Department of Orthopaedic Surgery, Wake Forest University, Winston-Salem, North Carolina, United States The Lancet
(Impact Factor: 45.22).
06/2004; 363(9421):1619-31. DOI: 10.1016/S0140-6736(04)16207-7
Cerebral palsy, a range of non-progressive syndromes of posture and motor impairment, is a common cause of disability in childhood. The disorder results from various insults to different areas within the developing nervous system, which partly explains the variability of clinical findings. Management options include physiotherapy, occupational and speech therapy, orthotics, device-assisted modalities, pharmacological intervention, and orthopaedic and neurosurgical procedures. Since 1980, modification of spasticity by means of orally administered drugs, intramuscular chemodenervation agents (alcohol, phenol, botulinum toxin A), intrathecally administered drugs (baclofen), and surgery (neurectomy, rhizotomy) has become more frequent. Family-directed use of holistic approaches for their children with cerebral palsy includes the widespread adoption of complementary and alternative therapies; however, the prevalence of their use and the cost of these options are unknown. Traditional medical techniques (physiotherapy, bracing, and orthopaedic musculoskeletal surgery) remain the mainstay of treatment strategies at this time. This seminar addresses only the musculoskeletal issues associated with cerebral palsy and only indirectly discusses the cognitive, medical, and social issues associated with this diagnosis.
Available from: Al Shimaa Ramadan Azab
- "The clinical manifestations depend on the magnitude, extent and location of the insult that causes the irreversible damage to the brain, brain stem, or spinal cord. The severity ra8uy8gt6ytfvc6uygbn nges from subtle motor impairment to involvement of the whole body (Koman et al., 2004). Cerebral palsy (CP) is the commonest cause of neuromuscular spinal deformity. "
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DESCRIPTION: The purpose of this study was to examine the effect of suit therapy on back geometry in spastic diplegic cerebral palsied children. Subject: Thirty spastic diplegic children ranging in age from 7 to 9 years from both sexes. They were classified randomly into two groups of equal numbers group (A) and group (B). group A received designed exercise therapy program, while group B received the same exercise program while wearing the therasuit. Methods: The patients' posture was evaluated before and after the suggested treatment program by Formetric instrument system. The data were collected and analyzed using a paired and un-paired t-test to compare the difference between the results. Results: this study revealed that there were significant differences (p<0.05) of all of the measured variables (trunk imbalance, pelvic tilt, lateral rotation, surface rotation) between pre test and post test in the control and experimental groups. Conclusion: therasuit has got clear effect when added to treatment program in correcting the posture in spastic diplegic children.
Available from: Eric B Levey
- "A widely accepted classification of CP is into phenotypes including spastic (bilateral or unilateral), dyskinetic, and ataxic–hypotonic CP (Surveillance of Cerebral Palsy in 2000; Saint Hilaire et al. 1991; Koman et al. 2004), recognizing that many patients have several neurologic findings and are best characterized as having a mixed-type CP. Dyskinetic (also called ''Extrapyramidal'') CP is characterized by abnormal movements, with fluctuating patterns of tone and posture. "
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ABSTRACT: An ongoing challenge in children presenting with motor delay/impairment early in life is to identify neurogenetic disorders with a clinical phenotype, which can be misdiagnosed as cerebral palsy (CP). To help distinguish patients in these two groups, conventional magnetic resonance imaging of the brain has been of great benefit in "unmasking" many of these genetic etiologies and has provided important clues to differential diagnosis in others. Recent advances in molecular genetics such as chromosomal microarray and next-generation sequencing have further revolutionized the understanding of etiology by more precisely classifying these disorders with a molecular cause. In this paper, we present a review of neurogenetic disorders masquerading as cerebral palsy evaluated at one institution. We have included representative case examples children presenting with dyskinetic, spastic, and ataxic phenotypes, with the intent to highlight the time-honored approach of using clinical tools of history and examination to focus the subsequent etiologic search with advanced neuroimaging modalities and molecular genetic tools. A precise diagnosis of these masqueraders and their differentiation from CP is important in terms of therapy, prognosis, and family counseling. In summary, this review serves as a continued call to remain vigilant for current and other to-be-discovered neurogenetic masqueraders of cerebral palsy, thereby optimizing care for patients and their families.
Available from: Mohamed A. Eid
- "Improving the ability to walk or perform other functional activities is often the primary therapeutic goal for spastic diplegic children . Adaptive equipment that try to compensate for reduced mobility consume a large proportion of the costs related to CP , thus measures that improve mobility in children with CP could potentially result in substantial savings for health care systems. "
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ABSTRACT: Background and purpose
Spastic diplegia is a common form of cerebral palsy (CP) and is characterized by spasticity and muscle weakness of both lower limbs resulting in decreased walking ability. The purpose of this study was to evaluate the effect of whole body vibration (WBV) training on muscle strength, spasticity, and motor performance in spastic diplegic cerebral palsy children after 12-weeks treatment.
Thirty spastic diplegic CP children (8–12 years) were randomized to two equal groups, control group and WBV group. The control group received a selected physical therapy treatment program for spastic diplegic CP and the WBV group received the same program in addition to WBV training. Measurements of isometric strength of knee extensors, spasticity, walking speed, walking balance and gross motor function were performed before and after 12 weeks of the treatment program.
Isometric strength of knee extensors, spasticity and the walking speed were significantly improved only in the WBV group (P < 0.05). Growth motor function measure-88 (GMFM-88) (D%) was significantly increased (P < 0.05) in both groups in favor of the WBV group and GMFM-88 (E%) was significantly increased (P < 0.05) only in the WBV group, while walking balance did not change significantly in either group.
The obtained results suggest that 12-weeks’ intervention of whole-body vibration training can increase knee extensors strength and decrease spasticity with beneficial effects on walking speed and motor development in spastic diplegic CP children.
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