Northern Ireland Cerebral Palsy Research Articles

Risk factors for intellectual disability in children with spastic cerebral palsy

BackgroundCerebral palsy (CP) is a non-progressive disorder of posture and movement caused by prenatal or perinatal lesions of the brain. Children with CP are also at increased risk of other...

Population-based study on the prevalence and clinical profile of adults with cerebral palsy in Northern Ireland

ObjectivesThis study aimed to report the prevalence and clinical characteristics of adults with cerebral palsy (CP) in a geographically defined region of the UK.Design and settingCross-sectional study using the Northern...

Did previous involvement in research affect recruitment of young people with cerebral palsy to a longitudinal study of transitional health care?

ObjectiveTo assess whether being contacted about or participating in previous research and method of approaching potential participants affected recruitment to a transition study from child to adult healthcare services of...

A population-based data-linkage study of prescribed pain medications dispensed to persons with cerebral palsy

BackgroundPopulation-based surveys to investigate pain in cerebral palsy (CP) can be costly and results limited by recruitment bias, recall issues, and differences between self-reports and parental accounts. Secondary data analysis may provide a cost-effective alternative to study this issue and its impact in this population.
 ObjectiveInvestigate factors associated with dispensing of prescribed pain medications for those with CP.
 MethodsData from the Northern Ireland CP Register were linked with the Enhanced Prescribing Database, a database of prescriptions dispensed by community pharmacies, to investigate dispensing of prescribed pain medications (non-steroidal antiinflammatories, opioids, non-opioids) between 2010 and 2014. The sample comprised 1,430 individuals with CP and 699,645 with no diagnosis of CP, born 1981-2008.
 FindingsPain medications were dispensed to 61% of the CP population and 51% of the general population (p < 0.05). Individuals with CP displayed increased odds of receiving opioid analgesics compared to the general population (OR 2.81, 95%CI 2.32 to 3.40). Among those with CP, likelihood of being dispensed prescribed pain medications was greater amongst females (OR 1.34, 95%CI 1.06 to 1.70), younger age individuals (OR 1.60, 95%CI 1.02 to 2.51), those with reduced motor function (GMFCS V: OR 2.60, 95%CI 1.52 to 4.47), having seizures (OR 2.55, 95%CI 1.68 to 3.87), and living in deprived areas (OR 2.06, 95%CI 1.41 to 3.24).
 ConclusionDispensing of pain medications in CP is associated with clinical factors, though even after adjustment for these, living in deprived areas influences uptake of pain medication.

Neurology team finalists

Nigel Hawkes finds out how the nominated teams have redesigned services to improve care Children born with cerebral palsy in Northern Ireland faced a fragmented pattern of care when Claire...

To what extent do children with cerebral palsy participate in everyday life situations?

The aims of the study are to describe participation of children with cerebral palsy in everyday life situations, to investigate the relationship between participation (primary outcome variable) with child and parent characteristics (independent variables) and to compare the frequency of participation (secondary outcome variable) of children with cerebral palsy with children without disabilities. A cross-sectional survey of parents of children with cerebral palsy in Northern Ireland was undertaken in families' homes using standard questionnaires. Children with cerebral palsy born between 31/8/1991 and 1/4/1997 were identified from a case register of people with the condition. A total of 102 parents opted in (51% response rate). Questionnaires included the Life Habits Questionnaire (Life-H) to measure difficulties in participation and The Frequency of Participation Questionnaire (FPQ), to measure frequency of participation with comparative data for children without disability. Overall, children with cerebral palsy participated less often than their non-disabled peers across a number of lifestyle and cultural pursuits. Among the 102 children with cerebral palsy, participation in 'relationships' was the least disrupted area of everyday life and aspects of 'school', 'personal care' and 'mobility' were the most disrupted. Children with cerebral palsy and severe co-impairments were significantly less likely to experience higher levels of participation in most areas of everyday life when compared to children with cerebral palsy and no severe co-impairments. Child physical and psychological well-being did not influence participation although higher parenting stress was significantly related to lower child participation in 'community activities'. Participation is an important health outcome for children with cerebral palsy and should be incorporated in routine clinical practice. Professionals have a role to play both at the level of addressing individual child and family needs as well as influencing legislation and policy to ensure improved access to services and local communities.

Trends in the prevalence of cerebral palsy in Northern Ireland, 1981-1997

Trends in the prevalence of cerebral palsy in Northern Ireland, 1981-1997

Trends in the prevalence of cerebral palsy in Northern Ireland, 1981–1997

We describe trends in the prevalence of cerebral palsy (CP) by birthweight group, and in the severity of motor impairments and presence of associated intellectual impairment, in Northern Ireland from 1981 to 1997 (n=909; 510 males, 399 females; total population 415,936 live births) using data from a population-based register of CP. Children with suspected CP or who died before 1 year of age and those with CP of postneonatal origin were excluded. Prevalence of CP was 2.2 per 1,000 live births without significant change over time. Among very-low-birthweight (<1,500 g) live births, prevalence was 44.5 per 1,000 (95% confidence interval 32.3-59.8) from 1994 to 1997, with evidence of a statistically significant decline in prevalence since the mid- to late 1980s accompanied by a decrease in the severity of motor impairment and likelihood of intellectual impairment. Among moderately-low-birthweight (1,500-2,499 g) children there was weaker evidence of a peak prevalence in the late 1980s. Prevalence among normal-birthweight infants did not change significantly, but outcome in terms of severity of motor impairment and intellectual impairment improved in the 1990s. Occurrence of bilateral spasticity from 1994 to 1997 was associated with greater severity and likelihood of intellectual impairment for normal-birthweight individuals than for low- or very-low-birthweight individuals.

Children and Young People with Cerebral Palsy in Northern Ireland (Birth Years: 1977–97)

Children and Young People with Cerebral Palsy in Northern Ireland (Birth Years: 1977–97)

What influences physiotherapy use by children with cerebral palsy?

To investigate factors that influence the frequency of physiotherapy currently used by a population of children with moderate to severe cerebral palsy (CP). A survey using a postal questionnaire was sent to 212 parents of children with moderate to severe CP. The families were identified from a geographically defined case register of children with CP in Northern Ireland (the Northern Ireland Cerebral Palsy Register). Eighty-five per cent of parents responded. One-third of parent responses regarding their child's use of physiotherapy were validated with their child's physiotherapist and the level of agreement was high. Ninety-four per cent (169/180) of children received conventional physiotherapy from a statutory source during the school term. Of these, 61% (104/169) used 'intense' levels of physiotherapy (defined as at least twice a week). A higher proportion of intense users were children with severe CP compared with moderate CP (69% vs. 47%; P < 0.01); with moderate intellectual impairment (IQ </= 70 > 50) compared with severe (IQ </= 50) or no intellectual impairment (IQ > 70) (81% vs. 64% vs. 39% respectively; P < 0.01) and at schools for physical disability (PD) compared with severe learning disability (SLD) or mainstream (MS) schools (82% vs. 66% vs. none respectively; P < 0.001). After controlling for severity of motor impairment and the presence and severity of intellectual impairment, children with CP at MS schools used on average significantly less physiotherapy compared with children with similar levels of motor impairment at PD schools (P < 0.001). Children with CP in MS schools use less physiotherapy compared with children with similar levels of disability in special schools. Organizing services around special schools may limit the degree to which children with CP and other disabilities are successfully integrated into MS education.