861 research outputs found

    A Novel Intervention Technology for Cerebral Palsy: Brain Stimulation

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    Abstract:A common pediatric disorder with posture and motor dysfunctionin neurological diseases is known as cerebral palsy (CP). Recently,a series of effective techniques have been developed for treatmentof CP. These promising methods need high-tech equipment forbrain stimulation and mainly classified into invasive and noinvasiveapproaches. This study aimed to introduce these techniquesfor treatment of patients who suffer from CP. The potential andperformance of currently available brain stimulation techniques havebeen mentioned in detail. Moreover, the clinical application, safety,efficacy and challenges of these methods have been discussed. Herewe review the recent advances in the CP treatment with an emphasison brain stimulation techniquesKeywords:Cerebral palsy; Brain stimulation; Pediatric disorde

    Cerebral palsy: Physical therapy and medical treatment issues

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    A discussion of the various terms associated with CP as well as the different classifications will precede a review of several randomized controlled trials, case studies, cohort studies and other related articles regarding treatment methods. Specifically, the use of Intrathecal Baclofen Therapy (1TB), Botulinum toxin injections (Botox), Selective Dorsal Rhizotomy, Threshold Electrical Stimulation (TES), and Pediatric Constraint-Induced Movement Therapy will be examined

    The Use of Neuromuscular Electrical Stimulation in the Gait Training of Children with Cerebral Palsy: A Literature Review

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    Cerebral palsy is a common developmental disorder that causes a wide array of problems in the population. The manifestations of cerebral palsy commonly interfere with the child\u27s activities of daily living, including the important function of gait. It is therefore important that physical therapists be knowledgeable about the various treatment options used in gait training of children with cerebral palsy, as well as their effectiveness. Neurodevelopmental techniques (NDT), neurosurgical interventions, and orthotics are just a few of the numerous treatment options available for the gait training of children with cerebral palsy. Neuromuscular Electrical Stimulation (NMES) has recently become a popular method used to improve the child with cerebral palsy\u27s gait pattern, however the use of NMES, and more specifically its effectiveness, is controversial. The purpose of this literature review is to discuss the theoretical foundations supporting NMES, the mechanism behind NMES, and the various forms and effects of NMES, and its use in the gait training of children with cerebral palsy. Through the review of current literature, NMES was found to be an effective method of improving gait function in children with cerebral palsy

    The neuronal correlates of mirror illusion in children with spastic hemiparesis: a study with functional magnetic resonance imaging.

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    To investigate the neuronal activation pattern underlying the effects of mirror illusion in children/adolescents with normal motor development and in children/adolescents with hemiparesis and preserved contralateral corticospinal organisation. The type of cortical reorganisation was classified according to results of transcranial magnetic stimulation. Only subjects with congenital lesions and physiological contralateral cortical reorganisation were included. Functional magnetic resonance imaging was performed to investigate neuronal activation patterns with and without a mirror box. Each test consisted of a unimanual and a bimanual motor task. Seven children/adolescents with congenital hemiparesis (10-20 years old, three boys and four girls) and seven healthy subjects (8-17 years old, four boys and three girls) participated in this study. In the bimanual experiment, children with hemiparesis showed a significant effect of the mirror illusion (p<0.001 at voxel level, family-wise error corrected at cluster level) in the dorsolateral prefrontal cortex and anterior cingulate cortex of the affected and unaffected hemispheres, respectively. No significant effects of the mirror illusion were observed in unimanual experiments and in healthy participants. Mirror illusion in children/adolescents with hemiparesis leads to activation of brain areas involved in visual conflict detection and cognitive control to resolve this conflict. This effect is observed only in bimanual training. We consider that for mirror therapy in children and adolescents with hemiparesis a bimanual approach is more suitable than a unimanual approach

    Effects of Vibrotactile Stimulation on the Control of Muscle Tone and Movement Facilitation in Children with Cerebral Injury

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    Afferent signals from the muscle’s proprioceptors play important role in the control of muscle tone and in the facilitation of movements. Peripheral afferent pathway enables the restoration of connections with supraspinal structures and so includes mechanism of synaptic inhibition in the performance of normal movement. Different sensory stimuli, as vibrotactile stimulation, excite muscle’s proprioceptors which then send sensorimotor information via spinal cord. In this way afferent signals promote cortical control and modulation of movements. The goal of this study is to evaluate the effects of vibrotactile stimulation on the spasticity and motor performance in children with cerebral injury. Subjects included in this study were 13 children who were developing the classification of spastic cerebral palsy. For all children perinatal brain damage was documented by medical reports and neonatal brain ultrasound scan. At the mean age of 3 years and 6 months subject underwent the assessment of motor development by Gross Motor Function Measurement (GMFM-88). Gross Motor Classification System (GMFCS) has been used to classify functions of lower extremities. Therapeutic intervention was conducted once a week during 3 months. All subjects were stimulated with vibrotactile stimuli of 40Hz in duration of 20 minutes in order to reduce spasticity. After the ending of the treatment subjects underwent second assessment of motor performance and the classification of lower extremities functions. The results have shown that there was a significant improvement in motor performance, what has been seen in the facilitation of rotations, better postural trunk stability and head control and in greater selectivity of movements. Further randomized, control trial investigations with bigger sample and included spasm scale are needed to gain better insight in the role of vibrotactile stimulation in the facilitation of normal movements

    Management of Spasticity and Cerebral Palsy

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    A review of the effectiveness of lower limb orthoses used in cerebral palsy

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    To produce this review, a systematic literature search was conducted for relevant articles published in the period between the date of the previous ISPO consensus conference report on cerebral palsy (1994) and April 2008. The search terms were 'cerebral and pals* (palsy, palsies), 'hemiplegia', 'diplegia', 'orthos*' (orthoses, orthosis) orthot* (orthotic, orthotics), brace or AFO
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