Cerebral Palsy Rehabilitation Research Articles

Artificial intelligence and machine learning approaches in cerebral palsy diagnosis, prognosis, and management: a comprehensive review

Cerebral palsy (CP) is a group of disorders that alters patients’ muscle coordination, posture, and movement, resulting in a wide range of deformities. Cerebral palsy can be caused by various factors, both prenatal and postnatal, such as infections or injuries that damage different parts of the brain. As brain plasticity is more prevalent during childhood, early detection can help take the necessary course of management and treatments that would significantly benefit patients by improving their quality of life. Currently, cerebral palsy patients receive regular physiotherapies, occupational therapies, speech therapies, and medications to deal with secondary abnormalities arising due to CP. Advancements in artificial intelligence (AI) and machine learning (ML) over the years have demonstrated the potential to improve the diagnosis, prognosis, and management of CP. This review article synthesizes existing research on AI and ML techniques applied to CP. It provides a comprehensive overview of the role of AI-ML in cerebral palsy, focusing on its applications, benefits, challenges, and future prospects. Through an extensive examination of existing literature, we explore various AI-ML approaches, including but not limited to assessment, diagnosis, treatment planning, and outcome prediction for cerebral palsy. Additionally, we address the ethical considerations, technical limitations, and barriers to the widespread adoption of AI-ML for CP patient care. By synthesizing current knowledge and identifying gaps in research, this review aims to guide future endeavors in harnessing AI-ML for optimizing outcomes and transforming care delivery in cerebral palsy rehabilitation.

Children with Cerebral Palsy Rehabilitation In-Session Engagement: Lessons Learnt from a Story Tool Training Program

ABSTRACT Rehabilitation aims to increase individuals’ ability to interact with their environment. Focusing on the paediatric context, rehabilitation is likely to optimise children’s development while improving and maintaining their functioning. However, children with neurodevelopmental disabilities, such as cerebral palsy, often show low engagement in rehabilitation sessions. This study aimed to assess the effectiveness of a narrative-based training program in increasing in-session engagement for children with cerebral palsy undergoing rehabilitation (i.e. targeting affective, behavioural, and cognitive dimensions). The study was conducted in three cerebral palsy rehabilitation centres and followed a one-group double-pre-test, one-post-test design. Fifteen children with cerebral palsy participated in the training program twice a week over nine weeks. The program aimed to promote children’s in-session engagement in rehabilitation through a story tool grounded in a self-regulation theory. Current data revealed the key effects of implementation time in the three dimensions of in-session engagement. Post-hoc tests of within-subjects indicated significant differences between pre-test 1 versus post-test and pre-test 2 versus post-test in the three dimensions of in-session engagement. This narrative-based intervention was a helpful tool promoting in-session affective, behavioural, and cognitive engagement in rehabilitation for this sample of children with cerebral palsy.

Design of a Real-Time Monitoring System for Electroencephalogram and Electromyography Signals in Cerebral Palsy Rehabilitation via Wearable Devices

Cerebral palsy is a disorder of central motor and postural development, resulting in limited mobility. Cerebral palsy is often accompanied by cognitive impairment and abnormal behavior, significantly impacting individuals and society. Time, energy, and economic investment in the rehabilitation process is substantial, yet the rehabilitation outcomes often remain unsatisfactory. Additionally, some patients have limited sensory perception during rehabilitation training, making it challenging to effectively regulate exercise intensity. Traditional evaluation methods are mostly based on recovery performance, lack guidance at the neurophysiological level, and have an unequal distribution of medical rehabilitation resources, which pose great challenges to the rehabilitation of patients. Based on the issues mentioned above, this paper proposes a real-time cerebral signal monitoring system based on wearable devices. This system can monitor and store blood oxygen, heart rate, myoelectric, and EEG signals during cerebral palsy rehabilitation, and it can track and monitor signals during the rehabilitation treatment process. The system includes two parts: hardware design and software design. The hardware design includes a data signal acquisition module, a main control chip (ESP32), a muscle electrical sensor module, a brain electrical sensor module, a blood/heart rate acquisition module, etc. It is primarily for real-time signal data acquisition, processing, and uploading to the cloud server. The software design includes functions such as data receiving, data processing, data storage, network configuration, and remote communication and enables the visual monitoring of data signals. The system can achieve real-time monitoring of electromyography, electroencephalography, and blood oxygen levels, as well as the heart rate of patients with cerebral palsy, and adjust rehabilitation training in real-time during the rehabilitation process. At the same time, based on the real-time storage of the original electromyography and electroencephalography data, it can provide auxiliary guidance for later rehabilitation evaluation and effective data support for the entire rehabilitation treatment process.

Electroacupuncture activates the peroxisome proliferators-activated receptor pathway to improve thephenotype of cerebral palsy.

This study explores the efficacy of electroacupuncture (EA) in treating cerebral palsy (CP) in Sprague-Dawley (SD) pups, specifically CP animal models, and its molecular mechanisms. Gait analysis and Y-maze were used to detect the improvement of motor ability and cognitive function of CP rats after EA treatment. Transcription sequencing was used to determine the key pathway for EA to improve the symptoms of CP. PPAR agonists were used to verify the causal relationship between the pathway and the improvement of CP phenotype. The motor ability and cognitive function of CP pups were improved after EA treatment. The results of transcriptome sequencing suggest that the improvement of CP phenotype may be caused by the activation of PPAR pathway. PPAR pathway is widely activated in the epithelium of CP pups treated with EA, which is verified by qPCR. Rosiglitazone (Ros), a PPAR agonist, can improve CP phenotype while activating PPAR pathway, which proves the causal relationship between PPAR pathway activation and CP phenotype improvement. Our study demonstrated behavioral improvements and enhanced cognitive functions in CP models after EA treatment by activating PPAR pathway, suggesting new perspectives for CP rehabilitation, and providing theoretical support for acupuncture treatment of CP.

An analysis of stimulation methods used in rehabilitation equipment for children with cerebral palsy.

This paper summarizes the research progress into stimulation methods used in rehabilitation equipment for pediatric cerebral palsy (CP) for the past 20 years from 2003 to 2023. We also provide ideas for innovative research and development of artificial intelligence-based rehabilitation equipment. Through a certain search strategy, Keywords are searched in the China National Knowledge Network Database (CNKI), the Wanfang Database knowledge service platform, the Chongqing VIP information service, PubMed, Web of Science, Cochrane, ScienceDirect, Medline, Embase, and IEEE database. A total of 3,049 relevant articles were retrieved, and 49 articles were included that mentioned research and development of rehabilitation equipment. We excluded articles that were not specific to children with CP, were duplicated or irrelevant literature, were missing data, the full article was not available, the article did not describe the method of stimulation used with the rehabilitation equipment on children with CP, were not Chinese and English, and were the types of reviews and commentaries. Physical stimulation is the main stimulation method of rehabilitation equipment for children with CP. Force stimulation is the main mode of physical stimulation, and there are 17 articles that have verified the clinical efficacy of force stimulation-based equipment. Research on the stimulation mode of pediatric cerebral palsy rehabilitation equipment is likely to focus on simulating the force of the Chinese medicine called "tuina manipulation." When this method is combined with artificial intelligence and personalized direction we believe this will lay the foundation for future development of a novel therapy for children with CP.

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.

Exploring the Potential Effect of Negative Air Ions for Rehabilitation in Cerebral Palsy and Polycystic Ovary Syndrome

Exploring the Potential Effect of Negative Air Ions for Rehabilitation in Cerebral Palsy and Polycystic Ovary Syndrome

Wearable Sensor‐Based Multi‐modal Fusion Network for Automated Gait Dysfunction Assessment in Children with Cerebral Palsy

Gait, fundamental to human movement, becomes compromised in cerebral palsy (CP), a childhood‐onset central nervous system motor disorder. Precise assessment of patients’ gait is crucial for tailored rehabilitation interventions. Currently, clinical scales assessing CP gait dysfunction mostly, while valuable, rely on subjective clinician observations. To enhance objectivity and efficiency in CP diagnosis and rehabilitation, there is a need for more objective assessment procedures. This study introduces a multi‐modal and multi‐scale feature fusion (MMFF) framework, a new framework for automating gait dysfunction assessment in children with CP. By utilizing surface electromyography and acceleration signals recorded during children's walking, MMFF generates a feature vector enriched with adaptively refined feature maps, cross‐mode correlations, and both local and global information. Validation of MMFF's effectiveness is evident through an accomplished classification accuracy of 99.13%. The mean values for precision, recall, and F1‐score in Gross Motor Function Classification System (GMFCS)‐1, GMFCS‐2, and GMFCS‐3, reaching 99.00%, 99.00%, and 98.33%, respectively, further reflect the accuracy of functional assessments at each level. This study underscores MMFF's potential as an objective, streamlined tool for clinicians, promising improved gait assessment and well‐informed rehabilitation strategies for children with CP.

The Possibility of Improvement in Balance and Function Following Conjunct Effects of Transcranial Direct Current Stimulation and Whole-Body Vibration Therapy in Spastic Cerebral Palsy Patients: A Hypothesis Study

Cerebral palsy (CP) results from developmental brain injury, affecting posture and muscular coordination. Traditional treatments offer varying effectiveness, among them the most recent therapies are whole-body vibration therapy (WBVT) and transcranial direct current stimulation (tDCS). WBV enhances proprioceptive function, muscle mass, bone density, and joint stability by stimulating muscle spindle fibers and activating dormant motor units. It also modulates spastic reflexes through mechanoreceptors, proving more effective than traditional physiotherapy. tDCS, a non-invasive neuromodulation, reshapes cortical excitability and modulates synaptic plasticity by altering neuronal activity. It affects long-term potentiation and depression, crucial in learning and adaptive functions. tDCS's interaction with neurotransmitters, especially dopamine and GABA, and its effect on NMDA and dopaminergic receptors make it promising for CP rehabilitation. Both therapies offer novel insights into CP rehabilitation through their influence on central and peripheral neural system. This hypothesis study tends to explore the conjunct effects of transcranial direct current stimulation (tDCS) and whole-body vibration therapy (WBVT) on improving balance and function in children with spastic cerebral palsy. The hypothesis suggests that WBVT's vibratory input, alongside tDCS's central stimulation, enhances function by modulating neuronal excitability and sensory information. The tonic vibration reflex (TVR) from WBV is believed to amplify muscle strength and modulate spinal excitability. When integrated with tDCS, it might accelerate excitability in the motor cortex, essential for brain-injured patient rehabilitation. Despite evidence of individual benefits from both therapies, conjunct effects remain under-researched. Preliminary results show improvements in balance, gait velocity, and motor functions. Validating this combined approach could revolutionize treatment for children with spastic cerebral palsy.

Construction, evaluation, and application of an electronic medical record corpus for cerebral palsy rehabilitation.

The electronic medical records (EMRs) corpus for cerebral palsy rehabilitation and its application in downstream tasks, such as named entity recognition (NER), requires further revision and testing to enhance its effectiveness and reliability. We have devised an annotation principle and have developed an EMRs corpus for cerebral palsy rehabilitation. The introduction of test-retest reliability was employed for the first time to ensure consistency of each annotator. Additionally, we established a baseline NER model using the proposed EMRs corpus. The NER model leveraged Chinese clinical BERT and adversarial training as the embedding layer, and incorporated multi-head attention mechanism and rotary position embedding in the encoder layer. For multi-label decoding, we employed the span matrix of global pointer along with softmax and cross-entropy. The corpus consisted of 1405 EMRs, containing a total of 127,523 entities across six different entity types, with 24,424 unique entities after de-duplication. The inter-annotator agreement of two annotators was 97.57%, the intra-annotator agreement of each annotator exceeded 98%. Our proposed baseline NER model demonstrates impressive performance, achieving a F1-score of 93.59% for flat entities and 90.15% for nested entities in this corpus. We believe that the proposed annotation principle, corpus, and baseline model are highly effective and hold great potential as tools for cerebral palsy rehabilitation scenarios.

Early differential diagnosis and restorative treatment of cerebral palsy

The article is devoted to an urgent problem of modern neurology - early diagnosis and complex restorative treatment of cerebral palsy (cerebral palsy). Etiological factors and pathogenetic aspects of the formation of various forms of cerebral palsy are considered in detail, as well as modern possibilities of differential diagnosis in children of the first years of life of cerebral palsy and a wide range of pathological conditions (somatic, endocrine, hereditary-conditioned, including hereditary-metabolic and neuromuscular diseases). The leading directions of complex rehabilitation of cerebral palsy are widely presented, taking into account modern standards and clinical recommendations. The high efficacy of the drug Cortexin has been shown, due to its positive multimodal action (stimulation of the processes of neuropreparation, neuroprotection, neuroplasticity) in the treatment of motor, cognitive and autonomic disorders in children with perinatal lesions of the central nervous system and cerebral palsy.

Comorbidity of cerebral palsy and epilepsy with autism in children

Background. Cerebral palsy is often combined with epilepsy (up to about 50 % of children). The treatment of epilepsy limits the rehabilitation of cerebral palsy, and the rehabilitation of cerebral palsy often provokes epileptic seizures. Epilepsy in children with cerebral palsy is often manifested in a form of developmental and epileptic encephalopathy with spike-and-wave activation in sleep, which is characterized by epileptiform activity according to the type of benign epileptiform patterns of childhood with a high index on the electroencephalogram (up to 100 %), severe epileptic seizures of a status course, and mental disorders by type autism-like behavior (the so-called atypical autism) and disorders of speech communication. The problem of comorbidity of cerebral palsy, epilepsy and autism remains relevant and needs further study.Aim. To study the features of autism spectrum disorder in a group of children with a combination of cerebral palsy and epilepsy.Materials and methods. We examined 100 patients aged 3–10 years with various forms of cerebral palsy, combined with epilepsy, to identify the clinical features of autism spectrum disorder. Criteria for inclusion in the study: age 3–10 years; verified diagnosis of epilepsy in combination with cerebral palsy and autism spectrum disorder; informed consent of the patient’s parents to participate in the study. Criteria for exclusion from the study: severe somatic diseases and disorders of the sense organs (in particular, kyphoscoliosis, gastrostomy and others, as well as deafness, blindness); age less than 3 or more than 10 years.Results. The average age of visiting a psychiatrist was 5.4 ± 0.5 years. The reasons for visit were: violation of the communication (76 %), decreased eye contact (75 %), lack of compassion for surrounding or adjacent animals (100 %), dysphoric disorders (77.1 %), aggression (55 %), autoaggression (40 %), phobias (90 %), impaired speech development (18 %). Perinatal brain damage was diagnosed in 100 % of cases. Epilepsy was manifested by focal motor seizures. Patients with complex treatment (drugs and pedagogical correction) have more pronounced positive dynamics compared with patients who received only drug therapy or only rehabilitation (p <0.05).Conclusion. In children with a combination of cerebral palsy and epilepsy, the cause of autism is perinatal lesions of the central nervous system, as well as the severity of motor pathology and the presence of continued epileptiform activity on the electroencephalogram. Autism in this group of children requires timely recognition and medical and pedagogical correction.

Research Progress on Rehabilitation of Children with Spastic Cerebral Palsy

Spastic cerebral palsy is a classification of pediatric cerebral palsy, in China and even the world has a high incidence rate, the disease can lead to central motor injury, limited functional activity, posture development disorders and other symptoms. At present, there is no clinical treatment can be completely its root treatment, mainly by drug treatment and rehabilitation training combined methods for treatment. This paper mainly introduces the common rehabilitation techniques of spasm cerebral palsy rehabilitation, which are common in sports therapy, physical factor therapy, traditional Chinese medicine rehabilitation techniques and joint comprehensive rehabilitation nursing, and the latter have robotics, vibration therapy, cord blood stem cell transplantation. In order to provide reference suggestions and research ideas for the study of the rehabilitation of children with spastic cerebral palsy.

Altered excitation-inhibition balance in the primary sensorimotor cortex to proprioceptive hand stimulation in cerebral palsy

ObjectiveOur objective was to clarify the primary sensorimotor (SM1) cortex excitatory and inhibitory alterations in hemiplegic (HP) and diplegic (DP) cerebral palsy (CP) by quantifying SM1 cortex beta power suppression and rebound with magnetoencephalography (MEG). MethodsMEG was recorded from 16 HP and 12 DP adolescents, and their 32 healthy controls during proprioceptive stimulation of the index fingers evoked by a movement actuator. The related beta power changes were computed with Temporal Spectral Evolution (TSE). Peak strengths of beta suppression and rebound were determined from representative channels over the SM1 cortex. ResultsBeta suppression was stronger contralateral to the stimulus and rebound was weaker ipsilateral to the stimulation in DP compared to controls. Beta modulation strengths did not differ significantly between HP and the control group. ConclusionsThe emphasized beta suppression in DP suggests less efficient proprioceptive processing in the SM1 contralateral to the stimulation. Their weak rebound further indicates reduced intra- and/or interhemispheric cortical inhibition, which is a potential neuronal mechanism for their bilateral motor impairments. SignificanceThe excitation-inhibition balance of the SM1 cortex related to proprioception is impaired in diplegic CP. Therefore, the cortical and behavioral proprioceptive deficits should be better diagnosed and considered to better target individualized effective rehabilitation in CP.

Application of Virtual Reality-Assisted Exergaming on the Rehabilitation of Children with Cerebral Palsy: A Systematic Review and Meta-Analysis.

Rehabilitation programs for children with cerebral palsy (CP) aim to improve their motor and cognitive skills through repeated and progressively challenging exercises. However, these exercises can be tedious and demotivating, which can affect the effectiveness and feasibility of the programs. To overcome this problem, virtual reality VR-assisted exergaming has emerged as a novel modality of physiotherapy that combines fun and motivation with physical activity. VR exergaming allows children with CP to perform complex movements in a secure and immersive environment, where they can interact with virtual objects and scenarios. This enhances their active engagement and learning, as well as their self-confidence and enjoyment. We aim to provide a comprehensive overview of the current state of research on VR exergaming for CP rehabilitation. The specific objectives are: To identify and describe the existing studies that have investigated the effects of VR exergaming on motor function and participation outcomes in children with CP. In addition, we aim to identify and discuss the main gaps, challenges, and limitations in the current research on VR exergaming for CP rehabilitation. Finally, we aim to provide recommendations and suggestions for future research and practice in this field. In June 2023, we conducted a systematic search on Scopus, Web of Science, PubMed, Cochrane, and Embase for randomized trials and cohort studies that applied VR-assisted exergaming to rehabilitating patients with CP. The inclusion criteria encompassed the following: (1) Randomized controlled trials (RCTs) and cohort studies involving the rehabilitation of children with CP; (2) the application of VR-based exergaming on the rehabilitation; (3) in comparison with conventional rehabilitation/usual care. The quality of the selected RCTs was evaluated using Cochrane's tool for risk of bias assessment bias includes. Whereas the quality of cohort studies was assessed using the National Institutes of Health (NIH) tool. The systematic search of databases retrieved a total of 2576 studies. After removing 863 duplicates, 1713 studies underwent title and abstract screening, and 68 studies were then selected as eligible for full-text screening. Finally, 45 studies were involved in this review (n = 1580), and 24 of those were included in the quantitative analysis. The majority of the included RCTs had a low risk of bias regarding study reporting, participants' attrition, and generating a random sequence. Nearly half of the RCTs ensured good blinding of outcomes assessors. However, almost all the RCTs were unclear regarding the blinding of the participants and the study personnel. The 2020 retrospective cohort study conducted at Samsung Changwon Hospital, investigating the effects of virtual reality-based rehabilitation on upper extremity function in children with cerebral palsy, demonstrated fair quality in its methodology and findings. VR-assisted exergaming was more effective than conventional physiotherapy in improving the Gross Motor Function Measurement (GMFM)-88 score (MD = 0.81; 95% CI [0.15, 1.47], p-value = 0.02) and the GMFM walking and standing dimensions (MD = 1.45; 95% CI [0.48, 2.24], p-value = 0.003 and MD = 3.15; 95% CI [0.87, 5.42], p-value = 0.007), respectively. The mobility and cognitive domains of the Pediatric Evaluation of Disability Inventory score (MD = 1.32; 95% CI [1.11, 1.52], p-value < 0.001) and (MD = 0.81; 95% CI [0.50, 1.13], p-value < 0.0001) were also improved. The Canadian Occupational Performance Measure performance domain (MD = 1.30; 95% CI [1.04, 1.56], p-value < 0.001), the WeeFunctional Independence Measure total score (MD = 6.67; 95% CI [6.36, 6.99], p-value < 0.0001), and the Melbourne Assessment of Unilateral Upper Limb Function-2 score (p-value < 0.001) improved as well. This new intervention is similarly beneficial as conventional therapy in improving other efficacy measures. Our findings suggest that VR-assisted exergaming may have some advantages over conventional rehabilitation in improving CP children's functioning and performance in daily life activities, upper and lower limb mobility, and cognition. VR-assisted exergaming seems to be as effective as conventional physiotherapy in the other studied function measures. With its potential efficacy, better feasibility, no reported side effects, and entertaining experience, VR-assisted exergaming may be a viable complementary approach to conventional physiotherapy in rehabilitating children with CP.

Investigation of the Relationship between Sensory-Processing Skills and Motor Functions in Children with Cerebral Palsy.

The main purpose of this study is to examine the relationship between sensory-processing skills and gross motor functions, bimanual motor functions, and balance in children with cerebral palsy (CP). A total of 47 patients between the ages of 3 and 10, diagnosed with CP, who received or applied for treatment in our physical therapy and rehabilitation unit were included in the study. Sensory profiling (SP), assisting hand assessment (AHA), the Gross Motor Function Measure-66 (GMFM-66), and the Pediatric Berg Balance Scale (PBBS) were used in the evaluation of the children with CP who participated in the study. The Gross Motor Function Classification System (GMFCS) was used to classify the children based on functional abilities and limitations, and the Manual Ability Classification System (MACS) was used to classify the children based on manual dexterity. The SP parameters were compared with AHA, GMFM-66, and PBBS results, and with GMFCS and MACS levels. Statistically significant relationships were found between AHA and SP, PBBS, and SP and between GMFM-66 and SP (p < 0.05). Our study shows that there are some disorders in sensory processing in children with CP. We think that sensory evaluations should be included in the CP rehabilitation program.

Effect of upper extremity kinesio tape application on hand function, wrist joint position and grip strength in children with hemiparetic cerebral palsy

Abstract Although kinesio taping (KT) is frequently used in musculoskeletal disorders, there is not enough data on the effectiveness of holistic KT application on the upper extremity in spastic hemiparetic children. Our study aims to evaluate the effect of KT application on spasticity, range of motion, dexterity and hand grip strength in these patients. Twenty patients diagnosed with spastic hemiparetic cerebral palsy, aged 5-17 years, who were trained and treated in a private educational institution, were included in the study. Between November 2021 and January 2022, in addition to neurodevelopmental therapy for 12 weeks, KT was applied from the lateral epicondyle region to the end of the metacarpals, with 15-25% tension, to the dorsal face of the hand, with the taping direction facilitation technique (starting direction is the origin of the muscle). Spasticity, range of motion, dexterity and hand grip strength were evaluated as pre-test and post-test. It was determined that the mean score difference between the pre-test and post-test range of motion (ROM) shoulder abduction, ROM supination, ROM wrist flexion, ROM wrist extension and hand grip strength of the individuals was statistically significant (). It was determined that the individuals’ pre-test-post-test Jebsen hand function test (JHFT) Writing, JHFT card flipping, JHFT small objects, JHFT nutrition simulation, JHFT backgammon checkers stamps, JHFT large light objects, JHFT total score average difference was statistically significant (). These results indicate that KT application positively affects upper extremity functions in the rehabilitation of hemiparetic cerebral palsy. Longitudinal studies are recommended in patients with hemiparetic cerebral palsy.

Effectiveness of Tizanidine and intensive rehabilitation in Spastic Cerebral Palsy

Background: The treatment of cerebral palsy is multifactorial. The aim of the study is to find out the efficacy of tizanidine and intensive rehabilitation in the treatment of spastic cerebral palsy. Methods: This observational study was conducted over 35 patients in Sir Salimullah Medical Mitford Hospital from January 2022 to December 2022.The patients satisfying the inclusion and exclusion criteria were enrolled: total 35 patients received tizanidine (2mg) orally at a dose of 1 mg given at bed time under 10 years and 2 mg given at bed time more than 10 years of age, then after 1 week maintenance dose was given at 0.3 mg/kg/day, three times daily in combination with intensive rehabilitation 1 hour daily five times a week. Total 24 weeks of intensive rehabilitation was given. All patients were followed up at 4 weeks interval and were evaluated for a total of 24 weeks. Results: The study shows high efficacy in reducing tone in spastic cerebral palsy measured by using Modified Ashworth scale (p&lt;0.001).Also there is improvement in physician rating scale crouch (p&lt;0.0001) and foot contact, (p&lt;0.0001) and also improvement in gross motor function (p&lt;0.01). Conclusion: Combination of tizanidine and intensive rehabilitation is effective for reduction of generalized spasticity regarding muscle tone, range of motion of the joint and improvement of gait in cerebral palsy patients. Bangladesh J Medicine 2023; 34(3): 223-228

Altered corpus callosum structure in adolescents with cerebral palsy: connection to gait and balance.

Cerebral palsy (CP) is the most common motor disorder in childhood. Recent studies in children with CP have associated weakened sensorimotor performance with impairments in the major brain white-matter (WM) structure, corpus callosum (CC). However, the relationship between CC structure and lower extremity performance, specifically gait and balance, remains unknown. This study investigated the transcallosal WM structure and lower limb motor stability performance in adolescents aged 10-18 years with spastic hemiplegic (n = 18) or diplegic (n = 13) CP and in their age-matched controls (n = 34). The modern diffusion-weighted MRI analysis included the diffusivity properties of seven CC subparts and the transcallosal lower limb sensorimotor tract of the dominant hemisphere. Children with CP had comprehensive impairments in the cross-sectional area, fractional anisotropy, and mean diffusivity of the CC and sensorimotor tract. Additionally, the extent of WM alterations varied between hemiplegic and diplegic subgroups, which was seen especially in the fractional anisotropy values along the sensorimotor tract. The diffusion properties of transcallosal WM were further associated with static stability in all groups, and with dynamic stability in healthy controls. Our novel results clarify the mechanistic role of the corpus callosum in adolescents with and without CP offering valuable insight into the complex interplay between the brain's WM organization and motor performance. A better understanding of the brain basis of weakened stability performance could, in addition, improve the specificity of clinical diagnosis and targeted rehabilitation in CP.

Rehabilitation of cerebral palsy and need for collaborative assessment using rehabilitation problem solving (RPS) form

Rehabilitation of cerebral palsy and need for collaborative assessment using rehabilitation problem solving (RPS) form