Correlation between hand function and activities of daily living in children with cerebral palsy

Introduction: Aim of this study was investigating the correlation between hand function and activities of daily living in children with cerebral palsy. Patient and method:15 children with bilateral or unilateral cerebral palsy in GMFCS level I, II or III were included the study. The subjects were being treated according to the Bobath concept. We used Manual Ability Classification Sys-tem (MACS) for assessing hand functions and Functional Independence Measure for Children (WeeFIM) for assessing independence in daily living activities. Results: Subjects mean age was 120.4 (SD 31.69) months. According to MACS, 7 subjects were both in Level I and II, and 1 subject was in Level III. According to GMFCS, 3 sub-jects were in level I, 8 subjects were in level II, and 4 subjects were in level III. Mean WeeFIM total point was 112.06 (SD13.34). Results of correlation analysis showed that there was a statistically significant negative strong correlation between GMFCS and WeeFIM scores, and negative weak correlation(r=-0.286) between MACS and WeeFIM. Conclusions: There was a strong correlation between gross motor function skills and activities of daily living in children with cerebral palsy. There was a moderate correlation between hand functions and gross motor function skills, and a weak correlation between hand functions and independence in activities of daily living

Exploring the meaning of cerebral palsy and its treatment: a preliminary prospective study related to the perceptions of mothers and physical therapists in Turkey

Background: Cerebral palsy (CP) is the most common cause of disability in childhood. Parents of children with this particular neurodevelopmental disorder are included in the rehabilitation process. Objective: The purposes of this research were (1) to understand perceptions of mothers and physical therapists (PTs) about the rehabilitation programme their children receive and (2) to report the current knowledge of mothers and PTs highlighting consensus and disagreement. Method: Through in-depth interviews with mothers and PTs, the study explored issues that challenge both mothers and PTs’ attitudes. Twenty-two mothers and 11 PTs (work experience; 8.09 SD 6.8 years) answered the questions related to 22 children with CP. Three themes emerged from the interviews: (1) perceptions of disability, (2) expectations about the treatment, and (3) perception of the rehabilitation programme. Results: 22.7% of the PTs and 40.9% of the mothers described the health status of the children as good. A majority of the PTs (95.5%) reported that they often used the Bobath method. Consensus among PTs and mothers about the context (100%) and the effectiveness (45.5%) of the treatment was attained. 31.8% of the PTs and 59.1%of the mothers expected that the children would able to walk with or without assistance. However, consensus about the additional treatments could not be attained. 81.8% of the PTs (13.6% speech therapy; 9.1% aqua therapy;36.4% special education; 9.1% reflexology; 4.5% Vojta therapy; 9.1% surgery) and 50% of the mothers (18.2%aqua therapy; 18.2% special education; 13.6% speech therapy) believed that the children needed additional therapies. While PTs and mothers were totally in agreement in terms of the context and the effectiveness of the rehabilitation programme, they were in disagreement regarding the health status of the children, additional therapies, and expectations. Conclusions: The results suggest that the perceptions of mothers are different from those of PTs. A lack of consensus in these matters affects clinical judgment or rehabilitation of these children

Examining various factors affecting communication skills in children with cerebral palsy

BACKGROUND AND OBJECTIVE: Cerebral palsied children may have difficulties in acting as senders and/or receivers in the communication process. The aim of this study is examining that which maternal and child-related factors affect the communication skills of cerebral palsied children. METHODS: 188 cerebral palsy diagnosed children ages between 2-18 years were assessed by Communication Function Classification System for communication skills. Maternal factors such as occupation, and educational status, and child-related factors such as gender, time of birth, clinical type of cerebral palsy, origin period of cerebral palsy; also daily living activities and gross motor functions of children were included in the assessment for examining how they affect the communication skills of cerebral palsied children. RESULTS: Lower maternal age, higher gross motor function level, ataxic type and hemiparetic involvement (p  0,05) affected positively on the communication skills. There were no effects of delivery method (p > 0,05). CONCLUSIONS: Communication skills of cerebral palsied children are affected by maternal age, educational status, occupation, and child's gender, birth term, origin period of cerebral palsy, clinical type of cerebral palsy, extremity involvement, motor development level and gross motor function. But the method of delivery has no effect on the communication functions of cerebral palsied children

The efficacy of botulinum toxin a lower limb injections in addition to physiotherapy approaches in children with cerebral palsy: A systematic review.

BACKGROUND: To assess treatment effect of lower limb botulinum toxin type A (BTX-A) in combination with physiotherapy approaches on gross motor functions in children with cerebral palsy compared with only physiotherapy treatment. OBJECTIVE: The purpose of this review was to analyze the efficacy botulinum toxin a lower limb injections in addition to physiotherapy approaches in children with cerebral palsy. METHODS: A literature search was conducted in the following databases: Cochrane, PEDro, PubMed, MEDLINE, AMED and EMBASE. The searches were limited to the period from July 2009 to July 2015. The intervention had to contain BTX-A into the lower limb plus physiotherapy approaches and be compared with only physiotherapy. The methodological quality and clinical relevance were independently assessed by the authors. RESULTS: The database search resulted in a total of 1521 studies, of which 4 (Level II of evidence) trials were included in this review. The population represented by were age between from 11 month to 15 years. Overall there were 153 children all diagnosed with CP (87 Male, 66 Female). CONCLUSIONS: The use of BTX-A injections in addition to physiotherapy approaches seems to have positive effect on spasticity and ROM. However, the question of whether the treatment of BTX-A plus physiotherapy has a greater improvement on functional capacity, such as gross motor function or gait parameter than only physiotherapy treatments, was inconclusive. Further investigation by rigorous studies is required

Yoga versus home exercise program in children with enthesitis related arthritis: A pilot study

Purpose: The aim was to compare the effects of yoga and home exercise program on lower extremity functional status, pain, and quality of life in children with enthesitis related arthritis (ERA). Methods: Twenty-one children with ERA were divided into two groups as yoga (n = 11) and home exercise (n = 10). Yoga group performed supervised yoga exercises twice a week for eight weeks. Home exercise group performed video-based exercises for the same period. Pain in rest and activity, lower extremity functional status, and quality of life were evaluated at baseline and following eight weeks. Results: The groups were similar at baseline (p > 0.05). All the parameters, except parent reported quality of life, significantly improved in yoga group (p < 0.05), where only stair climb test times significantly improved in home exercise group (p < 0.05). Conclusions: Yoga seems promising for improving lower extremity functional status, pain, and quality of life as an exercise intervention in rehabilitation programs of children with ERA

Serebral Palsi rehabilitasyonunda EEG bulgularının prognostik değeri

Prognostic value of EEG findings in cerebral palsy rehabilitation-EEG of 32 cerebral palsy patient who are treated according to the with rehabilitation program by the Bobath technique were evaluated. Patients motor improvement was assessed by motor development test. The difference and monthly improvement scores were compared with EEG findings which is defined between 1-9 points. No correlation was found. On the other hand there were no significant difference also in the motor development parameters if we separete patients into two group according to their EEG's such as normal and abnormal