Birth Prevalence Of Cerebral Palsy Research Articles

Cerebral palsy as a public health indicator.

Cerebral palsy as a public health indicator.

EFFECTS OF EXERCISE THERAPY WITH THE BOBATH METHOD ON BALANCE IN A CHILD WITH SPASTIC DIPLEGIC CEREBRAL PALSY: A CASE REPORT

ABSTRACT
 The overall birth prevalence of cerebral palsy is about 2 per 1000 live births. Weakness in balance control is one of the most common problems encountered in children with CP. One of the most widely used physiotherapy approaches for children with CP is Bobath therapy. Exercise with the Bobath method can improve postural control and balance in children with CP. This study aims is to determine the effect of exercise therapy with the Bobath method for balance in a child with spastic diplegic cerebral palsy. This study using a single-subject research conducted on a child with a diagnosis of spastic diplegic cerebral palsy who was given exercise therapy using the Bobath method 4 times a week for 4 weeks. Measurement of balance using the Pediatric Balance Scale (PBS) which was carried out before exercise therapy was given (A1), follow-up (A2), and evaluation of the final outcome (A3). The results showed that the patient had an increase in the PBS score, which means that there was an increase in functional balance. The conclusion of this study is that exercise therapy with the Bobath method which has been carried out 4 times a week for 4 weeks improves functional balance in a child with a diagnosis of spastic diplegic cerebral palsy.
 
 Keywords: Cerebral Palsy, Balance, Bobath Method

Systematic Monitoring of Cognition for Adults With Cerebral Palsy-The Rationale Behind the Development of the CPCog-Adult Follow-Up Protocol.

Cerebral palsy (CP) comprises a heterogeneous group of conditions recognized by disturbances of movement and posture and is caused by a non-progressive injury to the developing brain. Birth prevalence of CP is about 2–2.5 per 1,000 live births. Although the motor impairment is the hallmark of the diagnosis, individuals with CP often have other impairments, including cognitive ones. Cognitive impairments may affect communication, education, vocational opportunities, participation, and mental health. For many years, CP has been considered a “childhood disability,” but the challenges continue through the life course, and health issues may worsen and new challenges may arise with age. This is particularly true for cognitive impairments, which may become more pronounced as the demands of life increase. For individuals with CP, there is no one-to-one correlation between cognition and functioning in other areas, and therefore, cognition must be individually assessed to determine what targeted interventions might be beneficial. To facilitate this for children with CP, a systematic follow-up protocol of cognition, the CPCog, has been implemented in Norway and Sweden. However, no such protocol currently exists for adults with CP. Such discontinuity in healthcare services that results from lack of follow-up of cognitive functioning and subsequent needs for adjustments and interventions makes transition from pediatric to adult healthcare services challenging. As a result, a protocol for the surveillance of cognition in adults with CP, the CPCog-Adult, has been developed. It includes assessment of verbal skills, non-verbal reasoning, visual–spatial perception, and executive functioning. It is recommended to perform these assessments at least once in young adulthood and once in the mid-fifties. This report describes the process of developing the CPCog-Adult, which has a three-fold purpose: (1) to provide equal access to healthcare services to enable the detection of cognitive impairments; (2) to provide interventions that increase educational and vocational participation, enhance quality of life, and prevent secondary impairments; and (3) to collect systematic data for research purposes. The consent-based registration of data in the well-established Swedish and Norwegian national CP registries will secure longitudinal data from childhood into adulthood.

Perinatal care with a view to preventing cerebral palsy.

Birth prevalence of cerebral palsy (CP) is declining in high‐income countries, to as low as 1.4 per 1000 live births in the most recent international reports. This represents a 35% reduction in birth prevalence over a 15‐year period. This reduction is underpinned by a heightened focus of attention towards all aspects of CP, including: increased awareness, better data collection, development of national networks and registries, an explosion of research in basic science, perinatal care, neonatal neurology, public health, early detection, and targeted early intervention. Quick uptake of evidence into practice has ensued and overall improvements in clinical care occurred concurrently. It is anticipated that with continued partnerships with families, ongoing research driving further clinical improvement and vice versa, birth prevalence and severity of CP will further decline and the focus will shift to prevention in low‐ and middle‐income countries.What this paper adds Research in the field of perinatal care and cerebral palsy (CP) prevention has increased significantly.In high‐income countries, increased awareness of CP and scientific advances have improved clinical care.Population‐based registers have limitations but remain the best mechanism to quantify birth prevalence of CP and accurately track trends.There have been recent reductions in the birth prevalence of CP.

Cerebral palsy trends in Australia (1995-2009): a population-based observational study.

To investigate trends in birth prevalence of cerebral palsy (CP) overall and by gestational age, and examine the distribution of motor type, spastic topography, and severity using Australian CP Register data from 1995 to 2009. Prenatal and perinatal CP data were collated from state/territory CP registers. Birth prevalence estimates per 1000 live births and per 1000 neonatal survivors (NNS) were calculated in five epochs. Data from three state registers with population-level ascertainment were used to investigate birth prevalence trends by gestational age using Poisson regression. Distribution of motor type, spastic topography, and moderate to severe disability (IQ≤50 and/or Gross Motor Function Classification System levels III-V) were evaluated within birthweight categories. Birth prevalence of CP varied across population-level states but within each state declined significantly over time (p<0.05). Birth prevalence per 1000 neonatal survivors declined amongst children born before 28 weeks (South Australia, Victoria p<0.001) and those born at or after 37 weeks (Victoria p<0.001, Western Australia p<0.002). Across Australia the percentage of children with bilateral spastic CP declined amongst those born less than 1000g. The percentage of children with moderate to severe disability decreased (48%-34%, p<0.001). Birth prevalence of CP declined. Encouragingly, the percentage of children with CP whose disability was moderate to severe also decreased. Birth prevalence of cerebral palsy (CP) differed but declined across Australian states (1995-2009). Australian CP birth prevalence declined significantly amongst children born before 28 weeks and those born at or after 37 weeks. The percentage of children with moderate to severe disability decreased.

The complex aetiology of cerebral palsy.

Cerebral palsy (CP) is the most prevalent, severe and costly motor disability of childhood. Consequently, CP is a public health priority for prevention, but its aetiology has proved complex. In this Review, we summarize the evidence for a decline in the birth prevalence of CP in some high-income nations, describe the epidemiological evidence for risk factors, such as preterm delivery and fetal growth restriction, genetics, pregnancy infection and other exposures, and discuss the success achieved so far in prevention through the use of magnesium sulfate in preterm labour and therapeutic hypothermia for birth-asphyxiated infants. We also consider the complexities of disentangling prenatal and perinatal influences, and of establishing subtypes of the disorder, with a view to accelerating the translation of evidence into the development of strategies for the prevention of CP.

Cerebral palsy after assisted reproductive technology: a cohort study.

To calculate the birth prevalence of cerebral palsy (CP) after assisted reproductive technology (ART) and compare the clinical outcomes of children with CP after ART or natural conception. This cohort study used linked CP and ART register data from live births in Western Australia (1994-2002). Birth prevalence was calculated and data analysed using descriptive statistics and logistic regression. It was adjusted for confounding variables and stratified by plurality and gestational age. In total, 211 660 live births were included; prevalence of CP was increased in children born after ART (7.2/1000 live births compared with naturally conceived births, 2.5/1000). Odds of CP were doubled for singletons; when stratified by gestational age odds were only increased in the under 32-week group. Prevalence of CP was increased in ART (9.9/1000 live births) and naturally conceived twins (8.4/1000 live births). Clinical outcomes were similar between ART and naturally conceived children. The birth prevalence of CP is increased two-fold after ART. After stratification for gestational age and plurality, residual risk remains in singletons born very preterm. Birth prevalence of CP will be tracked over time to identify any impact of changes to clinical practice. In Western Australia, assisted reproductive technology (ART) increases birth prevalence of cerebral palsy (CP), mediated mostly by preterm and multiple births. Preterm birth alone does not account for the doubled odds of CP for ART singletons born very preterm. Clinical outcomes are similar between ART and naturally conceived children with CP.

Promptly assess trends in birth prevalence of cerebral palsy up to age 4 in South Carolina using administrative sources including Medicaid data, 1996 to 2009

Promptly assess trends in birth prevalence of cerebral palsy up to age 4 in South Carolina using administrative sources including Medicaid data, 1996 to 2009

Trends in the prevalence of cerebral palsy among very preterm infants (

The birth prevalence of cerebral palsy varies over time among very preterm infants, and the reasons are poorly understood. To describe the variation in the prevalence of cerebral palsy among very preterm infants over time, and to relate these differences to other maternal or neonatal factors. A population-based cohort of very preterm infants was evaluated over a 20-year period (1988 to 2007) divided into four equal epochs. The prevalence of cerebral palsy peaked in the third epoch (1998 to 2002) while mortality rate peaked in the second epoch (1993 to 1997). Maternal anemia, tocolytic use and neonatal need for home oxygen were highest in the third epoch. Lower mortality rates did not correlate well with the prevalence of cerebral palsy. Maternal risk factors, anemia and tocolytic use, and the newborn need for home oxygen were highest during the same epoch as the peak prevalence of cerebral palsy.

The role of migration and choice of denominator on the prevalence of cerebral palsy.

Differential migration and choice of denominator have been hypothesized to contribute to differences between period prevalence and birth prevalence of cerebral palsy (CP). The purpose of this study was to evaluate the effects of migration and choice of denominator on the prevalence of CP. Data from the Metropolitan Atlanta Developmental Disabilities Surveillance Program and census and birth certificate files were used to calculate various CP prevalence estimates for 2000. The overall CP period prevalence was 3.2 (95% confidence interval [CI] 2.7-3.8) per 1000 8-year-olds and was similar for those born in Atlanta who resided there at age 8years (3.3; 95% CI 2.7-4.1) and those born outside Atlanta who moved into Atlanta by age 8years (3.0; 95% CI 2.3-3.9). CP prevalence in these two migration strata was similar by sex and race/ethnicity. CP birth prevalence of 8-year-olds in Atlanta in 2000 was 2.0 (95% CI 1.6-2.5) per 1000 live births in 1992. The authors found no evidence to support the hypothesis that differential in-migration explained higher period than birth prevalence of CP in Atlanta. Comparability of CP prevalence across geographic areas will be enhanced if future studies report both period and birth prevalence.

Cerebral palsy registers and high-quality data: an evaluation of completeness of the 4Child register using capture-recapture techniques

As the survival of very preterm and low-birthweight infants increases, so does the importance of monitoring the birth prevalence of childhood impairments; disease registers provide a means to do so for these rare conditions. High levels of ascertainment for disease research registers have become increasingly difficult to achieve in the face of additional challenges posed by consent and confidentiality issues. 4Child - Four Counties Database of Cerebral Palsy, Vision Loss and Hearing Loss in Children has been collecting data and monitoring these three major childhood impairments since 1984. This study used capture-recapture and related techniques to identify areas which are particularly affected by low ascertainment, to estimate the magnitude of missing cases on the 4Child register and to provide birth prevalence estimates of cerebral palsy which allow for these missing cases. Estimates suggest that while overall around 27% of cerebral palsy cases were not reported to 4Child, ascertainment for severely motor-impaired children (93% complete) and those born in two of the four counties was good (Oxfordshire: 90%, Northamptonshire: 94%). After allowing for missing cases, adjusted estimates of cerebral palsy birth prevalence for 1984-1993 were 3.0 per 1000 live births versus 2.5 per 1000 live births in 1994-2003. Capture-recapture techniques can identify areas of poor ascertainment and add to information around the provision of cerebral palsy birth prevalence estimates. Despite variation in ascertainment over time, capture-recapture estimates supported a decline in cerebral palsy birth prevalence between the earlier and later study periods in the four English counties of the geographical area covered by 4Child.

Cerebral palsy in eastern Denmark: Declining birth prevalence but increasing numbers of unilateral cerebral palsy in birth year period 1986–1998

The Cerebral Palsy Registry in eastern Denmark has been collecting cases using a uniform data sampling procedure since birth year 1979. Children are included by two child neurologists and an obstetrician. Information on pregnancy, birth, neonatal period, impairments and demographic data are registered. The total cerebral palsy birth prevalence has been significantly decreasing since the birth period 1983–1986 with 3.0 per 1000 live births until the period 1995–1998 with 2.1 per 1000 live births. The overall decrease was seen in preterm infants (<31 weeks) as well as in term infants and despite a simultaneous fall in perinatal and early neonatal mortality in the preterm group. Analysing the subtypes of CP we found a significant increase in the numbers as well as the rate of unilateral CP with a simultaneous fall in the numbers as well as the rate of bilateral CP. The explanation of this rise is not obvious. A change from bilateral periventricular lesions to unilateral is a possibility, but no major change in the neonatal handling could be documented. Regarding associated impairments, developmental delay/learning disabilities as well as motor function assessed by ability to walk (unassisted/assisted), both have changed toward higher percentage of children with unassisted walking and in need of special education.

Data Watch: Cerebral Palsy Birth Prevalence Dropped In Very-Low-Birth-Weight* Infants in Europe

Data Watch: Cerebral Palsy Birth Prevalence Dropped In Very-Low-Birth-Weight* Infants in Europe

Data Watch: Cerebral Palsy Birth Prevalence Dropped In Very-Low-Birth-Weight* Infants in Europe

Data Watch: Cerebral Palsy Birth Prevalence Dropped In Very-Low-Birth-Weight* Infants in Europe

Cerebral palsy births in eastern Denmark, 1987--90: implications for neonatal care.

The Cerebral Palsy Register in eastern Denmark has collected cases using a uniform data sampling procedure since birth year 1979. We have investigated changes in the rate of cerebral palsy, related to gestational age, mortality and perinatal risk factors in children born 1983--90. The total cerebral palsy birth prevalence decreased from 3.0 in the birth year period 1983--86 to 2.4 per 1000 live births (P < 0.01) in 1987--90, owing to a decrease among all preterm infants (29--19 per 1000, P < 0.001). The perinatal and early neonatal mortality in preterm infants was unchanged from 1983--86 to 1987--90. The rate of cerebral palsy in term infants was 1.5 per 1000 in all birth-year periods from 1979--90. Among the cerebral palsy infants, the proportion of very preterm babies treated with mechanical ventilation in the neonatal period decreased from 95% in 1983--86 to 61% in 1987--90 (P < 0.001), while the group treated with CPAP among the moderately preterm babies increased from 61% to 78% (P < 0.05). The significant decline in cerebral palsy rate in preterm infants born 1987--90 may be due to a change in treatment at the neonatal intensive care units using less mechanical ventilation, a hypothesis which needs further investigation.

030 A correlation between a change of neonatal very low birth weight-treatment and a reduction of cerebral palsy birth prevalence

030 A correlation between a change of neonatal very low birth weight-treatment and a reduction of cerebral palsy birth prevalence

Issues in the classification and epidemiology of cerebral palsy

This paper discusses the definition and subclassification of cerebral palsy, its ascertainment, birth prevalence, and aetiology. Cerebral palsy is a description defined by clinical observation rather than a diagnosis informative about aetiology, pathology, or prognosis. As a disease entity it is aetiologically and pathologically diverse. The cerebral palsy grouping is useful for management and service planning but the combining of several individually rare congenital and early childhood conditions creates an epidemiological challenge. The birth prevalence of cerebral palsy in the developed world has not declined since the mid-1950s, in contrast to perinatal mortality. The proportion of children with cerebral palsy that are born very preterm has increased with the advent of neonatal intensive care, and refinement of the techniques of neonatal intensive care may be necessary before its benefits can be fully realised. Since cerebral palsy is, by definition, incurable, epidemiology strives to elucidate causation as a necessary step towards prevention. Definitive allocation of cause before the post-neonatal period is usually impossible and a large proportion of all cases of cerebral palsy are not adequately explained. Recognised risk factors may be single or multiple and can occur at any stage from before conception to infancy. In developed countries, the majority of aetiological paths are likely to commence before labour and delivery. Approximately 10% of cases are believed to now be causally associated with adverse intrapartum events, less than either the proportion traditionally assumed or the proportion caused post-neonatally. The proportions of children with cerebral palsy resulting from an intrapartum cause and from a post-neonatal cause are both believed to be higher in developing countries. Since post-neonatally acquired brain damage has the most easily recognised and understood causes, post-neonatally acquired cerebral palsy should be the most preventable. MRDD Research Reviews 3:184-193, 1997. © 1997 Wiley-Liss, Inc.

Trends in birth prevalence of cerebral palsy.

Trends in birth prevalence of cerebral palsy.

Effects of birth weight, gestational age, and maternal obstetric history on birth prevalence of cerebral palsy.

A register of children with cerebral palsy born to mothers resident in the Mersey region from 1966 to 1977 was compiled from health service records. Frequency distributions and prevalences of birth weight and gestational age differed for those with hemiplegia, diplegia, and quadriplegia. In particular, the children with diplegia showed a bimodal frequency distribution. Children of normal birth weight with diplegia had a higher prevalence of severe mental retardation than those of low birth weight. These differences may be due to survival bias and may not be of aetiological importance. Furthermore, the mothers of diplegic infants had a significantly higher proportion of spontaneous abortions, stillbirths, and low birthweight infants in their obstetric history. This suggests that prenatal factors predominate in the aetiology of diplegia.

Trends in birth prevalence of cerebral palsy.

A register of children with cerebral palsy born in the period 1966-77 to mothers resident in the Mersey region was compiled from several different data sources. There were 685 cases, with a male:female ratio of 1.4:1. The birth prevalence of cerebral palsy ranged from 1.18 to 1.97 per 1000 live births each year, with a mean of 1.51 per 1000 live births. There was no discernible trend in overall prevalence, but there was a highly significant upward trend in the prevalence of cerebral palsy among low birthweight infants, which was evident for all the major types of cerebral palsy. It is postulated that this is due to improved survival rather than a real change in incidence. Alternatively, because the register was compiled from health service records, a diagnostic access bias from improved follow up of low birthweight infants may have led to an apparent increase in prevalence.