Cerebral Palsy Research Articles

Commentary on "How Does Standing Anteroposterior Stability Limits Correlate to Foot/Ankle Functions in Bilateral Spastic Cerebral Palsy?"

Commentary on "How Does Standing Anteroposterior Stability Limits Correlate to Foot/Ankle Functions in Bilateral Spastic Cerebral Palsy?"

The management of Pseudomonas aeruginosa respiratory infection in children with cerebral palsy: A narrative review.

Children with cerebral palsy have increased respiratory morbidity and mortality. Infection with Pseudomonas aeruginosa (PA) is associated with poorer outcomes, yet there are no formal guidelines to inform treatment of respiratory infection in children with cerebral palsy. This review explores the existing literature regarding management of PA-infection in children with cerebral palsy, with the aim of synthesising clinical recommendations and identifying gaps in current understanding. Medline (Ovid), PubMed and Embase were searched using keywords. Full-text articles involving the paediatric population and antimicrobial therapy were included. There was no limit on date of publication. Four retrospective case series were identified. Respiratory microbiology, in samples collected from a range of sites along the respiratory tract, was reported in three studies. Patients who received PA-specific antibiotics clinically improved. Two studies suggest that the use of suppressive inhaled anti-pseudomonal therapy may improve respiratory morbidity in the chronic setting. There is minimal evidence to guide management of PA respiratory infection in children with cerebral palsy. Children with cerebral palsy are at risk of developing bronchiectasis, so in the absence of high-quality evidence, management should be informed by extrapolating from the non-cystic fibrosis bronchiectasis guidelines. Further research examining surveillance and management of PA-infection in this population is required given that early intervention may prevent irreversible lung damage.

MANUAL OROFACIAL STIMULATION AND ITS IMPACT ON CHILDREN WITH CEREBRAL PALSY

Orofacial education of children with cerebral palsy is a long-lasting process that requires perseverance especially from their families. The main methods based on active orofacial exercises and those from speech therapy continue to question the effectiveness of oral motor treatment, leaving a gap in the literature concerning the feeding skills improvements of the children diagnosed with cerebral palsy. Based on this concern, we ask ourselves the question: are there other better methods of oral motor rehabilitation for these children with special needs? In this study we aimed to investigate, within the complex rehabilitation programme for CP, the impact of manual orofacial stimulation in order to reduce sialorrhea and improve mandibular movements, which play an important role in the feeding process. The study included 10 participants (5 girls and 5 boys), aged 8-10 years, diagnosed with cerebral palsy, spastic tetraplegia form with severe orofacial impairment and the intervention protocol consisted of a manual orofacial stimulation programme 4 times a week. Statistical results revealed that the application of the proposed orofacial stimulation programme was highly effective for the 10 research participants, whose scores improved significantly at the final assessment compared to those achieved at the beginning of the study, reaching almost normal values even in the case of mandibular parameters.

Benefits of Extracorporeal Shock Wave Therapy to Reduce Spasticity in Cerebral Palsy and Stroke Patients

Background: Spasticity, a common issue in cerebral palsy and stroke patients, significantly impairs mobility and quality of life. Non-invasive treatments like Extracorporeal Shock Wave Therapy (ESWT) have been explored for spasticity reduction.Objective: To evaluate the effectiveness of ESWT in reducing spasticity in cerebral palsy (CP) and stroke patients using the Modified Ashworth Scale (MAS).Methods: A randomized controlled trial (RCT) was conducted on 28 spastic CP and stroke patients. Participants were divided into Group A (n = 14, ESWT combined with conventional physiotherapy) and Group B (n = 14, conventional physiotherapy only). ESWT was administered at 5 Hz frequency, 0.10 mJ/mm² energy flux density, and 1500 impulses per session for 30 minutes, 5 days a week, for 6 months. Spasticity was assessed using MAS pre- and post-intervention. Data were analyzed using IBM SPSS version 25.Results: The ESWT group showed a significant reduction in MAS scores from 3.21 ± 0.25 to 1.77 ± 0.37 (p < 0.001), compared to the control group (3.10 ± 0.44 to 2.36 ± 0.60; p < 0.001).Conclusion: ESWT significantly reduced spasticity in CP and stroke patients, demonstrating its potential as an adjunctive therapy.

Impact of Serial Casting on Autonomic Nervous System Responses during Virtual Reality Tasks in Children with Cerebral Palsy: A Pilot Study Comparing Orthoses and Barefoot Conditions.

Cerebral palsy (CP) is a group of movement disorders that impair posture and mobility, often leading to spasticity and joint contractures. Interventions like serial casting are commonly used to improve joint mobility and manage spasticity in children with CP. However, its effects on the autonomic nervous system (ANS) remain unclear. This study aimed to evaluate the effects of serial casting and ankle-foot orthoses (AFOs) on ANS responses during a virtual reality (VR) standing task, comparing these interventions with a barefoot condition. Thirty children with CP were randomized into three groups (n = 10 per group): serial casting, AFOs, and barefoot. Heart rate variability (HRV) was used to assess ANS responses across three phases: seated rest, VR task, and recovery. The results showed that the serial casting group exhibited higher sympathetic activity during rest compared to the other groups, but had a reduced sympathetic response during the VR task. Additionally, the serial casting group displayed a more pronounced parasympathetic rebound during recovery, similar to the orthoses and barefoot groups. While serial casting provides essential joint stability, it alters ANS response patterns, leading to heightened sympathetic activation at rest, without providing significant improvements in ANS behavior during physical activity.

Precision measurement of rehabilitation interventions-a secondary analysis of motor error in a clinical trial with young children with cerebral palsy.

The delivery of precision medicine in rehabilitation will require not only precise measurement of participant response, but also precise measurement of the "ingredients" of intervention and their dose. As an example, we report the measurement of motor error in two treatment groups from a randomized controlled trial in toddlers (mean age 26.3 months) with cerebral palsy (CP). Our objective was to measure the type and amount of motor error during physical therapy sessions in young children with CP. Participants were stratified by motor function and age and randomly allocated to "conventional" physical therapy that generally prevented falls or to an intervention that encouraged error experience by not preventing falls (experimental group). Baseline motor and cognitive function were measured using the Gross Motor Function Measure-66 (GMFM-66) and Bayley 3 cognitive subscale (B3-C) prior to randomization. Randomly selected video recorded therapy sessions were manually coded to identify losses of balance defined as falls (child contacted floor), rescues (therapist prevented fall) or saves (child recovered their balance independently). Average number of losses of balance per session were higher in the experimental group than the conventional group due to significantly greater falls. Saves were infrequent in both groups but were also significantly higher in the experimental group. Average number of rescues did not differ between groups. In the experimental group, greater frequency of falls was significantly related to GMFM-66. In both groups, greater frequency of saves was related to GMFM-66. Neither total losses of balance per session nor rescues were related to GMFM-66 in either group. There were no significant relationships between losses of balance and baseline cognition in either group, except greater frequency of saves was related to higher cognitive ability in the experimental group. Our observations suggest that motor error experience is lower in toddlers with CP compared to peers with typical development but can be manipulated to higher doses of error during therapy sessions. Future work should investigate the relationship between type and amount of error experience and rehabilitation outcomes, as well as other "ingredients" of rehabilitation therapy. Tools to automate the precise measurement of intervention content are necessary for broad scale implementation.

A Retrospective Evaluation of Patients Who Had Den¬tal Treatments Under General Anesthesia

Aim: This retrospective study aimed to evaluate the demographic and operational data of uncooperative healthy individuals and individuals with special needs who underwent dental treatments under sedation and general anesthesia. Methods: Data of 458 patients with special needs and 77 healthy noncooperative patients who were examined at XXX University Faculty of Dentistry between January 2022 and May 2023 and underwent dental treatments under general anesthesia were examined retrospectively. Demographic data of the patients, American Society of Anesthesiologists (ASA) scores, mallampati (MP) scores, disability status, if they have systemic diseases, type of anesthesia (sedation/general anesthesia), anesthetic agents and analgesia used, operation duration and dental treatments, were evaluated. Results: The average age of 535 patients who received dental treatment was 13.5±9.9 years and 58.1% (n=311) of the patients were male and 41.9% (n=224) were female. According to ASA scores, the distribution was 15.7% ASA I, 77.6% ASA II, and 6.7% ASA III. While 14.4% of the patients were systemically healthy, 16.7% had epilepsy, 12.9% had cerebral palsy, 12.1% had mental retardation, and 7.1% had Down syndrome. Of 7.1% had various comorbidities such as cardiological problems. Sedation was applied to 7.3% (n=39) of the patients, and general anesthesia was applied to 92.7% (n=496). The average anesthesia duration was 74.5±34.6 minutes. While the average restorative treatment applied to the patients was calculated as 6.45±3.9, tooth extraction 5.25±4.3, fissure sealant 2.44±2.5, pulp treatment 1.62±0.9; Trauma splint was applied to 3 patients. Conclusions: While pre-anesthesia evaluation is very important in determining the risks in dental general anesthesia and sedation applications, the operating conditions and the general and oral health of the patients are effective in the dental treatment decision.

Epilepsy trends in Kazakhstan: A retrospective longitudinal study using data from unified national electronic health system 2014–2020

ObjectiveThis study is designed to estimate the epidemiology of epilepsy in Kazakhstan, using a large-scale administrative health database during 2014–2020. MethodsUsing the Unified National Electronic Health System of Kazakhstan over a seven-year span, we explored incidence and prevalence rates, disability-adjusted life years (DALY), and all-cause mortality. Regression models using Cox proportional hazards were used to analyze the sociodemographic, mental, behavioral, and neurological factors affecting survival. Overall analyses were performed using STATA (V.16). ResultsThe total cohort comprised of 82,907 patients, with a significant increase in the incidence of epilepsy from 26.15 in 2014 to 88.80 in 2020 per 100,000 people. Similar trends were observed in the prevalence rates, which tripled from 26.06 in 2014 to 73.10 in 2020. While mortality rates fluctuated, the elderly and children had the greatest rates of 9.97 and 2.98 per 1000 person-years respectively. DALYs revealed a substantial disease burden, with 153,532 DALYs (824.5 per 100,000) being lost during the study period. A few comorbidities, such as cerebral palsy (adjusted hazard ratio (aHR) 2.23) and central nervous system atrophy (aHR, 27.79), markedly elevated all-cause mortality. Furthermore, extrapyramidal and movement disorders (aHR 2.16, p = 0.06) and demyelinating diseases of the central nervous system (aHR 6.36, p = 0.06) showed a trend toward increased mortality risk. ConclusionTo the best of our knowledge, this is the first study from Central Asia exploring a large epilepsy cohort. The findings highlight the need for targeted interventions to address the growing burden of epilepsy, particularly among children, male sex, and those with neurological comorbities.

Children presenting with toe walking: when should concern arise?

Purpose: This study aimed to evaluate children who present with tiptoe walking (TW) and to identify potential indicators of underlying medical conditions. Materials and Methods: Out of the 248 patients who visited the Pediatric Neurology Outpatient Clinic for gait disturbances, 90 individuals aged 1-17 years were identified as exhibiting TW. After excluding those with systemic neurological diseases and pervasive developmental disorders (PDD), the study ultimately included 47 patients. Results: Among the participants, 19 were female (40.5%) and 28 were male (59.5%). The mean age of the patients was 4.9 years (SD ± 3.53). When evaluating the etiology of TW, 30 patients (63.8%) were found to have idiopathic tiptoe walking (ITW), 8 (17%) had cerebral palsy (CP), 6 (12.7%) had Achilles tendon shortness (ATS), 2 (4.2%) had hereditary spastic paraplegia (HSP), and 1 (2.1%) had syringomyelia. Imaging was not performed for 17 patients (36.1%), while cranial magnetic resonance imaging (MRI) was conducted for 13 (27.6%), spinal MRI for 2 (4.2%), and both cranial and spinal MRI for 15 (31.9%). Pathology was detected in 5 of the patients who underwent imaging (10.6%): 4 (8.5%) showed hypoxic-ischemic processes, and 1 (2.1%) showed syringomyelia. Conclusion: In cases where patients exhibit normal neurological examinations and neuromotor development, TW is often identified as idiopathic. However, for patients presenting with risk factors in their personal or family history, delays in neuromotor milestones, or abnormal neurological findings, a diagnosis should be pursued at an earlier stage.

The Effects of Treadmill Training with Visual Feedback and Rhythmic Auditory Cue on Gait and Balance in Cerebral Palsy: A Randomized Controlled Trial

The Effects of Treadmill Training with Visual Feedback and Rhythmic Auditory Cue on Gait and Balance in Cerebral Palsy: A Randomized Controlled Trial

Long-term neurodevelopmental outcomes at three years in preterm infants born before 29 Weeks gestation following Preterm Premature Rupture of Membranes (PPROM).

To determine the association between preterm premature rupture of membranes (PPROM) and neurodevelopmental impairment (NDI) at 3 years corrected age (CA) in infants born before 29 weeks of gestational age (GA). Infants born before 29 weeks GA between 2005 and 2017 were included. The primary outcome was a composite of death or NDI (full-scale intelligence quotient<85, cerebral palsy, vision or hearing impairment) at 3 years of CA. Infants were stratified by maternal PPROM status. Associations were explored using multivariate models. Of 1231 participants, 481 were in the PPROM group, and 750 were in the No PPROM group. After adjusting for factors, the odds ratio of death or NDI for PPROM vs. No PPROM was 1.22 (95% Confidence Interval 0.93-1.59). Our study suggests that PPROM was not associated with an increased risk of a composite outcome of death or NDI at 3 years CA.

Neurodevelopmental disorders in children born to mothers involved in maternal motor vehicle crashes.

To evaluate the association between maternal MVCs during pregnancy and neurodevelopmental disorders (NDDs, including intellectual disability, ADHD, ASD, and infantile cerebral palsy) in children. This population-based cohort of live births in Taiwan was analyzed, comparing children born to mothers involved in MVCs during pregnancy with those without such exposure. Children were linked to the insurance database to identify the possible diagnosis of NDDs. The Cox proportional hazards regression model was used to estimate the relative hazards. A total of 19,277 children with maternal MVCs and 76,015 children without exposure were included. Children exposed to maternal MVCs during the first two trimesters or whose mothers sustained mild to severe injuries showed a higher risk of intellectual disability. Severe maternal injuries also increased the risk of infantile cerebral palsy (aHR = 3.86; 1.27-11.78). MVCs in the third trimester, or mild maternal injuries, were associated with a higher risk of ASD (third trimester: aHR = 1.40; 1.04-1.87; mild injuries: aHR = 1.38; 1.09-1.74). Children exposed to maternal MVCs with severe injuries had a higher risk of intellectual disability and cerebral palsy. Third-trimester exposure may increase the risk of ASD. However, these findings should be interpreted cautiously as genetic factors may contribute to the observed association. There is some evidence linking maternal MVCs during pregnancy to the development of neurodevelopmental disorders in children. Children of mothers with severely injured were more likely to suffer from infantile cerebral palsy and intellectual disability. The risk of autism spectrum disorder is higher in children whose mothers are involved in MVCs during the late stage of pregnancy, and there is also an increased risk of intellectual disability during the first two trimesters.

Postnatal weight loss and neurodevelopmental outcomes at age 3 years in extremely preterm infants: a cohort study

BackgroundPrevious research has suggested a correlation between postnatal maximum weight loss (MWL) and both neonatal mortality and morbidities in extremely preterm infants. However, the relationship between MWL and neurodevelopmental outcomes remains underexplored.MethodsIn a single-center, retrospective cohort study at Okayama Medical Center, we evaluated data from extremely preterm infants admitted to the neonatal intensive care unit from 2010 to 2020. Infants who died within the first 10 days of life were excluded. MWL in the first 10 days was the main exposure, categorized into three groups: >15%, 5–15%, and < 5%. The primary outcome evaluated was the occurrence of death or neurodevelopmental impairment (NDI) at age 3 years, defined as developmental impairments (developmental quotient [DQ] < 85), cerebral palsy, hearing impairments, or visual impairments. Data analysis involved robust Poisson regression, adjusted for perinatal confounders, with a restricted cubic spline function to examine the dose-response relationship. We also conducted a sensitivity analysis using a DQ of < 70 to define developmental impairment.ResultsAmong 135 infants assessed for neurodevelopmental outcomes, 40 were in the > 15% MWL group, 71 in the 5–15% group, and 24 in the < 5% group. Median gestational ages and birth weights were 25.9 weeks and 821 g for > 15% MWL; 26.1 weeks and 818 g for 5–15% MWL; and 26.0 weeks and 734 g for < 5% MWL. Compared with the 5–15% MWL group, the < 5% group exhibited a higher risk of death or NDI at age 3 years (62.8% vs. 80.8%, risk ratio [RR] 1.36, 95% confidence interval [CI] 1.04–1.79) and NDI alone (59.2% vs. 79.2%, RR 1.43, 95% CI 1.06–1.94). Furthermore, higher risks of developmental impairment were also noted in the > 15% (RR 1.32, 95% CI 1.00–1.75) and < 5% (RR 1.46, 95% CI 1.08–1.98) groups. These associations were confirmed by spline analyses. In contrast, the associations between MWL and neurodevelopmental outcomes using a DQ of < 70 were not apparent.ConclusionsMWL within the first 10 days of life may be associated with increased risks of NDI and developmental impairments by age 3 years in extremely preterm infants.

Treatment of Spastic quadriplegia resulting from hypoxia in newborn through body engineering technique-hand therapy Case Report Described by Parents: Qualitative study

Objectives: Summary of Case Report on Spastic quadriplegia accompanied by several disabilities. Treatment with Body Engineering/Hand Therapy. This case report describes the successful treatment of a 4 years old girl who was diagnosed with Spastic quadriplegia and global developmental delay accompanied with relapse, slurred speech, and cognitive delay resulting from hypoxia during child birth. To report a case of a girl who suffered Spastic quadriplegia, seizures, and delay in speech and perception due to hypoxia and to highlights the critical role of body engineering techniques for the rehabilitation of children with similar cases. Methods: An informed case report was given by from the child's parents. Functional recovery was achieved through a customized rehabilitation plan according to the body engineering / hand therapy techniques We highlight: -Medical Management for such cases. -A rehabilitation plan based on body engineering/ hand therapy techniques that led to complete recovery. -Satisfaction of the patient's parents after treatment. Results: Treating the patient through body engineering (hand therapy) and rehabilitating him for a full year led to the appearance of signs of clinical and radiographic improvement. Conclusions: Hypoxia-induced spastic quadriplegia often results in multiple disabilities, as seen in this case. Early intervention using body engineering techniques can lead to significant improvements in physical and cognitive functions. Continuous monitoring and rehabilitation are recommended to sustain progress and prevent relapses (Odding et al., 2006). Based on the provided information, body engineering and hand therapy have proven to be highly effective in rehabilitating a girl with hypoxia-induced cerebral palsy. Through a comprehensive rehabilitation program, the patient's physical, cognitive, and communication abilities have significantly improved. This case report underscores the importance of early intervention in maximizing outcomes for children with spastic quadriplegia. By providing ongoing support and tailoring rehabilitation programs to individual needs, it is possible to help these children reach their full potential, aligning with the World Health Organization's definition of rehabilitation as a process to improve performance and reduce disability.

Clinical and Functional Characteristics of Co-occurring Cerebral Palsy and Autism Spectrum Disorder Among Children and Young Adults

Clinical and Functional Characteristics of Co-occurring Cerebral Palsy and Autism Spectrum Disorder Among Children and Young Adults

Predicting the development of optic nerve atrophy in children with cerebral palsy

Introduction. Optic nerve atrophy (ONA) holds a leading position in the nosological structure of ophthalmopathology. In children with cerebral palsy (CP), the presence of concomitant pathology such as ONA significantly worsens their health and quality of life. The combination of ONA and CP, as well as the interrelationship of these diseases, represents a relevant subject for research, particulary in studying the clinical and epidemiological features of ONA in children with CP to find optimal clinical solutions and prognostic approaches. Purpose: to investigate the prevalence of optic nerve atrophy in children with cerebral palsy to determine the prognosis for the development of this pathology in the study group. Materials and methods. A retrospective analysis of medical records of 640 patients diagnosed with cerebral palsy who were hospitalized in the clinic from 2015 to 2020 was conducted. The analysis included data from children with early-onset cerebral palsy (up to 3 years old) who were hospitalized for the first time. MS EXCEL software was used to calculate the main indicators of linear regression. Results. The study revealed that optic nerve atrophy in young children develops more frequently in boys (1.5 times more often than in girls), in rural areas, and in those with spastic cerebral palsy (36.3 %). The second most common form was ataxic cerebral palsy (69 children, 21.6 %), followed by infantile hemiplegia (61 children, 19%). Based on the dynamics of the prevalence of optic nerve atrophy in children with cerebral palsy, a mid-term forecast was made using the main indicators of linear regression. The prevalence of optic nerve atrophy in children with cerebral palsy is increasing, with prognostic estimates indicating further growth (14.9% in 2015, 15.4% in 2020, and 16.2% in 2024). Conclusion. The results of the study showed that cerebral palsy in children is often associated with optic nerve atrophy. ONA in young children is more frequently developed in cases of spastic cerebral palsy. As a result of calculating, an increase in the prevalence of optic nerve atrophy in children with cerebral palsy was observed over time, based on the correlation calculated using Spearman’s non-parametric correlation analysis Prognostic estimates indicate a significant increase in the near future.

Exploring Parents' Experiences and Needs During Disclosure of a Cerebral Palsy Diagnosis of Their Young Child: A Scoping Review.

Parents often perceive the news that their child has cerebral palsy (CP) as overwhelming and shocking. They are at increased risk of parental stress and mental health problems, which in turn can affect the interaction between the parent and the child. Parental mental health outcomes are known to be affected by the process of disclosure of a diagnosis. In this study, we aimed to synthesize the current knowledge about parents' experiences and needs regarding communication during the disclosure of the diagnosis of their child with (or at risk of) CP. A scoping review following the methodological steps outlined by the Joanna Briggs Institute was performed using PubMed, Embase, CINAHL and PsycINFO. We qualitatively explored parent-reported experiences and needs across included studies, using thematic analysis. A total of 19 studies were included. Six themes were identified, three in relation to experiences (i.e., preceding experiences and feelings, perceptions of the disclosure and emotional impact) and three in relation to needs (i.e., transparency in information, supportive attitude and having a say). Despite high variability across studies regarding parental needs, most studies reported the need for (i) honest and clear information, (ii) good communication skills amongst professionals and (iii) emotional and practical support after diagnosis. Our findings suggest that parents' experiences and needs in the period when their child's diagnosis of (high risk of) CP is communicated are highly variable, due to an interplay of personal and contextual factors. To facilitate good communication during disclosure, it is crucial that health care professionals assess and understand this complex process and consider parents' needs for open communication and autonomy in the process. Therefore, professionals need to attune to parents' needs and their individual preferences regarding conversations about their child with (or at risk of) CP.

Effect of Backward Walking Versus Forward Walking Training on Balance Among Children with Cerebral Palsy

Background: Cerebral palsy is characterized by long-term impairments in movement and posture that limit an individual’s ability to perform daily activities. Effective rehabilitation methods, such as forward and backward walking training, can improve balance and functional mobility in children with cerebral palsy.Objective: To compare the effects of backward walking training versus forward walking training on balance in children with cerebral palsy.Methods: A randomized clinical trial was conducted with 20 children aged 7-14 years, recruited from Children’s Hospital and Jinnah Hospital, Lahore. Participants were randomly divided into two groups: Group A (Forward Walking Training) and Group B (Backward Walking Training). Each group underwent training three times per week for 40 minutes over four weeks. Balance and mobility were assessed using the Time-Up-and-Go (TUG) test, Pediatric Balance Scale (PBS), and Figure-8 Walk Test (FW8T). Statistical analysis was performed using SPSS version 25, with Mann-Whitney U test used for between-group comparisons.Results: The backward walking group showed significant improvements in TUG (p = 0.03), PBS (p = 0.01), and FW8T (p = 0.01) compared to the forward walking group.Conclusion: Backward walking training showed superior improvements in balance and functional mobility compared to forward walking training in children with cerebral palsy.

The Effects of a Multi-Sports Program on the Physical Fitness, Quality of Life, and Well-Being of People with Intellectual and Developmental Disabilities—A Study Protocol

We intend to develop an intervention program based on sports for people with Intellectual and Developmental Disability (IDD) to analyze its effects on physical fitness, quality of life (QoL), and well-being. The convenience sample will consist of at least 24 participants aged between 18 and 65, of both sexes, who are institutionalized with a previous diagnosis of IDD and no associated comorbidities (e.g., visual impairment or cerebral palsy). The participants will be divided into two groups: (i) the experimental group and (ii) the control group. The experimental group will have a weekly session, lasting 60 min, for 36 weeks. There will be a baseline assessment, a final assessment, and a follow-up assessment (three months after the end of the program). The results of this study are intended to contribute to the development of more assertive community interventions, based on sports, for the benefit of this population.

Classification of windswept posture in daily life using tri-axial accelerometers.

An asymmetric windswept posture is often seen in children with severe cerebral palsy (CP). However, it is still unclear how long children with CP remain in the windswept posture in daily life. Thus, we developed a triple-accelerometer system for detecting windswept posture. The aim of this study was to assess the validity of a system for classifying various body postures and movements. We assessed the accuracy of our system in nine healthy young adults (age range, 21-23 years). The participants wore acceleration monitors on the sternum and both thighs, then spent 3 min each in eight different positions and three physical activities. Once accuracy was confirmed, we assessed the posture and movements for 24 h in six healthy young adults (age range, 21-23 years) in their home environments. The body postures and activities were correctly detected: the agreement across the subjects were 100% compatible with the subjects' activity logs at least 68% of the time, and at least 96% of the time for recumbent positions. We concluded that the proposed monitoring system is a reliable and valid approach for assessing windswept hip posture in a free-living setting.