Journal of Pediatric Rehabilitation Medicine - Volume 5, issue 3

Article Type: Other

DOI: 10.3233/PRM-2012-0218

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 145-146, 2012

Article Type: Other

DOI: 10.3233/PRM-2012-0219

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 147-147, 2012

Article Type: Other

DOI: 10.3233/PRM-2012-0220

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 149-149, 2012

Authors: de Brito Brandão, Marina | de Cássia Gonçalves, Shirley | Carvalho, Lívia A.S.R.P. | Crepaldi, Patrícia Vieira | Abrahão, Leonardo Cury | de Melo Mambrini, Juliana Vaz | Mancini, Marisa Cotta

Article Type: Research Article

Abstract: Purpose: To analyze the agreement between gross motor and hand function levels and clusters of functional performance in children with cerebral palsy (CP). Method}: The sample consisted of 129 children with CP aged 4 to 13~years. Children's gross motor and hand function were classified with the Gross Motor Classification System (GMFCS) and Manual Ability Classification System (MACS). Their daily functioning on self-care and mobility was assessed with the Pediatric Evaluation of Disability Inventory …(PEDI). Cluster analyses grouped children with similar repertoires on self-care and mobility skills using the agglomerative hierarchical technique. The associations across self-care and mobility clusters with daily living skills were tested with Chi-Square tests. The level of agreement was quantified with the Kappa coefficient. Results: Four groupings of children's functional skills in self-care (R^{2}= 0.92) and mobility (R^{2}= 0.95) were identified. These groupings were associated with hand function (χ ^{2}= 145.43; p< 0.001) and mobility levels (χ ^{2}= 198.13; p< 0.001), respectively. The agreement between MACS and self-care skills was 61.7% (Kappa=0.47; p< 0.001) and between GMFCS and mobility skills was 64.4% (Kappa=0.54; p< 0.001). Conclusion: The findings support the adequacy of functional classifications and functioning repertoires. The magnitude of agreement reinforces the importance of the concomitant use of functional classification and assessments. Show more

Keywords: Cerebral palsy, clinical evaluation, activities of daily living, mobility, cross-sectional study

DOI: 10.3233/PRM-2012-0207

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 151-158, 2012

Authors: Christy, Jennifer Braswell | Chapman, Corinne G. | Murphy, Patrice

Article Type: Research Article

Abstract: Purpose: To determine the effect of an intense physical therapy intervention on gross motor function, community walking and participation in children with cerebral palsy (CP). Methods: A single group design was used with two pre-test and two post-test measures. Subjects were 17 ambulatory children with CP who participated in an intense intervention (i.e. four hours per day, five days per week, three weeks), a modified version of the TheraSuit™ protocol. Gross Motor Function Measure …(GMFM-66), Step Watch Activity Monitor (SAM), Canadian Occupational Performance Measure (COPM) and Pediatric Outcomes Data Collection Instrument (PODCI) were tested twice at baseline, immediately following the intervention, and three months later. Results: Immediately following the intervention, GMFM-66, COPM and PODCI scores improved significantly (p< 0.001). At three months, improvements remained for GMFM-66 and COPM (p< 0.01). Walking amount or intensity (SAM) did not improve. Conclusions: Participants improved gross motor skills and participation but not community ambulation following this intense physical therapy intervention. Show more

Keywords: Cerebral palsy, cerebral palsy/classification, cerebral palsy/rehabilitation, child, child/preschool, patient satisfaction, physical therapy/modalities, movement, intense, treatment outcome

DOI: 10.3233/PRM-2012-0208

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 159-170, 2012

Authors: Degelean, Marc | De Borre, Ludo | Salvia, Patrick | Pelc, Karine | Kerckhofs, Eric | De Meirleir, Linda | Cheron, Guy | Dan, Bernard

Article Type: Research Article

Abstract: Introduction: Ankle-foot orthoses may significantly improve lower limb kinematics in the gait of children with cerebral palsy. Here we aimed to analyze the effect of ankle-foot orthoses on trunk postural control and lower limb intersegmental coordination in children with mild spastic diplegia (GMFCS I or II). Methods: We recorded tridimensional trunk kinematics and thigh, shank, and foot elevation angles in 20 4–12 year-old children born preterm with spastic diplegia and 20 typically developing children while walking either …barefoot or with ankle-foot orthoses. Results: We found significantly greater trunk excursions in children with cerebral palsy compared to typically developing children in both conditions. When wearing ankle-foot orthoses cerebral palsy children showed increased trunk frontal angular velocity. No significant changes in trunk displacement and angular velocity were recorded in the sagittal plane in either group. Typically developing children wearing orthoses showed increased trunk frontal displacement. Wearing orthoses induced significant changes in shank and foot elevation in both groups. Conclusion: Ankle-foot orthoses affect postural control and intersegmental coordination in children with cerebral palsy. This should be taken into account when planning therapeutic management. Show more

Keywords: Gait, postural control, ankle-foot orthoses, cerebral palsy

DOI: 10.3233/PRM-2012-0209

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 171-179, 2012

Authors: Fatudimu, Margaret Bukola

Article Type: Research Article

Abstract: Assessment and physiotherapy intervention for children with cerebral palsy (CP) are conventionally carried out in the hospital or clinic setting. However, the daily lives of these children include a variety of environmental settings in addition to the clinical setting. The objective of this study was therefore to explore the possible influence of the environment on motor function in children with CP. Purposively selected children with CP (n=107), ages 1 and 6 years with mean …age of 2.1 years (SD 1.10 yrs), were involved in this study. The motor function of each child was assessed in the hospital and at their homes within a one-week interval, using the Gross Motor Function Measure (GMFM); this was done at the baseline and on a monthly basis for eight consecutive months. The paired t-test rank was computed to compare the overall GMFM score and each of the sub-domain scores measured in the clinic and at home. GMFM scores measured at home were significantly higher than those measured in the clinic and this pattern was also obtained for the sub-domains throughout the study period, suggesting that children performed gross motor functions better at their homes than in the clinic. Show more

Keywords: Environment, gross motor function, cerebral palsy

DOI: 10.3233/PRM-2012-0210

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 181-186, 2012

Authors: Houtrow, Amy | Kang, Taewoon | Newcomer, Robert

Article Type: Research Article

Abstract: Introduction: Individuals with cerebral palsy (CP) may require personal assistance services for optimal functioning. The primary goal of this project is to determine if differences in health services exist between individuals with CP with family versus non-family member paid personal assistance providers. The secondary goal is to describe the population of children and non-elderly adults with CP receiving In-Home Supportive Services (IHSS) and determine their health care costs compared to other IHSS recipients. Methods: Administrative …data from the California Departments of Health and Human Services, Social Services and Developmental Services were linked and de-identified to provide information about individuals receiving IHSS in California in 2005. Recipients with CP were characterized and compared by age. Then to determine the factors associated with hospital use and emergency room (ER) use for IHSS recipients with CP adjusted odds were calculated. Monthly expenditures were calculated from claims data. Results: 2.3% of all IHSS recipients in 2005 had CP of which 46% were children. 59% of recipients with CP have a parent as their paid provider. The presence of other medical diagnoses was the only factor associated with increased adjusted odds of hospital and ER use for both child-aged and non-elderly adult recipients with CP. Functional limitations and provider type were not associated with increased odds of health care utilization. Monthly health care expenditures for recipients with CP were ∼ $1000 higher than for other IHSS recipients. Conclusions: Having a parent as the IHSS provider was not associated with difference in health service utilization. This finding supports the policy of allowing parents to be paid providers. Show more

Keywords: Cerebral palsy, personal assistance services, Medicaid, health care utilization, expenditures

DOI: 10.3233/PRM-2012-0211

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 187-195, 2012

Authors: Pritula, Stephanie L. | Fox, Margaret A. | Ayyangar, Rita

Article Type: Research Article

Abstract: Objective: To identify changes in weight for children receiving intrathecal baclofen (ITB) therapy for the treatment of spasticity. Design: Retrospective medical chart review. Weights were obtained before and after ITB pump implantation. Setting: Tertiary care children's hospital. Participants: 52 children < 20 years old at the time of data collection receiving ITB therapy for the treatment of cerebral origin spasticity for > 1 year. Measures: Paired t-test compared pre and post-implantation weights. Analyses …of covariance were run to compare differences in overall weight change as defined by variables of gender, diet, diagnosis, and ethnicity. Results: A significant change in pre-implantation weight (M=26.77, SD=11.29) from post-implantation weight (M=32.11, SD=12.62) was noted. No significant weight change was noted among variables. Conclusion: Study participants gained an average of 5.43 kg (SD=4.34) after receiving 1 year of ITB therapy. Show more

Keywords: Intrathecal baclofen pump, weight gain, children, spasticity, cerebral palsy

DOI: 10.3233/PRM-2012-0212

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 197-201, 2012

Authors: Jeglinsky, Ira | Salminen, Anna-Liisa | Carlberg, Eva Brogren | Autti-Rämö, Ilona

Article Type: Research Article

Abstract: Objective: To explore the types of procedures and practices in rehabilitation planning for children with cerebral palsy and how multidisciplinary team members experience them. Design, subjects, and setting: A qualitative research approach was used. Participants were members of multidisciplinary teams in neuropediatric wards at five university hospitals. Methods: In order to explore the rehabilitation planning procedure within multidisciplinary teams, focus group interviews were conducted. The interviews were tape recorded and transcribed. Three …content areas guided the interviews: goal setting, the different transition phases, and the use of the International Classification of Functioning, Disability and Health, Child and Youth version (ICF-CY). Qualitative content analysis was used to analyze the results. Results: Three themes arose from the focus group discussions; challenging goal setting, transition without routines, and ICF-CY not in use. A family-centered service model had been adopted, but there was no clear procedure in the collaboration with parents. Goal setting was found to be challenging and the concern arose of how to integrate goals into the child's everyday life. There was a lack of systematic planning of the different transition phases. There was also a general variation in the rehabilitation planning procedures due to local and regional differences in practice. The ICF-CY was familiar, but not in formal use in clinical practice. Conclusion: There is a need to enhance the procedures and to systematize coordination of services in the rehabilitation process. The ICF-CY framework might help to optimize collaborative goal setting and to structure both procedures and documentation of the rehabilitation plans and goals. Show more

Keywords: Cerebral palsy, planning rehabilitation, multidisciplinary teams, transition, goal setting, ICF-CY

DOI: 10.3233/PRM-2012-0213

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 203-215, 2012