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Effects of Ankle Foot Orthoses on the Gait Patterns in Children with Spastic Bilateral Cerebral Palsy: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8100903. [PMID: 34682168 PMCID: PMC8534539 DOI: 10.3390/children8100903] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cerebral palsy (CP) is the most common cause of motor disability in children and can cause severe gait deviations. The sagittal gait patterns classification for children with bilateral CP is an important guideline for the planning of the rehabilitation process. Ankle foot orthoses should improve the biomechanical parameters of pathological gait in the sagittal plane. METHODS A systematic search of the literature was conducted to identify randomized controlled trials (RCT) and controlled clinical trials (CCT) which measured the effect of ankle foot orthoses (AFO) on the gait of children with spastic bilateral CP, with kinetic, kinematic, and functional outcomes. Five databases (Pubmed, Scopus, ISI Web of SCIENCE, SciELO, and Cochrane Library) were searched before February 2020. The PEDro Score was used to assess the methodological quality of the selected studies and alignment with the Cochrane approach was also reviewed. Prospero registration number: CRD42018102670. RESULTS We included 10 studies considering a total of 285 children with spastic bilateral CP. None of the studies had a PEDro score below 4/10, including five RCTs. We identified five different types of AFO (solid; dynamic; hinged; ground reaction; posterior leaf spring) used across all studies. Only two studies referred to a classification for gait patterns. Across the different outcomes, significant differences were found in walking speed, stride length and cadence, range of motion, ground force reaction and joint moments, as well as functional scores, while wearing AFO. CONCLUSIONS Overall, the use of AFO in children with spastic bilateral CP minimizes the impact of pathological gait, consistently improving some kinematic, kinetic, and spatial-temporal parameters, and making their gait closer to that of typically developing children. Creating a standardized protocol for future studies involving AFO would facilitate the reporting of new scientific data and help clinicians use their clinical reasoning skills to recommend the best AFO for their patients.
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Wang J, Shi W, Khiati D, Shi B, Shi X, Luo D, Wang Y, Deng R, Huang H, Li J, Yan W, Yang H. Acupuncture treatment on the motor area of the scalp for motor dysfunction in children with cerebral palsy: study protocol for a multicenter randomized controlled trial. Trials 2020; 21:29. [PMID: 31907027 PMCID: PMC6945653 DOI: 10.1186/s13063-019-3986-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 12/11/2019] [Indexed: 01/09/2023] Open
Abstract
Background Scalp acupuncture has been widely used as treatment for motor dysfunction in children with cerebral palsy in China. Previous studies have failed to provide high-quality evidence to demonstrate the effectiveness of this treatment in children with cerebral palsy. No high-quality randomized controlled trials on scalp acupuncture have been published. The aim of this study is to evaluate the effectiveness of Jiao’s scalp acupuncture when combined with routine rehabilitation treatment versus routine rehabilitation treatment alone for motor dysfunction in children with cerebral palsy. Methods/Design This is a four-centre randomized controlled trial. One hundred cerebral palsy patients with motor dysfunction were enrolled. Patients will be allocated in a 1:1 ratio into either an acupuncture treatment group or a control group. Cerebral palsy patients in the control group will receive conventional rehabilitation treatment, whereas patients in the acupuncture group will receive a combination of scalp acupuncture and conventional rehabilitation treatment. Thirty-six treatment sessions will be performed over a 12-week period. The Gross Motor Function Measure and the Fine Motor Function Measure Scale will be assessed as the primary outcome measures. The Paediatric Evaluation of Disability Inventory and the Cerebral Palsy Quality of Life Questionnaire for Children will be selected as secondary outcome measures. All assessments will be conducted at baseline, week 4 (treatment 12), week 8 (treatment 24), week 12 (treatment 36) and week 24 (follow-up). Discussion This is the first trial evaluating the efficacy and safety of scalp acupuncture as a treatment for motor dysfunction in children with cerebral palsy. The results of this trial are expected to provide relevant evidence demonstrating that scalp acupuncture can be used as an effective rehabilitation treatment method for improving motor dysfunction in children with cerebral palsy. Trial registration ClinicalTrials.gov, NCT03921281. Registered on 19 April 2019.
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Affiliation(s)
- Jun Wang
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Wei Shi
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Dhiaedin Khiati
- School of Medicine, Royal College of Surgeons in Ireland - Medical University of Bahrain, Adilya, 15503, Bahrain
| | - Bingpei Shi
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Xiaojuan Shi
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Dandan Luo
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Yin Wang
- Clinical Trial Unit, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Rencai Deng
- Department of Rehabilitation, The 445th Hospital of Chinese People's Liberation Army, Shanghai, 200052, China
| | - Huayu Huang
- Department of Rehabilitation, Huajing Community Health Service Centre of Xuhui District, Shanghai, 200231, China
| | - Jian Li
- Department of Rehabilitation, Jiangchuan Community Health Service Centre of Minhang District, Shanghai, 201100, China
| | - Weili Yan
- Clinical Trial Unit, Children's Hospital, Fudan University, Shanghai, 201102, China.
| | - Hong Yang
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China.
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Liu H, Jiang H, Wang X, Zheng J, Zhao H, Cheng Y, Tao X, Wang M, Liu C, Huang T, Wu L, Jin C, Li X, Wang H, Yang J. Treatment response prediction of rehabilitation program in children with cerebral palsy using radiomics strategy: protocol for a multicenter prospective cohort study in west China. Quant Imaging Med Surg 2019; 9:1402-1412. [PMID: 31559169 DOI: 10.21037/qims.2019.04.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Cerebral palsy (CP) is a major cause of chronic childhood disability worldwide, causing activity limitation as well as impairments in sensation, cognition, and communication. Leveraging biomarkers to establish individualized predictions of future treatment responses will be of great value. We aim to develop and validate a model that can be used to predict the individualized treatment response in Children with CP. Methods A multicenter prospective cohort study will be conducted in 4 hospitals in west China. One hundred and thirty children with CP will be recruited and undergo clinical assessment using the Peabody Developmental Motor Scales, Manual Ability Classification System (MACS), Hand Assessment for Infants (HAI), Assisting Hand Assessment (AHA), and Gross Motor Function Classification System (GMFCS). The data collected will include MRI image, clinical status, and socioeconomic status. The clinical information and MRI features extracted using radiomics strategy will be combined for exploratory analysis. The accuracy, sensitivity, and specificity of the model will be assessed using multiple modeling methodologies. Internal and external validation will be used to evaluate the performance of the radiomics model. Discussion We hypothesized that the findings from this study could provide a critical step towards the prediction of treatment response in children with CP, which could also complement other biomarkers in the development of precision medicine approaches for this severe disorder. Trial registration The study was registered with clinicaltrials.gov (NCT02979743).
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Affiliation(s)
- Heng Liu
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710054, China.,Medical Imaging Center of Guizhou Province, Department of Radiology, the Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
| | - Haoxiang Jiang
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710054, China
| | - Xiaoyu Wang
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Jie Zheng
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Huifang Zhao
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Yannan Cheng
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Xingxing Tao
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Miaomiao Wang
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Congcong Liu
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Ting Huang
- Department of Radiology, the First Affiliated Hospital of Henan University of TCM, Zhengzhou 450046, China
| | - Liang Wu
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710054, China
| | - Chao Jin
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Xianjun Li
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Hui Wang
- Department of Brain Disease, Xi'an Brain Disease Hospital of Traditional Chinese Medicine, Xi'an 710032, China
| | - Jian Yang
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710054, China
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Abstract
PURPOSE To investigate the relationship between trunk control in sitting and functionality in children with spastic cerebral palsy (CP). METHODS Fifty-eight children with spastic CP were included in the study. Functional abilities were evaluated with the Gross Motor Function Measurement-88 (GMFM-88) and the Pediatric Evaluation of Disability Inventory Functional Skills domain (PEDI-FSD). Trunk control in sitting was tested with the Trunk Control Measurement Scale (TCMS) and the Trunk Impairment Scale (TIS). The scores of the TCMS and TIS were compared with GMFM-88 and PEDI-FSD with Spearman correlation analysis. RESULTS The total score of GMFM-88 was significantly correlated with the total score of TCMS (rho = 0.90, p < 0.01) and TIS (rho = 0.78, p < 0.01). The total score of PEDI-FSD was also significantly correlated with the total score of TCMS (rho = 0.76, p < 0.01) and TIS (rho = 0.72, p < 0.01). CONCLUSIONS The evaluation of trunk control can provide valuable information for functional abilities of children with spastic CP.
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Affiliation(s)
- Gulce Kallem Seyyar
- a School of Health Sciences, Department of Physical Therapy and Rehabilitation , Dumlupinar University , Kutahya , Turkey
| | - Bahar Aras
- a School of Health Sciences, Department of Physical Therapy and Rehabilitation , Dumlupinar University , Kutahya , Turkey
| | - Ozgen Aras
- a School of Health Sciences, Department of Physical Therapy and Rehabilitation , Dumlupinar University , Kutahya , Turkey
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Saquetto MB, de Santana Bispo A, da Silva Barreto C, Gonçalves KA, Queiroz RS, da Silva CM, Gomes Neto M. Addition of an educational programme for primary caregivers to rehabilitation improves self-care and mobility in children with cerebral palsy: a randomized controlled trial. Clin Rehabil 2018; 32:878-887. [PMID: 29493280 DOI: 10.1177/0269215518757051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess whether the addition of an education programme for primary caregivers to rehabilitation improves daily functioning in children with cerebral palsy. DESIGN A randomized, single-blind, controlled study. SETTING This study was conducted in a rehabilitation centre in Salvador, Brazil. PARTICIPANTS A total of 63 boys and girls with cerebral palsy, at 1-12 years of age, with Gross Motor Function Classification Systems I-V, were randomly assigned to two groups: educational programme for primary caregivers and conventional rehabilitation ( n = 29) or conventional rehabilitation alone ( n = 31). INTERVENTION Each group received 12 sessions of 30 minutes of conventional rehabilitation and 12 sessions of 45 minutes to intervention group. MEASUREMENTS Gross Motor Function Classification System, Gross Motor Function Measure and daily functioning with the Pediatric Evaluation of Disability Inventory were assessed by a blinded assessor. The clinical outcomes were obtained at the completion of treatment (12 weeks). RESULTS Of the 63 patients included, 60 (mean ± SD age: 4.6 ± 2.74 years) completed the protocol. The combined education and rehabilitation, as compared with conventional rehabilitation alone, yielded significantly greater benefit in the self-care domain of the Functional Skills Scale (mean change 1.74 versus 5; P = 0.001), self-care (mean change 5.52 versus 13.99; P = 0.017) and the mobility domain of the Caregiver Assistance Scale of Pediatric Evaluation of Disability Inventory (mean change 0.87 versus 17.88; P = 0.002). CONCLUSION Self-care and mobility improved in children with cerebral palsy with the addition to conventional rehabilitation of an educational programme for primary caregivers.
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Affiliation(s)
- Micheli Bernardone Saquetto
- 1 Departamento de Fisioterapia, Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | | | | | - Katiuce Almeida Gonçalves
- 2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,3 Departamento de Saúde I, Curso de Fisioterapia, Universidade Estadual do Sudoeste da Bahia, Jequié, Brazil
| | - Rodrigo Santos Queiroz
- 2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,3 Departamento de Saúde I, Curso de Fisioterapia, Universidade Estadual do Sudoeste da Bahia, Jequié, Brazil
| | - Cássio Magalhães da Silva
- 1 Departamento de Fisioterapia, Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Mansueto Gomes Neto
- 1 Departamento de Fisioterapia, Instituto de Ciências da Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,2 Grupo de Pesquisa em Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,4 Programa de Pós Graduação em Medicina e Saúde, Universidade Federal da Bahia (UFBA), Salvador, Brazil.,5 The GREAT Group (GRupo de Estudos em ATividade física), São Paulo, Brazil
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Yoo JE, Yun YJ, Shin YB, Kim NK, Kim SY, Shin MJ, Yu SA. Protocol for a prospective observational study of conventional treatment and traditional Korean medicine combination treatment for children with cerebral palsy. Altern Ther Health Med 2016; 16:172. [PMID: 27267182 PMCID: PMC4897905 DOI: 10.1186/s12906-016-1161-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 06/03/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cerebral palsy leads to many complications as well as delayed motor development, and early intensive rehabilitation in infancy, which is based on the theory of brain plasticity, is emphasized. In addition to conventional treatment, including physical, occupational, or speech-language therapies, children also have a demand for traditional Korean medicine interventions such as acupuncture or herbal medicine; however, a lack of evidence has made traditional Korean medicine difficult to implement in practice. We planned a multicentre, prospective, observational study to assess the effectiveness, safety and cost-effectiveness of conventional treatment and traditional Korean medicine combination treatment for children with cerebral palsy. METHODS/DESIGN Three hundred children with cerebral palsy aged 6 to 78 months will be recruited from six institutions. Data from each child are collected every month for a one-year period, during which time treatment might be changed or discontinued. A qualified investigator visits the sites to measure effectiveness variables, including Gross Motor Function Measure and Paediatric Evaluation of Disability Inventory. Adverse events and cost-effectiveness variables are collected using surveys conducted at baseline, mid-study, and end of study, as well as monthly tracking surveys. In the analyses, participants will be classified into two groups: group A children will be the conventional treatment group with physical, occupational, speech-language or other conventional rehabilitation therapies, whereas group B children will be the combination treatment group with traditional Korean medicine interventions, that is, herbal medicine, chuna, moxibustion and acupuncture, in addition to conventional treatment. DISCUSSION Only a few clinical case reports have evaluated the effectiveness and safety of traditional Korean medicine; therefore, more data are required to provide optimal information to children with cerebral palsy and their guardians. We hypothesized that traditional Korean medicine combination treatment for children with cerebral palsy would have benefits compared with conventional therapy alone. The findings of this study might provide informative data for conducting economic evaluations and developing clinical research on combination treatment for cerebral palsy in South Korea. TRIAL REGISTRATION NCT02223741.
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Kwon TG, Yi SH, Kim TW, Chang HJ, Kwon JY. Relationship between gross motor function and daily functional skill in children with cerebral palsy. Ann Rehabil Med 2013; 37:41-9. [PMID: 23525125 PMCID: PMC3604233 DOI: 10.5535/arm.2013.37.1.41] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 09/03/2012] [Indexed: 12/05/2022] Open
Abstract
Objective To investigate the relationship between gross motor function and daily functional skill in children with cerebral palsy (CP) and to explore how this relationship is moderated by the Gross Motor Function Classification System, Bimanual Fine Motor Function (BFMF), neuromotor types, and limb distribution of CP. Methods A cross-sectional survey of 112 children with CP (range, 4 years to 7 years and 7 months) was performed. Gross motor function was assessed with the Gross Motor Function Measure-66 (GMFM-66) and functional skill was assessed with the Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS). Results GMFM-66 scores explained 49.7%, 67.4%, and 26.1% of variance in the PEDI-FSS scores in the self-care, mobility, and social function domains, respectively. Significant moderation by the distribution of palsy and BFMF classification levels II, III, and IV was found in the relationship between GMFM-66 and PEDI-FSS self-care. Further significant moderation by the distribution of palsy was also observable in the relationship between GMFM-66 and PEDI-FSS mobility. Conclusion These findings suggest that limb distribution and hand function must be considered when evaluating gross motor function and functional skills in children with CP, especially in unilateral CP.
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Affiliation(s)
- Tae Gun Kwon
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Concurrent validity and reliability of the pediatric evaluation of disability inventory-computer adaptive test mobility domain. Pediatr Phys Ther 2012; 24:171-6; discussion 176. [PMID: 22466386 DOI: 10.1097/pep.0b013e31824c94ca] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine concurrent validity, item-specific reliability, and score distributions of the new Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) Mobility domain with the original PEDI Functional Skills (FS) Mobility Scale. METHODS Thirty-five parents of children with neurodevelopmental disabilities completed the PEDI-CAT on a computer and the paper PEDI FS via interview. RESULTS Strength of association between the PEDI-CAT Mobility domain and PEDI FS Mobility Scale scores was good to excellent (r = 0.82; P < .001). Intraclass correlation coefficients ranged from .3390 to 1.000, and agreement ranged from 60% to 100% for 8 specific items. No child had the minimum score on either test, whereas 9 children (26%) had a maximum score on the PEDI FS Mobility Scale. CONCLUSIONS This study provides evidence for potential users that the concurrent validity, reliability, and score distribution for the PEDI-CAT Mobility domain are adequate for use with children with varied diagnoses and throughout the pediatric age span.
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