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Keeratisiroj O, Thawinchai N, Siritaratiwat W, Buntragulpoontawee M, Pratoomsoot C. Prognostic predictors for ambulation in children with cerebral palsy: a systematic review and meta-analysis of observational studies. Disabil Rehabil 2016; 40:135-143. [DOI: 10.1080/09638288.2016.1250119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Orawan Keeratisiroj
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Nuanlaor Thawinchai
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Wantana Siritaratiwat
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand
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Keeratisiroj O, Thawinchai N, Siritaratiwat W, Buntragulpoontawee M. Prognostic Predictors for Ambulation in Thai Children With Cerebral Palsy Aged 2 to 18 Years. J Child Neurol 2015; 30:1812-8. [PMID: 25922262 DOI: 10.1177/0883073815582267] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 03/14/2015] [Indexed: 11/15/2022]
Abstract
The objectives of this study were to determine prognostic predictors for ambulation among Thai children with cerebral palsy and identify their ambulatory status. A retrospective cohort study was performed at 6 special schools or hospitals for children with physical disabilities. The prognostic predictors for ambulation were analyzed by multivariable ordinal continuation ratio logistic regression. The 533 participants aged 2 to 18 years were divided into 3 groups: 186 with independent ambulation (Gross Motor Function Classification System [GMFCS I-II]), 71 with assisted ambulation (Gross Motor Function Classification System III), and 276 with nonambulation (Gross Motor Function Classification System IV-V). The significant positive predictors for ambulation were type of cerebral palsy (spastic diplegia, spastic hemiplegia, dyskinesia, ataxia, hypotonia, and mixed type), sitting independently at age 2 years, and eating independently. These predictors were used to develop clinical scoring for predicting the future ability to walk among Thai children with cerebral palsy.
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Affiliation(s)
- Orawan Keeratisiroj
- Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Nuanlaor Thawinchai
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Wantana Siritaratiwat
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Thailand
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Hurley DS, Sukal-Moulton T, Gaebler-Spira D, Krosschell KJ, Pavone L, Mutlu A, Dewald JPA, Msall ME. Systematic Review of Cerebral Palsy Registries/Surveillance Groups: Relationships between Registry Characteristics and Knowledge Dissemination. INTERNATIONAL JOURNAL OF PHYSICAL MEDICINE & REHABILITATION 2015; 3:266. [PMID: 27790626 PMCID: PMC5079705 DOI: 10.4172/2329-9096.1000266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The aims of this study were to provide a comprehensive summary of the body of research disseminated by Cerebral Palsy (CP) registries and surveillance programs from January 2009 through May 2014 in order to describe the influence their results have on our overall understanding of CP. Secondly, registries/surveillance programs and the work they produced were evaluated and grouped using standardized definitions and classification systems. METHOD A systematic review search in PubMed, CINAH and Embase for original articles published from 1 January 2009 to 20 May 2014 originating from or supported by population based CP registries and surveillance programs or population based national registries including CP were included. Articles were grouped by 2009 World CP Registry Congress aim, registry/surveillance program classification, geographical region, and the International Classification of Function, Disability and Health (ICF) domain. Registry variables were assessed using the ICF-CY classification. RESULTS Literature searches returned 177 articles meeting inclusion criteria. The majority (69%) of registry/surveillance program productivity was related to contributions as a Resource for CP Research. Prevention (23%) and Surveillance (22%) articles were other areas of achievement, but fewer articles were published in the areas of Planning (17%) and Raising the Profile of CP (2%). There was a range of registry/surveillance program classifications contributing to this productivity, and representation from multiple areas of the globe, although most of the articles originated in Europe, Australia, and Canada. The domains of the ICF that were primarily covered included body structures and function at the early stages of life. Encouragingly, a variety of CP registry/surveillance program initiatives included additional ICF domains of participation and environmental and personal factors. INTERPRETATION CP registries and surveillance programs, including novel non-traditional ones, have significantly contributed to the understanding of how CP affects individuals, families and society. Moving forward, the global CP registry/surveillance program community should continue to strive for uniformity in CP definitions, variables collected and consistency with international initiatives like the ICF so that databases can be consolidated for research use. Adaptation to new technologies can improve access, reduce cost and facilitate information transfer between registrants, researchers and registries/surveillance programs. Finally, increased efforts in documenting variables of individuals with CP into adulthood should be made in order to expand our understanding of CP across the lifespan.
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Affiliation(s)
- Donna S Hurley
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Theresa Sukal-Moulton
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Kristin J Krosschell
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | | | - Akmer Mutlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Julius PA Dewald
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Michael E Msall
- University of Chicago Comer Children’s Hospital and Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, IL, USA
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Oliva D, Campodonico F, Buono S. Walker devices and microswitch technology to enhance assisted indoor ambulation by persons with multiple disabilities: three single-case studies. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:2191-2199. [PMID: 23643772 DOI: 10.1016/j.ridd.2013.03.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 03/25/2013] [Indexed: 06/02/2023]
Abstract
These three single-case studies assessed the use of walker devices and microswitch technology for promoting ambulation behavior among persons with multiple disabilities. The walker devices were equipped with support and weight lifting features. The microswitch technology ensured that brief stimulation followed the participants' ambulation responses. The participants were two children (i.e., Study I and Study II) and one man (i.e., Study III) with poor ambulation performance. The ambulation efforts of the child in Study I involved regular steps, while those of the child in Study II involved pushing responses (i.e., he pushed himself forward with both feet while sitting on the walker's saddle). The man involved in Study III combined his poor ambulation performance with problem behavior, such as shouting or slapping his face. The results were positive for all three participants. The first two participants had a large increase in the number of steps/pushes performed during the ambulation events provided and in the percentages of those events that they completed independently. The third participant improved his ambulation performance as well as his general behavior (i.e., had a decline in problem behavior and an increase in indices of happiness). The wide-ranging implications of the results are discussed.
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Shevell M, Dagenais L, Oskoui M. The epidemiology of cerebral palsy: new perspectives from a Canadian registry. Semin Pediatr Neurol 2013; 20:60-4. [PMID: 23948680 DOI: 10.1016/j.spen.2013.06.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Michael Shevell
- Department of Neurology/Neurosurgery, McGill University, Montreal, Quebec, Canada.
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Cheng HYK, Ju YY, Chen CL, Chang YJ, Wong AMK. Managing lower extremity muscle tone and function in children with cerebral palsy via eight-week repetitive passive knee movement intervention. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:554-561. [PMID: 23123868 DOI: 10.1016/j.ridd.2012.09.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Revised: 09/27/2012] [Accepted: 09/27/2012] [Indexed: 06/01/2023]
Abstract
This study used a repeated measures design to assess the effect of an eight-week repetitive passive movement (RPM) intervention on lower extremity muscle tone and function in children with cerebral palsy (CP). Eighteen children (aged 9.5 ± 2.1 years) with spastic CP were randomly assigned to a knee RPM intervention condition of 3 times a week for 8 weeks or a control condition. The 8 weeks were followed by 4 weeks of washout period, after which the participants were crossed over to the other group. In the RPM condition, each subject's knees were intervened with continuous passive motion device (at a velocity of 15°/s) for 20 min. The subjects were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, after, 1 day after, and 3 days after each intervention. Repeated-measures statistical analyses found significant differences between condition variable on active range-of-motion of the knee (AROM, increased), relaxation index (RI, increased), Modified Ashworth Scale (MAS, decreased), timed up-and-go (TUG, decreased), 6-min walk test (6 MWT, increased); and significant differences among time variable including RI, MAS, and 6 MWT. No difference was found in passive range-of-motion measurements. Repetitive passive movement reduced lower extremity spastic hypertonia in children with cerebral palsy, and it also improved ambulatory function in terms of walking speed. Effects of this treatment protocol on ambulation lasted up to 3 days post intervention. Findings of this study provide clinicians and patients an alternative, effective and efficient strategy for spastic control and ambulatory improvement.
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Affiliation(s)
- Hsin-Yi Kathy Cheng
- Graduate Institute of Early Intervention, Chang Gung University, Tao-Yuan, Taiwan.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Boccasini A, Oliva D, Buono S. Technology-based programs to improve walking behavior of persons with multiple disabilities: two single-case studies. Disabil Rehabil Assist Technol 2012; 8:92-8. [PMID: 22515417 DOI: 10.3109/17483107.2012.678030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Assessing two technology-based programs for reducing toe walking and breaks during walking of two men with multiple disabilities, respectively. METHOD The men were involved in separate single-case studies, each of which was carried out according to an ABAB design. The technology included a microprocessor with specific software, optic sensors, and visual plus vibrotactile or auditory systems for presenting preferred stimuli. In Study I, the man received 1 s of preferred flickering lights and vibratory input for each step performed with the heel of the left foot touching the ground or coming close to it (i.e. within a 2-mm distance). In Study II, the other man received 10 s of preferred music anytime he crossed one of the small marks present along the travel routes. RESULTS The B phases showed that (a) the man included in Study I increased the percentages of left- and right-foot steps performed with the heels touching or nearing the ground to above 85% and 70%, respectively, and (b) the man included in Study II walked with very few breaks. CONCLUSION Technology-based programs can be highly effective in helping persons with multiple disabilities improve their walking behavior.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, La Martire ML, Oliva D, Groeneweg J. Technology-based programs to promote walking fluency or improve foot-ground contact during walking: two case studies of adults with multiple disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:111-118. [PMID: 22093655 DOI: 10.1016/j.ridd.2011.08.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Accepted: 08/30/2011] [Indexed: 05/31/2023]
Abstract
These two case studies assessed technology-based programs for promoting walking fluency and improving foot-ground contact during walking with a man and a woman with multiple disabilities, respectively. The man showed breaks during walking and the woman presented with toe walking. The technology used in the studies included a microprocessor with specific software, an MP3 with the recordings of preferred stimulus items, and optic sensors. Both studies were carried out according to an ABAB design. In Study I, the optic sensors were activated when the man crossed small marks distributed along the travel routes. At each sensor's activation, the man received a brief period of preferred stimulation. In Study II, the woman received preferred stimulation when the sensors at the toe and the heel of her shoes were activated in close time proximity. The man walked virtually without breaks and improved his mood (with an increase in indices of happiness) during the intervention phases of the study. The woman largely increased her percentages of steps with adequate foot-ground contact, which reached a mean of about 80 during the second intervention phase. The results were discussed in terms of rehabilitation implications and technology demands.
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Hurley DS, Sukal-Moulton T, Msall ME, Gaebler-Spira D, Krosschell KJ, Dewald JP. The cerebral palsy research registry: development and progress toward national collaboration in the United States. J Child Neurol 2011; 26:1534-41. [PMID: 21677201 PMCID: PMC3223319 DOI: 10.1177/0883073811408903] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cerebral palsy is the most common neurodevelopmental motor disability in children. The condition requires medical, educational, social, and rehabilitative resources throughout the life span. Several countries have developed population-based registries that serve the purpose of prospective longitudinal collection of etiologic, demographic, and functional severity. The United States has not created a comprehensive program to develop such a registry. Barriers have been large population size, poor interinstitution collaboration, and decentralized medical and social systems. The Cerebral Palsy Research Registry was created to fill the gap between population and clinical-based cerebral palsy registries and promote research in the field. This is accomplished by connecting persons with cerebral palsy, as well as their families, to a network of regional researchers. This article describes the development of an expandable cerebral palsy research registry, its current status, and the potential it has to affect families and persons with cerebral palsy in the United States and abroad.
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Affiliation(s)
- Donna S. Hurley
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Department of Biomedical Engineering, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Michael E. Msall
- Section of Developmental and Behavioral Pediatrics, University of Chicago, Chicago, IL, USA, Comer and La Rabida Children's Hospitals, Chicago, IL, USA, Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, IL, USA
| | - Deborah Gaebler-Spira
- Department of Pediatrics, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Rehabilitation Institute of Chicago, Chicago, IL, USA, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Kristin J. Krosschell
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Julius P. Dewald
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Department of Biomedical Engineering, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
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Elkamil AI, Andersen GL, Salvesen KÅ, Skranes J, Irgens LM, Vik T. Induction of labor and cerebral palsy: a population-based study in Norway. Acta Obstet Gynecol Scand 2010; 90:83-91. [PMID: 21275920 DOI: 10.1111/j.1600-0412.2010.01022.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the association between labor induction and later development of cerebral palsy (CP). DESIGN Registry-based cohort study. SETTING Perinatal data on all children born in Norway 1996-1998 were obtained from the Medical Birth Registry of Norway (MBRN). Neurodevelopmental data were collected from the Norwegian Cerebral Palsy Registry (CPRN). POPULATION A total of 176,591 children surviving the neonatal period. Of 373 children with CP, detailed data were available on 241. METHODS Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated as estimates of the relative risk that a child with CP was born after labor induction. MAIN OUTCOME MEASURES Total CP and spastic CP subtypes. RESULTS Bilateral cerebral palsy was more frequently observed after induced labor (OR: 3.1; 95% CI 2.1-4.5). For children born at term the association between bilateral CP and labor induction was stronger (OR: 4.4; 95% CI 2.3-8.6). The association persisted after adjustment for maternal disease, gestational age, standard deviation score for birthweight (z-score) and prelabor rupture of membranes (PROM) (adjusted OR: 3.7; 95%CI 1.8-7.5). Among children with CP born at term, four-limb involvement (quadriplegia) was significantly more frequent after induced (45.5%) compared with non-induced labor (8.0%). There was no significant association between labor induction and unilateral CP subtype or CP in preterm born children. CONCLUSIONS In this study population, we found that labor induction at term was associated with excess risk of bilateral spastic CP and in particular CP with four-limb involvement.
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Affiliation(s)
- Areej I Elkamil
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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