Cerebral Palsy Children Research Articles

Evaluation of Single Event Multilevel Surgery (SEMLS) in Cerebral Palsy Children with Lower Limb Deformities

Evaluation of Single Event Multilevel Surgery (SEMLS) in Cerebral Palsy Children with Lower Limb Deformities

Comparison of the prevalence of malocclusion and oral habits between children with cerebral palsy and healthy children

BackgroundCerebral palsy (CP) represents for children an important problem of health and affects roughly 2 per 1000 live births and is the most common pediatric developmental motor disability. Therefore, the purpose of this study was to determine the prevalence, type and severity of malocclusion and oral habits in children with Cerebral Palsy (CP) and to compare them with a control group of healthy children in Sana’a city.Materials and methodsA prospective, case–control study was made of two groups, a cerebral palsy and a control group. The study population consisted of 60 children who had CP, and a control group of 60 matched children with no physical or mental disabilities. Data were collected using a questionnaire and assessment for malocclusion was done clinically. The patients were compared with equal number of age-matched controls. The inclusion criteria were individuals aged over 6 years; absence of previous orthodontic treatment; no missing permanent first molars.ResultsResults showed an increased prevalence of malocclusion in children with cerebral palsy. Molar class II relationship was statistically higher in cerebral palsy children than healthy control (P = 0.001). Cerebral palsied children are likely to have a significantly increased protrusion of the anterior teeth (P < 0.001) when compared with normal children. Mouth breathing and Tongue thrust. Habits were significantly higher in the CP group (p = 0.0001) when compared with normal children.ConclusionThe prevalence of malocclusion was higher in children with Cerebral palsy than in normal children, and the present study concludes that in children with Cerebral Palsy, more oral Habits problems due to oral motor dysfunctions are common and problems of mouth breathing and Tongue thrust produce different malocclusion and poor oral hygiene complications in these children.

Modeling neurophysiological and psychomotor relevant criteria in children with motor dysfunction

Background. Cerebral palsy is the most common cause of childhood disability among diseases of the nervous system, the prevalence of which averages 2.5 cases per 1,000 children.Aim. To identify relevant indicators in relation to the prediction of delayed rates of neuropsychic development in children and the formation of cerebral palsy in children 5–8 years old using mathematical modeling.Materials and methods. The study included 100 patients aged 5–8 years: 79 patients with neurological disorders and deviations in psycho-speech development, 21 patients – comparison group. The examination of children in both groups included: analysis of the child’s life history, analysis of psychomotor development in the first year of life, analysis of morbidity in the first year of life, assessment of psychomotor development at the time of the study, electroneuromyography using stimulation and superficial electroneuromyography, as well as ultrasound examination of the lower leg muscles with assessment of the functional state and muscle density using fibroscan.For statistical processing of the obtained data, descriptive statistics were performed. Determination of the statistical significance of indicators was carried out using the Kolmogorov–Smirnov test for continuously distributed values and Fisher’s exact test for discrete values. One-hot coding was used to represent categorical features. The analysis of the obtained data was carried out using a Python program using the pandas, numpy, scikit-learn, and boruta libraries.Results and conclusion. For children with deviations in neuropsychic development, significant early diagnostic markers are parameters of psychomotor development and neurological status (age when the child began to hold his head, decreased strength of the flexors of the foot and hip, level of walking) and instrumental examination (ultrasound of muscles thighs, electroneuromyography) – changes in the density and parameters of electrical excitability of muscles, which can serve as an early diagnostic sign of the development of motor dysfunction and an indicator for the formation of a trajectory of rehabilitation therapy.

Morbidity rate of children's cerebral palsy in Baku city

To study the morbidity rate of children's cerebral palsy (CP) in Baku in children born in 2006-2016. During 2006-2016, 35 891, 37 130, 37 459, 40 050, 34 726, 34 192, 33 258, 30 373, 29 722, 29 654 and 29 564 children were born in Baku. CP was diagnosed in 1162 of these children. Newborns and children with CP were divided into 3 groups by body mass (<1500; 1500- 2500; 2500 and more) and into 4 groups by the gestational age (<28, 28-32; 32-36, 36 and more weeks). The morbidity rates were detected in these groups. The statistical significance of morbidity rates was assessed by χ2 criteria. The morbidity rate of CP changed within the interval 0.27% (95% CI 0.22-0.33%) in 2006 to 0.37% (95% CI 0.30-0.44%) in 2016. The difference between the minimum and maximum morbidity rates was not statistically significant (p>0.05). The morbidity rate of CP in newborns with body mass <1500 grams was 10.35% (95% CI 0-21.65%) and was 6.1 times higher than in the group of newborns weighing 1500-2500 grams at birth (1.72%; 95% CI 0.20-3.25%) and 30.4 times higher than in the group of newborns with body mass ≥2500 grams (0.34%; 95% CI 0.27-0.41%). The difference between morbidity rates of CP in groups depending on birth body mass was significant (p<0.0001). The incidence rate of CP in a cohort of newborns during the first 60 months after birth in 2006-2016 fluctuated in the range of 0.27-0.37% and had a weak growth trend. The morbidity rate of children's CP is significantly higher in children with body mass at birth <1500 (10.34%) and 1500-2500 grams (1.72%) than in children with body mass at birth 2500 and more grams (0.34%). The gestational age of newborns affects the morbidity rate of CP, which is 5.48; 1.78 and 0.34% at gestational age <32, 32-36 and ≥36 weeks. The structure of subtypes of this pathology is close to that in other populations against the background of the comparative morbidity rate of CP in Baku, the proportion of spastic unilateral, spastic bilateral, dyskinetic and atonic CP is 35.2; 58.0; 3.9 and 1.4%, respectively.

Ispitivanje povezanosti polimorfizma u genu za interleukin 6 sa nastankom cerebralne paralize kod dece sa hipoksično-ishemijskom encefalopatijom na rođenju

Hypoxic-ischemic Encephalopathy (HIE) is one of the most common neurologic diseases in children and an important cause of cerebral palsy (CP). It is a permanent, non-progressive motor disorder that results in a delay in psychomotor development. Brain damage is followed by the activation of the immune system, and increased cytokine concentration in the plasma. Cytokines are circulating soluble proteins, mediators of communication for immune cells. The main biological activity of interleukin-6 (IL-6) is the stimulation of the liver to produce acute-phase proteins. Aim: The frequency of genotypes and alleles of the IL-6 gene polymorphism will be determined, analyzing the possible connection between IL-6 gene polymorphism and the onset of CP. Material and methods: This study involved 117 newborns who were treated in the Clinic of Neurology and Psychiatry for Children and Youth and the Clinic for Gynecology and Obstetrics of the University Clinical Centre of Serbia in Belgrade. Data was collected for each patient regarding their gender, gestational age, birth weight and Apgar score. Genotyping of rs1800795 in the IL-6 gene was performed by real-time PCR using a standardized TaqMan SNP assay. The difference in frequency of genotypes and alleles was analyzed by the X2 test. Results: The frequencies of genotypes in patients with CP were: 86.5% for GC + GG and 13.5% for CC, and in patients without CP were: 84.6% for GG + GC and 15.4% for CC. The frequency of alleles in patients with CP for G allele was 63.5% and for C allele 36.5%. In the group without CP, 56.2% had G allele and 43.8% C allele. No statistical significance has been demonstrated. Conclusion: No connection between IL-6 gene polymorphism with the development of cerebral palsy in newborns diagnosed with HIE at birth was demonstrated.

Different care mode alter composition and function of gut microbiota in cerebral palsy children.

Specialized care is essential for the recovery of children with cerebral palsy (CP). This study investigates how different care modes impact the gut microbiota. Fecal samples from 32 children were collected, among whom those cared for by family (n = 21) were selected as the observation group, and those cared for by children's welfare institutions (n = 11) were selected as the control group (registration number of LGFYYXLL-024). The gut microbiota profiles were analyzed. There was no significant difference in the α-diversity of the gut microbiota and the abundance at the phylum level. However, at the genus level, the observation group showed a significant increase in the abundance of butyrate-producing bacteria Bacteroides and Lachnospiracea incertae sedis (P < 0.05), and a significant decrease in the abundance of opportunistic pathogens Prevotella, Clostridium cluster IV, Oscillibacter, and Fusobacterium (P < 0.05). Additionally, lipid metabolism, carbohydrate metabolism, transcription, cellular processes and signaling, and membrane transport were significantly upregulated in the observation group. Lipid metabolism was positively correlated with Bacteroides and Lachnospiracea incertae sedis, indicating a positive impact of the family-centered care mode on bacterial metabolism processes. This study highlights that the family-centered care mode had a positive impact on the composition and function of the gut microbiota. The study provides valuable insights into the relationship between care mode and gut microbiota, which can inspire the development of interventions for cerebral palsy.

Effectiveness of routine physical therapy with or without home-based intensive bimanual training on clinical outcomes in cerebral palsy children: a randomised controlled trial

IntroductionThis study aimed to test how normal physical treatment, with or without home-based intense bimanual training, affected hand coordination and daily living activities in children with cerebral palsy.MethodsA randomised controlled experiment was carried out at DHQ Hospital in Kasur, Pakistan. Thirty children with unilateral spastic cerebral palsy took part in the study. The first group received standard physical treatment, whereas the second group received bimanual training along with routine physical therapy. Follow-ups were performed in the fourth and sixth weeks. The paediatric motor log activity scale and the ABILHAND questionnaire were used to assess daily activities and coordination, respectively.ResultsAt baseline, no significant association was seen between treatment groups and hand coordination outcome among the patients (p = 0.0450) and no significant difference was seen in patients in both treatment groups regarding their activities of daily living. In group A, no significant improvement was seen in hand coordination from baseline until the 6th week (p = 0.257) while in group B, a significant difference was seen in hand coordination from baseline until the 6th week follow-up (p = 0.000).ConclusionsThis study concluded that the combined effect of home-based bimanual exercises and routine physical therapy shows significant achievements in hand coordination and activities of daily living.

Oromotor rehabilitation on drooling and feeding activities in children with cerebral palsy: A case study

Abstract: Cerebral palsy (CP) is a neurological disorder that affects the brain and causes difficulties with muscle coordination, body movement, and balance. Children with CP frequently present with severe oral motor impairments. Children with CP suffer from a variety of motor disorders, which are frequently accompanied by sensory, cognitive, communication, perception, and behavioral disorders, as well as epilepsy, nutrition, dysphagia, and oral motor dysfunction. CP refers to a group of long-term movement and posture impairments that occur in the developing infant brain, limiting many activities such as independent walking, stair climbing, running, or walking on an uneven surface. The purpose of this case report is to describe the difficulty in oromotor functional activity experienced by a CP child. A 5-year-10-month-old baby presented with drooling and difficulty in feeding activities, which greatly affected her day-to-day activities. Her pediatric Ability for Basic Feeding and Swallowing in Children-10 (ABFS-C) was 6/15 and The Drooling Impact Scale (DIS) 72/100 total score improved to (DIS) 83/100 and (ABFS-C) 10/15.

Effectiveness of Constraint-induced Movement Therapy on Hand Function in Cerebral Palsy Children: A Narrative Review

A neurodevelopmental disease known as Cerebral Palsy (CP) first manifests in infancy and affects a variety of developing abilities, including motor control, coordination, tactile perception, cognition, and attention. The most prevalent type, accounting for 60%-70% of cases, is spastic CP. Ataxic CP accounts for 10%-15%, athetoid CP for 10%-15%, and mixed CP for 10%. Children diagnosed with hemiplegia exhibit firmness and muscle weakness due to unilateral involvement of both upper and lower limbs on the opposite side of the brain lesion. These variables may manifest upper limb motor deficits, such as restricted grasp, reach, and manipulation. These disabilities result in functional restrictions during daily activities and may cause the affected extremity to be underutilised. Hand impairment in hemiplegic CP occurs from damage to the motor cortex and corticospinal pathways, which are in charge of fine motor control of the fingers and hand. In terms of enhancing fine motor abilities and improving functional results, it has been demonstrated that Constraint-induced Movement Therapy (CIMT) is useful for individuals with CP. CIMT involves teaching a child to use their affected hand by using a constraint on the unaffected hand and repetitive extensive implementation of movements with the affected hand. The aim of the present review was to find out how CIMT affected the hand functionality in children with CP

Association Between Calf Muscle Tone, Plantar Surface Area, and Gross Motor Function in Children with Spastic Diplegic Cerebral Palsy.

Children diagnosed with spastic diplegic Cerebral Palsy (CP) usually demonstrate hypertonicity of the lower limb muscles which affects the normal alignments and weight reception by the feet. These impairments could be correlated to the limitations in gross motor function such as standing and walking abilities. Understanding these relationships can contribute to developing more effective rehabilitation strategies and improving overall motor outcomes for affected children. The current study was designed to explore the relationship between plantar surface area, weight distribution on the plantar surface, and gross motor function (namely, standing and walking abilities) in spastic diplegic CP children. Seventy-one spastic diplegic CP children aged 8-14 years joined this cross-sectional study. The Person's correlation coefficient and regression tests were used to assess the correlation between variables, namely, Gross Motor Function (GMFM), Calf Muscle Tone, Plantar surface area (PSA), and Peak pressure on mid and hind feet (PPMF, PPHF, respectively). These variables were assessed using the GMFM-88 scale, Modified Ashworth scale, and foot scan plantar pressure detection system, respectively. The correlation analysis demonstrated a strong to moderate positive correlation between PSA, PPMF, PPHF, and GMFM-D and GMFM-E. Additionally, regression model showed prediction levels equal to 0.791 for the GMFM-D and 0.720 for the GMFM-E categories, respectively. Standing and walking abilities were positively correlated (r ≥.6) with the increased plantar surface area and higher peak pressure on mid and hind feet in spastic diplegic CP. Future longitudinal studies should investigate changes in gross motor function in relation to improvement in plantar surface area and peak pressure values.

Assessing the Therapeutic Impact of Virtual Reality Interventions on Upper Limb Range of Motion and Functional Mobility in Pediatric Patients with Spastic Hemiplegic Cerebral Palsy: A Faisalabad-based Study

Cerebral palsy is a non-progressive central nervous system injury, most common in children, resulting from the damage to brain. Objectives: To see the effects of non-immersive virtual reality on range of motion, muscle strength, spasticity and functional mobility of upper limb in spastic hemiplegic cerebral palsy children. Methods: This was a quasi-experimental study, in which participants were selected through simple random sampling on the basis of defined selection criteria, there were two groups. Group A received conventional physical therapy exercises and group B was a received functional mobility exercises using non-immersive virtual reality. Data collection tools included Modified Ashworth scale to measure the spasticity, Functional assessment scale for functional status, Goniometer was used to measure the rage of mobility and Manual muscle testing MMT was used to measure the strength. Data was analyzed by SPSS version 26. Results: Mean age of children was 9.818 ± 2.639. From total participants 63.6% were males and 36.4% were females CP child. Paired-t test sowed that, there was a statistically significant difference in means of all outcome measures before and after treatment in group-A as well as in group–B (p-value&lt;0.05). Between-group analysis of A and B showed a statistically significant difference with p-value ≤0.05. Conclusions: Both groups showed improvement in spasticity, functional status, range of motion and muscle strength, but treatment group receiving functional mobility exercises using non-immersive virtual reality was found to be more effective than the control group.

Prevalence of Depression among Mothers of Children with Cerebral Palsy (CP) Enrolled in Occupational Therapy Unit at Lady Reading Hospital Peshawar, Pakistan

Cerebral Palsy (CP) is one of the most prevalent physical disorder in developmental disabilities among children. This condition may prone the parents for development of depression and anxiety especially the mothers. Objective: To assess the prevalence of depression among mothers of children with CP in Peshawar, Pakistan. Methods: A descriptive cross sectional study was conducted prior to randomize control trials in Occupational Therapy Department of Lady Reading Hospital Peshawar. The sample was calculated through Openepi, consisted of 240 participants through consecutive sampling technique. The quantitative data were collected through Hospital Anxiety and Depression (HADS) scale from mothers whose score was greater than 3 on the general health questionnaire (GHQ-12). Results: The mean age of the participants was 31.63± 7.09 years. In a sample of 240 participants, married were 230 participants followed by 6 divorced and 4 widows. Furthermore, 58% participants have male children affected followed by 42% female children. The mean score of the participants’ depression was 12.49 ± 3.18 in a total score of 21, which was moderate to severe in the current study. Conclusions: The study concluded that mothers of CP child have moderate to severe level of depression. Furthermore, the study highlighted that majority of the participants were married and the prevalence rate of CP was higher male children as compared to female.

The effects of COVID-19 restrictions on gross motor function of children with cerebral palsy

Purpose. COVID-19 is an extremely infectious, life-threatening viral illness that has constituted a global public health emergency. Rehabilitation programs of children with cerebral palsy were interrupted during the COVID-19 pandemic. The aim of the study was to assess the effects of COVID-19 restrictions on gross motor function of children with cerebral palsy.&#x0D; Material and Methods. In this study, a survey of fifty eight cerebral palsied children of both genders who received physical therapy recruited from three hospitals in Cairo, Egypt (October 6 university hospital -6th of October general hospital- El Hosary hospital- Zaid general hospital- Zaid specialled hospital- Private physical therapy centers). It was done through paediatrics Quality of life inventory (cerebral therapy module) to compare between the level of the children’s quality of life before and after frequent stopping of physical therapy sessions due to covid-19 pandemic.&#x0D; Results. The result of this study shows that there was a significant difference in movement and balance before and after the lockdown (p &lt;0.001). The mean value was decreased from 54.1% to 33.3%. Also, there was a significant decrease in Pain and hurt (p&lt;0.001) from 68.2% to 37.1% and in fatigue (p&lt;0.001) from 58.8% to 37.8%. Regarding age there was a significant difference between different age groups regarding daily activities (p&lt;0.001), pain (p&lt;0.010) and fatigue (p&lt;0.030), while after lockdown, there was a significant difference between different age groups regarding daily activities (p&lt;0.001) and fatigue (p&lt;0.001).&#x0D; Conclusion. Children with cerebral palsy were protected from COVID-19 exposure by staying at home, but their rehabilitation activities were disrupted. Therefore, during pandemics, caregivers must develop effective homecare therapy procedures, and healthcare professionals must routinely reassess the state of the child and caregiver. Additionally, caregivers of children with CP should experience less stress and anxiety. Children with CP can get multidisciplinary support, effective communication, and contact between medical professionals and families.

Impact of mother's care burden, fatigue and child's functional level on quality of life in spastic cerebral palsy.

Cerebral palsy (CP) may be considered one of the most common motor disabilities that require a lot of caregiving from mothers or caregivers; therefore, the mothers of children with CP face a lot of difficulties in their caregiving, which in turn may affect the child's quality of life (QOL). This work was conducted to evaluate the impact of the children's functional level in different types of spastic CP, mothers' care burden (CB), and fatigue on the child's QOL. One hundred thirty-eight children with different types of spastic CP (unilateral and bilateral) with different levels of the gross motor function classification system (GMFCS), with an age range of 6-12years, and their mothers with ages ranged from 25 to 45years, participated in this study. Mother CB, fatigue, and child QOL were measured and compared between different groups by using the Zarit burden Interview (ZBI), Chalder Fatigue Questionnaire (CFQ), and Pediatric Quality of Life Inventory (PedsQL) CP Module, respectively. There were significant differences in all measured variables (ZBI, CFQ, GMFCS, and PedsQL) with p-value <0.001 among the different spastic groups (unilateral and bilateral CP). However, the results revealed a positive impact of the child's GMFCS, mother's CB, and fatigue level on the quality of the child's life, with a greater effect on those with quadriplegic type. The mother's CB and fatigue should be considered in the rehabilitation of spastic CP children based on their GMFCS, as they have a negative impact on child QOL; therefore, helping the mother with her needs should not be ignored, especially in families with severely spastic CP children and low financial income.

СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ ЛЕЧЕБНОГО ПИТАНИЯ ПАЦИЕНТОВ С ДЕТСКИМ ЦЕРЕБРАЛЬНЫМ ПАРАЛИЧОМ ПРИ НАРУШЕНИЯХ НУТРИТИВНОГО СТАТУСА

With the purpose of successful rehabilitation, reduction of concomitant diseases, improvement of nutritional status and the quality of life of patients with cerebral palsy (CP) it is necessary to develop therapeutic nutrition technology, which would include methods for nutritional status assessment, choosing of enteral nutrition formulas, methods of their delivery and the duration of nutritional support. The purpose of this research was to substantiate the nutritional support for patients with CP. Materials and methods used: 98 children aged 2 to 16 years and 9 months old (Me 5.7 y/o) with a spastic form of CP that had been admitted for examination, treatment and rehabilitation at the National Medical Research Center for Children’s Health (Moscow, Russia) were examined. Depending on the level of motor activity calculated with GMFCS, the participants were divided into two groups: G1 of 51 (52%) with severe motor impairment (GMFCS IV to V) and G2 of 47 (48%) with mild and moderate motor impairment (GMFCS I to III). Clinical and anamnestic data, information about the severity and the course of the disease, concomitant pathology were analyzed as well as the anthropometric data (Z-scores: weight/age, height/age, BMI/age) using the WHO AnthroPlus application (2009 revision). EDACS survey had also been carried out. Results: Patients with severe motor impairments were significantly more likely to have problems associated with food intake, such as: prolonged feeding (over 30 minutes), predominance of semi-liquid and pureed food in the diet as well as frequent choking, vomiting, wheezing and coughing during the feeding process. All patients in this group needed external assistance in feeding. 75% had respiratory and 72% had gastrointestinal complications. Severe impairments (EDACS IV to V) characterized by significant restrictions on food safety were identified in 24 (23%) children, that met statistically significantly (p&lt;0.001) more often in patients from G1 than from G2 (41% vs. 4%, respectively). Dietary analysis children with CP had showed that the quality and quantity of food consumed were monotonous and deficient. Consumption of pasta, cereals, and baking was 1.5 times higher than recommended whilst vegetables, fruits and healthy dairy products were reduced by 3 and 1.8 times, respectively, on the contrary. The WHO recommendations for children on the mandatory daily intake of 3 to 4 servings of various vegetables and fruits were not followed: in the majority (80%) of cases they’ve only had it once per day, and they even were completely absent in some cases. Nutritional assessment revealed that patients with severe movement disorders, regardless of the gender and nutritional status, had significant deficiencies in energy and protein intake. All studied anthropometric indicators in G1 patients were significantly (p&lt;0.005) lower compared to G2 children. Prevalence of undernutrition was 72% and 32% (p&lt;0.001), respectively. Individual nutritional program was developed for each and every studied patient with identified malnutrition and oropharyngeal dysphagia, followed by its clinical effectiveness assessment. Conclusion: enteral nutritional support with specialized formulas based on both whole and hydrolyzed proteins using the sipping/gastrostomy method, as well as with the use of a food and liquids thickeners, proved to be highly effective in the treatment and rehabilitation of CP children. Indicators characterizing food intake (time taken for feeding, frequency of choking records during meals, episodes of vomiting and regurgitation) have improved as well as the anthropometric indicators improved accordingly.

The Role of Ayurveda in managing Cerebral Palsy in Children: A Holistic Approach

The Role of Ayurveda in managing Cerebral Palsy in Children: A Holistic Approach

Application of the Drill Method in Improving Movement- Building Skills For Cerebral Palsy Children

This research aims to determine the effect of applying the drill method in improving movement development skills for children with cerebral palsy. Cerebral Palsy is a defect in muscle and nerve function and the cause of the disability lies in the brain. Motor disorders that occur in children with Cerebral Palsy cause children to experience difficulties in carrying out activities that use motor skills, especially children's daily activities, namely helping themselves (Activity Daily Living). Therefore, a learning method is needed, especially related to habituation for Cerebral Palsy children, to train all their limbs. The drill method used is beneficial for children with cerebral palsy because the drill or practice method is also a teaching method that can be used to activate students during the teaching and learning process, because the drill method makes students always practice. The research method used is a qualitative approach with a case study research type. The subject in this research was a 7 year old Cerebral Palsy child with the initials A. This program focuses on the effect of applying the drill method, especially on gross motor aspects. The result of applying this drill method is that the subject experiences an improvement in the motoric aspect.

The Influence Of Montessori Games Educational Methods And Media In Improving The Fine Motorcy Of Cerebral Palsy Children For Pre-Hooting Skills

This research investigates the impact of Montessori game educational methods and media on improving the fine motor skills of Cerebral Palsy children, especially in the context of pre-buttoning skills. Fine motor skills have a crucial role in daily activities, delays in the development of these skills can hinder children's learning abilities. Cerebral Palsy as a condition of brain dysfunction can cause fine motor disorders in children. Using a qualitative approach with a case study of subject B, this research implemented intervention using the Montessori method to train children's fine motor skills over nine meetings. Initial assessment results indicated challenges in the subject's behavior and fine motor skills. However, after the intervention, significant positive changes were seen. Subjects can be arranged to sit, complete tasks, and successfully place objects into containers according to their shape. This program also improves children's patience and sitting ability. Even though it has not yet reached the buttoning stage, satisfactory progress can be seen.

Effects of routine physical therapy with and without kinesio taping in improving gross motor function in sitting and standing in spastic diplegic cerebral palsy children

ObjectiveTo determine the effectiveness of Kinesio taping along with routine physical therapy on improving gross motor function in sitting and standing among spastic diplegic Cerebral Palsy children. DesignRandomized controlled trial. SettingsUniversity Teaching Hospital University of Lahore, Lahore. Participants53 participants with diagnosed spastic diplegic cerebral palsy were randomly allocated in control and experimental groups. Intervention26 Participants were treated by kinesio taping which was applied in a criss-cross manner along with routine physical therapy program while the control group (n = 27) received NDT exercise program that comprises of stretching, functional reaching, weight-bearing exercises and walking. Outcome measureGross motor function was assessed using 2 components of Gross Motor Function Classification System (GMFCS-88), i.e., sitting as well as standing at the base line and after every 3rd week for 12 weeks follow up. ResultsIn study and control group the mean score of gross motor function for sitting at baseline was 33.96 ± 3.11 and 31.50 ± 3.32 respectively. After intervention, it changed to 47.70 ± 5.46 and 43.46 ± 1.81 respectively. Mean score for Gross Motor Function calculated at base line in study and control group for standing was 27.37 ± 1.14 and 26 ± 3.01 respectively. At the end of intervention, the score improved to 36.55 ± 4.27 and 33.69 ± 2.46 respectively. ConclusionIn comparison to control group, significant increase in gross motor function of intervention group was seen after the 12 weeks of intervention. In this way, over back muscles the application of kinesio tape in a Criss-Cross manner may be helpful. Also it can be used as an additional approach along with routine physical therapy to improve standing and sitting in spastic diplegic children.

Frequency of hearing loss in children with cerebral palsy and parents’ perception regarding their child’s hearing.

Objective: To determine frequency of hearing loss in cerebral palsy (CP) children and perception of child’s hearing and brain evoked response auditory (BERA) / brainstem auditory evoked potential (BAEP) results in CP patients. Study Design: Cross-sectional study. Setting: Department of Pediatric Neurology, Liaquat National Hospital, Karachi. Period: January 2022 to December 2022. Material &amp; Methods: The parents of all the CP children having cerebral palsy and who were nor assessed for hearing screening at birth (newborn hearing screening) were included. In child neurology clinic, parents were interviewed for the perception of the hearing of the child. Parental perception, CP type and the BERA results were recorded. Results: Total 102 patients were studied with median age of 27.9 (IQR= 17 – 48) months. Majority of the patients were normally delivered (n=59, 57.8%). Nearly quarter of them underwent neonatal screening (n=22, 21.6%). Majority of mothers (n=85, 83.3%) and father (n=80, 78.4%) had perception of hearing. BERA test was normal for 44 (43.1%) children. Age was significantly higher among patients with abnormal results. Frequency mothers’ perception of normal hearing was higher in abnormal BERA result. Frequency of difficult speech was higher in patients with abnormal BERA results. Conclusion: The frequency of hearing loss was high among children with CP. Frequency of mothers’ perception of their CP child’s normal hearing was higher when compared to the father’s perception.