Therapy For Cerebral Palsy Research Articles

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

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

Botulinum toxin as a therapy for cerebral palsy

Cerebral palsy (CP) is a neuromuscular condition caused by deficits in the developmental trajectory of the brain or due to physical injury to the developing brain. It affects many school-going and newly born children and is indicated by exaggerated movements and reflexes and unusual movements of the limbs, digits and posture. The present review article discusses the therapeutic potential of botulinum toxin (BoNT) for the treatment of CP. BoNT is a well-known commercially available neurotoxin which blocks the release of neurotransmitters (e.g. acetylcholine), thereby decreasing the undesirable muscle movement of the voluntary muscles in the case of CP. The review also discusses the effectiveness of the therapy, rehabilitation of the patients after treatment and various scales used to measure the movement before and after therapy.

Stem Cell Treatment and Cerebral Palsy: A Systematic Review and Meta-Analysis.

We designed this systematic review and meta-analysis to estimate the pooled efficacy and safety profile of different types of stem cells in treating patients with cerebral palsy (CP). We systematically searched PubMed, Scopus, EMBASE, Web of Science, Google Scholar, and also gray literature, including references of the included studies which were published before November 2021. We extracted data regarding the total number of participants, first author, publication year, country of origin, mean age, cell type, cell dose, cell source, method of transplantation, duration of follow-up, Gross motor function, Ashworth scale, and adverse events. We found 2073 articles by literature search; after deleting duplicates, 1194 remained. Nine articles remained for meta-analysis. The SMD of GMF-66 score (after-before) treatment was 1.5 (95% CI:0.7-2.3) (I2 = 89.9%, P < 0.001). The pooled incidence of Gastrointestinal (GI) complications after transplantation was 21% (95% CI:9-33%) (I2 = 56%, P = 0.08). The pooled incidence of fever after transplantation was 18 % (95% CI:6-30%) (I2 = 87.9%, P = 0.08 < 0.001) Conclusion: The result of this systematic review and meta-analysis show that stem cell therapy in cerebral palsy has neuroprotective properties from anti-inflammatory and anti-apoptotic activities. Stem cell therapy seems to be a promising adjunct to traditional therapies for cerebral palsy patients.

Stem Cell Therapy in Neonatal Hypoxic-Ischemic Encephalopathy and Cerebral Palsy: a Bibliometric Analysis and New Strategy.

The aim of this study was to identify related scientific outputs and emerging topics of stem cells in neonatal hypoxic-ischemic encephalopathy (NHIE) and cerebral palsy (CP) through bibliometrics and literature review. All relevant publications on stem cell therapy for NHIE and CP were screened from websites and analyzed research trends. VOSviewer and CiteSpace were applied to visualize and quantitatively analyze the published literature to provide objective presentation and prediction. In addition, the clinical trials, published articles, and projects of the National Natural Science Foundation of China associated with stem cell therapy for NHIE and CP were summarized. A total of 294 publications were associated with stem cell therapy for NHIE and CP. Most publications and citations came from the USA and China. Monash University and University Medical Center Utrecht produced the most publications. Pediatric research published the most studies on stem cell therapy for NHIE and CP. Heijnen C and Kavelaars A published the most articles. Cluster analyses show that current research trend is more inclined toward the repair mechanism and clinical translation of stem cell therapy for NHIE and CP. By summarizing various studies of stem cells in NHIE and CP, it is indicated that this research direction is a hot topic at present. Furthermore, organoid transplantation, as an emerging and new therapeutic approach, brings new hope for the treatment of NHIE and CP. This study comprehensively summarized and analyzed the research trend of global stem cell therapy for NHIE and CP. It has shown a marked increase in stem cell therapy for NHIE and CP research. In the future, more efforts will be made on exploring stem cell or organoid therapy for NHIE and CP and more valuable related mechanisms of action to achieve clinical translation as soon as possible.

Robot-assisted therapy for upper limb impairments in cerebral palsy: A scoping review and suggestions for future research

AbstractA growing number of studies investigate the use of robotics therapy for motor (re)habilitation with children with cerebral palsy (CP). Most of these studies use functional robots in very repetitive sessions. While the therapy is effective, very few studies employ social robots, which appears to be a missed opportunity to design more compelling and enjoyable sessions for the children. In this article, we will review robot-assisted upper limb motor (re)habilitation for children with CP. Previous reviews of robot-assisted therapy for CP had mostly focused on lower limbs, or the review was made from a medical point of view, with the sole concern being the therapy’s effectiveness. Here, we focus our review on robot-assisted upper limb (re)habilitation and address human–robot interaction considerations. We searched PubMed, Scopus, and IEEE databases and argue that although this area of research is promising and already effective, it would benefit from the inclusion of social robots for a more engaging and enjoyable experience. We suggest four scenarios that could be developed in this direction. The goal of this article is to highlight the relevance of the past work and encourage the development of new ideas where therapy will socially engage and motivate children.

Human Umbilical Cord Mesenchymal Stem Cells Improve the Status of Hypoxic/Ischemic Cerebral Palsy Rats by Downregulating NogoA/NgR/Rho Pathway

Human umbilical cord mesenchymal stem cells (hUCMSC) have shown promising potential in ameliorating brain injury, but the mechanism is unclear. We explore the role of NogoA/NgR/Rho pathway in mediating hUCMSC to improve neurobehavioral status and alleviate brain injury in hypoxia/ischemia-induced CP (cerebral palsy) rat model in order to promote the clinical application of stem cell therapy in CP. The injury model of HT22 cells was established after 3 h hypoxia, and then co-cultured with hUCMSC. The rat model of CP was established by ligation of the left common carotid artery for 2.5 h. Subsequently, hUCMSC was administered via the tail vein once a week for a total of four times. The neurobehavioral status of CP rats was determined by behavioral experiment, and the pathological brain injury was determined by pathological staining method. The mRNA and protein expressions of NogoA, NgR, RhoA, Rac1, and CDC42 in brain tissues of rats in all groups and cell groups were detected by real-time quantitative polymerase chain reaction (RT-qPCR), Western blot, and immunofluorescence. The CP rats exhibited obvious motor function abnormalities and pathological damage. Compared with the control group, hUCMSC transplantation could significantly improve the neurobehavioral situation and attenuate brain pathological injury in CP rats. The relative expression of NogoA, NgR, RhoA mRNA, and protein in brain tissues of rats in the CP group was significantly higher than the rats in the sham and CP+hUCMSC group. The relative expression of Rac1, CDC42 mRNA, and protein in brain tissues of rats in the CP group was significantly lower than the rats in the sham and CP+hUCMSC group. The animal experiment results were consistent with the experimental trend of hypoxic injury of HT22 cells. This study confirmed that hUCMSC can efficiently improve neurobehavioral status and alleviate brain injury in hypoxia/ischemia-induced CP rat model and HT22 cell model through downregulating the NogoA/NgR/Rho pathway.

Convalescent plasma therapy in the management of COVID-19 patients and its effect on morbidity and mortality

BACKGROUND: Since the beginning of the COVID-19 pandemic, there have been preliminary studies worldwide, hoping to shed some light on the efficacy of convalescent plasma therapy (CPT) in the management and recovery of SARS-CoV-2-infected patients. There is a dearth of such studies, especially from one of the world's second-worst hit country-India. This study aims to determine the effects of CPT on the clinical and biochemical profile, and overall mortality of patients suffering from moderate-to-severe SARS-CoV-2 infection. MATERIALS AND METHODS: After random selection of inpatients with COVID-19 disease, patients were matched for various characteristics and allotted into cases and control groups. This was done keeping a 1:2 ratio for cases and controls. Cerebral palsy (CP) therapy was administered to only cases, and these groups were compared. P &lt; 0.05 was considered statistically significant. RESULTS AND CONCLUSIONS: Totally, 141 patients – 47 cases and 94 controls – were compared for the efficacy of CPT on clinical and biochemical profiles along with mortality benefit. It was found that CP therapy provided no significant morbidity and mortality benefit.

Improved abdomen muscle activity with interferential current therapy in cerebral palsy with constipation: a randomized controlled trial study

Background: Children with cerebral palsy (CP) often experience many comorbidities, such as constipation. Pain and discomfort that often accompany constipation have an impact on behavior and decrease quality of life. Abdominal muscle weakness can cause a low increase in intra-abdominal pressure so that the expulsive force during defecation is not adequate. The aim of this study was to evaluate the addition of interferential current (IFC) therapy on standard therapy (lactulose) on abdominal muscle activity in children with cerebral palsy (CP) with constipation. Methods: This research is a true experimental study with pre and post-test randomized control group design. Subjects were 18 children with CP who were constipated according to the ROMA IV criteria, which were divided into two groups, namely the control group who received standard therapy (lactulose) and the intervention group who received lactulose plus IFC therapy with a frequency of 4000-4100 Hz, duration 20 minutes, 3 times a week for 1 month. The parameters evaluated in this study were the value of abdominal muscle activity at rest and during contraction. Measurements were carried out twice, before and one week after the completion of the IFC therapy series. Data were analyzed computerized with SPSS v20.0. Results: There was a significant decrease in abdominal muscle activity at rest (P= .024) in the treatment group, while there was an insignificant increase in the control group (P= 0,266). The abdominal muscle activity during contraction in the treatment group showed a greater increase (P= 0.730) than in the control group (P= 0.831). The effect size in the treatment group is 0.2, which means it has a small effect, while in the control group is 0.1, which means it has no effect. Conclusion: The addition of IFC to standard therapy (lactulose) can improve abdominal muscle activity so that IFC can be an alternative supporting therapy in cerebral palsy with constipation to provide a good clinical response.

Russian consensus on the use of incobotulinumtoxinA in children with cerebral palsy for the treatment of spasticity and sialorrhea

Botulinum therapy for cerebral palsy (CP) is considered not only as one of the effective approaches for the treatment of increased muscle tone and spasticity, but also as a method of excessive salivation correction. The article presents an overview of the results of Russian and foreign studies on the efficacy and safety of incobotulinumtoxinA for the treatment of spasticity of the lower and upper limbs, as well as sialorrhea in patients with CP. The article also provides a consensus opinion of Russian specialists working with patients with CP and using Xeomin (incobotulinumtoxinA) in their practice for the treatment of spasticity and sialorrhea. This consensus was based on the results of a Russian retrospective multicenter study on the use of incobotulinumtoxinA for the treatment of spasticity and sialorrhea in CP, data from recently published international clinical trials, and our own clinical experience. We present detailed practical recommendations on the calculation of the total dose of incobotulinumtoxinA per procedure for the treatment of spasticity in CP, on the calculation of incobotulinumtoxinA dose for the most common target muscles (lower and upper limbs) for spasticity treatment in CP, on incobotulinumtoxinA dilution and dose calculation for sialorrhea treatment in children, on incobotulinumtoxinA dilution and dose calculation for simultaneous treatment of spasticity and sialorrhea in CP. We justify incobotulinumtoxinA use, when simultaneous treatment of spasticity and sialorrhea is necessary, which allows reducing the intervals between repeated injection cycles. IncobotulinumtoxinA use in children with CP demonstrates a favorable safety profile, including long-term use.

Research Progress of Acupoint Application Therapy in Cerebral Palsy Based on Ancient and Modern Literature

Cerebral palsy, is a progressive brain damage due to various reasons syndrome, main show is congenital movement disorders and pose obstacles, is a common central nervous system dysfunction syndrome of infantile period, pathological changes in the brain, often before birth, around the time of birth and after birth, disease involving the limbs, often accompanied by mental retardation, Behavioral disorders, audio-visual disorders, epilepsy and other abnormalities [1]. In traditional Chinese medicine, cerebral palsy is classified into the categories of "five late", "five soft", "five hard", and so on. There are many causes of cerebral palsy, and its pathogenesis is congenital deficiency and postnatal loss. Studies have shown that the incidence of cerebral palsy is 2.22% ~ 2.9% in developed countries and 2.7% ~ 2.9%in low-income countries, while the incidence of cerebral palsy in China is 1.29% ~ 5.06% [2]. In traditional Chinese medicine (TCM) treatment, acupoint application is relatively quick, simple and safe, which can make up for the deficiency of internal medicine treatment. Therefore, it is widely used in ancient and modern clinical practice, and is also widely used in cerebral palsy diseases. This paper summarizes the research progress and analysis of acupoint application therapy in the treatment of cerebral palsy patients in ancient and modern times, and provides a more convenient and feasible treatment method and new ideas for the rehabilitation treatment of cerebral palsy patients.

A parent’s perception of the impact of recreational therapy on their child’s quality of life with cerebral palsy: A case study

There is a need for research centered around recreational therapy, cerebral palsy (CP), and quality of life (QOL). This study focused on one parent’s perceptions of their child’s QOL with spastic CP before and after receiving recreational therapy treatment. The PedsQL™ Infant Scales was utilized for this study in a pretest/post-test case report. Data were collected from the participant at a health center in Stillwater, Oklahoma. The data collected determined that the parent did perceive an improvement in QOL of their child with CP after receiving recreational therapy treatment. There is a minimal research in the specific areas of recreational therapy for CP and the effect that recreational therapy has on a child’s QOL with CP; however, this study helps build the foundation for future studies.

High Acceptability of Neural Stem Cell Therapy for Cerebral Palsy: Survey of the Australian Cerebral Palsy Community

High Acceptability of Neural Stem Cell Therapy for Cerebral Palsy: Survey of the Australian Cerebral Palsy Community

Stem Cell Therapies for Cerebral Palsy and Autism Spectrum Disorder-A Systematic Review.

Autism spectrum disorder (ASD) and cerebral palsy (CP) are some of the most common neurodevelopmental diseases. They have multifactorial origin, which means that each case may manifest differently from the others. In patients with ASD, symptoms associated with deficits in social communication and characteristic, repetitive types of behaviors or interests are predominant, while in patients with CP, motor disability is diagnosed with accompanying cognitive impairment of various degrees. In order to minimize their adverse effects, it is necessary to promptly diagnose and incorporate appropriate management, which can significantly improve patient quality of life. One of the therapeutic possibilities is stem cell therapy, already known from other branches of medicine, with high hopes for safe and effective treatment of these diseases. Undoubtedly, in the future we will have to face the challenges that will arise due to the still existing gaps in knowledge and the heterogeneity of this group of patients. The purpose of this systematic review is to summarize briefly the latest achievements and advances in stem cell therapy for ASD and CP.

The Effect of Insight Questions Inventory and Visual Support Strategies on Carer-Reported Quality of Life for Children With Cerebral Palsy and Perceptual Visual Dysfunction in Nigeria: A Randomized Controlled Trial.

Structured clinical history question inventories have previously been used to try and elicit symptoms of perceptual visual dysfunction (PVD) in children with cerebral palsy (CP) in different settings. Earlier studies have suggested that PVD may affect quality of life and specific habilitational strategies, linked to inventory responses, may improve quality of life. Through an RCT, based on a community based sample of children with CP in Cross River State, Nigeria, we aimed to determine if a structured history inventory such as the Insight question inventory (IQI) and associated tailored visual support strategies (IQI VSS) for the management of those children who have PVD, can improve quality of life and is superior to standard therapy. Children with CP were recruited by the key informant method and confirmed by clinical examination. The parent reported IQI was used to identify children with PVD. Primary outcome measures were both Pediatric Quality of Life 4.0 Generic (PedsQL 4.0 Generic) and Pediatric Quality of Life 3.0 Cerebral Palsy (PedsQL 3.0 CP) scale scores. Children were enrolled with a parallel arm allocation to either IQI and IQI VSS or to standard therapy for CP. Children were followed up for 6 weeks with weekly phone call session and the questionnaires repeated at the end of the 6 weeks’ period. Results show that the children in the treatment group (n = 191) showed no significantly different change between baseline and follow up in quality of life (PedsQL 4.0 Generic p = 0.943: and PedsQL-CP 3.0 p = 0.287), compared to the control group. There was suggestion of a better improvement (p = 0.035) in the PedsQL 3.0 CP subscale of speech and communication for the intervention group. The use of IQI VSS for the treatment of PVD in children with CP in this population does not show any superiority over current standard CP management in terms of overall quality of life. However, there was some evidence of improvement in quality of life in the area of speech and communication. Further research and refinement of these management method is required.Clinical Trial Registration: www.ClinicalTrials.gov, identifier [PACTR20161200188] 6396.

Pros and cons of botulinum toxin injection therapy in cerebral palsy: A qualitative study exploring caregivers' perspective.

To describe and understand the experiences and beliefs of caregivers of children with cerebral palsy following botulinum toxin injection. A descriptive case study approach with focus group interviews was employed. A semi-structured questionnaire was conducted to collect data. Twenty-one caregivers of children (3-13 years old) with cerebral palsy were recruited with a maximum variation sampling strategy to gain insight through different perspectives. Qualitative analysis with verbatim transcripts was analysed using a thematic approach. Four themes emerged from qualitative analyses: acceptance of diagnosis, perceptions about treatment, caregivers' experiences with the health environment, and feelings and thoughts after the treatment. This study highlights caregivers' requests for information about the possible long-term effect of botulinum toxin, as well as information and support to provide the best rehabilitation programme immediately after injection.

Rehabilitation status of children with cerebral palsy and anxiety of their caregivers during the COVID-19 pandemic.

OBJECTIVE:The purpose of the study is to explore the rehabilitation status of children with cerebral palsy (CP) and anxiety level of their caregivers during the Coronavirus disease-2019 (COVID-19) pandemic.METHODS:Caregivers of children with CP who were being followed up in our outpatient CP clinic were contacted between May 28 and June 26, 2020. Two hundred and six caregivers who voluntarily agreed to participate were administered the State-Trait Anxiety Inventory and were questioned about the rehabilitation status of their children. Demographic data, other health problems, Gross Motor Function Classification System, and Manual Ability Classification System levels of children were recorded from their files.RESULTS:All children were at home with their families during the pandemic. Their mean age was 9.58±3.84 years. One hundred and ninety-nine children were going to the rehabilitation center before the pandemic, only three children went to the rehabilitation center twice a week during the pandemic period. The anxiety level of all the caregivers was found to be high. Trait anxiety of the caregivers who did not perform home exercise to their children were found to be statistically significantly higher than those who performed exercise (p<0.05).CONCLUSION:Rehabilitation strategies should focus on reducing anxiety level in caregivers of children with CP and effective homecare therapy techniques should be acquired by the caregivers.

Is Stem Cell Therapy the New Savior for Cerebral Palsy Patients? A Review

Cerebral Palsy (CP) is one of the foremost causes of childhood motor disability and disrupts the individual's development and ability to function. Several factors contribute to the development of CP such as preterm delivery, low birth weight, infection/inflammation, and additional pregnancy complications, both in preterm and term infants. As there is no specific treatment for CP, rehabilitation is the current option for the management of patients. The serious nature of this condition creates deficits that last a lifetime. We collected studies that were published in the past 10 years, using PubMed as our main database. We chose studies that were relevant to CP and stem cell therapy. We mainly focused on various types of stem cells that can be used in treatment, mechanism of action (MOA) of stem cells, routes, dosage, and adverse effects, their efficacy, and safety in CP patients. Of all the 38 studies we reviewed, we found that five articles discussed the utilization of human umbilical cord blood [hUCB], four articles discussed autologous bone marrow stem cells, and one discussed allogeneic umbilical cord blood usage. One article discussed neural stem-like cells (NSLCs) derived from bone marrow and the remaining 27 articles were about CP and its treatment.We reviewed detailed information about the possible stem cell therapies and their benefits in patients with CP. We found that immune modulation is the major mechanism of action of stem cells, and among all the types of stem cells. Autologous umbilical cord mesenchymal stem cells appear to be safe and most effective in treatment compared to other stem cell treatments. Among all symptoms, motor symptoms are best corrected by stem cell therapy. Still, it did not show any marked improvement in treating other symptoms like speech defects, sensory or cognitive defects, or visual impairment.

A Collaborative and Cognitive-based Intervention for Young People with Cerebral Palsy.

Evidence-based approaches to improve function in individuals with cerebral palsy are needed. To investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance approach™ (CO-OP) to improve performance on self-chosen, functional goals as compared to traditional occupational therapy for cerebral palsy. Crossover design with 12 participants, aged 6-15 years, randomly assigned to CO-OP and traditional intervention groups, followed by crossover and a 3-month follow-up. The participants identified three occupation-based goals for CO-OP and each group received ten 45-minutes intervention twice weekly in clinical context. Occupational performance, manual dexterity and Gross Motor Function Measures were analysed using generalized estimating equations. There were clinical and statistically significant improvements in functional goals following CO-OP and not traditional therapy. There were gains in dexterity but not in gross motor skills. CO-OP was effective to improve functional performance in young people with cerebral palsy and should be more utilized.

Therapeutic Evidence of Human Mesenchymal Stem Cell Transplantation for Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials.

Cerebral palsy (CP) is a kind of movement and posture disorder syndrome in early childhood. In recent years, human mesenchymal stem cell (hMSC) transplantation has become a promising therapeutic strategy for CP. However, clinical evidence is still limited and controversial about clinical efficacy of hMSC therapy for CP. Our aim is to evaluate the efficacy and safety of hMSC transplantation for children with CP using a meta-analysis of randomized controlled trials (RCTs). We conducted a systematic literature search including Embase, PubMed, ClinicalTrials.gov, Cochrane Controlled Trials Register databases, Chinese Clinical Trial Registry, and Web of Science from building database to February 2020. We used Cochrane bias risk assessment for the included studies. The result of pooled analysis showed that hMSC therapy significantly increased gross motor function measure (GMFM) scores (standardized mean difference (SMD) = 1.10, 95%CI = 0.66‐1.53, P < 0.00001, high-quality evidence) and comprehensive function assessment (CFA) (SMD = 1.30, 95%CI = 0.71‐1.90, P < 0.0001, high-quality evidence) in children with CP, compared with the control group. In the subgroup analysis, the results showed that hMSC therapy significantly increased GMFM scores of 3, 6, and 12 months and CFA of 3, 6, and 12 months. Adverse event (AE) of upper respiratory infection, diarrhea, and constipation was not statistically significant between the two groups. This meta-analysis synthesized the primary outcomes and suggested that hMSC therapy is beneficial, effective, and safe in improving GMFM scores and CFA scores in children with CP. In addition, subgroup analysis showed that hMSC therapy has a lasting positive benefit for CP in 3, 6, and 12 months.

Methods of complex use of physical therapy in cerebral palsy in children

Methods of complex use of physical therapy in cerebral palsy in children