MedWorm: Cerebral Palsy

Cooling May Reduce Brain Lesions in Newborns

MedlinePlus Health News — Fri, 06 Nov 2009 00:00:00 +0100

Treatment after oxygen deprivation accounts for better motor skills later, study suggests Source: HealthDay Related MedlinePlus Topics: Brain Diseases, Cerebral Palsy, Infant and Newborn Care (Source: MedlinePlus Health News)

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Words of Wisdom Wednesday: A Parent's Perspective

Psychology Today Parenting Center — Wed, 04 Nov 2009 18:36:39 +0100

Editor's Note: From the moment I began reading Ellen's To The Max, a blog about life and love with her son, Max, who had a stroke at birth. I immediately found myself captivated by her honesty, something that is sometimes lacking in the disability world. Read on for her thoughts on raising a child with a disability and the importance of the mother-child bond. And, of course, I couldn't resist asking Max a few questions, too...Describe a bit of the emotional journey you found yourself on after Max's birth? After Max was born, I was pretty devastated. Obviously, you're never prepared to have something go wrong during a birth, but what happened to me was beyond shocking: my baby had a stroke. I hadn't even known babies could have strokes. And we were told the worst: That Max might never walk ...

Age and electromyographic frequency alterations during walking in children with cerebral palsy. - Lauer RT, Pierce SR, Tucker CA, Barbe MF, Prosser LA.

SafetyLit: All (Unduplicated) — Sun, 01 Nov 2009 15:26:38 +0100

The use of surface electromyography (sEMG) recorded during ambulation has provided valuable insight into motor development and changes with age in the pediatric population. However, no studies have reported sEMG differences with age in the children with ce... (Source: SafetyLit: All (Unduplicated))

A systematic review of the effectiveness of treadmill training for children with cerebral palsy.

Disability and Rehabilitation — Sun, 01 Nov 2009 02:56:03 +0100

Conclusions. The review suggests that treadmill training is safe and feasible for children with CP and indicates that there may be some positive benefits in walking speed over short distances and in general gross motor skills. The provision of PBWS may be particularly beneficial for children with more severe walking disability (GMFCS III and IV). Further research is necessary before it can be concluded that treadmill training is beneficial for children with CP. PMID: 19874075 [PubMed - in process] (Source: Disability and Rehabilitation)

Experienced Problems of Young Adults With Cerebral Palsy: Targets for Rehabilitation Care

Archives of Physical Medicine and Rehabilitation — Sun, 01 Nov 2009 00:00:00 +0100

Conclusions: Although frequently addressed during pediatric rehabilitation care, problems with mobility and self-care still prevail in young adults with CP. In addition, during the transition into adulthood, young adults with CP may experience problems regarding domestic life and work, which they consider important. (Source: Archives of Physical Medicine and Rehabilitation)

Development of lower limb range of motion from early childhood to adolescence in cerebral palsy: a population-based study

BMC Medicine — Wed, 28 Oct 2009 00:00:00 +0100

Conclusions: We found a decreasing ROM in children with CP from 2-14 years of age. This information is important for both the treatment and follow-up planning of the individual child as well as for the planning of health care programmes for all children with CP. (Source: BMC Medicine)

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Ophthalmological, cognitive, electrophysiological and MRI assessment of visual processing in preterm children without major neuromotor impairment

Developmental Science — Tue, 27 Oct 2009 00:00:00 +0100

Many studies report chronic deficits in visual processing in children born preterm. We investigated whether functional abnormalities in visual processing exist in children born preterm but without major neuromotor impairment (i.e. cerebral palsy). Twelve such children (< 33 weeks gestation or birthweight < 1000 g) without major neuromotor impairment and 12 born full-term controls were assessed at 8[ndash]12 years of age by means of ophthalmological assessment (visual acuity, colour vision, stereopsis, stereoacuity, visual fields, ocular motility, motor fusion), cognitive tests of visual-motor, visual-perceptual and visual-spatial skills and pattern-reversal visual evoked potentials (PR-VEPs). All participants also underwent magnetic resonance imaging (MRI) of the brain and neuromotor asses...

Achilles Lengthening Procedures

Foot and Ankle Clinics — Mon, 26 Oct 2009 15:22:06 +0100

This article reviews the anatomical and evolutionary basis for human foot structure, implications of tight gastrocnemius, and specific disease states. Operative releases for lengthening, including proximal gastrocnemius recession, tendo-Achilles lengthening, and endoscopic recession, are detailed. (Source: Foot and Ankle Clinics)

Continuous intrathecal baclofen for children with spasticity and/or dystonia: Goal attainment and complications associated with treatment

Journal of Paediatrics and Child Health — Mon, 26 Oct 2009 00:00:00 +0100

Conclusions: ITB results in statistically significant levels of satisfaction and goal attainment in children with spasticity and/or dystonia. GAS was a useful measure of goal attainment. While, ITB is effective for children with spasticity and dystonia, those with dystonia have a higher rate of complications. (Source: Journal of Paediatrics and Child Health)

Goal-directed functional therapy: A longitudinal study on gross motor function in children with cerebral palsy.

Disability and Rehabilitation — Mon, 26 Oct 2009 00:00:00 +0100

Conclusion. Gross motor function improved during GDT, and was maintained 12 weeks later. The goals were reached to a high extent, and the children gradually progressed towards their goals after the end of the intervention. The therapy did not induce any deterioration of body functions. PMID: 19852713 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)

Pain and fatigue consistency in adults with cerebral palsy.

Disability and Rehabilitation — Mon, 26 Oct 2009 00:00:00 +0100

Conclusions. Pain and fatigue consistently and significantly affect adults with CP. Both factors impact the ability of adults, who have CP, to participate in daily life. PMID: 19852712 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)

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The effect of physiotherapy on sit-to-stand movements in a child with spastic diplegia.

Disability and Rehabilitation — Mon, 26 Oct 2009 00:00:00 +0100

Conclusion. These findings lead us to conclude that the effect of PT on STS movement before and after PT showed objective kinematic data. PMID: 19852706 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)

60 Minutes will feature Children’s epilepsy research

Thrive, Children's Hospital Boston — Sat, 24 Oct 2009 13:00:29 +0100

Did you know that epilepsy affects over 3 million people in the United States? Despite the fact that it affects more people than Parkinson’s, cerebral palsy and multiple sclerosis combined, the disease and its causes remain stubbornly bewildering. Tomorrow, the news program 60 Minutes will feature the epilepsy research of Children’s Frances Jensen, MD. You can watch a preview here. If you use Twitter, please help us promote the episode by tweeting “http://bit.ly/1t2wdK – tune in to 60 Minutes this Sunday to see Children’s Hospital docs talk about epilepsy.” Read about how one young girl fought epilepsy and won. Related posts:140 characters about 140 yearsCatching the lightningHealth headlines: August 14 (Source: Thrive, Children's Hospital Boston...

Video: Preview: Fighting for a Cure

Health News: CBSNews.com — Fri, 23 Oct 2009 22:28:13 +0100

More Americans are suffering from epilepsy than Parkinson's, cerebral palsy and multiple sclerosis combined. Katie Couric reports on a disease that may not be getting the attention it deserves. (Source: Health News: CBSNews.com)

Evolution indicators of patients with cerebral palsy and oropharyngeal dysphagia after therapeutic intervention

Revista da Sociedade Brasileira de Fonoaudiologia — Fri, 23 Oct 2009 15:40:00 +0100

CONCLUSION: Speech-language intervention in dysphagia, along with the work of a multidisciplinary team, promotes better functionality of swallowing and reduction of suggestive signs of penetration and/or tracheal aspiration, as well as improved clinical stability. (Source: Revista da Sociedade Brasileira de Fonoaudiologia)

The ELGAN study of the brain and related disorders in extremely low gestational age newborns

Early Human Development — Fri, 23 Oct 2009 15:19:14 +0100

Conclusions: In addition to supporting a potential role for many previously identified antecedents of brain damage in ELGANs, our study is the first to provide strong evidence that brain damage in extremely preterm infants is associated with microorganisms in placenta parenchyma. (Source: Early Human Development)

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Neonatal hyperbilirubinemia and kernicterus — Not gone but sometimes forgotten

Early Human Development — Fri, 23 Oct 2009 15:19:14 +0100

Abstract: The introduction of exchange transfusion made it possible to prevent severe hyperbilirubinemia and kernicterus, but kernicterus has never completely disappeared and it is still occurring in North America and, more frequently in Western Europe and the developing world. I discuss the epidemiology and major causes of severe hyperbilirubinemia and the potential root causes and system failures associated with the development of extreme hyperbilirubinemia and, subsequently, kernicterus. In the Western world, kernicterus remains a rare cause of cerebral palsy but, in contrast to the other causes of cerebral palsy, kernicterus should almost always be preventable. The key elements in preventing kernicterus are risk assessment and appropriate follow-up for the newborn infant and these are ...

Congo-Kinshasa: Child Disability, the Forgotten Crisis

AllAfrica News: Health and Medicine — Fri, 23 Oct 2009 12:30:15 +0100

Looking at herself in the mirror, nine-year-old Helena squealed with delight at her reflection, standing upright with just the slightest support of her therapist. A year before, Helena was diagnosed with cerebral palsy and identified for therapy in Mugunga II IDP camp in Goma, eastern Democratic Republic of Congo. Helena, able only to crawl, had been confined to very specific spaces due to the lava in the IDP camp. (Source: AllAfrica News: Health and Medicine)

Influence of accuracy constraints on bimanual coordination during a goal-directed task in children with hemiplegic cerebral palsy.

Experimental Brain Research — Fri, 23 Oct 2009 00:00:00 +0100

Authors: Hung YC, Charles J, Gordon AM Previously we found that children with hemiplegic cerebral palsy (CP) have impaired bimanual coordination compared to typically developing children during a functional drawer-opening task. However, performance of the task under time constraints (fast-as-possible) facilitated better bimanual coordination for these children. Accuracy is another important task constraint that could influence the coordination of the two hands during such tasks. The effect of accuracy constraints on bimanual coordination in children with hemiplegic CP is not well understood. In the present study, children were asked to reach forward and open a drawer with one hand and then activate a light switch inside the drawer with the contralateral hand. Task accuracy constraints ...

Children's respiratory illnesses

BMJ Online First — Wed, 21 Oct 2009 23:05:50 +0100

(Source: BMJ Online First)

The Spastic Forms of Cerebral Palsy (Ferrari et al.)

Springer Medicine titles — Wed, 21 Oct 2009 23:02:26 +0100

A Guide to the Assessment of Adaptive Functions This book is the result of studies on cerebral palsy (CP) in children that the authors and their collaborators (medical doctors and therapists) have carried out in recent years. It addresses the main topics associated with the evaluation of adaptive functions in the spastic forms of CP (definition and modifications over the most recent decades, newly classified orientations, ... (Source: Springer Medicine titles)

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Lipid resuscitation in a carnitine deficient child following intravascular migration of an epidural catheter*

Anaesthesia — Wed, 21 Oct 2009 23:00:00 +0100

A child with cerebral palsy and carnitine deficiency developed ventricular arrhythmias with loss of cardiac output during elective surgery under general anaesthesia with concomitant epidural analgesia. Sinus rhythm was restored on administration of adrenaline, but hypotension persisted despite resuscitation. Bolus administration of 0.8 ml.kg[minus]1 (20 ml) lipid emulsion resulted in rapid improvement in cardiac output. Blood samples taken before and after the lipid bolus did not demonstrate toxic concentrations of bupivacaine. This case suggests that carnitine deficiency may increase susceptibility to bupivacaine cardiotoxicity. (Source: Anaesthesia)

Neuroprotective Effect of Oligodendrocyte Precursor Cell-Transplantation in a Long-Term Model of Periventricular Leukomalacia.

The American Journal of Pathology — Wed, 21 Oct 2009 23:00:00 +0100

Authors: Webber DJ, Van Blitterswijk M, Chandran S Perinatal white matter injury, or periventricular leukomalacia (PVL), is the most common cause of brain injury in premature infants and is the leading cause of cerebral palsy. Despite increasing numbers of surviving extreme premature infants and associated long-term neurological morbidity, our understanding and treatment of PVL remains incomplete. Inflammation- or ischemia/hypoxia-based rodent models, although immensely valuable, are largely restricted to reproducing short-term features of up to 3 weeks after injury. Given the long-term sequelae of PVL, there is a need for subchronic models that will enable testing of putative neuroprotective therapies. Here, we report long term characterization of a neonatal inflammation-induced rat m...

Two-year follow-up of a randomised trial with repeated antenatal betamethasone

Archives of Disease in Childhood - Fetal and Neonatal Edition — Wed, 21 Oct 2009 17:02:02 +0100

Conclusions: A single repeat dose of antenatal BM tended not to influence physical growth or neurodevelopment at 2 years of age. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)

Validation of deuterium and oxygen(18) in urine and saliva samples from children using on-line continuous-flow isotope ratio mass spectrometry.

Rapid Communications in Mass Spectrometry : RCM — Mon, 19 Oct 2009 23:00:00 +0100

Authors: Schierbeek H, Rieken R, Dorst KY, Penning C, van Goudoever JB The doubly labelled water method is valuable for measuring energy expenditure in humans. It usually involves blood or urine sampling, which might be difficult in neonates and children with cerebral palsy or other disabilities. We therefore aimed to validate a method making use of saliva samples analyzed by automated thermal conversion elemental analyzer in combination with isotope ratio mass spectrometry (TC-EA/IRMS). The subjects received labelled water orally and urine and saliva samples were collected and analyzed. Deuterium as well as oxygen(18) was measured in one single run using a peak jump method. Excellent linearity was found for measurement of enrichments of deuterium (R(2) = 0.9999) and oxygen(18) (R(2) =...

The Drooling Impact Scale: a measure of the impact of drooling in children with developmental disabilities

Developmental Medicine and Child Neurology — Thu, 15 Oct 2009 23:00:00 +0100

Aim To describe the development and clinimetric properties of a new scale to evaluate changes in the impact of drooling in children with developmental disabilities.Method After examining the properties of potential items, 10 items were retained for inclusion in the final Drooling Impact Scale. The clinimetric properties of the scale were evaluated using data from two convenience samples of children attending a saliva-control clinic: a stable group (n=31, 22 males, nine females; mean age 10y 7mo, SD 4y 5mo, range 3y 6mo[ndash]18y 3mo; cerebral palsy [CP] n=17, intellectual disability n=10; non-ambulatory n=13, nonverbal n=12) and an intervention group (n=49, 29 males, 20 females; mean age 11y, SD 3y 6mo, range 3y 4mo[ndash]16y 10mo; CP n=31, intellectual disability n=15; non-ambulatory n=27...

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Cerebral Palsy International Research Foundation Research Grant Program

ScanGrants feed — Wed, 14 Oct 2009 23:00:00 +0100

The Foundation provides funding for pilot studies on research important to the prevention and treatment of cerebral palsy, including improvement in the quality of life of persons with disabilities due to cerebral palsy and closely related developmental brain disorders. This broad research agenda includes basic, clinical and applied research in the biomedical and bioengineering sciences. Research grant applications are reviewed for scientific merit by the Foundation’s Scientific Advisory Council and then for funding by the Foundation’s Board of Directors. Grants are awarded on a competitive basis taking into account scientific merit, scientific and clinical significance and relevance to cerebral palsy. Grants are generally awarded for up to 2 years at a maximum of $50,000 a yea...

Cerebral Palsy International Research Foundation Ethel & Jack Hausman Clinical Research Scholars Award

ScanGrants feed — Wed, 14 Oct 2009 23:00:00 +0100

The objective of the Ethel & Jack Hausman Clinical Research Scholars Award is to assist institutions in the United States to recruit promising clinician-investigators early in their careers and to help in their establishment as focal points for scholarly activities in areas of direct relevance to cerebral palsy and related developmental brain disorders; these scholarly activities include research, teaching and associated clinical responsibilities. Candidates for the Award will either be citizens of the United States or have permanent residency status.The Award is in the amount of $75,000 a year for each of three years. The funds can be used at the discretion of the awardee within the purposes of the Award, the broad confines of the annual approved budget and grantee institutional polic...

Neuro conditions cited in H1N1 deaths

Managed Healthcare Executive Magazine Online — Wed, 14 Oct 2009 23:00:00 +0100

Almost two-thirds of the children who died with H1N1 had epilepsy, cerebral palsy or other neurodevelopmental conditions. (Source: Managed Healthcare Executive Magazine Online)

Effects of tuning of ankle foot orthoses-footwear combination using wedges on stance phase knee hyperextension in children with cerebral palsy - Preliminary results.

Disability and Rehabilitation. Assistive Technology. — Tue, 13 Oct 2009 14:52:17 +0100

Conclusions. The findings of this study clearly indicate the potential clinical utility of tuning using wedges to correct knee hyperextension during the stance phase in children with cerebral palsy. However, observations support the need for an adequately powered study to assess the long-term effects of tuning on gait parameters, activity level and quality of life. PMID: 19817654 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation. Assistive Technology.)

3D-Quantitative evaluation of a rigid seating system and dynamic seating system using 3D movement analysis in individuals with dystonic tetraparesis.

Disability and Rehabilitation. Assistive Technology. — Tue, 13 Oct 2009 14:52:11 +0100

Authors: Cimolin V, Piccinini L, Avellis M, Cazzaniga A, Turconi AC, Crivellini M, Galli M To improve postural stability in individuals with dystonic cerebral palsy, the concept of a dynamic seat has been suggested as a potential solution. An experimental set-up for the acquisition of movement during extensor thrusts while sitting on a seating system was defined and applied on a group of dystonic individuals, to compare a dynamic versus a rigid seat system, using quantitative movement analysis. The seating system in dynamic configuration is able to reduce the extensor thrust experienced by the consumers, as well as to increase range of motion in the anterior-posterior direction, limiting the sliding down of trunk and showing better upper limb smoothness during extensor thrusts. The pro...

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Horseback riding as therapy for children with cerebral palsy - is there evidence of its effectiveness

Neurological Conditions Specialist Library — Tue, 13 Oct 2009 14:30:53 +0100

A structured abstract written by CRD reviewers. The abstract was published on 9 September 2009 from an original article published in 2007. (Source: Neurological Conditions Specialist Library)

Children and Orthopedic Impairments

Disabled World — Fri, 09 Oct 2009 15:13:49 +0100

The definition of an, "Orthopedic Impairment," is one that includes impairments caused by congenital anomalies such as absence of a member, clubfoot, impairments caused by disease such as bone tuberculosis, poliomyelitis, or impairments for other causes to include amputations, fractures, cerebral palsy, burns, or fractures. (Source: Disabled World)

Monozygotic twinning, cerebral palsy and congenital anomalies

Human Reproduction Update — Thu, 08 Oct 2009 15:25:19 +0100

CONCLUSIONS CP and congenital anomalies share a common pathogenic mechanism attributable to MZ twinning. These abnormalities in singletons are coincident with very early loss of one conceptus. The quantitative contribution of monozygosity and monochorionicity to the genesis of CP and congenital anomalies needs to be made. (Source: Human Reproduction Update)

Social and Community Participation of Children and Youth With Cerebral Palsy Is Associated With Age and Gross Motor Function Classification.

Physical Therapy — Wed, 07 Oct 2009 23:00:00 +0100

CONCLUSIONS:/b> The ability to walk without restrictions is desirable for social and community participation. For children and youth with CP who have limitations in mobility, physical therapists have roles as consultants for accessibility, activity accommodations, and assistive technology and as advocates for inclusive environments. PMID: 19815646 [PubMed - as supplied by publisher] (Source: Physical Therapy)

Cerebral Palsy in the 21st Century: Is There Anything Left To Say?

Neuropediatrics — Wed, 07 Oct 2009 14:51:47 +0100

Neuropediatrics 2009; 40: 56-60DOI: 10.1055/s-0029-1234104AbstractIn April 2009 I was honoured to be asked to present the Emil Becker Lecture at the 35 annual meeting of the German-Swiss-Austrian Society for Neuropaediatrics (Gesellschaft für Neuropädiatrie). Focusing on my interest and involvement as a clinician and researcher in cerebral palsy, I took the opportunity to look both back at the past 35 years and forward to what I believe are some of the important clinical challenges that are still to be addressed and solved in the 21 century. This paper is therefore a personal reflection rather than a comprehensive review of the literature in cerebral palsy. It is my hope that these reflections will be of interest to others.[...]© Georg Thieme Verlag KG Stuttgart · New YorkGet connected...

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Review - antenatal magnesium sulphate prevents cerebral palsy in preterm infants

Neurological Conditions Specialist Library — Wed, 07 Oct 2009 12:13:41 +0100

Critically appraised topic from Evidence-Based Medicine, a secondary evidence journal containing abstracts and expert commentaries about the best quality research from primary care medicine. (Source: Neurological Conditions Specialist Library)

What is Left to Say About Cerebral Palsy in the 21st Century

Neuropediatrics — Wed, 07 Oct 2009 00:49:56 +0100

Neuropediatrics 2009; 40: 55-55DOI: 10.1055/s-0029-1237388© Georg Thieme Verlag KG Stuttgart · New YorkGet connected:Table of contents | FREE: Full text (Source: Neuropediatrics)

Social functioning and communication in children with cerebral palsy: association with disease characteristics and personal and environmental factors

Developmental Medicine and Child Neurology — Tue, 06 Oct 2009 23:00:00 +0100

The objective of this longitudinal study was to describe the course of social functioning and communication in children with cerebral palsy (CP) over a 3-year period, its difference with the normative course, and its relationship with disease characteristics and personal and environmental factors.Method Participants in this study were 110 children with CP (70 males, 40 females) with a mean age of 11 years and 3 months (SD 1y 8mo). Social functioning and communication were measured with the Vineland Adaptive Behavior Scales. Comparisons were made with normative data; data were analysed with generalized estimating equations. According to the Gross Motor Function Classification System (GMFCS), 50 of the 110 children were categorized as GMFCS level I, 16 as level II, 13 as level III, 13 as lev...

Two hands are better than one: bimanual skill development in children with hemiplegic cerebral palsy

Developmental Medicine and Child Neurology — Tue, 06 Oct 2009 23:00:00 +0100

(Source: Developmental Medicine and Child Neurology)

Relationship between neuromuscular body functions and upper extremity activity in children with cerebral palsy

Developmental Medicine and Child Neurology — Tue, 06 Oct 2009 23:00:00 +0100

Aim Our aim was to investigate the relationship between the dimensions of neuromuscular body function and elbow, forearm, and hand activity in the upper extremities in children/adolescents with spastic cerebral palsy (CP), within the framework of the World Health Organization International Classification of Functioning, Disability and Health.Method Twenty-three participants (10 males, 13 females, mean age 13y, SD 3y, range 8[ndash]18y) with spastic CP (21 with hemiplegia, two with diplegia) at Manual Ability Classification System levels I to III participated in the study. Neuromuscular body function measures were (1) muscle strength in the elbow, forearm, and grip, (2) muscle tone in elbow flexors and forearm supinators, (3) active supination range and elbow extension range, and (4) force ...

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Development of the Hypertonia Assessment Tool (HAT): a discriminative tool for hypertonia in children

Developmental Medicine and Child Neurology — Tue, 06 Oct 2009 23:00:00 +0100

Aim The aim of this study was to develop a tool to identify paediatric hypertonia subtypes.Method Items generated by experts were subscaled (spasticity, dystonia, rigidity). The tool was administered to 34 children (19 males, 15 females, mean age 8y 2mo, range 2y 5mo[ndash]18y 7mo) with hypertonia and cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels: I, n=7; II, n=5; III, n=7 level IV, n=7; and level V, n=8 level. Kuder[ndash]Richardson Formula 20 determined internal consistency. To assess reliability, two physicians administered the tool to 25 additional children with CP (15 males, 10 females; mean age 10y 8mo; GMFCS levels I, n=4; II, n=3; III, n=7; IV, n=4; and V, n=7) on two occasions, 2 weeks apart. To evaluate validity, a third physician diagnosed the ...

Development and validation of item sets to improve efficiency of administration of the 66-item Gross Motor Function Measure in children with cerebral palsy

Developmental Medicine and Child Neurology — Tue, 06 Oct 2009 23:00:00 +0100

Aim To develop an algorithmic approach to identify item sets of the 66-item version of the Gross Motor Function Measure (GMFM-66) to be administered to individual children, and to examine the validity of the algorithm for obtaining a GMFM-66 score.Method An algorithmic approach was used to identify item sets of the GMFM-66 (GMFM-66-IS) using data from 95 males and 79 females with cerebral palsy (CP; mean age 14y 7mo, SD 1y 8mo, range 12y 7mo to 17y 8mo). The GMFM-66-IS scores were then validated using combined data from three Dutch studies involving 134 males and 92 females with CP (mean age 7y, SD 4y 6mo, range 1y 4mo to 13y 8mo), representing all levels of the Gross Motor Function Classification System.Results The final algorithm contains three decision items from the GMFM-66 that determ...

Assessment and correction of skinfold thickness equations in estimating body fat in children with cerebral palsy

Developmental Medicine and Child Neurology — Tue, 06 Oct 2009 23:00:00 +0100

Aim To assess the accuracy of skinfold equations in estimating percentage body fat in children with cerebral palsy (CP), compared with assessment of body fat from dual energy X-ray absorptiometry (DXA).Method Data were collected from 71 participants (30 females, 41 males) with CP (Gross Motor Function Classification System [GMFCS] levels I[ndash]V) between the ages of 8 and 18 years. Estimated percentage body fat was computed using established (Slaughter) equations based on the triceps and subscapular skinfolds. A linear model was fitted to assess the use of a simple correction to these equations for children with CP.Results Slaughter's equations consistently underestimated percentage body fat (mean difference compared with DXA percentage body fat [minus]9.6/100 [SD 6.2]; 95% confidence in...

Survival of individuals with cerebral palsy receiving continuous intrathecal baclofen treatment: a matched-cohort study

Developmental Medicine and Child Neurology — Tue, 06 Oct 2009 23:00:00 +0100

Aim To determine whether intrathecal baclofen (ITB) changes mortality risk in persons with cerebral palsy (CP).Method Records were reviewed for all persons with CP who were managed with ITB for hypertonicity at a specialty hospital in Minnesota between May 1993 and August 2007. A comparison cohort was randomly selected from clients of the California Department of Developmental Services who were initially evaluated between 1987 and 1990 and were matched to those with ITB for age, sex, Gross Motor Function Classification System (GMFCS) level, presence or absence of epilepsy, and feeding-tube use. Survival probabilities were estimated using the Kaplan[ndash]Meier method, and differences were tested via log-rank.Results Three hundred and fifty-nine persons with CP (202 males, 157 females) rece...

White matter abnormalities and dystonic motor disorder associated with mutations in the SLC16A2 gene

Developmental Medicine and Child Neurology — Tue, 06 Oct 2009 23:00:00 +0100

Aim Mutations in the SLC16A2 gene have been implicated in Allan[ndash]Herndon[ndash]Dudley syndrome (AHDS), an X-linked learning disability* syndrome associated with thyroid function test (TFT) abnormalities. Delayed myelination is a non-specific finding in individuals with learning disability whose genetic basis is often uncertain. The aim of this study was to describe neuroimaging findings and neurological features in males with SLC16A2 gene mutations.Method We reviewed brain magnetic resonance imaging (MRI) findings and neurological features in a cohort of five males aged between 1 year 6 months and 6 years (median 4y) from four families harbouring SLC16A2 gene mutations.Results The participants presented aged between 4 and 9 months with initial hypotonia and subsequent spastic parapare...

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Hand function in relation to brain lesions and corticomotor-projection pattern in children with unilateral cerebral palsy

Developmental Medicine and Child Neurology — Mon, 05 Oct 2009 23:00:00 +0100

Aim To investigate relationships between hand function, brain lesions, and corticomotor projections in children with unilateral cerebral palsy (CP).Method The study included 17 children (nine males, eight females; mean age 11.4 [SD 2.4] range 7[ndash]16y), with unilateral CP at Gross Motor Function Classification System level I and Manual Ability Classification System level I or II. Hand function was assessed with the Box and Blocks test and Assisting Hand Assessment (AHA). Conventional structural magnetic resonance images were assessed visually for type, location, and extent of brain lesions. Single-pulse transcranial magnetic stimulation (TMS) provided information on organization of corticomotor projections.Results The most favourable hand function was seen in children who had white-matt...

The Efficacy of the Floor-Reaction Ankle-Foot Orthosis in Children with Cerebral Palsy

JBJS [Am] — Thu, 01 Oct 2009 17:01:57 +0100

Conclusions: The floor-reaction ankle-foot orthosis is effective in restricting sagittal plane ankle motion during the stance phase of gait in patients with cerebral palsy. As a result, improvements in knee extension and the sagittal plane knee extensor moment in stance phase are achieved. The best outcomes with this orthosis, as determined by peak knee extension in midstance, were seen in the subjects with knee and hip flexion contracture of ≤10°. Knee and hip flexion contractures of ≥15° were found to limit the efficacy of the orthosis in controlling knee extension in midstance. Such contractures should be considered as contraindications to the prescription of this orthosis or should be addressed (surgically or otherwise) prior to the application of a floor-reaction ankle-f...

Cold 'cuts baby brain damage'

NHS News Feed — Thu, 01 Oct 2009 11:13:00 +0100

This study brings the decision on whether this treatment should become standard practice closer. However, the evidence is not quite there yet, some issues about how the treatment is delivered and the extent of any long-term benefit still need to be resolved. Where did the story come from? The research was carried out by Dr Denis Azzopardi from the Division of Clinical Sciences and Medical Research Council, Clinical Sciences Centre, based at Imperial College London and colleagues from other UK institutions. It was supported by grants from the UK Medical Research Council and the Department of Health. It was published in the peer-reviewed medical journal The New England Journal of Medicine. What kind of scientific study was this? This research investigated whether cooling (hypothermic...

Letters

Pediatric News — Thu, 01 Oct 2009 00:00:00 +0100

The research summary in “Risk of GI Disorders Increased With Autism” (March 2009, p. 15) is valuable, but should include critical analysis Dr. Lulu W. Wang's study has several flaws that, however unintentionally, echo the “gut-brain” connection and alternative vaccine schedules so cogently rebuked by Dr. Stephen I. Pelton in the same issue (ID Consult, “Delaying Vaccines Risks Serious Infection,” p. 4). As with many autism studies, Dr. Wang does not seem to employ the five PDD (pervasive developmental disorder) categories of DDSM-IV or to describe underlying genetic conditions. Children meeting criteria were “quite low functioning and had few language skills”—exactly the group who will have hypertonia from cerebral palsy/neurologic disorders or hypotonia from Mendelian/c...

Total hip replacement in patients with neurological conditions.

The Journal of Bone and Joint Surgery. British volume — Wed, 30 Sep 2009 23:00:00 +0100

Authors: Queally JM, Abdulkarim A, Mulhall KJ Neurological conditions affecting the hip pose a considerable challenge in replacement surgery since poor and imbalanced muscle tone predisposes to dislocation and loosening. Consequently, total hip replacement (THR) is rarely performed in such patients. In a systematic review of the literature concerning THR in neurological conditions, we found only 13 studies which described the outcome. We have reviewed the evidence and discussed the technical challenges of this procedure in patients with cerebral palsy, Parkinson's disease, poliomyelitis and following a cerebrovascular accident, spinal injury or development of a Charcot joint. Contrary to traditional perceptions, THR can give a good outcome in these often severely disabled patients. ...

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The efficacy of the floor-reaction ankle-foot orthosis in children with cerebral palsy.

The Journal of Bone and Joint Surgery. American volume — Wed, 30 Sep 2009 23:00:00 +0100

CONCLUSIONS: The floor-reaction ankle-foot orthosis is effective in restricting sagittal plane ankle motion during the stance phase of gait in patients with cerebral palsy. As a result, improvements in knee extension and the sagittal plane knee extensor moment in stance phase are achieved. The best outcomes with this orthosis, as determined by peak knee extension in midstance, were seen in the subjects with knee and hip flexion contracture of < or =10 degrees . Knee and hip flexion contractures of > or =15 degrees were found to limit the efficacy of the orthosis in controlling knee extension in midstance. Such contractures should be considered as contraindications to the prescription of this orthosis or should be addressed (surgically or otherwise) prior to the application of a floor...

Article 7: Fugl-Meyer Assessment: Reliability for Children with Hemiplegia

Archives of Physical Medicine and Rehabilitation — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: The Fugl-Meyer Assessment is being used with greater frequency to evaluate changes in upper limb motor impairment in children with neurologic disorders and hemiplegia. Reliable standard administration will allow for outcome comparisons among pediatric and adult research studies, and may prove useful in measuring rehabilitation outcomes in clinical practice. (Source: Archives of Physical Medicine and Rehabilitation)

Poster 7: Outcomes of a Treadmill Training Exercise Program for Marginally Ambulatory Children with Cerebral Palsy: A Preliminary Report

Archives of Physical Medicine and Rehabilitation — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: Preliminary results indicate trends for improvements in both groups. Due to the small sample size to date, the data contain much variability. More subjects are being enrolled into the study to determine if the trends continue or become significant. (Source: Archives of Physical Medicine and Rehabilitation)

Poster 9: Misdiagnosis of Spinal Cord Injury and Hearing Loss as Cerebral Palsy: A Case Report

Archives of Physical Medicine and Rehabilitation — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: Appropriate diagnosis was crucial in establishing a tailored rehabilitation program to prevent further cognitive complications related to the patient's undiagnosed hearing loss and avoid preventable secondary complications of her SCI. The patient received physical/occupational/speech therapy services in a Total Communication Deaf Special Education program, neuropsychological assessment, hearing aids, adaptive equipment for self-care and writing given concomitant BPI, a bowel/bladder program, and regular assessments by ENT, urology, and orthopedics for scoliosis. Cognition improved with improved speech and signing, although progress was still limited by factors including her MR, weak oral motor skills, and hand weakness due to BPI. Early recognition and diagnosis of SCI is crit...

Poster 10: Determinants of Family Needs of Parents of Children and Youth with Cerebral Palsy

Archives of Physical Medicine and Rehabilitation — Wed, 30 Sep 2009 23:00:00 +0100

Objective: To test models of child, family, and service characteristics as determinants of the amount of three types of family needs. Design: Cross-section study. Setting: Shriners Hospitals.Participants: 579 children and youth with cerebral palsy (CP) (11+4.5 years) and their parents. Interventions: Research assistants collected data and determined the Gross Motor Function Level of children. A parent completed the Family Needs Survey and standardized measures of child, family, and service characteristics. Main Outcome Measures: Family needs for (1) information and explaining to others; (2) family functioning and support; and (3) community services and financial support. Structural equation modeling was used to test each model of determinants of family needs. Results: Fit statistics indica...

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Poster 11: Relationship Between Gait Efficiency, Gait Kinematics and Muscular Strength in Children With Cerebral Palsy

Archives of Physical Medicine and Rehabilitation — Wed, 30 Sep 2009 23:00:00 +0100

Objective: To examine the relationship between gait efficiency, gait kinematic and lower limb muscular strength in children with cerebral palsy (CP). Design: Pediatric rehabilitation center. Setting: Prospective cohort study. Participants: Ten children (14–22y) with spastic CP (level I–III). Interventions: Not applicable. Main Outcome Measures: Three dimension kinematics gait, flexion and extension knee isometric muscular strength and Energy Expenditure Index during gait (EEI) was calculated. Gross Motor Function Measure (GMFM) was assessed. Results: EEI (1.5±.7 beats/m) is correlated with gait velocity (R2=.63; P (Source: Archives of Physical Medicine and Rehabilitation)

Poster 53: Neurogenic Bladder In Cerebral Palsy

Archives of Physical Medicine and Rehabilitation — Wed, 30 Sep 2009 23:00:00 +0100

This study was done to evaluate bowel and bladder problems in patients with cerebral palsy. Design: Prospective study wherein the all the patients attending the clinic were screened for bladder and bowel problems and were included in study with the consent of the parents. Setting: Tertiay Care setting in a premier multispeciality hospital. Participants: All the children attending OPD were screened for duration of 1 year. Inclusion criteria being Patients who have symptoms of bowel and bladder disorder, informed consent and willingness to participate in the study. Exclusion criteria was Patients with congenital urinary tract anomaly excluded for CMG, Patients with uncontrollable urinary tract infection, fever and pain abdomen are excluded for CMG, Patients suffering from any other neurologi...

Poster 54: Effects of Dual Task Training on a Child with Cerebral Palsy: A Case Report Using ICF-Based Quantitative Analysis of Functional Progress

Archives of Physical Medicine and Rehabilitation — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: The use of dual-task training was beneficial in improving the skills of this young patient. This intervention may present as a cost-effective way of addressing balance impairment among children with cerebral palsy. Dual-task training can be easily incorporated in pediatric rehabilitation programs. (Source: Archives of Physical Medicine and Rehabilitation)

Poster 84: The Effects of Revised Exercise Programs for People with Disabilities Who Already Exercise

Archives of Physical Medicine and Rehabilitation — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: Program revision increased the intensity of the exercise program, and resulted in increased endurance, but not in increased strength or weight loss. The 37 months of exercise participation did decrease secondary conditions in the sample. This study demonstrates the value exercise in health promotion for a sample of individuals with a variety of disabilities. (Source: Archives of Physical Medicine and Rehabilitation)

Distal femoral extension osteotomy and patellar tendon advancement to treat persistent crouch gait in cerebral palsy. Surgical technique.

The Journal of Bone and Joint Surgery. American volume — Wed, 30 Sep 2009 23:00:00 +0100

CONCLUSIONS: Inclusion of patellar tendon advancement is necessary to achieve optimal results in the surgical management of a persistent crouch gait exhibited by adolescents and young adults with cerebral palsy. When this procedure is done alone or in combination with a distal femoral extension osteotomy (for the treatment of a knee flexion contracture), knee function in gait can be restored to values within typical limits, with gains in community function. PMID: 19805590 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

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The Effects of Osteopathic Treatment on Constipation in Children With Cerebral Palsy: A Pilot Study

Journal of Manipulative and Physiological Therapeutics — Wed, 30 Sep 2009 23:00:00 +0100

Conclusion: Osteopathic methods were as effective as osteopathic methods in addition to medical care for both treatment groups. The results of this study suggest that osteopathic methods may be helpful as an alternative treatment in constipation. Additional advanced studies should be conducted. (Source: Journal of Manipulative and Physiological Therapeutics)

Improving Hand Function in Children with Cerebral Palsy: Theory, Evidence and Intervention

Journal of Hand Therapy — Wed, 30 Sep 2009 23:00:00 +0100

Children with cerebral palsy today have a much brighter outlook toward achieving maximal functional independence. In the last two decades, newer technologies to image the brain and extensive research on cortical processing have contributed greatly to the improved understanding of normal and abnormal motor and sensory functioning. More importantly, critical thinking and evidence-based practice have helped to reshape what the main focus of therapeutic intervention can and should be, to achieve the best possible outcomes. The whole concept of classification of children with cerebral palsy has been redirected to define functional levels and not necessarily impairments. There is also a much greater importance given to the context and environment in which the child lives. (Source: Journal of Han...

Words of Wisdom Wednesday: Meet Amanda

Psychology Today Personality Center — Wed, 30 Sep 2009 17:53:02 +0100

Editor's Note: Welcome to the new Wednesday feature, Words of Wisdom Wednesday. We could all use a little more wisdom and advice in our lives, so each week, look to this blog for interviews and insights from experts, organizations and real people living, working and most of all, thriving in the disability world. I guarantee you it will open your eyes. I know it will open mine. I "met" Amamda after she discovered my blog and found me on facebook (friend me if you like!). I was immediately struck my her strength, confidence and honesty. This woman was a girl after my own heart."Living with a physical disability is what a person makes it out to be," she wrote in her facebook biography. "A disability can either be a tiny house made of thin pieces of wood held together by nail...

Review: antenatal magnesium sulphate prevents cerebral palsy in preterm infants [Therapeutics]

Evidence-Based Medicine — Wed, 30 Sep 2009 17:01:36 +0100

(Source: Evidence-Based Medicine)

[Therapeutics] Review: antenatal magnesium sulphate prevents cerebral palsy in preterm infants

Evidence-Based Medicine — Tue, 29 Sep 2009 23:00:00 +0100

(Source: Evidence-Based Medicine)

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Sciele Pharma Submits New Drug Application To FDA For Glycopyrrolate Oral Solution, A Treatment For Chronic Drooling In Pediatric Patients

Health News from Medical News Today — Tue, 29 Sep 2009 12:00:00 +0100

Sciele Pharma, Inc., a Shionogi company, announced that it has submitted a New Drug Application (NDA) to the United States Food and Drug Administration (FDA) for glycopyrrolate oral solution to treat chronic, moderate-to-severe drooling in pediatric patients. This condition often results from cerebral palsy as well as from other neurological disorders. (Source: Health News from Medical News Today)

Media Advisory: Request for Event Listing & Coverage

United Cerebral Palsy National News — Mon, 28 Sep 2009 23:05:00 +0100

(Source: United Cerebral Palsy National News)

United Cerebral Palsy (UCP) 60 Years and Onward Celebration

United Cerebral Palsy National News — Mon, 28 Sep 2009 23:05:00 +0100

(Source: United Cerebral Palsy National News)

Practice parameter - Evaluation of the child with microcephaly - an evidence-based review

Neurological Conditions Specialist Library — Mon, 28 Sep 2009 16:25:27 +0100

Systematic review published in Neurology in September 2009. Recommendations: Neuroimaging may be considered useful in identifying structural causes in the evaluation of the child with microcephaly (Level C). Targeted and specific genetic testing may be considered in the evaluation of the child with microcephaly who has clinical or imaging abnormalities that suggest a specific diagnosis or who shows no evidence of an acquired or environmental etiology (Level C). Screening for coexistent conditions such as cerebral palsy, epilepsy, and sensory deficits may also be considered (Level C). Further study is needed regarding the yield of diagnostic testing in children with microcephaly. (Source: Neurological Conditions Specialist Library)

Occupational Therapy Home Programs for Cerebral Palsy: Double-Blind, Randomized, Controlled Trial

PEDIATRICS — Sun, 27 Sep 2009 23:00:00 +0100

CONCLUSION: Pediatricians can advise families that OTHPs developed with a collaborative, evidence-based approach and implemented by parents at home were clinically effective if implemented 17.5 times per month for an average of 16.5 minutes per session. (Source: PEDIATRICS)

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Individuals with Disabilities Act of 2004 and the John H. Chafee Foster Care Independence Act of 1999: What are the policy implications for youth with disabilities transitioning from foster care?

Child Welfare — Sat, 26 Sep 2009 23:42:02 +0100

This article examines the similarities and differences between the transition mandates in each of the two laws and makes recommendations for policy improvements. PMID: 19777790 [PubMed - in process] (Source: Child Welfare)

My Child Without Limits - United Cerebral Palsy

Disabled World — Fri, 25 Sep 2009 16:09:04 +0100

United Cerebral Palsy (UCP), today announced the launch of My Child Without Limits (MyChildWithoutLimits.org), UCP's pioneering initiative that provides parents of children with disabilities an online resource with critical information that also connects parents to a vital social network of parents of newly diagnosed children ages 0 to 5. (Source: Disabled World)

United Cerebral Palsy Presents Online Resource for Parents of Young Children with Developmental Delays

United Cerebral Palsy National News — Wed, 23 Sep 2009 15:21:00 +0100

(Source: United Cerebral Palsy National News)

Distribution of periodontopathic bacterial species in Japanese children with developmental disabilities

BMC Oral Health - Latest articles — Tue, 22 Sep 2009 23:00:00 +0100

Conclusions: We found that approximately one-fourth of the present subjects with disabilities who possessed at least one of T. denticola, T. forsythia, and C. rectus were at possible risk for periodontitis. Follow-up examinations as well as preventive approaches should be utilized for such individuals. (Source: BMC Oral Health - Latest articles)

Maternal Antenatal Complications and the Risk of Neonatal Cerebral White Matter Damage and Later Cerebral Palsy in Children Born at an Extremely Low Gestational Age

American Journal of Epidemiology — Mon, 21 Sep 2009 23:00:00 +0100

In a 2002–2004 prospective cohort study of deliveries of infants at <28 weeks at 14 US centers, the authors sought the antecedents of white matter damage evident in newborn cranial ultrasound scans (ventriculomegaly and an echolucent lesion) and of cerebral palsy diagnoses at age 2 years. Of the 1,455 infants enrolled, those whose mothers received an antenatal steroid tended to have lower risks of ventriculomegaly and an echolucent lesion than their peers (10% vs. 23%, P < 0.001 and 7% vs. 11%, P = 0.06, respectively). Risk of ventriculomegaly was increased for infants delivered because of preterm labor (adjusted odds ratio (OR) = 2.3, 95% confidence interval (CI): 1.1, 4.9), preterm premature rupture of fetal membranes (OR = 3.6, 95% CI: 1.5, 8.7), and cervical insufficiency (...

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Multiple births and aplasia cutis

The Journal of Pediatrics — Fri, 18 Sep 2009 17:01:55 +0100

To the Editor: Schaffer et al consider the etiology of aplasia cutis congenita and implicate the role of monochorionic twin gestation. They propose disseminated intravascular coagulation secondary to the transfer of thromboplastic proteins from the dead twin into the surviving twin's circulation to explain the ischemic insults to the survivor's skin and other organs. They also consider direct thrombolization from the dead twin's circulation, but dismiss it as improbable. Both of these hypotheses assume that the death of one twin is sine qua non for the survivor to be affected. This assumption is unjustified. It does not explain those cases in which both twins survive and one or both have a congenital anomaly. Other authors have proposed that perturbations in feto-fetal transfusion are res...

Experience, Cortical Remapping, and Recovery in Brain Disease.

Neurobiology of Disease — Thu, 17 Sep 2009 23:00:00 +0100

Authors: Wittenberg GF Recovery of motor function in brain and spinal cord disorders is an area of active research that seeks to maximize improvement after an episode of neuronal death or dysfunction. Recovery likely results from changes in structure and function of undamaged neurons, and this plasticity is a target for rehabilitative strategies. Sensory and motor function are mapped onto brain regions somatotopically, and these maps have been demonstrated to change in response to experience, particularly in development, but also in adults after injury. The map concept, while appealing, is limited, as the fine structure of the motor representation is not well-ordered somatotopically. But after stroke, the spared areas of the main cortical map for movement appears to participate in repr...

Imaging Data Reveal a Higher Pediatric Stroke Incidence Than Prior US Estimates.

Stroke — Wed, 16 Sep 2009 23:00:00 +0100

CONCLUSIONS: Our incidence estimate doubles that of prior US reports, a difference at least partially explained by our use of radiology searches for case identification. Studies relying purely on International Classification of Diseases, 9th Revision code searches may underestimate childhood ischemic stroke rates, particularly for neonates. PMID: 19762687 [PubMed - as supplied by publisher] (Source: Stroke)

Intensive speech and language therapy for older children with cerebral palsy: a systems approach

Developmental Medicine and Child Neurology — Tue, 15 Sep 2009 23:00:00 +0100

Aim To investigate whether speech therapy using a speech systems approach to controlling breath support, phonation, and speech rate can increase the speech intelligibility of children with dysarthria and cerebral palsy (CP).Method Sixteen children with dysarthria and CP participated in a modified time series design. Group characteristics were as follows: seven males, nine females; age range 12 to 18 years (mean 14y, SD 2); CP type: nine spastic, two dyskinetic, four mixed, one Worster[ndash]Drought; Gross Motor Function Classification System levels range I to V (median IV). Children received three 30- to 45-minute sessions of individual therapy per week for 6 weeks. Intelligibility in single words and connected speech was compared across four points: 1 week and 6 weeks before therapy, and ...

Head stability during quiet sitting in children with cerebral palsy: effect of vision and trunk support.

Experimental Brain Research — Tue, 15 Sep 2009 23:00:00 +0100

Authors: Saavedra S, Woollacott M, van Donkelaar P Deficits in postural control are one of the hallmarks of disability in children with cerebral palsy (CP). Yet, much remains unknown regarding the etiology of postural deficits in these children. Here we evaluated postural control at a simplified task level by measuring head stability during quiet sitting while systematically manipulating the level of trunk support and vision in 15 children with CP (6-16 years), 26 typically developing (TD) children (4-14 years), and 11 adults. While TD children did not differ significantly from adults, children with CP had greater head movement than adults in both the sagittal and frontal planes under all conditions except frontal plane movement with Torso Support. Vision did not affect head stability ...

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Effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture: A randomized controlled trial

International Journal of Nursing Studies — Mon, 14 Sep 2009 16:55:32 +0100

Abstract: Objectives: To study the effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture daily in a clinical setting.Design: A randomized controlled trial.Setting: Acupuncture Unit at Shenzhen Hospital of Traditional Chinese Medicine in Shenzhen City of China.Participants: Sixty children with cerebral palsy undergoing acupuncture.Methods: Intervention: Children listened to their favorite music or a blank disc for 30min. Measurements: (1) the modified Yale preoperative anxiety scale for children's anxiety (mYPAS); (2) children's hospital of eastern Ontario pain scale (CHEOPS) and Wong-Baker faces pain rating scale (FACES) for pain intensity; (3) vital signs including mean arterial blood pressure (MAP), heart rate (HR) and respiratory rate (RR).Results: A...

Practice Parameter: Evaluation of the child with microcephaly (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society

Neurology — Sun, 13 Sep 2009 23:00:00 +0100

Objective: To make evidence-based recommendations concerning the evaluation of the child with microcephaly. Methods: Relevant literature was reviewed, abstracted, and classified. Recommendations were based on a 4-tiered scheme of evidence classification. Results: Microcephaly is an important neurologic sign but there is nonuniformity in its definition and evaluation. Microcephaly may result from any insult that disturbs early brain growth and can be seen in association with hundreds of genetic syndromes. Annually, approximately 25,000 infants in the United States will be diagnosed with microcephaly (head circumference <–2 SD). Few data are available to inform evidence-based recommendations regarding diagnostic testing. The yield of neuroimaging ranges from 43% to 80%. Genetic etio...

N.D.T. in Cerebral Palsy

Pediatric Physiotherapy Research, Lovely Professional University — Sat, 12 Sep 2009 20:28:00 +0100

EFFICACY OF INTENSIVE NEURODEVELOPMENT THERAPY VERSUS CONVENTIONAL PHYSIOTHERAPY IN CHILDREN WITH SPASTIC CEREBRAL PALSY *Mehta Poonam, *MPT Pediatrics Department of Physiotherapy, Lovely Professional University, Punjab ABSTRACT Cerebral palsy (CP) is a well-recognized neurodevelopmental condition beginning in early childhood and persisting through the lifespan. There are many systems of treatment for cerebral palsy. In a very effective method of treatment, NDT, the patient learns to control movement through the use of the development sequence using activities that promote “normal” selective movements. The main aim of this study is to prove the difference of effectiveness of intensive neurodevelopment therapy with conventional physiotherapy treatment. -------------------------...

Leisure activities for 6 to 12-year-old children with cerebral palsy

Developmental Medicine and Child Neurology — Thu, 10 Sep 2009 23:00:00 +0100

(Source: Developmental Medicine and Child Neurology)

Measuring mobility limitations in children with cerebral palsy: interrater and intrarater reliability of a mobility questionnaire (MobQues)

Developmental Medicine and Child Neurology — Thu, 10 Sep 2009 23:00:00 +0100

The objective of this study was to assess the reliability of a mobility questionnaire (MobQues) that was developed to measure the mobility limitations of children with cerebral palsy (CP) as rated by their parents. A clinical version of the questionnaire, consisting of 47 items (MobQues47), is available, as well as a research version with 28 items for a specific population (MobQues28). Total scores are expressed on a scale of 0 to 100.Method We assessed the interrater reliability between both parents of 289 children with CP (168 males, 121 females, age range 2[ndash]13y, Gross Motor Function Classification System levels I[ndash]IV) and the intrarater reliability within a subgroup of 38 parents (of 23 children) who completed the MobQues twice.Results For the interrater reliability, high int...

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Hyperbaric oxygen therapy for brain injury cerebral palsy and stroke

Neurological Conditions Specialist Library — Thu, 10 Sep 2009 18:18:27 +0100

A structured abstract written by CRD reviewers. The abstract was published on 19 August 2009 from an original article published in 2003. (Source: Neurological Conditions Specialist Library)

Interhemispheric interaction in the motor domain in children with cerebral palsy

Neurology India — Thu, 10 Sep 2009 16:51:18 +0100

Conclusion</b> : Hand/finger synkineses in CP children change with rehabilitation. The methods used in the study can be recommended for application in the system of medico-biological and psycho-pedagogical monitoring of children with CP. (Source: Neurology India)

Congenital anomalies in children with cerebral palsy: a population-based record linkage study

Developmental Medicine and Child Neurology — Tue, 08 Sep 2009 23:00:00 +0100

Aim Our aim was to determine the proportion of children with cerebral palsy (CP) who have a congenital anomaly (CA) in three regions (Isère Region, French Alps; Funen County, Denmark; Northern Region, England) where population-based CP and CA registries exist, and to classify the children according to CA subtype.Method Data for children born between 1991 and 1999 were linked using electronic matching of cases. All potential matches were checked manually by each centre and verified as true matches.Results A total of 1104 children with CP were born during the study period (663 males, 441 females). Of these, 166 (15%; 95% Confidence Interval [CI] 13.0[ndash]17.3) children with CP had a CA: 8.8% had a cerebral anomaly, 4.8% had a non-cerebral anomaly, and 1.4% had a non-cerebral-related syndr...

Microbiologic and histologic characteristics of the extremely preterm infant's placenta predict white matter damage and later cerebral palsy. The ELGAN Study.

Pediatric Research — Tue, 08 Sep 2009 23:00:00 +0100

Authors: Leviton A, Allred EN, Kuban KC, Hecht JL, Onderdonk AB, Oʼshea TM, Paneth N Inflammatory phenomena appear to contribute to the occurrence of perinatal cerebral white matter damage and cerebral palsy (CP). The stimulus that initiates the inflammation remains obscure. 1246 infants born before the 28 post-menstrual week had a protocol ultrasound scan of the brain read concordantly by two independent sonologists. 899 of the children had a neurologic examination at approximately 24 months post term equivalent. The placenta of each child had been biopsied under sterile conditions, and later cultured. Histologic slides of the placenta were examined specifically for this study. Recovery of a single microorganism predicted an echolucent lesion, whereas polymicrobial cultures and ...

Neuromuscular adaptations to eccentric strength training in children and adolescents with cerebral palsy

Developmental Medicine and Child Neurology — Mon, 07 Sep 2009 23:00:00 +0100

Aim To determine the neuromuscular outcomes of an eccentric strength-training programme for children and adolescents with cerebral palsy (CP).Method In this randomised, parallel-group trial with waiting control, 14 participants with CP (six males, eight females; mean age 11y, SD 2y range 9[ndash]15y), diagnosed with upper-limb spasticity were compared with 14 age- and sex-matched typically developing participants. Participants with CP completed a 6-week progressive resistance-strengthening programme, performing eccentric lengthening contractions of their upper limb three times a week. Data from dynamometer and surface electromyography (EMG) assessments included peak torque normalised to body mass (T/Bm), work normalised to body mass (W/Bm), angle at peak torque, curve width, and EMG activa...

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The health of children with cerebral palsy and stress in their parents

Journal of Advanced Nursing — Mon, 07 Sep 2009 23:00:00 +0100

Conclusion. Children with cerebral palsy and associated impairments are at higher risk of poorer health and family well-being. A family-centred approach to the care of children with cerebral palsy and their families is essential to ensure both receive adequate care and support. (Source: Journal of Advanced Nursing)

What Are The Options for Treating Excessive Salivation?

PediatricEducation.org — Mon, 07 Sep 2009 00:01:02 +0100

Discussion Drooling, excessive salivation, hypersalivation, or sialorrhea can be a big problem for children. It can cause wet clothing necessitating bibs or multiple changes of clothing. It can cause dermatitis of the face, neck and chest, with possible skin breakdown and/or possible secondary infection. Sialorrhea can also potentiate the spread of common infections to others though direct or indirect contact with the saliva. It can also cause impaired social interaction as noted above. Therefore it is a problem that should be taken seriously and treated as necessary. Sialorrhea is generally considered abnormal if it occurs during the day after the age of 3-4 years. Most people affected have some other neurological problem including cerebral palsy or in adult populations, patients with Pa...

The relationship between spasticity in young children (18 months of age) with cerebral palsy and their gross motor function development

BMC Musculoskeletal Disorders — Thu, 03 Sep 2009 23:00:00 +0100

Conclusions: Our findings indicate that when measured over one year, spasticity is marginally related to gross motor function development in infants with CP. The initial level of spasticity is only one of the many child, environmental and family factors that determines gross motor development of a young child with CP. (Source: BMC Musculoskeletal Disorders)

[Intrathecal baclofen therapy : Overdose during replacement of a medication pump.]

Der Anaesthesist — Thu, 03 Sep 2009 23:00:00 +0100

Authors: Kramer K, Weber M, Koulousakis A, Lier H, Krep H This case report reviews the anesthesiological complications of intrathecal baclofen (ITB) therapy. An 11-year-old boy with spasticity and apallic syndrome needed general anesthesia for exchange of a baclofen pump but 2 h later he became increasingly hypothermic, hypotonic with bradycardy and dyspnea. The cause was an intra-operative bolus of ITB. Reduction of the baclofen administration rate caused disappearance of all symptoms without any residual effects. The ITB is an increasingly used therapeutic option for multiple sclerosis and cerebral palsy. Therefore, emergency personal and anesthesiologists must be aware of the possible side effects of this medication. PMID: 19730795 [PubMed - as supplied by publisher] (Source: De...

A Life Less Ordinary

Cerebral Palsy International Research Foundation Website Updates — Thu, 03 Sep 2009 19:19:24 +0100

Hi everyone, read more (Source: Cerebral Palsy International Research Foundation Website Updates)

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Evidence of changes in the immunophenotype and metabolic characteristics (intracellular reactive oxygen radicals) of fetal, but not maternal, monocytes and granulocytes in the fetal inflammatory response syndrome

Journal of Perinatal Medicine — Thu, 03 Sep 2009 17:50:53 +0100

Journal of Perinatal Medicine 37 (5): 543-552 Abstract Objective: The fetal inflammatory response syndrome (FIRS) is present in a fraction of fetuses exposed to intra-amniotic infection and is associated with the impending onset of labor and multisystem organ involvement. Neonates born with funisitis, the histologic counterpart of fetal systemic inflammation, are at increased risk for cerebral palsy and bronchopulmonary dysplasia. The aim of this study was to determine whether fetal and maternal granulocytes and monocytes have the phenotypic and metabolic characteristics of activation in cases with FIRS. Study design: A case-control study was conducted with umbilical cord and maternal blood samples obtained from patients who delivered preterm with (n=30) and without funisitis (n=15). The p...

Newborn Blood Data Used To Study Cerebral Palsy

Health News from Medical News Today — Thu, 03 Sep 2009 08:00:00 +0100

A statewide team of researchers led by a Michigan State University epidemiologist are hoping Michigan's archive of newborn blood spots will help them uncover the causes of cerebral palsy, the most common disabling motor disorder in children with annual health costs of $12 billion. The research team, led by MSU's Nigel Paneth and recently awarded $1. (Source: Health News from Medical News Today)

Functional impairment severity is associated with health status among older persons with intellectual disability and cerebral palsy*

Journal of Intellectual Disability Research — Wed, 02 Sep 2009 23:00:00 +0100

Conclusion With the exception of dysphagia, impairment in ADLs and walking capabilities, and not CP diagnosis alone, accounted for disparities in specific diseases. Although the diagnosis of CP may be correlated with functional impairment, it alone may play a minor role in determining health trajectories in older persons with conjoint ID and CP. (Source: Journal of Intellectual Disability Research)

Abstracts from the Special Care Dentistry 21st Annual Meeting can be accessed in the electronic version of this issue at interscience.wiley.com

Special Care in Dentistry — Wed, 02 Sep 2009 23:00:00 +0100

This study's purpose was to note trends in the prevalence of oral manifestations of HIV and assess variations in the dental care of adults with HIV given the current use of antiretroviral therapy in both the industrialized world and developing nations. A comprehensive review of the English literature was completed on the incidence and prevalence of oral diseases and the types of dental services that provided comprehensive oral care to patients who have been HIV positive since 1980. The study concluded that significant and similar disparities exist in the use of dental health services for both patients with HIV and the general population. With the use of HAART, the incidence of oral mucosal lesions is also being reduced. In this presentation, attendees will learn what effect the existing me...

Bound for Success: A Systematic Review of Constraint-Induced Movement Therapy in Children With Cerebral Palsy Supports Improved Arm and Hand Use.

Physical Therapy — Wed, 02 Sep 2009 23:00:00 +0100

CONCLUSIONS:/b> Studies varied widely in type and rigor of design; subject, constraint, and intervention characteristics; and ICF level for outcome measures. One outcome measure at the body functions and structure level and 4 outcome measures at the activity level had large and significant treatment effects (d>/=.80), and these findings were from the most rigorous studies. Evidence from more-rigorous studies demonstrated an increased frequency of use of the upper extremity following CIMT for children with hemiplegic CP. The critical threshold for intensity that constitutes an adequate dose cannot be determined from the available research. Further research should include a priori power calculations, more-rigorous designs and comparisons of different components of CIMT in relation to s...

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Neuregulin-1, the Fetal Endothelium, and Brain Damage in Preterm Newborns.

Brain, Behavior, and Immunity — Wed, 02 Sep 2009 23:00:00 +0100

In conclusion, our data indicate that gestational age, duration of LPS exposure, and the SNP8NRG221533 genotype affect NRG1 levels. Our results support the hypothesis that NRG1 may qualify as an endogenous protector during fetal development. PMID: 19733651 [PubMed - as supplied by publisher] (Source: Brain, Behavior, and Immunity)

Can Persistent Drop Foot After Calf Muscle Lengthening Be Predicted Preoperatively?

Journal of Foot and Ankle Surgery — Wed, 02 Sep 2009 00:00:00 +0100

Calf muscle lengthening usually corrects equinus gait satisfactorily in stance. While in swing, the foot remains in drop foot in approximately half the limbs. The aim of this study was to evaluate if any preoperative clinical findings or kinematic and kinetic data could predict the outcome regarding drop foot. The study included 34 children with cerebral palsy. The average age was 9.3 years. Only children with preoperative maximum ankle dorsiflexion in stance and maximum ankle dorsiflexion in swing more than 2 standard deviations below the normal mean were included. The children underwent preoperative and postoperative clinical examination and gait analysis. Forty calf muscle lengthenings were performed (26 tendo-achilles lengthenings, 14 gastrocnemius recessions). Nineteen of 40 limbs rem...

MSU researchers use newborn blood data to study cerebral palsy

EurekAlert! - Social and Behavioral Science — Tue, 01 Sep 2009 04:00:00 +0100

(Michigan State University) A statewide team of researchers led by a Michigan State University epidemiologist are hoping Michigan's archive of newborn blood spots will help them uncover the causes of cerebral palsy, the most common disabling motor disorder in children with annual health costs of $12 billion. (Source: EurekAlert! - Social and Behavioral Science)

Comparison of digito-palmar dermatoglyphic traits in children with cerebral palsy and their close family members.

Collegium Antropologicum — Tue, 01 Sep 2009 00:00:00 +0100

Authors: Polovina-Proloscić T, Milicić J, Cvjeticanin M, Polovina A, Polovina S Cerebral palsy is one of the main causes of severe disability in children. Sixty children (30 boys and 30 girls) were included in the study. Quantitative digito-palmar dermatoglyphic traits were analyzed. Prints of digito-palmar dermatoglyphs obtained from the children's parents (60 mothers and 60 fathers) and from 400 phenotypically healthy adults from the Zagreb ware used as control groups. Analysis of quantitative dermatoglyphic traits of the digito-palmar complex revealed statistically significant differences in a number of variables between the fathers and their children suffering from cerebral palsy (TRC 180.3 > 158.6), with a greater number of variables involved in male children with c...

Cerebral palsy following neonatal hypoxic seizures in singleton term infants: the influence of parity.

Ir Med J — Tue, 01 Sep 2009 00:00:00 +0100

Authors: Mahony R, Enright F, O'Herlihy C, Foley ME This was a retrospective review of term singleton neonates (> 37 weeks) with early onset seizures, with and without encephalopathy, from 1989 through 2000. Our aim was to examine the relationship between antepartum and intrapartum obstetric events, neonatal hypoxic seizures and subsequent neurological impairment of 77,838 infants, the incidence of seizures was significantly higher among primiparas (2.4/1000; 67/31,729) compared with multiparas (0.35/1000; 16/46,109)(p < 0.001). Compared with multiparas, seizures with encephalopathy occurred more frequently among primiparas (0.8/1000; 26/31,729) vs. multiparas (0.2/1000; 8/46,109), were more commonly associated with unexplained intrapartum hypoxia (0.6/1000, n = 20 vs.0.04/ 1000,...

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Disorders of Placental Circulation and the Fetal Brain

Clinics in Perinatology — Mon, 31 Aug 2009 23:00:00 +0100

Disorders of the placental circulation, including the release of deleterious mediators to the fetus, are important risk factors for central nervous system complications. These disorders result in discrete patterns of placental injury detectable by a thorough placental pathologic examination. Consideration of the location, severity, multiplicity, and timing of these lesions is critical to a full understanding of their significance. Less than 10% of placentas from term infants that later develop cerebral palsy lack any evidence of placental abnormalities potentially related to adverse outcome. (Source: Clinics in Perinatology)

Fetal Infections and Brain Development

Clinics in Perinatology — Mon, 31 Aug 2009 23:00:00 +0100

Current microbial diagnostics enable rapid and specific identification of the agents causing intrauterine and perinatal infections, and CT and MRI allow precise characterization of the central nervous system effects of these pathogens. Although infections with Toxoplasma gondii, Toxoplasma pallidum, Toxoplasma cruzi, and cytomegalovirus cannot currently be prevented by immunization, postnatal therapy of infected neonates can substantially improve outcome. Therapy with acyclovir should be initiated whenever perinatal herpes simplex virus encephalitis is suspected. Despite these strategies, intrauterine and perinatal infections remain major causes of permanent deafness, vision loss, cerebral palsy, and epilepsy among children throughout the world. (Source: Clinics in Perinatology)

Probing the Fetal Cardiac Signal for Antecedents of Brain Injury

Clinics in Perinatology — Mon, 31 Aug 2009 23:00:00 +0100

Obstetric care providers and researchers have long relied on analysis of the fetal heart rate tracing for insight into the fetal neurologic status. Although a normal fetal heart rate tracing does provide reassurance of intact neurologic function, an abnormal pattern is a very poor predictor of newborn brain injury. Indeed, if the clinical end point of interest is cerebral palsy, a non-reassuring fetal heart rate tracing has a 99% false positive rate. More recent analyses of fetal heart rate variability and fetal ECG waveforms, however, hold promise for improved diagnostic accuracy. (Source: Clinics in Perinatology)

Health of children born to mothers who had preeclampsia: a population-based cohort study

American Journal of Obstetrics and Gynecology — Mon, 31 Aug 2009 23:00:00 +0100

Conclusion: Preeclampsia was associated with an increased risk of being hospitalized for a number of diseases, especially in the children born at term. (Source: American Journal of Obstetrics and Gynecology)

Transcutaneous needle-free injection of botulinum toxin: a novel treatment of childhood constipation and anal fissure

Journal of Pediatric Surgery — Mon, 31 Aug 2009 23:00:00 +0100

Conclusion: Transcutaneous needle-free injection of botulinum toxin into the external anal sphincter is a novel and safe new treatment of chronic idiopathic constipation and anal fissure in children. A second injection may be required in 20% of patients. (Source: Journal of Pediatric Surgery)

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Genetics and Biology of Microcephaly and Lissencephaly

Seminars in Pediatric Neurology — Mon, 31 Aug 2009 23:00:00 +0100

Genetic microcephaly and lissencephaly are 2 of the most common brain malformations. Each of them is a heterogeneous group of disorders caused by mutations of many different genes. They are a significant cause of neurological morbidity in children worldwide, responsible for many cases of mental retardation, cerebral palsy, and epilepsy. Recent advances in molecular genetics have led to the identification of several genes causing these disorders, and thus accurate molecular diagnosis and improved genetic counseling has become available for many patients and their families. More recently identified genes include STIL, causing primary autosomal recessive microcephaly (microcephaly vera), and TUBA1A, causing lissencephaly. Numerous other disease genes are likely still to be identified. Functio...

Surgical Management of Spasticity in Persons with Cerebral Palsy

PM&R — Mon, 31 Aug 2009 23:00:00 +0100

Cerebral palsy is a disorder that primarily affects the neurologic system but secondarily affects the musculoskeletal system through the effects of spasticity, dystonia, and other movement disorders. The treatment of cerebral palsy requires a multidisciplinary approach with treatment aimed at modulating the movement disorder through oral medication, injectable drugs (phenol, botulinum toxin), and physical and occupational therapy. Treatment of the neurologic effects of the central movement disorders include selective dorsal rhizotomy, intrathecal baclofen pump placement, and potentially deep brain stimulation. Although any effect on tone is temporary, orthopedic surgery has an important role in the treatment of the musculoskeletal deformities and contractures present in the child with cere...

Commentary

Aesthetic Surgery Journal — Mon, 31 Aug 2009 23:00:00 +0100

In their article, Sutphin et al seek to examine the development of antibodies to a specific formulation of botulinum toxin type A (Botox, Allergan, Irvine, CA) with a seemingly simple and straightforward experiment. The question of antibody formation in response to BTA is obviously of greater import in the functional world of medicine as opposed to the aesthetic world. When treating cervical dystonia or cerebral palsy spasm, doses are much higher, intervals are frequently shorter, and the consequences of losing your best treatment option are much greater than when treating an aesthetic patient. However, loss of the toxin as a cosmetic treatment is obviously something we would rather avoid, however rare those cases might be. (Source: Aesthetic Surgery Journal)

Senator Edward M. Kennedy

United Cerebral Palsy National News — Mon, 31 Aug 2009 19:02:00 +0100

(Source: United Cerebral Palsy National News)

Using computer-based video analysis in the study of fidgety movements

Early Human Development — Mon, 31 Aug 2009 13:39:29 +0100

Conclusion: Video recordings can be used for qualitative and quantitative analyses of FMs provided by GMT. GMT is easy to implement in clinical practice, and may provide assistance in detecting infants without FMs. (Source: Early Human Development)

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Outcomes of combined hamstring release and rectus transfer in children with crouch gait.

Ortopedia, Traumatologia, Rehabilitacja — Sun, 30 Aug 2009 23:00:00 +0100

Conclusions: This study demonstrated that static parameters, time-distance parameters, knee and ankle kinematics were improved following combined hamstring release and rectus transfer in children with cerebral palsy without any cases of stiff knees. PMID: 19828915 [PubMed - as supplied by publisher] (Source: Ortopedia, Traumatologia, Rehabilitacja)

Letter to the editor on 'Safety of botulinum toxin type A among children with spasticity secondary to cerebral palsy: a systematic review of randomized clinical trials'.

Clinical Rehabilitation — Sun, 30 Aug 2009 07:16:04 +0100

Authors: Idrovo AJ, Albavera-Hernández C, Rodríguez JM PMID: 19713401 [PubMed - in process] (Source: Clinical Rehabilitation)

Probability of walking, wheeled mobility, and assisted mobility in children and adolescents with cerebral palsy

Developmental Medicine and Child Neurology — Thu, 27 Aug 2009 23:00:00 +0100

Aim Our aim was to describe how the probability of walking, wheeled mobility, and assisted mobility changes with environmental setting and age in children and adolescents with cerebral palsy (CP).Method The parents of a population-based sample of 642 children and adolescents (360 males, 282 females; age range 16mo[ndash]21y) reported their children's mobility at home, school, and outdoors at 6- or 12-month intervals a mean of 5.2 times. Generalized mixed-effects analyses were used to model the probabilities.Results By age 3 years, children with motor function classified as level I according to the Gross Motor Function Classification System (GMFCS) walked in all three settings. Children/adolescents classified as level V used assisted mobility, with a small number using wheeled mobility. In ...

Evaluating participation in children and young people with cerebral palsy

Developmental Medicine and Child Neurology — Thu, 27 Aug 2009 23:00:00 +0100

(Source: Developmental Medicine and Child Neurology)

how do mothers and fathers who have a child with a disability describe their adaptation/ transformation process?

Journal of Child Health Care — Wed, 26 Aug 2009 23:00:00 +0100

This qualitative study explored the adaptation/transformation process in mothers and fathers at the individual, parental, marital and extrafamilial levels, and the similarities and differences in their experience of living with a child with cerebral palsy. Interviews were conducted with 13 mothers and 13 fathers of children with cerebral palsy. The results show that mothers and fathers are more likely to view the situation differently than similarly. For both parents, the situation offers the potential for transformation. Complementarity between mothers and fathers is an important factor in each of the adaptation or transformation subsystems. Both parents embark on a journey that changes their beliefs about difference, apply their new knowledge to every aspect of their life, and endeavour ...

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Maternal Antenatal Complications and the Risk of Neonatal Cerebral White Matter Damage and Later Cerebral Palsy in Children Born at an Extremely Low Gestational Age.

Am J Epidemiol — Wed, 26 Aug 2009 23:00:00 +0100

Authors: McElrath TF, Allred EN, Boggess KA, Kuban K, O'Shea TM, Paneth N, In a 2002-2004 prospective cohort study of deliveries of infants at <28 weeks at 14 US centers, the authors sought the antecedents of white matter damage evident in newborn cranial ultrasound scans (ventriculomegaly and an echolucent lesion) and of cerebral palsy diagnoses at age 2 years. Of the 1,455 infants enrolled, those whose mothers received an antenatal steroid tended to have lower risks of ventriculomegaly and an echolucent lesion than their peers (10% vs. 23%, P < 0.001 and 7% vs. 11%, P = 0.06, respectively). Risk of ventriculomegaly was increased for infants delivered because of preterm labor (adjusted odds ratio (OR) = 2.3, 95% confidence interval (CI): 1.1, 4.9), preterm premature rupture of ...

Context-dependent IL-6 potentiation of interferon- gamma-induced IL-12 secretion and CD40 expression in murine microglia

Journal of Neurochemistry — Wed, 26 Aug 2009 23:00:00 +0100

Interleukin-6 (IL-6) is produced by neurons, astrocytes, and microglia, and elevated levels of IL-6 within the CNS have been documented in multiple neurological disorders including Alzheimer's disease, stroke, epilepsy, attention deficit disorder, cerebral palsy, and multiple sclerosis. Here, we sought to understand how IL-6 regulates microglial signal transduction and their immune properties. Using highly enriched cultures of neonatal murine microglia we show that IL-6 alone has direct effects on microglia as it activates STAT3 and extracellular signal-regulated kinase pathways in a time- and dose-dependent fashion and it enhances interferon-gamma (IFN[gamma])-stimulated IL-12 secretion. However, other immune properties were only weakly modulated by IL-6 when administered without the solu...

Impact of Video Review on Surgical Procedure Determination for Patients With Cerebral Palsy

The Journal of Hand Surgery — Wed, 26 Aug 2009 12:57:08 +0100

Conclusions: Videotaping evaluations allows for more precise understanding of ability and improves diagnosis. Changes to the initial presurgical plan were made in 77 patients (72%) after videotaped evaluation, most commonly for procedures addressing the wrist, digit, and thumb. (Source: The Journal of Hand Surgery)

Robots Teach Kids How to Walk

Medical Headlines From Ivanhoe.com — Wed, 26 Aug 2009 05:00:00 +0100

It impacts 8,000 babies every year … more than 750,000 kids and adults in the United States are living with cerebral palsy. (Source: Medical Headlines From Ivanhoe.com)

Transformational Technologies in Single-Event Neurological Conditions: Applying Lessons Learned in Stroke to Cerebral Palsy (August 14-15, 2008)

Neurorehabilitation and Neural Repair — Tue, 25 Aug 2009 23:00:00 +0100

(Source: Neurorehabilitation and Neural Repair)

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A predictive mathematical model of muscle forces for children with cerebral palsy

Developmental Medicine and Child Neurology — Mon, 24 Aug 2009 23:00:00 +0100

Aim The purpose of this study was to determine if our previously developed muscle model could be used to predict forces of the quadriceps femoris and triceps surae muscles of children with spastic diplegic cerebral palsy (CP).Method Twenty-two children with CP (12 males, 10 females; mean age 10y, SD 2y, range 7[ndash]13y; Gross Motor Function Classification System levels II and III) participated. A physiologically based mathematical model with four free parameters is presented.Results For individuals with CP, the model predicted well the force profile throughout each contraction and both peak force and force[ndash]time integral responses to a wide range of stimulation frequencies (5[ndash]100Hz) and different stimulation patterns (constant-, variable-, and doublet-frequency trains) both fo...

Caries experience in individuals with cerebral palsy in relation to oromotor dysfunction and dietary consistency

Special Care in Dentistry — Mon, 24 Aug 2009 23:00:00 +0100

The aim of this study was to investigate caries experience in individuals with cerebral palsy (CP) who have oromotor dysfunction and relate it to age and dietary consistency. Noninstitutionalized individuals with CP (n = 108) aged 4[ndash]19 years (mean: 10 years, 1 month ± SD 4 years, 5 months) were recruited for this study. Subjects who were severely impaired (35.2%) had orofacial motor dysfunction most frequently, followed by those who were slightly affected (27.7%), moderately affected (20.4%), and very slightly affected (16.7%). Age was a statistically significant factor for oromotor dysfunction (p= 0.007), with the youngest individuals having the most severe oromotor problems. Dietary consistency and oromotor function were statistically significant influence on the DMF index (p= 0.0...

Medical home optimizes care for children with cerebral palsy [FOCUS ON SUBSPECIALTIES]

AAP News — Sun, 23 Aug 2009 23:00:00 +0100

(Source: AAP News)

Early intervention in management of very preterm growth-restricted fetuses: 2-year outcome of infants delivered on fetal indication before 30 gestational weeks.

The Ultrasound Review of Obstetrics and Gynecology — Sun, 23 Aug 2009 23:00:00 +0100

CONCLUSIONS: Very preterm growth-restricted fetuses with umbilical artery ARED delivered on fetal indication, in most cases before the occurrence of severe changes in the ductus venosus velocity waveforms and/or fetal heart rate tracings, showed high 2-year survival and low morbidity. Copyright (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 19705404 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Long term follow-up of very low birthweight infants from a neonatal volume versus pressure mechanical ventilation trial [Original articles]

Archives of Disease in Childhood - Fetal and Neonatal Edition — Fri, 21 Aug 2009 17:02:03 +0100

Conclusions: The efficacy of VCV in very preterm and low birth babies appears to be maintained on longer term evaluation. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)

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Very preterm children show impairments across multiple neurodevelopmental domains by age 4 years [Original articles]

Archives of Disease in Childhood - Fetal and Neonatal Edition — Fri, 21 Aug 2009 17:02:02 +0100

Conclusions: A substantial proportion of preschool children born very preterm show clinically significant problems in at least one neurodevelopmental domain, with impairment in multiple domains being common. There is a need to monitor preschool development across a range of functional domains and to consider the likely cascading effects of multiple impairments on later development. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)

The impact of caring for a child with cerebral palsy: quality of life for mothers and fathers

Child: Care, Health and Development — Thu, 20 Aug 2009 23:00:00 +0100

Conclusions Caring for a child with CP can both positively and negatively impact on a parent's life. There is value for both parents and children if parental concerns and determinants of QOL are considered in overall programme planning and service delivery for children and their families. (Source: Child: Care, Health and Development)

Course of behaviour problems of children with cerebral palsy: the role of parental stress and support

Child: Care, Health and Development — Thu, 20 Aug 2009 23:00:00 +0100

Conclusions Levels of behaviour problems are elevated but diminish during adolescence for children with CP. Severity of CP plays a role as well as the family context in terms of the stress and support that caregivers experience. (Source: Child: Care, Health and Development)

[Miscellanea] Horse riding for children with cerebral palsy

Archives of Disease in Childhood — Thu, 20 Aug 2009 23:00:00 +0100

(Source: Archives of Disease in Childhood)

[Original articles] Very preterm children show impairments across multiple neurodevelopmental domains by age 4 years

Archives of Disease in Childhood - Fetal and Neonatal Edition — Thu, 20 Aug 2009 23:00:00 +0100

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[Original articles] Long term follow-up of very low birthweight infants from a neonatal volume versus pressure mechanical ventilation trial

Archives of Disease in Childhood - Fetal and Neonatal Edition — Thu, 20 Aug 2009 23:00:00 +0100

Conclusions: The efficacy of VCV in very preterm and low birth babies appears to be maintained on longer term evaluation. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)

Consensus research priorities for cerebral palsy: a Delphi survey of consumers, researchers, and clinicians

Developmental Medicine and Child Neurology — Wed, 19 Aug 2009 23:00:00 +0100

This study aimed to identify questions for future research that were agreed to be a high priority.Method An expert panel of consumers, researchers, and clinicians was assembled (n=127) and surveyed using a Delphi survey comprising three rounds. In round I, participants identified three important research topics. Three parallel surveys were constructed: (1) consumers; (2) intervention researchers and clinicians; and (3) aetiology and prevention researchers. In rounds II and III, participants rated priorities using a seven-point Likert scale. Questions reaching consensus were itemized and those not reaching consensus were discarded.Results Consumers identified questions in the themes of prevention/cure, quality of life/community participation, and service provision/intervention. Intervention...

Is progressive resistance exercise ineffective in increasing muscle strength in young people with cerebral palsy?

The Australian Journal of Physiotherapy — Wed, 19 Aug 2009 20:12:02 +0100

Authors: Taylor NF PMID: 19681747 [PubMed - in process] (Source: The Australian Journal of Physiotherapy)

Tibialis posterior in health and disease: a review of structure and function with specific reference to electromyographic studies

BioMed Central — Tue, 18 Aug 2009 23:00:00 +0100

We present an overview of tibialis posterior muscle and tendon anatomy with images from cadaveric work on fresh frozen limbs and a review of current evidence that define normal and abnormal tibialis posterior muscle activation during gait. A video is available that demonstrates ultrasound guided intra-muscular insertion techniques for tibialis posterior electromyography.Current electromyography literature indicates tibialis posterior intensity and timing during walking is variable in healthy adults and has a disease-specific activation profile among different pathologies. Flat-arched foot posture and tibialis posterior tendon dysfunction are associated with greater tibialis posterior muscle activity during stance phase, compared to normal or healthy participants, respectively. Cerebral pal...

Child Neurology: Past, present, and future: Part 1: History

Neurology — Sun, 16 Aug 2009 23:00:00 +0100

The founding period of child neurology occurred in 3 phases: 1) early individual contributory phase, 2) organized training phase, and 3) expansion phase. In the late 19th and early 20th centuries, individuals in pediatrics, neurology, and psychiatry established clinics and made important contributions to the literature on childhood epilepsy, cerebral palsy, and pediatric neurology. The latter half of the 20th century saw the organization of training programs in pediatric neurology, with fellowships supported by the NIH. This development was followed by a rapid expansion in the number of trainees certified in child neurology and their appointment to divisions of neurology in children’s hospitals. In recent years, referrals of children with neurologic disorders have increased, and diso...

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The European perinatal health report: Delivering comparable data for examining differences in maternal and infant health

European Journal of Obstetrics, Gynecology, and Reproductive Biology — Sun, 16 Aug 2009 23:00:00 +0100

Abstract: In December 2008, the first-ever European Perinatal Health Report was released by EURO-PERISTAT. Part of the EU Health Programme for health surveillance and reporting, this landmark report presents indicators of perinatal health and care derived from routine statistical data in 25 EU Member States and Norway. It also includes chapters from three other European projects with perinatal data: SCPE on cerebral palsy, EUROCAT on congenital anomalies and EURONEOSTAT on very preterm babies admitted to intensive care. (Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology)

CPIRF announces 2009 Goldenson Awardees

Cerebral Palsy International Research Foundation News — Fri, 14 Aug 2009 12:27:05 +0100

CPIRF will award Diane Damiano, PT, PhD with the 2009 Weinstein-Goldenson Award at the American Academy of Cerebral Palsy and Developmental Medicine 63rd annual meeting on read more (Source: Cerebral Palsy International Research Foundation News)

CPIRF Announces the Funding of 3 New Research Projects

Cerebral Palsy International Research Foundation News — Fri, 14 Aug 2009 12:20:44 +0100

Three new research awards were made in 2009 by the CPIRF Board. The first award was made to Dr. Ahamed Hossain of the Hugo W. Moser Research Institute at read more (Source: Cerebral Palsy International Research Foundation News)

Medico-legal problems in obstetrics

Obstetrics, Gynaecology and Reproductive Medicine — Fri, 14 Aug 2009 10:47:42 +0100

Abstract: For a claim to succeed, both ‘Breach of Duty’ and ‘Causation’ need to be established. In medico-legal cases, the records and all documentation will be reviewed in detail; case records should be as clear, concise and accurate as possible. Deviation from protocols or guidelines does not necessarily constitute Breach of Duty, however, the reason for deviating from any protocol should be clearly stated within the medical records.Obstetric cases frequently involve cardiotocographs; to avoid retrospective over-interpretations of the changes in the foetal heart rate pattern, it is helpful to refer to recognised, published guidelines.In many cases where a child suffers brain damage and develops cerebral palsy, it is accepted that the intrapartum care was substandard. However, the...

Epidemiology of neurodevelopmental disorders in 2 years old Georgian children. Pilot study - population based prospective study in a randomly chosen sample.

European Journal of Paediatric Neurology — Thu, 13 Aug 2009 23:00:00 +0100

Authors: Tatishvili N, Gabunia M, Laliani N, Tatishvili S Three hundred-forty-eight out of a regional population of 1272 newborn infants were randomly chosen and followed neurologically until age of two years to study the epidemiology of neurodevelopmental disorders, and to reveal the main factors influencing outcome. The most frequent neonatal pathologies were low Apgar scores - 45 (3.5%), neonatal sepsis - 28 (2.2%), neonatal seizures - 26 (2.0%), neonatal sepsis complicated with bacterial meningitis - 13 (1.0%), traumatic injury of peripheral nerves - 7 (0.6%), intracranial hemorrhages - 4 (0.3%) and CNS malformations - 3 (0.2%). At the age of 24 months abnormal development was identified in 29 cases (8.5%) of children, comprising global developmental delay in five (1.5%), unclassif...

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Review of quantitative measurements of upper limb movements in hemiplegic cerebral palsy

Gait and Posture — Wed, 12 Aug 2009 23:00:00 +0100

Abstract: This review provides an overview of results found in literature on objective measurements of upper limb movements in children with hemiplegic cerebral palsy (HCP). Seventeen articles were selected following a systematic search. Analysed tasks varied from simple reaching and gross motor functions to complex, fine motor tasks. Spatiotemporal characteristics have been extensively studied and longer movement durations, slower movement speed and reduced trajectory straightness at the affected upper limb, compared to the non-affected side or healthy children, were most frequently reported. Joint kinematics has been far less studied. The limited data confirm the clinical impression of children with HCP using less elbow extension and supination to reach for an object, which is compensate...

Clinical observation on treatment of spastic cerebral palsy with tuina plus music therapy

Journal of Acupuncture and Tuina Science — Wed, 12 Aug 2009 20:56:27 +0100

(Source: Journal of Acupuncture and Tuina Science)

United Cerebral Palsy Endorses the America?s Affordable Health Choices Act

United Cerebral Palsy National News — Wed, 12 Aug 2009 19:39:00 +0100

(Source: United Cerebral Palsy National News)

Treatment of femur fractures in children with cerebral palsy

Journal of Children's Orthopaedics — Wed, 12 Aug 2009 15:46:01 +0100

Conclusion Our study results suggest that femur fractures in children with cerebral palsy can be treated non-operatively; however, because of the high risk of malunion in this patient population, fracture alignment needs to be followed closely during healing. Careful attention during casting is necessary to prevent pressure sores. Strong consideration should be given to initial operative treatment in ambulatory patients in order to preserve function. Content Type Journal ArticleCategory Original Clinical ArticleDOI 10.1007/s11832-009-0191-8Authors Arabella I. Leet, The Johns Hopkins Hospital Department of Orthopaedic Surgery 601 North Caroline Street #5232 Baltimore MD 21287-0882 USAEric D. Shirley, The Johns Hopkins Hospital Department of Orthopaedic Surgery 601 Nor...