News Today)

Helping Stem Cells To Focus On Making Bone Despite Age, Disease

Health News from Medical News Today — Mon, 11 Mar 2013 08:00:00 +0100

How can we diagnose pure opium overdose cases in retrospective medical chart reviews?

The American Journal of Emergency Medicine — Thu, 07 Mar 2013 05:00:00 +0100

Discussion.” Regarding the use of toxicology screening for exclusion of other substances of abuse, it should be mentioned that each drug of abuse screening test may exhibit a different cross-reactivity profile. Depending on this profile, drug abusers may have false-positive or false-negative results . Furthermore, in drug screens, some substances of abuse cross-react with other medications . Therefore, with these limitations, the results of such screening tests may sometimes create confusion except for when they are confirmed by retesting using a nonimmunologic test . In addition, the major problem with opiates is that several opiates are metabolized into each other. For example, morphine is a metabolite of codeine and heroin as well as a constituent of opium. So, heroin exposure cannot ...

Quality of life and mental health among parents of children with cerebral palsy: the influence of self‐efficacy and coping strategies

Journal of Clinical Nursing — Wed, 06 Mar 2013 05:00:00 +0100

ConclusionsQuality of life and mental health can be affected in caregivers of children with CP. Personal resources like self‐efficacy also need attention as they can help in the understanding of the differences in these outcomes and the design of effective interventions. Relevance of clinical practiceSelf‐efficacy should be a key element in interventions addressed to parents of children with CP to elicit a process of empowerment that can improve the well‐being of the family as a whole. (Source: Journal of Clinical Nursing)

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Predictive value of neonatal brain MRI on the neurodevelopmental outcome of preterm infants by 5 years of age

Acta Paediatrica — Mon, 04 Mar 2013 05:00:00 +0100

ConclusionThe MRI of the brain at term equivalent age may be valuable in predicting neurodevelopmental outcome in preterm infants by 5 years of age. The findings should always be interpreted alongside the clinical information of the infant. Furthermore, MRI should not replace a long‐term clinical follow‐up for very preterm infants. (Source: Acta Paediatrica)

Serious Air Leak Syndrome Complicating High-Flow Nasal Cannula Therapy: A Report of 3 Cases

PEDIATRICS — Fri, 01 Mar 2013 05:00:00 +0100

Despite the absence of clinical safety data, heated, humidified high-flow nasal cannula (HHFNC) therapy is increasingly being used as an alternative to positive-pressure ventilation in pediatrics. This use of HHFNC is "off label" because the US Food and Drug Administration’s approval for these devices was only for air humidification and not as a modality to provide positive distending pressure. For the first time we describe 3 cases who developed serious air leaks related to HHFNC therapy. The first child was a previously healthy 2-month-old male infant with respiratory syncytial virus bronchiolitis who developed a right pneumothorax on day 5 of his illness at 8 liters per minute (lpm). He subsequently required intubation and ventilation for 14 days. The second case involved an other...

Group constraint-induced movement therapy for children with hemiplegic cerebral palsy: a pilot study.

The American Journal of Occupational Therapy — Fri, 01 Mar 2013 05:00:00 +0100

CONCLUSION. This preliminary study revealed that group-based CIMT for children with hemiplegic cerebral palsy may be a feasible and effective alternative to individual CIMT in clinical practice. PMID: 23433275 [PubMed - in process] (Source: The American Journal of Occupational Therapy)

Robotics and Gaming to Improve Ankle Strength, Motor Control, and Function in Children With Cerebral Palsy—A Case Study Series

IEE Transactions on Neural Systems and Rehabilitation Engineering — Fri, 01 Mar 2013 05:00:00 +0100

The objective of this study was to investigate the feasibility of game-based robotic training of the ankle in children with cerebral palsy (CP). The design was a case study, 12 weeks intervention, with no follow-up. The setting was a university research laboratory. The participants were a referred sample of three children with cerebral palsy, age 7–12, all male. All completed the intervention. Participants trained on the Rutgers Ankle CP system for 36 rehabilitation sessions (12 weeks, three times/week), playing two custom virtual reality games. The games were played while participants were seated, and trained one ankle at-a-time for strength, motor control, and coordination. The primary study outcome measures were for impairment (DF/PF torques, DF initial contact angle and gait spe...

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Postural Responses of Adults With Cerebral Palsy to Combined Base of Support and Visual Field Rotation

IEE Transactions on Neural Systems and Rehabilitation Engineering — Fri, 01 Mar 2013 05:00:00 +0100

We employed a virtual environment to examine the postural behaviors of adults with cerebral palsy (CP). Four adults with CP (22–32 years) and nine healthy adults (21–27 years) were tested with a Rod and Frame protocol. They then stood quietly on a platform within a three-wall virtual environment. The platform was either kept stationary or tilted 3 $^{circ}$ into dorsiflexion in the dark or with pitch up and down visual field rotations at 30 $^{circ}$/s and 45 $^{circ}$/s. While the visual field rotated, the platform was held tilted for 30 s and then slowly returned to a neutral position over 30 s. Center of pressure (CoP) was recorded and center of mass (CoM) as well as trunk and ankle angles were calculated. Electromyography (EMG) responses of the ankle and the hip muscles w...

Feasibility of Gestural Feedback Treatment for Upper Extremity Movement in Children With Cerebral Palsy

IEE Transactions on Neural Systems and Rehabilitation Engineering — Fri, 01 Mar 2013 05:00:00 +0100

External feedback of performance is an important component of therapy, especially for children with impairments due to cerebral palsy because they lack intrinsic experience of “good movements” to compare effort and determine performance outcomes. A robotic therapy system was developed to provide feedback for specific upper extremity movements (gestures) which are therapeutically desirable. The purpose of this study was to compare changes in forearm supination/pronation or wrist extension/flexion motion following conventional therapy and gestural robotic feedback therapy intervention. Six subjects with cerebral palsy (ages 5–18, GMFCS level IV—three subjects, level III—one subject, and level I—two subjects) participated in a blinded crossover design...

Speaker transfer in children's peer conversation: completing communication-aid-mediated contributions.

Augmentative and Alternative Communication — Fri, 01 Mar 2013 05:00:00 +0100

Authors: Clarke M, Bloch S, Wilkinson R Abstract Managing the exchange of speakers from one person to another effectively is a key issue for participants in everyday conversational interaction. Speakers use a range of resources to indicate, in advance, when their turn will come to an end, and listeners attend to such signals in order to know when they might legitimately speak. Using the principles and findings from conversation analysis, this paper examines features of speaker transfer in a conversation between a boy with cerebral palsy who has been provided with a voice-output communication aid (VOCA), and a peer without physical or communication difficulties. Specifically, the analysis focuses on turn exchange, where a VOCA-mediated contribution approach completion, and the child...

Participants' dynamic orientation to folder navigation when using a VOCA with a touch screen in talk-in-interaction.

Augmentative and Alternative Communication — Fri, 01 Mar 2013 05:00:00 +0100

Authors: Norén N, Svensson E, Telford J Abstract This paper reports on a conversation-analysis case study of interaction between a child with cerebral palsy and an adult using a computer-based voice output communication aid (VOCA) device with a touch-sensitive screen-input system. Data was collected from video recordings of everyday activities at school. The public nature of the VOCA-mediated turn construction process (hand movements towards the screen, on-screen folder navigation, synthetic speech) displays the projection of the turn under way and its possible continuations. The adult interlocutor orients to such projections when contributing to the topic of the ongoing turn and when initiating repair on its topical development. Contributing may activate the AAC user's further in...

Assessment of mastication in healthy children and children with cerebral palsy: a validity and consistency study

Journal of Oral Rehabilitation — Thu, 28 Feb 2013 17:47:00 +0100

This study describes the process of item definition and item selection and reports the content validity, reproducibility and consistency of the instrument. In the developmental phase, 15 experienced speech therapists assessed item relevance and descriptions over three Delphi rounds. Potential items were selected based on the results from a literature review. At the initial Delphi round, 17 potential items were included. After three Delphi rounds, 14 items that regarded as providing distinctive value in assessment of mastication (consensus >75%) were included in the Mastication Observation and Evaluation instrument. To test item reproducibility and consistency, two experts and five students evaluated video recordings of 20 children (10 children with cerebral palsy aged 29–65 months an...

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Oral myiasis: a case report

Special Care in Dentistry — Thu, 28 Feb 2013 05:00:00 +0100

We present a case report of oral myiasis in a 22‐year‐old male with cerebral palsy and severe mental retardation treated successfully by manual removal of the larvae by topical application of turpentine oil and oral systemic therapy with ivermectin. (Source: Special Care in Dentistry)

A study on the psychosocial behavior of the disabled children in Loni, Maharashtra

Indian Journal of Medical Sciences — Wed, 27 Feb 2013 05:00:00 +0100

Conclusion: The result of the study necessitates organizing counseling to disabled children and parents, community based rehabilitation program and integration of disabled into the main stream education to reduce the psychosocial behavioral changes. (Source: Indian Journal of Medical Sciences)

Familial KANK1 deletion that does not follow expected imprinting pattern.

European Journal of Medical Genetics — Wed, 27 Feb 2013 05:00:00 +0100

We present a family in which the proband's phenotype, including autism spectrum disorder, motor delay, and intellectual disability, is consistent with this previous report of KANK1 deletions. However, a paternally inherited deletion in the proband's unaffected sibling did not support maternal imprinting. This family raises consideration of further complexity of the KANK1 locus, including variable expressivity, incomplete penetrance, and the additive effects of additional genomic variants or the potential benign nature of inherited copy number variations (CNVs). However, when considered with the previous publication, our case also suggests that KANK1 may be subject to random monoallelic expression as a possible mode of inheritance. It is also important to consider that KANK1 has two alterna...

The impact of complementary and alternative medicine on hip development in children with cerebral palsy

Developmental Medicine and Child Neurology — Tue, 26 Feb 2013 07:51:57 +0100

This study aimed to evaluate the effect of complementary and alternative medicine (CAM) approaches on long‐term surgical requirements, and clinical and radiographic outcomes for children with cerebral palsy and hip displacement. MethodTwenty‐three children with cerebral palsy and early hip displacement who were offered preventive hip surgery and whose parents declined in favour of CAM approaches were followed (13 males, 10 females; mean age 13y 9mo [SD 3y 1mo]; mean length of follow‐up 10y 2mo [SD 2y 11mo]; 17 with spastic quadriplegia, two with spastic triplegia, and four with spastic diplegia; three with gross motor function classified at Gross Motor Function Classification System [GMFCS] level II, four at level III, six at level IV, and 10 at level V). Principal outcome measures w...

Characteristics of inflammatory bowel disease with an onset before eight years of age: A multicenter epidemiological survey in Japan

Journal of Gastroenterology and Hepatology — Tue, 26 Feb 2013 05:00:00 +0100

ConclusionOur results suggest that, in Japan, the pathogenesis of IBD in infants and children may differ from that in Western countries, and that the characteristics of early childhood‐onset IBD are distinct from those of school age‐onset IBD. (Source: Journal of Gastroenterology and Hepatology)

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Low birthweight babies catch up by puberty

NHS News Feed — Mon, 25 Feb 2013 10:04:00 +0100

Conclusion Overall, this study provides some evidence that babies considered to have growth problems in the first nine months of life have similar growth measurements at the age of 13 years when compared to baby’s considered not to have growth problems in the first nine months of life. This study has some limitations worth noting that may limit the overall validity of its findings: The researchers report there was a large amount of missing data, with some outcome measurements only available for 44% of those measured at the age of 13 years. Reassuringly however, there was no difference between missing data between groups. No data is reported for growth up the age of 18, so findings cannot be translated to children above the age of 13, when children are still growing. It is also no...

Sleep assessment of children with cerebral palsy: Using validated sleep questionnaire

Annals of Indian Academy of Neurology — Mon, 25 Feb 2013 05:00:00 +0100

Conclusion: Results of our study indicate that CP children have high incidence of sleep problem in both pre-school and school age groups. (Source: Annals of Indian Academy of Neurology)

Prophylactic maternal N-acetylcysteine in rats prevents maternal inflammation–induced offspring cerebral injury shown on magnetic resonance imaging

American Journal of Obstetrics and Gynecology — Fri, 22 Feb 2013 03:46:39 +0100

Conclusion: Maternal NAC treatment significantly reduced evidence of neonatal brain injury associated with maternal LPS. These studies suggest that maternal NAC therapy may be effective in human deliveries associated with maternal/fetal inflammation. (Source: American Journal of Obstetrics and Gynecology)

The effect of therapeutic horseback riding on balance in community-dwelling older adults a pilot study - Homnick TD, Henning KM, Swain CV, Homnick DN.

SafetyLit: All (Unduplicated) — Thu, 21 Feb 2013 05:00:49 +0100

Equine assisted activities (hippotherapy and therapeutic riding) improve balance in patients with disabilities such as cerebral palsy, but have not been systematically studied in older adults, at risk of falls due to balance deficits. We conducted a 10-wee... (Source: SafetyLit: All (Unduplicated))

Pain Catastrophizing in Youths With Physical Disabilities and Chronic Pain

Journal of Pediatric Psychology — Thu, 21 Feb 2013 05:00:00 +0100

Conclusions The study extends previous findings of significant associations between catastrophizing and both pain intensity and psychological adjustment to samples of youths with chronic pain and disabilities not previously examined. Further research that examines the causal association between catastrophizing and outcomes in youths with chronic pain and physical disability is warranted. (Source: Journal of Pediatric Psychology)

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Upper Extremity Spasticity in Children With Cerebral Palsy: A Randomized, Double-Blind, Placebo-Controlled Study of the Short-Term Outcomes of Treatment With Botulinum A Toxin

The Journal of Hand Surgery — Thu, 21 Feb 2013 04:17:46 +0100

Conclusions: Children receiving BoNT-A injections demonstrated clinically meaningful short-term improvements in upper extremity function. Injections were well tolerated and safe. In contrast to other studies, study participants underwent multiple injection sessions based on their individual spasticity patterns. Type of study/level of evidence: Therapeutic I. (Source: The Journal of Hand Surgery)

Muscle Plasticity and Ankle Control After Repetitive Use of a Functional Electrical Stimulation Device for Foot Drop in Cerebral Palsy

Neurorehabilitation and Neural Repair — Wed, 20 Feb 2013 05:00:00 +0100

Conclusions. This FES device produced evidence of use-dependent muscle plasticity in CP. Permanent improvements in voluntary ankle control after repetitive stimulation were not demonstrated. (Source: Neurorehabilitation and Neural Repair)

Non‐infectious risk factors for different types of cerebral palsy in term‐born babies: a population‐based, case–control study

BJOG: An International Journal of Obstetrics and Gynaecology — Tue, 19 Feb 2013 05:00:00 +0100

ConclusionsThe risk factor pattern differed by CP subtype. The presented risk factors may be useful indicators for identifying children at risk of developing CP, and helpful for targeting individuals for early intervention programmes. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

Non-infectious risk factors for different types of cerebral palsy in term-born babies: a population-based, case-control study.

BJOG : An International Journal of Obstetrics and Gynaecology — Tue, 19 Feb 2013 05:00:00 +0100

CONCLUSIONS: The risk factor pattern differed by CP subtype. The presented risk factors may be useful indicators for identifying children at risk of developing CP, and helpful for targeting individuals for early intervention programmes. PMID: 23418811 [PubMed - as supplied by publisher] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)

Clinical Characteristics and Treatment Strategies in Refractory Convulsive Status Epilepticus in Children: Results from the Pediatric Status Epilepticus Research Group (pSERG) (P03.012)

Neurology — Thu, 14 Feb 2013 05:00:00 +0100

CONCLUSIONS: In our series, RCSE was more frequently intermittent, and of undetermined etiology. Although AEDs used followed published guidelines, the period between administration of benzodiazepines and non-benzodiazepines was prolonged.Supported by: Epilepsy Foundation of America.Disclosure: Dr. Sánchez Fernández has nothing to disclose. Dr. Abend has nothing to disclose. Dr. Agadi has nothing to disclose. Dr. An has nothing to disclose. Dr. Arya has nothing to disclose. Dr. Carpenter has nothing to disclose. Dr. Chapman has nothing to disclose. Dr. Gaillard has received personal compensation for activities with King Pharmaceutical as a participant on an advisory board. Dr. Gaillard has received research support from Questcor. Dr. Glauser has received personal compensation ...

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Phenotypic Differences in Identical Twins with Mutated WDR45, a Newly Discovered X-Chromosome Gene Mutation Which Causes Neurodegeneration with Brain Iron Accumulation (NBIA) (P03.052)

Neurology — Thu, 14 Feb 2013 05:00:00 +0100

CONCLUSIONS: (1) When confronted with major phenotypic discordance in monozygotic twins, in utero and perinatal insults are important suspects, especially in monochorionic/diamniotic situations. (2) Patterns of X-inactivation are likely to influence penetrance and expressivity of the BPAN phenotype.Disclosure: Dr. Harik has nothing to disclose. Dr. Dandu has nothing to disclose. Dr. Angtuaco has nothing to disclose. Dr. Hayflick has nothing to disclose. (Source: Neurology)

Effect of whole body vibration training on mobility in children with cerebral palsy: a randomized controlled experimenter-blinded study.

Clinical Rehabilitation — Thu, 14 Feb 2013 05:00:00 +0100

Conclusions:These findings suggest that whole body vibration may improve mobility in children with cerebral palsy, probably through a positive effect on the leg muscles. PMID: 23411791 [PubMed - as supplied by publisher] (Source: Clinical Rehabilitation)

Effects of Deep Brain Stimulation in Dyskinetic Cerebral Palsy: A Meta‐analysis

Movement Disorders — Wed, 13 Feb 2013 05:00:00 +0100

ABSTRACT Secondary dystonia encompasses a heterogeneous group with different etiologies. Cerebral palsy is the most common cause. Pharmacological treatment is often unsatisfactory. There are only limited data on the therapeutic outcomes of deep brain stimulation in dyskinetic cerebral palsy. The published literature regarding deep brain stimulation and secondary dystonia was reviewed in a meta‐analysis to reevaluate the effect on cerebral palsy. The Burke‐Fahn‐Marsden Dystonia Rating Scale movement score was chosen as the primary outcome measure. Outcome over time was evaluated and summarized by mixed‐model repeated‐measures analysis, paired Student t test, and Pearson's correlation coefficient. Twenty articles comprising 68 patients with cerebral palsy undergoing deep brain stim...

Association of Interleukin 6 gene polymorphisms with genetic susceptibilities to spastic tetraplegia in males: A case-control study.

Cytokine — Wed, 13 Feb 2013 05:00:00 +0100

CONCLUSION: Genetic variation of the IL6 gene may influence susceptibility to spastic tetraplegia in males and its role in cerebral palsy deserves further evaluation in a large-scale and well-designed study. PMID: 23415255 [PubMed - as supplied by publisher] (Source: Cytokine)

Factors contributing to limited or non-use in the cochlear implant systems in children: 11 years experience

International Journal of Pediatric Otorhinolaryngology — Mon, 11 Feb 2013 21:17:28 +0100

Conclusions: It should always be considered in patients with additional factors like autism, mental-motor retardation, learning disabilities that they will show limited development from cochlear implantation. These patients are potential limited/non-users. These patients require unique rehabilitation and provide high family and educational interest. (Source: International Journal of Pediatric Otorhinolaryngology)

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Foetal umbilical artery Doppler in small preterms: (IQ) Neurocognitive outcome at 5 years of age

Acta Paediatrica — Mon, 11 Feb 2013 05:00:00 +0100

ConclusionAbsent or reversed end‐diastolic flow in the umbilical artery (AREDF) was associated with increased risk of SCH in extremely preterm infants (GA <28 weeks). (Source: Acta Paediatrica)

The influence of gait speed on co-activation in unilateral spastic cerebral palsy children

Clinical Biomechanics — Mon, 11 Feb 2013 05:00:00 +0100

This study aimed to assess the pathological component of co-activation in children with unilateral cerebral palsy.Methods: 10 children with unilateral cerebral palsy and 10 typically developing children walked at spontaneous, slow and fast speeds. The spatio-temporal parameters and electromyographic activity of the rectus femoris, vastus medialis, semi-tendinosus, tibialis anterior and soleus of both lower limbs were recorded. A co-activation index was computed from the EMG envelopes. A mixed linear model was used to assess the effect of walking speed on the index of the antagonistic muscle couples (rectus femoris/semi-tendinosus, vastus medialis/semi-tendinosus and tibialis anterior/soleus) in the different limbs.Findings: A greater effect of walking speed on co-activation was found in th...

Long‐term survival of children with cerebral palsy in Okinawa, Japan

Developmental Medicine and Child Neurology — Sat, 09 Feb 2013 05:00:00 +0100

This study included 580 children with CP (332 males, 248 females). In the cohort, 119 (20.5%) children were classified in Gross Motor Function Classification System (GMFCS) level I, 65 (11.2%) were classified in level II, 40 (6.9%) in level III, 189 (32.6%) in level IV, 166 (28.6%) in level V and GMFCS level was unknown for one. Of the 34 children who died, 29 were classified in GMFCS level V and GMFCS level was unknown for one. Mean age at start of follow‐up was 24.5 months (SD 2.6mo); mean length of follow‐up was 8 years 8 months (standard error of the mean 0.214y). The 5 year‐ and 18‐year survival percentages of the entire cohort were 98% and 89% respectively. In children with CP, significantly lower survival rates were associated with multiple factors, including a birth...

Predictive value of neonatal brain MRI on the neurodevelopmental outcome of preterm infants by 5 years of age

Acta Paediatrica — Thu, 07 Feb 2013 05:00:00 +0100

The effects of virtual reality game training on trunk to pelvis coupling in a child with cerebral palsy

Journal of NeuroEngineering and Rehabilitation — Thu, 07 Feb 2013 05:00:00 +0100

Conclusions: Increasing coupling appears to be an initial compensation mechanism using the better controlled trunk to drive rotation of the pelvis. Co-contractions causing increased coupling are expected to reduce over longer exposure to training. The control scheme of the training game can be set to facilitate de-coupling of pelvic movements from the trunk. Using large ranges of pelvic rotation required more coupling suggesting that training of selective pelvic movements is likely to be more effective close to a neutral pelvic posture. (Source: Journal of NeuroEngineering and Rehabilitation)

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Noninvasive ventilation in acute respiratory failure from respiratory syncytial virus bronchiolitis

Revista Brasileira de Terapia Intensiva — Tue, 05 Feb 2013 12:30:21 +0100

OBJETIVOS: Analisar se a ventilação não invasiva diminui a necessidade de intubação endotraqueal e se alterou a evolução clínica, relativamente a complicações infecciosas, da bronquiolite por vírus sincicial respiratório com insuficiência respiratória. MÉTODOS: Estudo retrospectivo de coortes: cohorte A, de crianças internadas na unidade de cuidados intensivos e especiais pediátrica antes da introdução da ventilação não invasiva (2003-2005); cohorte B, de crianças internadas após a introdução de ventilação não invasiva (2006-2008). Excluindo a ventilação não invasiva, a terapêutica de suporte foi igual nos dois grupos. Foram incluídas crianças com o diagnóstico de bronquiolite por vírus sincicial respiratório e insuficiência respiratória entre novemb...

Apolipoprotein E polymorphisms and severity of cerebral palsy: a cross‐sectional study in 255 children in Norway

Developmental Medicine and Child Neurology — Tue, 05 Feb 2013 05:00:00 +0100

AimThe aim of this study was to examine whether the presence of the apolipoprotein E (ApoE) allele APOEε4 is associated with less severe manifestations of cerebral palsy (CP), consistent with the suggested beneficial effect of this allele on neurodevelopment in children. MethodApoE genotyping was performed on buccal epithelial cells from 255 children (141 males 114 females; mean age 12y, SD 2y 3mo, range 9–17y) recorded in the Cerebral Palsy Register of Norway. The main outcome measure of CP severity was the Gross Motor Function Classification System (GMFCS). Secondary outcome measures were fine motor function, epilepsy, and the need for gastrostomy tube feeding (GTF). ResultsThere was no association between the APOEε4 genotype and GMFCS levels (odds ratio [OR] 1.15; 95% confidence int...

Apolipoprotein E and the genetics of cerebral palsy – where to next?

Developmental Medicine and Child Neurology — Tue, 05 Feb 2013 05:00:00 +0100

This commentary is on the original article by Lien et al (Source: Developmental Medicine and Child Neurology)

Association Between Transient Hypothyroxinaemia of Prematurity and Adult Autism Spectrum Disorder in a Low‐Birthweight Cohort: An Exploratory Study

Paediatric and Perinatal Epidemiology — Mon, 04 Feb 2013 05:00:00 +0100

ConclusionWhile the primary relation between THOP and ASD found here is not statistically significant, the magnitude of association and significant relationship observed in the subgroup whose mothers did not have hypertension during pregnancy suggest that it is worthy of further investigation. (Source: Paediatric and Perinatal Epidemiology)

Fatigue and muscle activation during submaximal elbow flexion in children with cerebral palsy

Journal of Electromyography and Kinesiology — Mon, 04 Feb 2013 05:00:00 +0100

Abstract: The purpose of this study was to investigate whether children with cerebral palsy (CP), like typically developing peers, would compensate for muscle fatigue by recruiting additional motor units during a sustained low force contraction until task failure.Twelve children with CP and 17 typically developing peers performed one submaximal isometric elbow flexion contraction until the task could no longer be sustained at on average 25% (range 10–35%) of their maximal voluntary torque. Meanwhile surface electromyography (EMG) was measured from the biceps brachii and triceps brachii, and acceleration variations of the forearm were detected by an accelerometer. Slopes of the change in EMG amplitude and median frequency and accelerometer variation during time normalised to their initial...

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Relation among the Gross Motor Function, Manual Performance and Upper Limb Functional Measures in Children with Spastic Cerebral Palsy.

Yonsei Medical Journal — Mon, 04 Feb 2013 03:20:04 +0100

Conclusion: Gross motor function, bimanual performance and the best capacity of each hand are closely related with each other in children with bilateral CP, but not in children with unilateral CP. PMID: 23364990 [PubMed - in process] (Source: Yonsei Medical Journal)

Comparison of body segmental kinematic characteristics between children with cerebral palsy performing sit-to-stand with and without a walker.

Disability and Rehabilitation. Assistive Technology. — Sun, 03 Feb 2013 15:20:59 +0100

Authors: Thanapan P, Prasertsukdee S, Vachalathiti R Abstract The study investigated how the subjects, 18 children with spastic diplegia aged 7-14 years, attained sit-to-stand (STS). The children were divided into two groups and three STS conditions: 1) those who could attain STS independently (I-STS), 2) those who could not attain STS independently (D-STS), and 3) subjects from the D-STS condition who could successfully attain STS with the walker (W-STS). The results showed that I-STS had more mean maximum horizontal location of the upper body and knee than the hip. All body segments of D-STS followed the same model as the I-STS condition, but they moved with less magnitude than I-STS. W-STS presented both pattern and magnitudes relatively similar to I-STS. Furthermore, I-STS show...

Moving on with cerebral palsy: New operation offers more mobility

Thrive, Children's Hospital Boston — Fri, 01 Feb 2013 14:10:01 +0100

Five-year-old Will DeMauvise has never been stopped by his cerebral palsy—in family videos, he swims, throws a baseball and drives a toy car. He and his parents want the same thing for him: a full life with as much independence as possible. Injections of botulinum toxin and phenol into Will’s legs helped relax his rigid, spastic muscle and increased his range of motion. But because the injections are very painful, he needed to go under general anesthesia each time. And the effect was short-lived. “We had to do it every three to four months, two to three times a year,” says Will’s mother Marlee. “Every time he did it he had to go under. It was heartbreaking.” Because his leg muscles were so tight, Will needed a walker to get around. His gait was unsteady and stiff-legged. U...

Failure of normal development of central drive to ankle dorsiflexors relates to gait deficits in children with cerebral palsy

Journal of Neurophysiology — Fri, 01 Feb 2013 05:00:00 +0100

Neurophysiological markers of the central control of gait in children with cerebral palsy (CP) are used to assess developmental response to therapy. We measured the central common drive to a leg muscle in children with CP. We recorded electromyograms (EMGs) from the tibialis anterior (TA) muscle of 40 children with hemiplegic CP and 42 typically developing age-matched controls during static dorsiflexion of the ankle and during the swing phase of treadmill walking. The common drive to TA motoneurons was identified through time- and frequency-domain cross-correlation methods. In control subjects, the common drive consists of frequencies between 1 and 60 Hz with peaks at beta (15–25 Hz) and gamma (30–45 Hz) frequencies known to be caused by activity within sensorimotor cortex netw...

Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study

BMC Pediatrics - Latest articles — Fri, 01 Feb 2013 05:00:00 +0100

This study is registered in the Dutch Trial Register as NTR3418. (Source: BMC Pediatrics - Latest articles)

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Evaluation of the clinical use of magnesium sulfate for cerebral palsy prevention.

Obstetrics and Gynecology — Fri, 01 Feb 2013 05:00:00 +0100

CONCLUSION: : It is feasible to implement a magnesium sulfate cerebral palsy prevention protocol into clinical practice. LEVEL OF EVIDENCE: : III. PMID: 23344271 [PubMed - in process] (Source: Obstetrics and Gynecology)

Magnesium sulfate, cerebral palsy prevention, and medical protocols.

Obstetrics and Gynecology — Fri, 01 Feb 2013 05:00:00 +0100

Authors: Repke JT PMID: 23344268 [PubMed - in process] (Source: Obstetrics and Gynecology)

Construction of an artifact to the suitability of sitting posture in children with cerebral palsy and multiple disabilities.

Disability and Rehabilitation. Assistive Technology. — Fri, 01 Feb 2013 05:00:00 +0100

Conclusion: The use of AT with physiotherapy treatment proved efficient in the postural alignment of children with CP children in a wheelchair. Implications for Rehabilitation Wheelchairs are manufactured in standard size, which makes difficult the adaptation of individuals with peculiar postures. Even the most sophisticated, with adjustments and special accessories, not always allow adjustments to shape up properly to deformities in children with cerebral palsy. It is hoped that this research will be useful in order to show rehabilitation professionals the ability to minimize the difficulties of keeping children with cerebral palsy and multiple disabilities properly seated in the wheelchair, facilitating posture, movement, breathing and swallowing. The construction of these artif...

Subtrochanteric valgus osteotomy with monolateral external fixator in hips for patients with severe cerebral palsy.

Orthopedics — Fri, 01 Feb 2013 05:00:00 +0100

Authors: Agashe M, Song SH, Tong XB, Hong JH, Song HR Abstract Subtrochanteric valgus osteotomy has been used for painful hip joint dislocation in patients with severe cerebral palsy. The goal of this study was to evaluate 11 patients (17 hips) with severe cerebral palsy who had chronically dislocated and painful hips treated with subtrochanteric valgus osteotomy using a monolateral external fixator.A retrospective review was performed of 11 patients (average age, 17.8 years) with severe quadriplegic cerebral palsy with flexion-adduction contractures due to chronically dislocated and painful hips. A subtrochanteric valgus osteotomy with a monolateral fixator was performed in all patients. Patients were analyzed clinicoradiologically, and caregivers were asked about ease of handling...

Increased salivary immunoglobulin A and reduced α‐amylase activity in whole saliva from spastic cerebral palsy individuals

Journal of Oral Pathology and Medicine — Fri, 01 Feb 2013 05:00:00 +0100

ConclusionThis study concluded that CP individuals presented alterations in the profile of salivary proteins involved in the defense system of the oral cavity. (Source: Journal of Oral Pathology and Medicine)

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Callum Brown, 8, walking again after parents raise £50k for cerebral palsy treatment

the Mail online | Health — Thu, 31 Jan 2013 20:56:30 +0100

Callum Brown, Northumberland, flew to St Louis Children's Hospital in Missouri for surgery that cuts the faulty nerves in the spine to help him move (Source: the Mail online | Health)

Hamstring and psoas length of crouch gait in cerebral palsy: a comparison with induced crouch gait in age- and sex-matched controls

Journal of NeuroEngineering and Rehabilitation — Wed, 30 Jan 2013 05:00:00 +0100

Conclusions: Normal controls mimicking crouch gait and cerebral palsy patients with crouch gait demonstrate similar muscle length patterns. However, mimicked crouch gait did not reproduce the excursion pattern shown by patients with crouch gait, which suggests that reduced hamstring and psoas excursion is an innate characteristic of pathologic crouch gait. (Source: Journal of NeuroEngineering and Rehabilitation)

Immunisation coverage in children with cerebral palsy compared with the general population

Journal of Paediatrics and Child Health — Tue, 29 Jan 2013 05:00:00 +0100

ConclusionThis study demonstrates that children with CP are at high risk of incomplete and delayed immunisation, a significant problem given the increased health‐care needs of this patient group and their increased vulnerability to the complications of vaccine‐preventable diseases. (Source: Journal of Paediatrics and Child Health)

Fetal and Infant Spontaneous General Movements as Predictors of Developmental Disabilities

Mental Retardation and Developmental Disabilities Research Reviews — Tue, 29 Jan 2013 05:00:00 +0100

The challenge of identifying infants who are at risk for developmental delay and possible adverse neurodevelopmental outcome demands methods of evaluation that will lead to early intervention to minimize developmental disability and to maximize the infant's potential. A qualitative assessment of spontaneous general movements (GMs) in the preterm, term, and young infant at risk is a valid and reliable tool for evaluation (Prechtl [1990] Early Hum. Dev. 23:151–158). The aim of this review is to describe the theoretical and clinical bases for the assessment of GMs and its relationship to developmental delay and brain dysfunction. Thirty‐seven studies related to the predictive validity of GMs were included in this review. Results suggested that consistent cramped synchronized GMs are highl...

Cerebral Palsy—Don't Delay

Mental Retardation and Developmental Disabilities Research Reviews — Tue, 29 Jan 2013 05:00:00 +0100

Cerebral palsy (CP) is the most severe physical disability within the spectrum of developmental delay. CP is an umbrella term describing a group of motor disorders, accompanied by many associated impairments. The disability is a result of injuries to the developing brain occurring any time from the first trimester of pregnancy through to early childhood. However, for the great majority, their full etiological causal pathway remains unclear. It is important to discriminate as early as possible between: (a) mild or nonspecific motor delay, (b) developmental coordination disorder, (c) syndromes, (d) metabolic and progressive conditions, and (e) CP with its various motor types and distributions. The most promising predictive tool for CP is the general movements assessment, which assesses the q...

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Longitudinal development of gross motor function among Dutch children and young adults with cerebral palsy: an investigation of motor growth curves

Developmental Medicine and Child Neurology — Tue, 29 Jan 2013 05:00:00 +0100

AimThe aim of this study was to describe patterns for gross motor development by level of severity in a Dutch population of individuals with cerebral palsy (CP). MethodThis longitudinal study included 423 individuals (260 males, 163 females) with CP. The mean age at baseline was 9 years 6 months (SD 6y 2mo, range 1–22y). The level of severity of CP among participants, according to the Gross Motor Function Classification System (GMFCS), was 50% level I, 13% level II, 14% level III, 13% level IV, and 10% level V. Participants had been assessed up to four times with the Gross Motor Function Measure (GMFM‐66) at 1‐ or 2‐year intervals between 2002 and 2009. Data were analysed using non‐linear mixed effects modelling. For each GMFCS level, patterns were created by contrasting a stab...

A qualitative study of adult AAC users' experiences communicating with medical providers.

Disability and Rehabilitation. Assistive Technology. — Mon, 28 Jan 2013 05:00:00 +0100

Conclusions: The participants' stories highlight important barriers they experience when communicating with medical providers. These barriers bring attention to the need for education for physicians, caregivers and patients with communication disabilities, along with increased research to improve patient--provider communication. Implications for Rehabilitation Patients with communication disabilities face multiple barriers to communicating with medical care providers. Patients, caregivers, and medical care providers all play a role in effective and ineffective communication during appointments. Education for medical care providers, caregivers, and patients with communication disabilities, along with increased research is needed to improve patient-provider communication. PMID: ...

Myotendinous lengthening of the elbow flexor muscles to improve active motion in patients with elbow spasticity following brain injury

Journal of Shoulder and Elbow Surgery — Mon, 28 Jan 2013 05:00:00 +0100

The objective of this study was to evaluate the outcomes of a novel technique of fractional myotendinous lengthening of the elbow flexors in patients with volitional motor control and spastic elbow flexion deformities after brain injury.Methods: A retrospective review of 42 consecutive patients with spastic elbow flexion deformities and upper motor neuron (UMN) syndrome was performed. Each patient had volitional motor control but limited elbow extension and underwent myotendinous lengthening of the elbow flexor muscles. Outcome measures included pre and post-operative active and passive arc of motion, Modified Ashworth Scale (MAS) of spasticity, and complications.Results: There were 26 men and 16 women. The etiologies of UMN syndrome were stroke (30 patients), traumatic brain injury (11 pa...

Translation of the Children Helping Out - Responsibilities, Expectations and Supports (CHORES) questionnaire into Brazilian-Portuguese: semantic, idiomatic, conceptual and experiential equivalences and application in normal children and adolescents and in children with cerebral palsy

Revista Brasileira de Fisioterapia — Sat, 26 Jan 2013 11:00:13 +0100

CONCLUSIONS: The translation of the CHORES questionnaire into Brazilian Portuguese offers a unique instrument for health professionals in Brazil, enabling the documentation of child and teenager participation in daily household tasks and making it possible to develop scientific investigation on the topic. (Source: Revista Brasileira de Fisioterapia)

Neural stem cell-like cells derived from autologous bone mesenchymal stem cells for the treatment of patients with cerebral palsy

Journal of Translational Medicine — Sat, 26 Jan 2013 05:00:00 +0100

Conclusion: Our results indicated that NSC-like cells are safe and effective for the treatment of motor deficits related to cerebral palsy. Further randomised clinical trials are necessary to establish the efficacy of this procedure. (Source: Journal of Translational Medicine)

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FDA Clears Stimulation System for Foot Drop in Children FDA Clears Stimulation System for Foot Drop in Children

Medscape Today Headlines — Fri, 25 Jan 2013 20:09:14 +0100

The device could help boost mobility and confidence in kids with stroke, cerebral palsy, and other motor neuron disorders. FDA Approvals (Source: Medscape Today Headlines)

An update on the prevalence of cerebral palsy: a systematic review and meta‐analysis

Developmental Medicine and Child Neurology — Thu, 24 Jan 2013 05:00:00 +0100

AimsThe aim of this study was to provide a comprehensive update on (1) the overall prevalence of cerebral palsy (CP); (2) the prevalence of CP in relation to birthweight; and (3) the prevalence of CP in relation to gestational age. MethodA systematic review and meta‐analysis was conducted and reported, based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐analyses) statement. Population‐based studies on the prevalence of CP in children born in 1985 or after were selected. Statistical analysis was carried out using computer package R, version 2.14. ResultsA total of 49 studies were selected for this review. The pooled overall prevalence of CP was 2.11 per 1000 live births (95% confidence interval [CI] 1.98–2.25). The prevalence of CP stratified by gestationa...

Prevalence of Cerebral Palsy in Quebec: Alternative Approaches

Neuroepidemiology — Wed, 23 Jan 2013 23:00:00 +0100

Neuroepidemiology 2013;40:264–268 (DOI:10.1159/000345120) (Source: Neuroepidemiology)

Identification of fidgety movements and prediction of CP by the use of computer-based video analysis is more accurate when based on two video recordings.

Physiotherapy Theory and Practice — Wed, 23 Jan 2013 05:00:00 +0100

This study evaluates the role of postterm age at assessment and the use of one or two video recordings for the detection of fidgety movements (FMs) and prediction of cerebral palsy (CP) using computer vision software. Recordings between 9 and 17 weeks postterm age from 52 preterm and term infants (24 boys, 28 girls; 26 born preterm) were used. Recordings were analyzed using computer vision software. Movement variables, derived from differences between subsequent video frames, were used for quantitative analysis. Sensitivities, specificities, and area under curve were estimated for the first and second recording, or a mean of both. FMs were classified based on the Prechtl approach of general movement assessment. CP status was reported at 2 years. Nine children developed CP of whom all recor...

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Differences in Lateral Ankle Ligaments Between Affected and Unaffected Legs in Children With Spastic Hemiplegic Cerebral Palsy

Journal of Ultrasound in Medicine — Tue, 22 Jan 2013 05:00:00 +0100

Conclusions This study revealed an increased anterior talofibular ligament thickness and a decreased calcaneofibular ligament thickness in the affected legs compared with the unaffected legs. These architectural features of the lateral ankle ligaments may contribute to the equinovarus deformity of the ankle together with spastic leg muscles in children with spastic hemiplegic cerebral palsy. (Source: Journal of Ultrasound in Medicine)

Stages of change in physical activity behavior in children and adolescents with cerebral palsy.

Disability and Rehabilitation — Tue, 22 Jan 2013 05:00:00 +0100

Conclusions: The identified facilitators and barriers, organized according to three stages of change (pre-intention, intention and action), provide important theoretical insights into how and why children and adolescents with CP and their parents might change their physical activity behavior. Implications for rehabilitation Understanding the barriers and facilitators of physical activity for children and adolescents with CP is essential for designing effective interventions to promote participation in this group. Using the three stages of change and the identified barriers and facilitators for participation can result in tailored advice to increase physical activity behavior. PMID: 23336120 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)

Learning and mastery behaviours as risk factors to abandonment in a paediatric user of advanced single-switch access technology.

Disability and Rehabilitation. Assistive Technology. — Tue, 22 Jan 2013 05:00:00 +0100

Conclusions: The benefit of gaining some degree of independent physical access might not necessarily enhance resilience to interaction errors or bouts of poor task performance. On the other hand, the participant's behaviours were consistent with those of a typically developing child learning or mastering any new skill or task. Implications for Rehabilitation The attitude and behaviour of a paediatric switch user towards skill development can be risk factors to abandonment of an access technology, despite successful clinical trial with the device. Children with severe disabilities can be associated with the same types of skill development behaviour patterns and achievement motivation as their typically developing peers. Empirical observations of the case participant's switch use be...

Caution regarding the Pediatric Motor Activity Log to measure upper limb intervention outcomes for children with unilateral cerebral palsy

Developmental Medicine and Child Neurology — Tue, 22 Jan 2013 05:00:00 +0100

(Source: Developmental Medicine and Child Neurology)

Trying hard for treatment

The Irish Times - Health — Tue, 22 Jan 2013 00:30:12 +0100

HEALTH EXPERIENCE:While Cherie will always suffer from cerebral palsy, a US operation offers hope for a better quality of life (Source: The Irish Times - Health)

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Modeling Developmental Plasticity After Perinatal Stroke: Defining Central Therapeutic Targets in Cerebral Palsy

Pediatric Neurology — Mon, 21 Jan 2013 17:47:39 +0100

Abstract: Perinatal stroke is presented as the ideal human model of developmental neuroplasticity. The precise timing, mechanisms, and locations of specific perinatal stroke diseases provide common examples of well defined, focal, perinatal brain injuries. Motor disability (hemiparetic cerebral palsy) constitutes the primary adverse outcome and the focus of models explaining how motor systems develop in health and after early injury. Combining basic science animal work with human applied technology (functional magnetic resonance imaging, diffusion tensor imaging, and transcranial magnetic stimulation), a model of plastic motor development after perinatal stroke is presented. Potential central therapeutic targets are revealed. The means to measure and modulate these targets, including evide...

Score for Neonatal Acute Physiology–II and Neonatal Pain Predict Corticospinal Tract Development in Premature Newborns

Pediatric Neurology — Mon, 21 Jan 2013 17:47:39 +0100

Abstract: Premature infants are at risk for adverse motor outcomes, including cerebral palsy and developmental coordination disorder. The purpose of this study was to examine the relationship of antenatal, perinatal, and postnatal risk factors for abnormal development of the corticospinal tract, the major voluntary motor pathway, during the neonatal period. In a prospective cohort study, 126 premature neonates (24-32 weeks' gestational age) underwent serial brain imaging near birth and at term-equivalent age. With diffusion tensor tractography, mean diffusivity and fractional anisotropy of the corticospinal tract were measured to reflect microstructural development. Generalized estimating equation models examined associations of risk factors on corticospinal tract development. The perinata...

Neurodevelopmental Outcome Among Multiples and Singletons: A Regional Neonatal Intensive Care Unit's Experience in Turkey.

Twin Research and Human Genetics — Mon, 21 Jan 2013 05:00:00 +0100

Conclusions: Multiple gestation in preterm infants is not associated with an increased risk of neurodevelopmental impairment at 12-18 months' corrected age compared with singleton preterm infants. For further information, long term and high participation in neurodevelopmental follow-up and evaluation at pre-school age will be needed. PMID: 23331543 [PubMed - as supplied by publisher] (Source: Twin Research and Human Genetics)

Comparison of Lateral Opening Wedge Calcaneal Osteotomy and Medial Calcaneal Sliding-opening Wedge Cuboid-closing Wedge Cuneiform Osteotomy for Correction of Planovalgus Foot Deformity in Children

Journal of Foot and Ankle Surgery — Mon, 21 Jan 2013 05:00:00 +0100

Abstract: The purpose of the present study was to compare the clinical and radiographic results between 2 procedures, lateral opening wedge calcaneal osteotomy (LCL) and medial calcaneal sliding-opening wedge cuboid-closing wedge cuneiform osteotomy (3C) in patients with planovalgus foot deformity. A total of 38 patients who underwent either LCL (18 patients, 28 feet) or 3C (20 patients, 32 feet) were included in the present study. The etiology of the planovalgus foot deformity was idiopathic in 16 feet and cerebral palsy in 44 feet. The 2 procedures used in the present study were indicated in symptomatic (pain or callus) children in whom conservative treatment, such as shoe modifications or orthotics, had been applied for more than 1 year but had failed. The patients were evaluated preope...

Fetal umbilical artery Doppler in small preterms: (IQ) Neurocognitive outcome at five years of age

Acta Paediatrica — Sat, 19 Jan 2013 08:45:08 +0100

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Neurodevelopmental outcomes of very low birth weight infants with neonatal sepsis: systematic review and meta-analysis

Journal of Perinatology — Thu, 17 Jan 2013 05:00:00 +0100

Authors: B Alshaikh, K Yusuf & R Sauve (Source: Journal of Perinatology)

Training to walk amid uncertainty with Re-Step: measurements and changes with perturbation training for hemiparesis and cerebral palsy.

Disability and Rehabilitation. Assistive Technology. — Wed, 16 Jan 2013 05:00:00 +0100

Conclusions: This pilot trial reveals the feasibility and applicability of this unique measurement and perturbation system for evaluating functional disabilities and changes with interventions to improve walking. Implication for Rehabilitation Walking, of individuals with cerebral palsy and hemiparesis following stroke, can be viewed in terms of a rigid motor behavior that prevents adaptation to changing environmental conditions. Re-Step system (a) measures and records linear and non-linear gait parameters during free walking to provide a detailed evaluation of walking disabilities, (b) is an intervention training modality that applies unexpected perturbations during walking. This perturbation intervention may improve gait and motor functions of individuals with hemiparesis and ce...

Outcome of severe placental insufficiency with abnormal umbilical artery Doppler prior to fetal viability

BJOG: An International Journal of Obstetrics and Gynaecology — Tue, 15 Jan 2013 18:11:19 +0100

ConclusionsPlacental insufficiency with AEDV in the umbilical arteries prior to fetal viability is associated with a high probability of perinatal death and neonatal complications. However, progressive amelioration of Doppler indices occurs in a subset of women, and these fetuses have a much better outcome. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

Perinatal and neonatal predictors of developmental coordination disorder in very low birthweight children

Archives of Disease in Childhood — Tue, 15 Jan 2013 05:00:00 +0100

Conclusions Male sex and low birth weight were significant predictors of DCD, suggesting that these infants should be followed for detection of this common, but under-recognised disorder. Future research aimed at identifying neural underpinnings of DCD and possible antecedents to the disorder is warranted. (Source: Archives of Disease in Childhood)

Baclofen in community paediatric management of hypertonia

Archives of Disease in Childhood — Tue, 15 Jan 2013 05:00:00 +0100

We wish to draw attention to the NICE guidelines for spasticity management in children, in particular, recommendations on oral baclofen prescribing.1 Despite its reported efficacy in reducing spastic tone in controlled studies, there is little information on the effectiveness, safety and quality of prescribing of baclofen in real-life practice.2 We noted that non-specialist (paediatric neurology, neurodisability) paediatricians express a lack of experience and knowledge in managing hypertonia with baclofen. The community paediatric setting is where children with hypertonia due to cerebral palsy, the predominant underlying condition, are routinely managed, as opposed to specialist tone management clinics, where controlled studies are typically performed. We conducted a baseline audit in a c...

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Outcome of severe placental insufficiency with abnormal umbilical artery Doppler prior to fetal viability.

BJOG : An International Journal of Obstetrics and Gynaecology — Tue, 15 Jan 2013 05:00:00 +0100

CONCLUSIONS: Placental insufficiency with AEDV in the umbilical arteries prior to fetal viability is associated with a high probability of perinatal death and neonatal complications. However, progressive amelioration of Doppler indices occurs in a subset of women, and these fetuses have a much better outcome. PMID: 23320863 [PubMed - as supplied by publisher] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)

"Handicap This:" Two men, one wheelchair

Health News: CBSNews.com — Mon, 14 Jan 2013 17:47:13 +0100

Tim Wambach and Mike Berkson have teamed up to create a stage show titled "Handicap This" to dispel myths about cerebral palsy and disabilities (Source: Health News: CBSNews.com)

In utero hypertensive diseases and cognition in offspring into old age

Maturitas — Mon, 14 Jan 2013 05:00:00 +0100

Hypertensive diseases of pregnancy including gestational hypertension and preeclampsia continue to pose a major obstetric risk, responsible for around 12% of the global burden of maternal mortality. Pregnancy-induced hypertensive disorders are unpredictable in their onset and progression, and are curable only by termination of the pregnancy, usually birth. There is increasing evidence that in addition to being a major cause of preterm birth, intrauterine growth restriction and cerebral palsy, hypertensive diseases of pregnancy can also lead to later adverse behavioral and cognitive consequences for the offspring in childhood. Recent research from Finland extends these findings through to old age, suggesting that far from being confined to neonatal and childhood life, the adverse consequenc...

Increased Death and Complications After Appendectomy in Patients With Cerebral Palsy: Are Special Needs Patients at Risk for Disparities in Outcomes?

Journal of Surgical Research — Thu, 10 Jan 2013 19:15:39 +0100

(Source: Journal of Surgical Research)

Functional capacity and assistance from the caregiver during daily activities in Brazilian children with cerebral palsy

International Archives of Medicine — Thu, 10 Jan 2013 05:00:00 +0100

Conclusion: We indicated that there was no difference between the performance of the subjects in areas of self-care, mobility and social function considering the functional skills and assistance required by the caregiver. (Source: International Archives of Medicine)

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Selective dorsal rhizotomy: Boy, 4, takes first steps after flying to U.S for surgery despite callous thieves stealing charity funds

the Mail online | Health — Wed, 09 Jan 2013 15:55:37 +0100

Corin Potts from Bristol was diagosed with cerebral palsy at 18months and could only walk with a frame. He is now re-learning how to use his legs after undergoing a £35,000 procedure. (Source: the Mail online | Health)

Mother whose son was left brain damaged after midwife error awarded £7.1m damages by hospital following 14 year legal battle

the Mail online | Health — Wed, 09 Jan 2013 15:36:56 +0100

Clare Scott, 36, from Bournemouth, began a long legal battle with NHS bosses after her son Charlie was born with a serious form of cerebral palsy. (Source: the Mail online | Health)

Cochrane Review: Prophylactic phototherapy for preventing jaundice in preterm or low birth weight infants

Evidence-Based Child Health: A Cochrane Review Journal — Wed, 09 Jan 2013 05:00:00 +0100

Abstract BackgroundLow birth weight and premature infants are at major risk for exaggerated hyperbilirubinaemia and jaundice that can lead to bilirubin encephalopathy. Phototherapy is the most common treatment for neonatal hyperbilirubinaemia and could be most effective in preventing the sequelae of hyperbilirubinaemia if initiated prophylactically. ObjectivesTo evaluate the efficacy and safety of prophylactic phototherapy for preterm (< 37 weeks gestational age) or low birth weight infants (birth weight < 2500 g). Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3) on 31 March 2011, MEDLINE (1950 to 31 March 2011), EMBASE (1980 to 31 March 2011) and CINAHL (1982 to 31 March 2011). Selection criteriaRandomised control...

Low-Contrast Acuity Measurement: Does It Add Value in the Visual Assessment of Down Syndrome and Cerebral Palsy Populations? [Clinical and Epidemiologic Research]

Investigative Ophthalmology — Wed, 09 Jan 2013 05:00:00 +0100

Conclusions. VA and LCA performance was significantly poorer in DS and CP groups than in controls, and high-contrast VA did not reliably predict low-contrast performance. Therefore both high- and low-contrast acuity assessment are valuable to fully describe an individual's visual function, and this may be particularly relevant in DS and CP in cases in which patients are unable to articulate visual difficulties. Age-specific reference data from a large sample of typically developing young people across a broad age range are presented for clinicians using high- and low-contrast Lea symbols. (Source: Investigative Ophthalmology)

A Randomized Controlled Trial of Group Stepping Stones Triple P: A Mixed‐Disability Trial

Family Process — Mon, 07 Jan 2013 05:00:00 +0100

Stepping Stones Triple P (SSTP) is a parenting program designed for families of a child with a disability. The current study involved a randomized controlled trial of Group Stepping Stones Triple P (GSSTP) for a mixed‐disability group. Participants were 52 families of children diagnosed with an Autism Spectrum Disorder, Down syndrome, Cerebral Palsy, or an intellectual disability. The results demonstrated significant improvements in parent‐reported child behavior, parenting styles, parental satisfaction, and conflict about parenting. Results among participants were similar despite children's differing impairments. The intervention effect was maintained at 6‐month follow‐up. The results indicate that GSSTP is a promising intervention for a mixed‐disability group. Limitations of th...

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Impaired muscle growth in spastic cerebral palsy

Developmental Medicine and Child Neurology — Mon, 07 Jan 2013 05:00:00 +0100

This commentary is on the original article by Smith et al (Source: Developmental Medicine and Child Neurology)

Are Results After Single-event Multilevel Surgery in Cerebral Palsy Durable?

Clinical Orthopaedics and Related Research — Thu, 03 Jan 2013 05:00:00 +0100

CONCLUSIONS: Severe gait dysfunction in patients with spastic diplegia can be improved short-term in one operative session by single-event multilevel surgery, but to preserve the early improvements many patients require additional surgery. It is unknown whether the improvements will last for decades. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID: 23283676 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)

Intrapartum Asphyxia, Neonatal Encephalopathy, Cerebral Palsy, and Obstetric Interventions in the Term and Near-Term Infant

NeoReviews recent issues — Tue, 01 Jan 2013 05:00:00 +0100

Intrapartum asphyxia (IA) as a cause of neonatal encephalopathy (NE) and cerebral palsy (CP) is a concern for obstetric providers due to the significant neonatal sequelae that ensue. CP is a nonprogressive static neuromuscular disorder appearing early after birth that occurs in 2 per 1,000 births. NE is a clinical syndrome of disturbed neurologic function in the first week after birth, and it occurs in 6 per 1,000 live births. Only ~6% of all term infants diagnosed with CP have a history of NE, and without the development of NE, IA cannot be considered as the sole cause of CP. There are various preconceptional, antepartum, and intrapartum risk factors associated with CP. Obstetric interventions, including various modalities of fetal monitoring and cesarean delivery, have not led to improve...

Pocket Guide to Children with Special Health Care and Nutritional Needs

Journal of Nutrition Education and Behavior — Tue, 01 Jan 2013 05:00:00 +0100

This quick reference includes updated information for health care professionals who monitor the nutrition care of children with special health care needs, including Down syndrome, autism, cerebral palsy, and other conditions. The pocket guide format is perfect for practitioners in a variety of practice settings. —Academy of Nutrition and Dietetics (Source: Journal of Nutrition Education and Behavior)

Brain imaging in normal kids: a community‐based MRI study in Malawian children

Tropical Medicine and International Health — Tue, 01 Jan 2013 05:00:00 +0100

ConclusionIncidental brain MRI abnormalities are common in normal Malawian children. The incidental atrophy and white matter abnormalities seen in this African population have not been reported among incidental findings from US populations, suggesting Malawi‐specific exposures may be the cause. (Source: Tropical Medicine and International Health)

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Outcome at two years of age in a Swiss national cohort of extremely preterm infants born between 2000 and 2008

BioMed Central — Fri, 28 Dec 2012 05:00:00 +0100

Conclusions: In this recent Swiss national cohort study of extremely preterm infants, neonatal mortality was determined by gestational age, birth weight, and antenatal corticosteroids while neurodevelopmental outcome was determined by the major neonatal morbidities. We observed an increase of survival without moderate or severe disability. (Source: BioMed Central)

U.S. Children's Hospitals Treating More Complex, Expensive Conditions

MedlinePlus Health News — Thu, 27 Dec 2012 19:00:00 +0100

Researchers find biggest increase in patients with special needs, such as cerebral palsy Source: HealthDay Related MedlinePlus Pages: Children's Health, Health Facilities (Source: MedlinePlus Health News)

Gene expression in archived newborn blood spots distinguishes infants who will later develop cerebral palsy from matched controls.

Pediatric Research — Wed, 26 Dec 2012 05:00:00 +0100

Conclusion:The newborn blood spot transcriptome can serve as a platform for investigating distinctive gene expression patterns in children who later develop CP.Pediatric Research (2012); doi:10.1038/pr.2012.200. PMID: 23269123 [PubMed - as supplied by publisher] (Source: Pediatric Research)

DHJO: The past and the future

Disability and Health Journal — Fri, 21 Dec 2012 18:30:21 +0100

This past year has been one of economic caution, slow-downs, and downsizing. Health care costs in the US continue to rise, and federal, state, and local system responses appear to be band-aid fixes for the moment. There is much concern in some disability circles about the ability to continue needed supports for health-related issues of people with disabilities, and many states report closer scrutiny and requirement for medical justifications. The Affordable Care Act (ACA) has recognized some of those issues, and now requires coverage of those with pre-existing conditions and disabilities and has extended the age of adult children (including those with life-long health care needs such as cystic fibrosis, cerebral palsy, etc.) to be covered by their parents' insurance. Although health and we...

For kids with cerebral palsy, quality of life is paramount

Thrive, Children's Hospital Boston — Thu, 20 Dec 2012 19:37:38 +0100

Ben Shore, MD When people hear the term “cerebral palsy,” they might envision a specific illness with very particular symptoms. But cerebral palsy (CP) is actually a broad term that covers several different disorders, so kids with CP have a wide variety of symptoms and experiences—and many different abilities. CP is a chronic, lifelong condition that involves an injury or disruption to the brain, which affects communication between the brain and the muscles. Sometimes it is congenital and can cause uncoordinated movements and postures. Other times, it occurs as a complication of another condition, like premature birth, low birth weight or neurological trauma. Often, it occurs for no identifiable reason. At Boston Children’s Cerebral Palsy Program, our specialists cover all ranges ...

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Paralysed schoolboy, 12, amazes his mother as he writes a Christmas song by BLINKING

the Mail online | Health — Thu, 20 Dec 2012 14:30:04 +0100

Twelve year old Adam Bojelian, from Edinburgh, who has cerebral palsy, wrote the song with the help of mother Zoe, 52, who painstakingly pointed at letters until the festive track was complete. (Source: the Mail online | Health)

Children and Youth With Disabilities: Innovative Methods for Single Qualitative Interviews

Qualitative Health Research — Thu, 20 Dec 2012 05:00:00 +0100

We describe three key aspects of our child-interview methodological approach: collaboration with parents, a toolkit of customizable interview techniques, and strategies to consider the power differential inherent in child–researcher interactions. Examples from our research illustrate what worked well and what was less successful. Researchers can optimize single interviews with children with disabilities by collaborating with family members and by preparing a toolkit of customizable interview techniques. (Source: Qualitative Health Research)

Challenges in organising surgical trials in cerebral palsy

Gait and Posture — Thu, 20 Dec 2012 05:00:00 +0100

Research in the field of gait analysis has led to improvements, both in the technology used and the reliability of the output available for clinical use. Scientific rigour on the part of engineers, scientists and clinicians involved in the motion analysis community has driven this field of research forward. As a result, scientific evidence supporting the reliability of gait analysis is now available and improvements have been introduced in the quality of clinical gait analysis . A recent randomised controlled trial (RCT) demonstrated that gait analysis results affect the clinicians’ decision-making in the management of children with cerebral palsy (CP) . A further study from the same centre appears in this issue and suggests that better surgical results can be achieved when gait analysis...

Jack Rooke: Football-mad boy denied surgery to help him walk, despite living just miles from specialist hospital

the Mail online | Health — Tue, 18 Dec 2012 17:38:19 +0100

Jack Rooke, from Bristol, suffers from cerebral palsy but a procedure available at a hospital just seven miles away could help him walk unaided for the first time. (Source: the Mail online | Health)