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Ambulant children with spastic cerebral palsy and their parents' perceptions and expectations prior to multilevel surgery.

https://arctichealth.org/en/permalink/ahliterature97734
Source
Dev Neurorehabil. 2010;13(2):80-7
Publication Type
Article
Date
2010
Author
Hilde Capjon
Ida Torunn Bjørk
Author Affiliation
Rikshospitalet, Oslo University Hospital, Department of Child Neurology, Oslo, Norway. hilde.capjon@rikshopitalet.no
Source
Dev Neurorehabil. 2010;13(2):80-7
Date
2010
Language
English
Publication Type
Article
Keywords
Adolescent
Cerebral Palsy - physiopathology - rehabilitation - surgery
Child
Disabled Children - psychology - rehabilitation
Fatigue - prevention & control
Female
Humans
Male
Muscle Contraction
Muscle, Skeletal - physiopathology
Norway
Pain - prevention & control
Parents - psychology
Quality of Life
Questionnaires
Severity of Illness Index
Walking
Abstract
PURPOSE: This study explores the pre-operative situation of children accepted for multilevel surgery for cerebral palsy (CP) and their parents. METHODS: Eight ambulatory children with varied severity of spastic CP and their parents were included. Qualitative, semi-structured interviews were carried out separately with the children and parents. RESULTS: Everyday life of the children and their parents was vulnerable. The degree to which children strived for social acceptance and normality increased their pain. Deteriorating physical capacity resulted in pain and fatigue and was the parents' and children's main motivation for the operation. Although the parents were ambivalent to the operation they mediated hope and cautious optimism about a better life for their children. CONCLUSION: Parents' and children's experiences imply the need for improvements to ensure facilitation for disabled children in schools and all levels of the health service, equality of communication and awareness-raising in the pre-operative phase of multilevel surgery.
PubMed ID
20222768 View in PubMed
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Assessment of body composition in children with cerebral palsy: a cross-sectional study in Norway.

https://arctichealth.org/en/permalink/ahliterature267380
Source
Dev Med Child Neurol. 2015 Sep;57(9):858-64
Publication Type
Article
Date
Sep-2015
Author
Ane-Kristine Finbråten
Catia Martins
Guro Lillemoen Andersen
Jon Skranes
Bente Brannsether
Pétur Benedikt Júlíusson
Unni Syversen
Richard D Stevenson
Torstein Vik
Source
Dev Med Child Neurol. 2015 Sep;57(9):858-64
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Adolescent
Body Composition
Body mass index
Body Weight
Cerebral Palsy - physiopathology
Child
Cross-Sectional Studies
Female
Humans
Male
Norway
Skinfold thickness
Abstract
The assessment of growth and body composition is challenging in children with cerebral palsy (CP). The aim of this study was to compare clinical assessments of body composition with measurements obtained using dual-energy X-ray absorptiometry (DXA) in this population.
Knee height, weight, and triceps and subscapular skinfold thickness (SFT) were measured in 47 children with CP (age range 8-18y; 18 females, 29 males). Height was estimated from knee height, and used to calculate body mass index (BMI). Using SFT measurements, body fat percentage was calculated by standard ('Slaughter') and CP-modified ('Gurka') equations and compared with results obtained using DXA.
Children with severe gross motor function impairments (Gross Motor Function Classification System [GMFCS] level III or IV) exhibited stunted growth and had higher fat percentages and lower lean body mass than children classified in GMFCS level I or II. In 10 children classified as 'thin' according to their BMI (five of whom were assigned thinness grade of 2 or lower), percentage of body fat, as determined by DXA, was normal or high. The Slaughter equations significantly underestimated body fat percentages, whereas the precision of the CP-modified Gurka equations was excellent.
In this study, children with CP and severe motor impairments displayed stunted growth, but were not undernourished. Relying solely upon BMIs may be misleading in children with CP. Therefore, clinicians should be encouraged to measure SFT and to calculate body fat percentages using the CP-modified version of the Slaughter equation.
Notes
Comment In: Dev Med Child Neurol. 2015 Sep;57(9):793-425827683
PubMed ID
25827868 View in PubMed
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Change in parent-identified goals in young children with cerebral palsy receiving a context-focused intervention: associations with child, goal and intervention factors.

https://arctichealth.org/en/permalink/ahliterature257019
Source
Phys Occup Ther Pediatr. 2014 Feb;34(1):62-74
Publication Type
Article
Date
Feb-2014
Author
Nancy Pollock
Nicole Sharma
Cheryl Christenson
Mary Law
Jan Willem Gorter
Johanna Darrah
Author Affiliation
1School of Rehabilitation Science and CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.
Source
Phys Occup Ther Pediatr. 2014 Feb;34(1):62-74
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Alberta
Cerebral Palsy - physiopathology - rehabilitation
Child, Preschool
Disability Evaluation
Female
Goals
Humans
Male
Motor Skills
Ontario
Physical Therapy Modalities
Treatment Outcome
Abstract
The purpose of this study was to examine the relationship between goal achievement measured by the Canadian Occupational Performance Measure (COPM) and child, goal, and intervention factors. Participants were 41 preschool children with cerebral palsy (CP) who were in the context-focused therapy arm of a randomized controlled trial. Factors including child age, Gross Motor Function Classification System (GMFCS) level, type and complexity of goals, and intervention strategies were analyzed. Children made large, positive mean changes on the COPM over 6 months (Performance = 3.8, SD = 1.9; Satisfaction = 4.3, SD 4.3) with younger children showing greater change. The COPM scores had low to moderate correlations with change on the Pediatric Evaluation of Disability Inventory and the Gross Motor Function Measure (GMFM-66). Regression analysis indicated that age, but not GMFCS level influenced COPM change scores. Goal complexity and intervention strategies were not significantly related to COPM change scores. The results provide support for using the COPM as an individualized measure of change in young children with CP receiving intervention.
PubMed ID
23713836 View in PubMed
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Community-based performance of a pelvic stabilization device for children with spasticity.

https://arctichealth.org/en/permalink/ahliterature173202
Source
Assist Technol. 2005;17(1):37-46
Publication Type
Article
Date
2005
Author
Stephen Ryan
Paula Snider-Riczker
Patricia Rigby
Author Affiliation
Bloorview MacMillan Children's Centre, University of Toronto, Toronto, Ontario, Canada.
Source
Assist Technol. 2005;17(1):37-46
Date
2005
Language
English
Publication Type
Article
Keywords
Cerebral Palsy - physiopathology
Child
Child, Preschool
Equipment Design
Humans
Immobilization
Male
Muscle Spasticity
Ontario
Pelvis
Seat Belts
Wheelchairs
Abstract
We developed a new type of pelvic stabilization device designed to help children be better positioned in their wheelchairs. The device replaces a wheelchair lap belt by providing firm anterior pelvic support for the seated user. We developed, tested, and evaluated instructions for installing, fitting, and using the device to study its performance in "typical" community settings in Toronto, Canada. Each of four therapists worked with a local rehabilitation technology supplier to install and fit the device onto an adaptive wheelchair seating system for a young child between 5 and 10 years of age. Therapists assessed the system's positioning effects, and children used the system for 12-14 days. Following the trials, therapists, parents, and children reported their levels of satisfaction with the performance of the device as compared with the children's existing lap belts. Participating therapists confirmed that the device provided better anterior pelvic stability for their clients. Parents felt that their children were generally better positioned in their seats and thought that the device was easy to use. Children had similar perspectives. Suppliers were confident that they could readily install the devices following the instructions provided. Based on the opinions of participants and our inspection of the installed devices, we proposed that minor modifications be made to the product design and instructions for installation, fitting, and use.
PubMed ID
16121644 View in PubMed
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Development of hand function among children with cerebral palsy: growth curve analysis for ages 16 to 70 months.

https://arctichealth.org/en/permalink/ahliterature184763
Source
Dev Med Child Neurol. 2003 Jul;45(7):448-55
Publication Type
Article
Date
Jul-2003
Author
Steven E Hanna
Mary C Law
Peter L Rosenbaum
Gillian A King
Stephen D Walter
Nancy Pollock
Dianne J Russell
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. hannas@mcmaster.ca
Source
Dev Med Child Neurol. 2003 Jul;45(7):448-55
Date
Jul-2003
Language
English
Publication Type
Article
Keywords
Age Factors
Cerebral Palsy - physiopathology
Child
Child Development
Child Welfare
Child, Preschool
Cross-Over Studies
Female
Growth - physiology
Hand - growth & development - physiology
Hemiplegia - physiopathology
Humans
Infant
Infant Welfare
Longitudinal Studies
Male
Motor Skills - physiology
Movement - physiology
Observer Variation
Ontario - epidemiology
Predictive value of tests
Quadriplegia - physiopathology
Randomized Controlled Trials as Topic
Severity of Illness Index
Time Factors
Abstract
This study documents the development of hand and upper-extremity function in young children who have cerebral palsy (CP) with upper-extremity involvement using longitudinal data. Assessments of hand function and the quality of upper-extremity movement were conducted on 29 males and 22 females (mean age 36.2 months, SD 10.6; age range 16 to 60 months at baseline) and on four other occasions over 10 months. Linear mixed effects modeling was used to estimate average developmental curves and the degree of individual differences in the patterns of development which were conditional on the body-site distribution of CP and severity of impairments. Results indicate that hand function in this clinical population develops differently from overall upper-extremity skills with declines in function in upper-extremity skills being more common and pronounced among older children. However, there is substantial interindividual variation. Distribution of CP and severity of impairments were significant predictors of development. Results are discussed in terms of their clinical implications.
Notes
Erratum In: Dev Med Child Neurol. 2003 Sep;45(9):644
PubMed ID
12828398 View in PubMed
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Development of spasticity with age in a total population of children with cerebral palsy.

https://arctichealth.org/en/permalink/ahliterature91346
Source
BMC Musculoskelet Disord. 2008;9:150
Publication Type
Article
Date
2008
Author
Hägglund Gunnar
Wagner Philippe
Author Affiliation
Department of Orthopaedics, Lund University Hospital, S-221 85 Lund, Sweden. gunnar.hagglund@med.lu.se
Source
BMC Musculoskelet Disord. 2008;9:150
Date
2008
Language
English
Publication Type
Article
Keywords
Adolescent
Aging - physiology
Cerebral Palsy - physiopathology
Child
Child, Preschool
Health Status Indicators
Humans
Infant
Muscle Spasticity - physiopathology
Muscle, Skeletal - physiopathology
Range of Motion, Articular
Severity of Illness Index
Sweden - epidemiology
Abstract
BACKGROUND: The development of spasticity with age in children with cerebral palsy (CP) has, to our knowledge, not been studied before. In 1994, a register and a health care program for children with CP in southern Sweden were initiated. In the programme the child's muscle tone according to the modified Ashworth scale is measured twice a year until six years of age, then once a year. We have used this data to analyse the development of spasticity with age in a total population of children with cerebral palsy. METHODS: All measurements of muscle tone in the gastrocnemius-soleus muscle in all children with CP from 0 to 15 years during the period 1995-2006 were analysed. The CP subtypes were classified according to the Surveillance of Cerebral Palsy in Europe network system. Using these criteria, the study was based on 6218 examinations in 547 children. For the statistical analysis the Ashworth scale was dichotomized. The levels 0-1 were gathered in one category and levels 2-4 in the other. The pattern of development with age was evaluated using piecewise logistic regression in combination with Akaike's An Information Criterion. RESULTS: In the total sample the degree of muscle tone increased up to 4 years of age. After 4 years of age the muscle tone decreased each year up to 12 years of age. A similar development was seen when excluding the children operated with selective dorsal rhizotomy, intrathecal baclofen pump or tendo Achilles lengthening. At 4 years of age about 47% of the children had spasticity in their gastro-soleus muscle graded as Ashworth 2-4. After 12 years of age 23% of the children had that level of spasticity. The CP subtypes spastic bilateral and spastic unilateral CP showed the same pattern as the total sample. Children with dyskinetic type of CP showed an increasing muscle tone up to age 6, followed by a decreasing pattern up to age 15. CONCLUSION: In children with CP, the muscle tone as measured with the Ashworth scale increases up to 4 years of age and then decreases up to 12 years of age. The same tendency is seen in all spastic subtypes. The findings may have implications both for clinical judgement and for research studies on spasticity treatment.
PubMed ID
18990204 View in PubMed
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Development, reliability and validity of a new measure of overall health for pre-school children.

https://arctichealth.org/en/permalink/ahliterature175572
Source
Qual Life Res. 2005 Feb;14(1):243-57
Publication Type
Article
Date
Feb-2005
Author
S. Saigal
P. Rosenbaum
B. Stoskopf
L. Hoult
W. Furlong
D. Feeny
R. Hagan
Author Affiliation
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. saigal@mcmaster.ca
Source
Qual Life Res. 2005 Feb;14(1):243-57
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Australia - epidemiology
Cerebral Palsy - physiopathology
Child, Preschool
Cohort Studies
Discriminant Analysis
Health Status Indicators
Humans
Infant, Newborn
Infant, Premature - growth & development
Infant, Very Low Birth Weight - growth & development
Longitudinal Studies
Observer Variation
Ontario - epidemiology
Questionnaires
Abstract
Few comprehensive systems are available for assessing and reporting the overall health of preschool children.
(i) To develop a multi-dimension health status classification system (HSCS) to describe pre-school (PS) children 2.5-5 years of age; (ii) to report reliability and validity of the newly developed measure.
Existing systems (Health Utilities Index, Mark 2 and 3) were adapted for application to a pre-school population. The new system was tested for acceptability, validity and reliability.
Three cohorts of children and their parents from Canada and Australia were utilized: Cohort 1 (MAC)-101 3-years old very low birthweight (VLBW,
PubMed ID
15789958 View in PubMed
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Effect of adaptive seating devices on the activity performance of children with cerebral palsy.

https://arctichealth.org/en/permalink/ahliterature149330
Source
Arch Phys Med Rehabil. 2009 Aug;90(8):1389-95
Publication Type
Article
Date
Aug-2009
Author
Patricia J Rigby
Stephen E Ryan
Kent A Campbell
Author Affiliation
Bloorview Research Institute, Bloorview Kids Rehab, University of Toronto, Toronto, ON, Canada. prigby@bloorview.ca
Source
Arch Phys Med Rehabil. 2009 Aug;90(8):1389-95
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Canada
Cerebral Palsy - physiopathology - rehabilitation
Child
Child, Preschool
Disabled Children - rehabilitation
Female
Humans
Intervention Studies
Male
Posture - physiology
Self-Help Devices
Abstract
To evaluate the short-term impact of 2 adaptive seating devices on the activity performance and satisfaction with performance of children with cerebral palsy (CP), as observed by their parents.
Baseline-intervention-baseline study.
Homes of participating families.
Parents and their children (N=30), mean age of 4 years 6 months, with Gross Motor Function Classification System levels III and IV CP participated.
Two special purpose seating devices: one for sitting support on the floor or on a chair, the other for postural control on a toilet.
Changes in activity performance and satisfaction were measured through parent ratings on the Canadian Occupational Performance Measure. We interviewed parents biweekly using the Home Activity Log to describe and explain their child's activity performance during the 3 study phases.
Parents identified 139 activity performance issues (4.6 a child): 58.3% in self-care, 34.5% in play, and 7.2% in socialization and quiet recreation. We used paired t tests to demonstrate significantly improved performance and satisfaction with self-care and play activities when the children used the adaptive seating devices during the 6-week intervention phase. Three themes arose from the analysis of comments made by parents during Home Activity Log interviews: adaptive seating can have an enabling influence on the child, caregivers and family find adaptive seating useful, and the adaptive seating devices did not meet every family's needs.
Parents reported that their young children with CP were more able to engage in self-care and play activities when using specific adaptive seating devices in their home. Parents indicated that their child's activity performance decreased after the seating devices were removed from their homes.
PubMed ID
19651273 View in PubMed
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The effect of asymmetrical limited hip flexion on seating posture, scoliosis and windswept hip distortion.

https://arctichealth.org/en/permalink/ahliterature293053
Source
Res Dev Disabil. 2017 Dec; 71:18-23
Publication Type
Journal Article
Date
Dec-2017
Author
Atli Ágústsson
Þórarinn Sveinsson
Elisabet Rodby-Bousquet
Author Affiliation
University of Iceland, School of Health Sciences, Research Centre of Movement Science, Reykjavík, Iceland. Electronic address: atli@hi.is.
Source
Res Dev Disabil. 2017 Dec; 71:18-23
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Cerebral Palsy - physiopathology
Cross-Sectional Studies
Female
Hip - physiopathology
Humans
Male
Middle Aged
Posture - physiology
Range of Motion, Articular - physiology
Scoliosis - physiopathology
Sweden
Torso
Young Adult
Abstract
Postural asymmetries with seating problems are common in adults with cerebral palsy.
To analyse the prevalence of asymmetrical limited hip flexion (90°.
Asymmetrical limited hip flexion affects the seating posture and is associated with scoliosis and windswept hip distortion.
PubMed ID
28987968 View in PubMed
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Factors Associated with Enhanced Gross Motor Progress in Children with Cerebral Palsy: A Register-Based Study.

https://arctichealth.org/en/permalink/ahliterature300958
Source
Phys Occup Ther Pediatr. 2018; 38(5):548-561
Publication Type
Journal Article
Date
2018
Author
Gunfrid V Størvold
Reidun B Jahnsen
Kari Anne I Evensen
Ulla K Romild
Grete H Bratberg
Author Affiliation
a Habilitation Centre, Nord-Trøndelag Hospital Trust , Levanger , Norway.
Source
Phys Occup Ther Pediatr. 2018; 38(5):548-561
Date
2018
Language
English
Publication Type
Journal Article
Keywords
Cerebral Palsy - physiopathology - rehabilitation
Child
Child Development - physiology
Child, Preschool
Cohort Studies
Disability Evaluation
Exercise Therapy - statistics & numerical data
Female
Follow-Up Studies
Humans
Male
Motor Skills - physiology
Norway
Prognosis
Prospective Studies
Registries
Severity of Illness Index
Abstract
To examine associations between interventions and child characteristics; and enhanced gross motor progress in children with cerebral palsy (CP).
Prospective cohort study based on 2048 assessments of 442 children (256 boys, 186 girls) aged 2-12 years registered in the Cerebral Palsy Follow-up Program and the Cerebral Palsy Register of Norway. Gross motor progress estimates were based on repeated measures of reference percentiles for the Gross Motor Function Measure (GMFM-66) in a linear mixed model. Mean follow-up time: 2.9 years.
Intensive training was the only intervention factor associated with enhanced gross motor progress (mean 3.3 percentiles, 95% CI: 1.0, 5.5 per period of =3 sessions per week and/or participation in an intensive program). Gross motor function was on average 24.2 percentiles (95% CI: 15.2, 33.2) lower in children with intellectual disability compared with others. Except for eating problems (-10.5 percentiles 95% CI: -18.5, -2.4) and ankle contractures by age (-1.9 percentiles 95% CI: -3.6, -0.2) no other factors examined were associated with long-term gross motor progress.
Intensive training was associated with enhanced gross motor progress over an average of 2.9 years in children with CP. Intellectual disability was a strong negative prognostic factor. Preventing ankle contractures appears important for gross motor progress.
PubMed ID
29714626 View in PubMed
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18 records – page 1 of 2.