Cerebral Palsy Children Research Articles

PENGGUNAAN ANKLE FOOT ORTHOSIS (AFO) TERHADAP KESEIMBANGAN FUNGSIONAL PADA ANAK PENDERITA CEREBRAL PALSY

Children with cerebral palsy will experience problems with their movements. Cerebral palsy affects muscles and a person's ability to control them. One of the disorders that occur in children with CP is disturbances in walking balance, which ultimately results in disturbances in walking motor skills, so children experience disturbances in daily living (ADL) activities in their daily lives. This research aims to determine the effect of using Anke Foot Orthosis on children's functional balance. Cerebral Palsy. Method: This type of research uses a Quasy Experiment with a pretest-posttest with a control group design. The total sample for this study was 10 respondents. Data collection was carried out using observation sheets. Analysis of this research data using univariate and bivariate analysis with Wilcoxon. Results: The influence of using Anke Foot Orthosis on the functional balance of Cerebral Palsy children, data taken before and after treatment with a value > 0.05. The conclusion is that there is no significant effect between using Anke Foot Orthosis and functional balance in children with cerebral palsy.

Clinical profile and associated comorbidities of cerebral palsy in children visiting Orotta National Referral Hospital, Eritrea: a cross-sectional study

BackgroundCerebral Palsy (CP) is one of the most common physical disabilities in children. This study aimed to explore the clinical spectrum of CP at Orotta National Referral and Teaching Hospital, including CP subtypes, gross motor function, patterns of associated comorbidities, and possible risk factors in children aged 2 to 12 years.MethodsA hospital-based cross-sectional study was conducted from January to April 2022 in 153 children with suspected motor symptoms. The Surveillance of CP in Europe (SCPE) decision tree was used as an inclusion criteria guideline and the evaluation of the participants was done using a standardized questionnaire and clinical examination. Descriptive statistics, chi-square test, and logistic regression were employed to statistically analyze the data.ResultsEighty-four children who fulfilled the clinical criteria were included in the study. The median age was 5-years [IQR: 3.8] with an equal distribution of males and females. Quadriplegic CP was the most common subtype (51.2%) followed by unilateral (hemiplegic) CP (22.6%), and dyskinetic CP (14.3%). Most children had severe gross motor impairment GMFCS level IV-V and females were almost three times more likely to have GMFCS level IV/V than males (AOR: 2.70; CI: 1.08–6.72; p-value = 0.033.) More than half (52.4%) of the neonates either did not cry within five minutes and/or needed breathing resuscitation, 55.3% had to be admitted to the NICU with a median of 5 days’ hospital stay. Between the first week of birth and the first year of life, 28.6% had trouble feeding, 26.2% had an infection, 10.7% had difficulty breathing, 20.2% had seizures and 6% had jaundice. Feeding problems (64.3%), speech problems of some sort (91.7%), and epilepsy (46.4%) were the most commonly associated comorbidities with CP.ConclusionsThe clinical profile of the CP patients was found to be dominated by the spastic subtype and moderate to severe disability. Since perinatal risk factors were found to be dominant, strengthening maternal and child healthcare systems is recommended to minimize incidents of preventable risk factors and the burden of the disability.

Quality of Life of the Family Caregivers of Children with the Cerebral Palsy and its Determinants: A Study from India

abstract Introduction: The responsibility of caring for a child with cerebral palsy (CP) at home can be challenging to the caregiver’s and children’s quality of life (QoL). This study was designed to assess the QoL and its determinants amongst family caregivers of children with CP. Materials and Methods: A study was conducted in a Tertiary Care Hospital in Yavatmal, Maharashtra, from March to May 2021, involving 126 participants selected through systematic random sampling. QoL was assessed using the World Health Organization QoL Brief Version scale. The data were analyzed using the statistical software, Epi Info Version 7.2. Results: The mean ± standard deviation of the overall QoL of family caregivers of CP children was 66.7 ± 1.44. The study found a significant association of QoL with the age of the caregiver, residence, education, socio-economic class, total number of children, health insurance and accessibility of services. Conclusion: More than half of the study participants exhibited low overall, physical, social and environmental QoL, influenced by various determinants.

Increasing prevalence of cerebral palsy in children born very preterm in Denmark.

To analyse the rising prevalence of cerebral palsy (CP) in children born preterm in Denmark. We included all live-born children born preterm in Denmark from 1997 to 2013. The prevalence of CP in children born preterm was categorized by gestational age and correlated with neonatal mortality and changes in clinical factors. Among 70876 children, 824 (1.2%) had CP. The overall CP prevalence in children born preterm decreased substantially until 2001, from when it increased annually by 2.8% (95% confidence interval 0.6-5.0). When categorized, the prevalence only increased significantly in children born very preterm (gestational weeks 28-31). Neonatal mortality rates decreased steadily at all gestational ages during the entire study period. Clinical factors that changed during the study period were increasing numbers of high-risk pregnancies, maternal obesity, emergency caesarean sections, neonatal admissions, and usage of assisted ventilation. The increasing prevalence of CP in children born preterm was driven by the subgroup born very preterm and matched their decrease in neonatal mortality. In similar population studies, decreased mortality was not followed by increased CP prevalence. An increase in clinical risk factors was unlikely to explain our findings, but more active neonatal life support may have played a role.

Dyskinetic Cerebral Palsy in Children: Clinical Perspectives on Common Comorbidities and Health-Related Quality of Life.

The data on specific comorbidities in children with dyskinetic cerebral palsy (DCP) is limited. We evaluated the pattern of comorbidities and health related quality of life (HRQOL) in these children and compared them between etiological and motor impairment subgroups. This cross-sectional study was conducted over 18 months in children with DCP of both sex, and age between one and 14 years. Comorbidities were assessed using standardized scales such as gross motor functioning scale (GMFCS), developmental profile-3 (DP-3), developmental behaviour checklist, sleep behaviour questionnaire (SBQ), and caregiver questionnaire. Sixty-five children with DCP were evaluated (hyperbilirubinemia n = 43, 66% and perinatal asphyxia n = 19, 29%). The majority of children were severely affected in gross motor functioning (level IV 29.2% and level V 53.8%). Epilepsy was seen in 21.5% of cases (19% in hyperbilirubinemia and 32% in asphyxia, p = 0.4). The mean age of onset of seizures was 15.4 + 20.6 months (range 2-72). Visual problems were seen in 54% of cases and included upgaze palsy, squint, refractive error, optic atrophy and cortical blindness. A significant proportion of children with hyperbilirubinemia had upgaze palsy as compared to those with perinatal asphyxia (70% vs. 32%, p 0.01). Rest of the visual problems were not significantly different between the two etiological subgroups. Drooling (87.6%), protein-energy malnutrition (66.6%), and reflux (57%) were the most common gastrointestinal problems in children with DCP. Children with DCP showed problems in social relating (33.8%), anxiety (26.2%), and self-absorbed behaviour (7.7%). However, there were no statistically significant differences between the etiological, motor impairment and age-based subgroups. Children with DCP had high scores on SBQ, suggesting sleep problems. Sleep scores were similar in the hyperbilirubinemia and perinatal asphyxia subgroups. Greater sleep problems were noted in children aged < 4y (70.6 + 10.1 vs. 56.5 + 11.3, p < 0.05 as compared to children above 4y of age) and severe motor impairments (68.2 + 11.3 vs. 57.2 + 13.1, p 0.008 as compared to mild-moderate motor impairment). Poor overall developmental scores were seen in 61.5% children and were significantly associated with GMFCS (p 0.04). The majority of children showed impairments in physical (58.5%), adaptive behaviour (58.5%), social-emotional (50.8%), cognitive (60%) and communication (52%) subscales of DP-3. Cognitive impairment was similar in the etiological (hyperbilirubinemia vs. perinatal asphyxia, p = 0.3), and motor impairment (mild-moderate vs. severe, p = 0.9) subgroups. HRQOL was significantly affected by motor impairment in positioning-transfer (p value 0.0001), and interaction-communication domains (p value 0.0001), however, there was no difference based on the etiology of hyperbilirubinemia and asphyxia. Children with DCP demonstrate several comorbidities and impaired quality of life. These are similar in hyperbilirubinemia and perinatal asphyxia cohorts, expect for significant proportion of upgaze palsy in DCP secondary to hyperbilirubinemia. Younger children have more problematic behaviour and impaired sleep quality. Severe motor disability influences the developmental outcomes, cognition, sleep and HRQOL in children with DCP.

Arabic Translation of The Caregiver Priorities and Child Health Index of Life with Disabilities CPCHILD Scale

Abstract Background Children with cerebral palsy have difficulties in daily life activities (feeding, toilet training, dressing), communication, and mobility. The children’s independence and quality of life decrease when their performance in activities of daily living is reduced. Evaluation of motor function for affected children with cerebral palsy (CP), individual needs and goals of these patients and their parents is still lacking and needs to be further addressed. The CPCHILD is a multidimensional patient centered assessment tool. Aim of the Work Our aim is to translate and provide an Arabic version of the CPCHILD for assessing the caregivers’ perceptions of the health status, comfort, wellbeing, functional abilities, and quality of life for their children with cerebral palsy. Patient and Methods This study was a cross sectional study, conducted at Pediatric Neurology Clinic at Children’s Hospital, and Physical Medicine Outpatient Clinic at Ain Shams University Hospitals. The CPCHILD was translated from English to Arabic with the agreement of the scale's owner. The Arabic version was provided through translation and back translation process, which was then presented to the caregivers of CP children for evaluation of the perspectives and quality of life for their children. Results An Arabic version of the CPCHILD scale was created. The enrolled caregivers for children with CP were the biological mothers. The mothers of the CP children were able to understand and respond to the translated scale and reported poor mean total CPCHILD score 26.45 (0-58.3). Conclusion The Arabic version of the scale was provided through translation and back translation process and the version was prepared for subsequent validation tests. The translated version will help in applying the scale in the caregivers' language in a culture proper setting and can be helpful in the assessment of health-related quality of life of children with CP.

Analysis of YouTube-Based Therapeutic Content for Children with Cerebral Palsy.

Cerebral palsy (CP) causes movement and posture challenges due to central nervous system damage, requiring lifelong management. During the COVID-19 pandemic, there was limited access to facility-based treatments, which increased the demand for home-based therapies and digital resources. We analyzed the qualitative and quantitative aspects of YouTube videos focusing on CP therapy for children. A total of 95 videos were evaluated for content quality using the modified DISCERN (mDISCERN) tool and Global Quality Scale (GQS). The therapeutic program efficacy was assessed via the International Consensus on Therapeutic Exercise and Training (i-CONTENT) tool, Consensus on Therapeutic Exercise Training (CONTENT) scale, and Consensus on Exercise Reporting Template (CERT), and popularity was measured by the video power index (VPI). YouTube-based therapeutic videos for children with CP generally exhibit reliability in video content and effectiveness in therapeutic programming, and no correlations were found between video popularity and quality. However, the qualitative analysis reveals insufficient mention of uncertainty in the treatment principles within the video content as well as a lack of detailed treatment descriptions encompassing aspects such as intensity, frequency, timing, setting, outcome measurement during and post-treatment, and safety considerations within therapeutic programs. In particular, this tendency was consistent regardless of the uploader's expertise level and the classification of the neuromotor therapy type in contrast to that of the exercise type. YouTube-based content for CP children still has significant limitations in how substantive viewers, such as caregivers, can acquire tailored information and apply practical information to their exercise and treatment programs.

A Birds Eye View on Different Ayurvedic Treatment Modalities in Cerebral Palsy in Children

A Birds Eye View on Different Ayurvedic Treatment Modalities in Cerebral Palsy in Children

Assessment of the Quality of Life and Relationship of Mental Status Among Parents with Cerebral Palsy Children in a Single Centre Study

Introduction: Children with cerebral palsy (CP) in Bangladesh suffer immensely, with no means or hope for a decent life and a public system lacking basic facilities.This study aims to analyze the quality of life (QoL) and depression status of parents among children with CP, as well as the relationship between these factors and their demographic profile. Materials and Methods: This is a descriptive cross-sectional study in which data were collected from the Pediatric Department of Centre for the Rehabilitation of the Paralysed (CRP) in Savar. The participants included 150 children with CP between January 2018 and December 2020. Results: The mean age of the mothers (29.86±6.14) was between 25 and 29 years (32.7%). The most common type of CP was spastic CP among 100 mothers (66.7%). A significant relationship was observed between the mother’s age during marriage and World Health Organization quality of life (WHOQoL-BREF), physical health (P&lt;0.01), psychological health (P&lt;0.01), and the age group of 31-35 years had the lowest scores (Mean±SD 62.00±5.16, 51±0.683) in both domains. A strong correlation (P&lt;0.001) was observed between QoL, physical health (r=0.319), psychological (r=0.365), social (r=0.390) and environmental (r=0.388). From the box plot, QoL showed that spastic CP posed good QoL for mild depression while all other types had neither poor nor good QoL. Conclusion: A hidden issue in every parent is that CP children are the misfortune of their fate that increases their level of depression and consequently decreases their QoL.

HABIT training in unilateral spastic cerebral palsy children having mirror movement disorder.

The single-arm feasibility study was planned to evaluate the therapeutic effect of hand arm bimanual intensive training in improving the fine and gross motor functions of hand, and in the reduction of intensity with respect to mirror movement disorder. The sample comprised unilateral spastic cerebral palsy children aged 6-16 years who were having mirror movement disorder and were able to make a gross grip. The hand arm bimanual intensive training was provided to the participants for 6 hours per day for 15 days for a total of 90 hours. Comparison of baseline and post-intervention showed that the functional independence level of children had improved, with improvement in unimanual and bimanual hand performance (p˂0.05). However, there was no improvement seen in the severity of mirror movements (p>0.05). Hence, hand arm bimanual intensive training was found to be effective in increasing the functional independence of cerebral palsy children by improving the hand function, but there was no effect on mirror movement disorder.

Efficacy of rehabilitation physiotherapy combined with brace correction in patients with mild to moderate scoliosis secondary to cerebral palsy.

Scoliosis secondary to cerebral palsy is one of the common complications of cerebral palsy in children with cerebral palsy. This study aimed to explore the efficacy of rehabilitation combined with brace correction in patients with scoliosis secondary to cerebral palsy. A total of 52 patients with scoliosis secondary to cerebral palsy were selected from our hospital from April 2019 to April 2022 and divided into the control group and experimental group according to the statistical randomization method (n= 26 in each group). Control group: mean age (14.28 ± 2.31) years; 16 males and 10 females. Experimental group: average age (14.24 ± 2.35) years; 15 males and 11 females. The control group wore scoliosis orthopedic brace, while the experimental group was treated with rehabilitation manipulation and rehabilitation training (including gymnastic training and weight training) on the basis of the control group for 1 year. The clinical efficacy of the two groups was compared and observed; the number of degrees of scoliosis (Cobb angle), the angle of vertebral rotation (AVR) and the distance of the parietal vertebrae from the sacral midline (AVT) were compared before and after treatment; the incidence of adverse events during treatment was observed in the two groups. After treatment, both groups showed significant improvement in the overall effectiveness of treatment, Cobb's angle, AVR and AVT compared with those before treatment (P< 0.05). The experimental group had a significantly higher overall effective rate of treatment than the control group (P< 0.05), a significantly smaller Cobb's angle and AVR than the control group (P< 0.05) and a significantly shorter AVT than the control group (P< 0.05). The incidence of adverse events during treatment was lower in both groups and was not significantly different (P> 0.05). The combination of rehabilitation physiotherapy and bracing is effective in optimizing the clinical outcome of patients with scoliosis secondary to cerebral palsy, improving their scoliosis dysfunction and providing a high level of safety in treatment.

Mechanistic Association of Hepatoblastoma with Cerebral Palsy: A Narrative Review.

Hepatoblastoma is a rare liver cancer that occurs most often in children who present with lower birth weight. Cerebral palsy (CP) is a neurodevelopmental disorder distinguished by irregularities in muscle tone, movement, and motor skills. CP is caused by damage to the developing brain and is often associated with secondary complications such as severe constipation. Clinicians must be aware of sudden worsening constipation occurring in CP children because it can also be a sign of hepatoblastoma. The aim of this review is to summarize the current understanding of the risks for hepatoblastoma development in children with CP. Cancer risks likely include dysfunction of the immune system surveillance in CP children. Elevated C-reactive protein and tumor necrosis factor-alpha levels may be higher in children with CP, which weakens their innate immune system. Metabolic disruption increases the risk of some cancers, and poor nutrition and reduced growth that occur in CP patients may have an impact on cancer development through a loss in immune function. Increased mobility and physical activity can increase the T-cell, natural killer cell, and neutrophil population. Children with CP tend to engage poorly in physical activity, and consequently, their immune system is affected. There are multiple factors associated with CP that increase the risk of childhood cancers such as hepatoblastoma.

Care burden, perceived social support, coping attitudes and life satisfaction of mothers with children with cerebral palsy.

This study's aim is to determine the relationship between care burden, perceived social support, coping attitudes and life satisfaction of mothers with children with cerebral palsy (CP). This descriptive study was conducted in Turkey between March and June 2022 to determine the relationship between caregiving burden, perceived social support, coping attitudes and life satisfaction of 122 mothers with CP children. Path analysis was used to evaluate the data. Correlation analysis showed a positive relationship between mothers' social support perceptions and life satisfaction and coping attitudes, a positive relationship between their life satisfaction and coping attitudes (p < .001). The path analysis showed that the social support perceived by the mothers significantly affected their coping attitudes (β = .257; p < .001) and life satisfaction (β= .081; p < .001). Mothers' care burden (β = .169; p < .001) and coping attitudes (β = .071; p < .05) also had a significant effect on their life satisfaction. It is an important finding of this study that mothers' perceptions of social support and coping attitudes have a positive effect on their life satisfaction. Long-term care can cause physical and psychological problems for mothers. Mothers' strong coping strategies and high levels of social support may reduce the occurrence of these problems. Drawing attention to this issue in mothers and revealing the effects of these variables is important in terms of indirectly supporting child outcomes.

Level of Participation in Daily Activities and its Association with Scoliosis among Hemiplegic Cerebral Palsy

Background: Cerebral palsy (CP) encompasses a spectrum of permanent movement disorders that originate in early childhood, leading to lifelong physical disabilities. Hemiplegic CP, the most prevalent subtype, features notable mobility but poses significant challenges in daily function and adaptation to everyday activities. Objective: This study aims to evaluate the level of daily activity participation and its association with scoliosis in children with hemiplegic CP. Methods: In this correlational study, data were gathered through non-probability convenient sampling from 110 hemiplegic CP children aged 4-18 years across various private and government hospitals and special education centers. The study excluded children with severe pain, impaired mobility, other neuromuscular diseases, or recent orthopedic surgery. Assessments included the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and KIDSCREEN-10 for quality of life. The association of scoliosis with GMFCS and MACS was analyzed using the chi-square test on SPSS-22 software. Results: The majority (60.9%) of participants were classified as GMFCS level II, while 46.4% ranked at MACS level I. There was a significant association between GMFCS levels and scoliosis presence (p &lt; 0.05), but no significant relationship between MACS levels and scoliosis (p &gt; 0.05). Scoliotic children exhibited poorer health outcomes, with 52% reporting poor health status. Conclusion: While most children with hemiplegic CP were capable of handling objects, they faced limitations in mobility affecting their daily activities. Scoliosis was relatively uncommon but significantly associated with reduced gross motor function.

Family-Resourced Early Intervention Program for Motor Development in Cerebral Palsy Children

This research was conducted to determine the results of implementing an early intervention program Family resource for children's motor development applied to cerebral children palsy aged 4 years. The research method used in this research is research. The experiment takes the form of Single Subject Research (SSR) with data collection techniques including GMFM and GMFCS tests, interviews, and observations. The results of this research, this program has successfully demonstrated significant progress in control development better head in children. This increase can be seen from the longer duration in Doing various activities shows that the child has started to have neck strength enough to support the head, especially when sitting with assistance. Results from research It is hoped that this can become a reference for educators, especially in improving motor development of children with cerebral palsy at an early age.

Differences in pulmonary function between diplegic and hemiplegic spastic cerebral palsy children

Differences in pulmonary function between diplegic and hemiplegic spastic cerebral palsy children

Quality of life in educated and non-educated cerebral palsy children

Quality of life in educated and non-educated cerebral palsy children

Factors Related to Nutritional Status of School-Age Cerebral Palsy Children

Introduction: Cerebral palsy (CP) is one of the most common causes of chronic disability in children, nutritional disorders in children with CP can manifest as malnutrition or more nutrition. The percentage of CP in children under 18 years is 65.4% of the total CP people in Indonesia. Methods: The type of research is observational with a cross-sectional research design. Samples of 45 school-age school-age children who meet the criteria with total sampling. The instruments used are a 24-hour recall form, a food photo book, and a parenting questionnaire. Bivariate analysis in this study uses a chi-square test to determine the relationship between food intake and parenting with the nutritional status of CP children. Results: The results of the study are the relationship between energy intake and the nutritional status of CP children with the value of P=0.003. There is no relationship between protein intake and the nutritional status of CP children with the value of P=0,462. There is no relationship between parenting with the nutritional status of CP children, the value of P=0.97. There is a relationship between food consistency and the nutritional status of CP children obtained with the value of P=0.017.

Robot-assisted gait training improves walking and cerebral connectivity in children with unilateral cerebral palsy.

Robot-assisted gait training (RAGT) is promising to help walking rehabilitation in cerebral palsy, but training-induced neuroplastic effects have little been investigated. Forty unilateral cerebral palsy children aged 4-18 years were randomly allocated in a monocentric study to ten 20-minute RAGT sessions with the G-EO system, five days a week (n = 20) or to a control group (who continued conventional care with six 30-minute physiotherapy sessions, three days a week) (n = 20), two weeks running, from September 2020 to December 2021. Clinical and MRI outcomes were compared before and one month after therapy. The primary outcome was gait speed. Secondary outcomes were a 6-minute walking test distance, Gross Motor Function Measure-88 (GMFM-88) dimensions D and E, Patient Global Impression of Improvement, resting-state functional connectivity within the sensorimotor network, and structural connectivity in the corticospinal tracts. Gait speed and the 6-minute walking test distance improved more after RAGT. Resting-state functional connectivity increased after RAGT but decreased in controls between superior and lateral healthy or lateral injured sensorimotor networks. GMFM-88 and structural connectivity in corticospinal tracts were unchanged. Impression of improvement in children was better after RAGT. Short-term benefit of repetitive RAGT on walking abilities and functional cerebral connectivity was found in unilateral cerebral palsy children. Short-term repetitive robot-assisted gait training improves gait speed and walking resistance and increases cerebral functional connectivity in unilateral cerebral palsy. GMFM dimensions D and E were unchanged after short-term repetitive robot-assisted gait training in unilateral cerebral palsy.

"Congenital cytomegalovirus in Sub-Saharan Africa-a narrative review with practice recommendations".

Cytomegalovirus (CMV) is the most common cause of congenital infection internationally, occurring in 0.67% of births, and increasingly recognised as a major public health burden due to the potential for long-term neurodevelopmental and hearing impairment. This burden includes estimates of 10% of childhood cerebral palsy and up to 25% of childhood deafness. In Sub-Saharan Africa, where CMV-seroprevalence is almost ubiquitous, prevalence of congenital CMV (cCMV) is higher than the global average, and yet there is a dearth of research and initiatives to improve recognition, diagnosis and treatment. This narrative review outlines the epidemiology and clinical presentation of cCMV, discusses issues of case identification and treatment in Sub-Saharan Africa, and recommends a framework of strategies to address these challenges. Considering the significant burden of cCMV disease in this setting, it is undoubtably time we embark upon improving diagnosis and care for these infants.