Journal of Pediatric Rehabilitation Medicine - Volume 12, issue 2

Authors: Pettersson, Katina | Rodby-Bousquet, Elisabet

Article Type: Research Article

Abstract: PURPOSE: Analyze the goals for treatment and attained goals for spinal orthoses in children with cerebral palsy (CP), and describe the use of spinal orthoses in relation to age, sex, gross motor function, and scoliosis. METHODS: Cross-sectional data for all children born between 2000 and 2014 and registered in the Swedish CP registry were analyzed in relation to age, sex, Gross Motor Function Classification System (GMFCS), and scoliosis. Treatment goals were to 1) prevent deformity; 2) improve stability/positioning; 3) improve head control; and 4) improve arm/hand function. RESULTS: Overall, 251 of the 2800 …children (9%) used spinal orthoses, and the frequency increased significantly with age and GMFCS level; 147 of the 251 children had scoliosis. Several treatment goals were reported for most children. The most common goal was improved stability/positioning (96%), followed by head control (51%) and arm/hand function (38%). Only one third of the children used spinal orthoses to prevent deformities. The rate of goal attainment was 78–87% for the functional outcomes and 57% for the prevention of deformities. CONCLUSION: Although the goal of using spinal orthosis to prevent curvature progression remains important, we found that its functional benefits (stability, head control, arm/hand function) were of greater importance. Show more

Keywords: Cerebral palsy, children, adolescents, spinal orthoses, goals, postural balance

DOI: 10.3233/PRM-180596

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 2, pp. 197-203, 2019

Authors: Belthur, Mohan | Bosch, Liam | Wood, William | Boan, Carla | Miller, Freeman | Shrader, M. Wade

Article Type: Research Article

Abstract: PURPOSE: Progressive scoliosis significantly impacts the quality of life in patients with cerebral palsy (CP). Spinal fusion is the mainstay of treatment of progressive spinal curves. The current study aims to identify approaches used by pediatric spine surgeons to optimize care of patients with CP undergoing scoliosis surgery. METHODS: A 33-question survey was distributed electronically to 181 POSNA/SRS members with an established interest in pediatric spinal deformity surgery. Eighty one responses were obtained (45%). Using the Delphi consensus guidelines, agreement > 75% was considered as consensus. RESULTS: There was a …consensus on 15 out of 33 questions (46%). 97% of responders identified nutrition status as a comorbidity which could be optimized. However, the timing and method of obtaining nutritional assessment varied. 92% of the surgeons stated that they used shared decision making with the family but only 22% used a formal decision aid. 83% use antifibrinolytics routinely, 81% used a surgical site infection prevention protocol, 78% obtained preoperative pulmonary consult, and 88% took steps postoperatively to prevent pulmonary complications. CONCLUSION: There is significant variability in the current practices of perioperative management of patients with CP undergoing scoliosis surgery. This data can be used in future studies to create a standardized integrated care pathway. Show more

Keywords: Scoliosis, cerebral palsy, perioperative management

DOI: 10.3233/PRM-170504

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 2, pp. 205-212, 2019

Article Type: Book Review

DOI: 10.3233/PRM-190006

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 2, pp. 213-214, 2019

Article Type: Other

DOI: 10.3233/PRM-190007

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 2, pp. 215-223, 2019

Article Type: Other

DOI: 10.3233/PRM-190009

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 2, pp. 225-, 2019