Quality of life and its predicting factors for Tunisian children with cerebral palsy

Background

Cerebral palsy (CP) can cause motor, sensory, perceptual, cognitive, communication and behavioural disorders. The complexity of this condition justifies measuring the quality of life (QOL) of children with CP. This measurement depends on personal and socio-economic factors, hence the relevance of performing it in our cultural context of Tunisia.

Objectives

The objectives of this study were to assess the QOL of Tunisian children with CP and to identify predictive factors for QOL.

Method

A cross-sectional study using a self-administered questionnaire (the CP QOL-Child) was employed. It included 68 children with CP and their parents who consulted the outpatient clinics of Physical Medicine and Rehabilitation of the University Hospital of Sahloul Sousse.

Results

The QOL of children with CP was altered, and the mean total score for the CP QOL-Child was 59.3 (± 14). All domains were affected by this alteration. Six predictive factors for lowered QOL in children with CP were identified, namely age older than 6 years, swallowing disorders, more intense chronic pain, greater level of motor impairment, the use of botulinum toxin injection and the absence of verbal communication.

Conclusion

Intervention with children with CP must be mindful of their altered QOL. Five out of the six predictive factors of QOL are modifiable through a multidisciplinary approach within the framework of the International Classification of Functioning, Disability and Health (ICF).

Contribution

The multiplicity of the factors associated with QOL revealed by this study incites clinicians to adopt the ICF approach by displaying its practical implications on the efficiency of the medical intervention.

Kinematic analysis of the shot-put: A method of assessing the mechanical work of the hand action force

The aims of this study were to (1) propose a method for evaluating shot-putters mechanical power, (2) investigate the relationship between mechanical work of hand action force (W_HAF), peak power output (PPO) of different limbs and shot-put performance and (3) show which of these two parameters (W_HAF, PPO) were the most appropriate to characterize the explosive abilities of the shot-putter. Twelve junior right-handed shot-putters, practised glide technique shot-put throwers (personal best = 13.57  ±  1.72 m), participated in this study. Arm and leg force-velocity tests were performed to measure PPO. Kinematic analysis was conducted during a shot-putting event in regular conditions to quantify the W_HAF at the release moment and shot-put performance. Significant correlations were found between absolute arm and leg PPO with upper and lower muscle volumes (r = .67; p = .03; r = .76; p = .01; r = .74, p = .01; r = .65, p = .04). Positive relationships were recorded between absolute arm and leg PPO and shot-put performance (r = .67, p = .02; r = .81, p = .004, respectively). Shot-put performance was also closely related to the W_HAF (r = .93, p = .0001) and release velocity parameter (r = .86, p = .001). The present results confirm that force-velocity test and W_HAF constitute useful tools for assessing mechanical power in throwing. The W_HAF could be considered as more suitable than force-velocity test.

[Socio-medical profile of post-polio syndrome patients in center east of Tunisia]

BACKGROUND

The diagnosis of the post polio syndrome is purely clinic. It occurs few decade after poliomyelitis. It associates recent appearance or progressive worsening of muscular weakness, pain, muscular fatigue or atrophy. It remains not recognized in Tunisia.

AIM

of our study is to identify the socio-medical profile of the postpolio population in the Tunisian east central region through a check of the risk factors and the clinical characteristics of these patients.

METHODS

Descriptive study analyzing 32 files (medical expertise) of post polio syndrome patients

RESULTS

The risk factors of post polio syndrome such us female gender, obesity, low educational level, early age of poliomyelitis appearance and the importance of physical effort at work, were observed in our study and are in agreement with the literature data. Average delay of post polio syndrome occurrence was 40 years. Most Disturbing symptom was the muscular pain. All our patients indicated negative impact on their everyday life and their work. They all asked for their right for incapacity or long-term disease beside the National health insurance fund (CNAM).

CONCLUSION

Recognition of patients affected by the Post polio syndrome and their social and medical needs are necessary.

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Infectious complications of finger-joints in association with hand burns are common and dominated by osteoarthritis. However, this issue has hardly ever been addressed in the literature. This ailment can either be identified while patients with extensive burns are undergoing intensive care, or during patient rehabilitation. In the former instance, it is difficult to recognize because patient sedation means the clinical signs are not obvious. In the latter phase, however, the pain, swelling (tumefaction), stiffness and radiological signs are clear. These infections should be diagnosed as soon as possible in order to preserve the function of the hand.