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Fox, Cynthia Marie. "Intensive voice treatment for children with spastic cerebral palsy". Diss., The University of Arizona, 2002. http://hdl.handle.net/10150/280175.
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Purpose. The purpose of this study was to examine the effects of an intensive speech treatment for children with spastic cerebral palsy (CP). Background. Children with spastic CP have speech and voice disorders, which may limit functional communication and negatively impact quality of life. There are limited published outcome data on speech treatment approaches for these children. Recent advances in theories of motor development and behavioral gait and limb treatment provide a solid framework (consistent with theories of motor learning) from which to test different speech treatment concepts (e.g., intensive treatment, high effort exercises, repeated practice trials, and sensory augmentation/sensory awareness training) in children with spastic CP. Method. A multiple baseline single-subject design with replication across participants (five children with spastic CP) was used. Acoustic measures related to voice functioning, auditory-perceptual analysis of speech samples, and perceptual ratings by parents of participants in this study were obtained from baseline, post-treatment, and 6 week follow-up data recording sessions. Results. The four participants who received treatment demonstrated a marked change in performance on one or more of the acoustic measures and there were strong listener preferences for the treated speech samples (post-treatment or follow-up sessions) over baseline samples for most perceptual characteristics rated. In addition, parents of these four participants reported improved perceptions on two or more voice, speech, or communication characteristics following treatment, and all had an overall favorable impression of their child's treatment outcome and of the treatment approach used. No changes were observed in the one participant with CP who did not receive treatment. Conclusions. These findings suggest that in these four participants with CP, intensive speech treatment changed the output of the speech motor system in a manner that listeners preferred over baseline speech samples. In addition, this positive effect was maintained in nearly all cases 6 weeks after the conclusion of treatment. These findings are consistent with those in limb and gait treatment literature, thus highlighting potential key treatment concepts to consider in behavioral treatment for children with spastic CP.
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Novak, Iona, University of Western Sydney i College of Social and Health Sciences. "The effect of a standardised occupational therapy home program for children with spastic hemiplegic cerebral palsy". THESIS_CSHS_XXX_Novak_I.xml, 2004. http://handle.uws.edu.au:8081/1959.7/694.
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Despite the popularity of home program interventions there is little evidence to demonstrate effectiveness, particularly when an explicit family centred framework is adopted. This single-group pre-post design study evaluates the impact of a standardised occupational therapy home program implemented with a group of 20 children (2-7 years, mean age 3.8)with spastic hemiplegic cerebral palsy. The study measured the effect of the program using: goal attainment scaling(GAS);pediatric evaluation of disability inventory (PEDI); and quality of upper extremity test(QUEST). In addition, parent participation intensity was measured through a home program log. The use of a standardised occupational therapy home program for children with cerebral palsy is recommended as an effective method to achieve therapy goals. Further research using more rigorous designs is required to fully explore treatment efficacy.Master of Science (Hons.)
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Fitzpatrick, Louise. "The efficacy of the neurodevelopmental therapy treatment approach in 4-7 year old children with cerebral palsy". Thesis, Stellenbosch : Stellenbosch University, 2001. http://hdl.handle.net/10019.1/52523.
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Thesis (MSc)--Stellenbosch University, 2001.ENGLISH ABSTRACT: Although the neurodevelopmental therapy (NDT) treatment approach is used extensively in the management of children with cerebral palsy, there is currently very little documented research to support its efficacy. The purpose of this study was to evaluate the efficacy of NDT in terms of its effect on motor function in a group of 10 cerebral palsy children. A multiple simple single-subject design was used in which the children each acted as their own controls. A 5 week baseline period, during which no intervention was received by the children, was followed by a 5 week intervention phase during which the children received twice weekly NDT treatment. The children were assessed at the beginning and end of each phase using the Gross Motor Function Measure (GMFM), and an assessment tool, which allowed the establishment of individualised outcome measures, called TELER. The group of children demonstrated no statistically significant gains in motor function on either of the outcome measures during the baseline phase of the study. However during the intervention phase the overall improvements demonstrated by the group on both the GMFM and TELER were statistically significant. Nine out of the ten children achieved greater improvements in their goal total GMFM scores during the intervention phase than during the baseline phase. Similarly all of the children achieved a greater number of clinically significant improvements on the TELER outcome measures. NDT was beneficial and useful in promoting motor function in this group of cerebral palsy children.
AFRIKAANSE OPSOMMING: Alhoewel die Neuro-ontwikkelingsterapie (NOT) behandelingsbenadering wydeverspreid gebraik word in die behandeling van kinders met serebrale verlamming, is daar huidiglik baie min gedokumenteerde navorsing om die effektiwiteit daarvan te staaf. Die doel van hierdie studie was om die effektitiwiteit van NOT te evalueer met betrekking tot die impak daarvan op die motoriese funksie van ‘n groep van 10 kinders met serebrale verlamming. ‘n Veelvuldige eenvoudige enkeling -subjek raamwerk is gebruik waarvolgens die kinders elk as hul eie kontrolegoep ageer het. ‘n 5-weke basislyn fase, waartydens die kinders aan geen intervensies onderwerp is nie, is gevolg deur ‘n 5-weke intervensie fase waartydens die kinders twee keer per week NOT behandeling ontvang het. Die kinders is geevalueer aan die begin en einde van elke fase met die Oorhoofse Motoriese Funksie Maatstaf (OMFM)/Gross Motor Function Measure (GMFM), asook ‘n evalueringsmaatstaf genaamd TELER, wat die bepaling van geindivualiseerde resultate moontlik gemaak het. Die groep kinders het geen statistics bewese vordering in motoriese fiinksies getoon volgens beide die evalueringsmaatstawwe tydens die basislyn fase van die studie nie. Daarteenoor het die groep tydens die intervensie fase oorhoofs gesproke statistics bewese vordering getoon met betrekking tot beide die OMFM en die TELER. Nege uit die 10 kinders het groter vordering getoon met hul totale OMFM resultate tydens die intervensie fase as gedurende die basislyn fase. A1 die kinders het tegelykertyd ‘n groter hoeveelheid substantiewe kliniese verbeterings getoon met betrekking tot hul TELER uitkomste. NOT was voordelig en nuttig in terme van die verbetering van motoriese funksie in die groep van serebraal verlamde kinders.
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高震雄 i Chun-hung Ko. "Double blind randomized placebo controlled trial in cerebral palsy: use of an innovative tongue acupuncturetechnique versus sham acupuncture". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B31970187.
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Lam, W. K., i 林永佳. "Evaluation of conventional and dynamic ankle foot: orthosis in cerebral palsy subjects using gaitanalysis". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B29520034.
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Mäenpää, Helena. "Electrostimulation therapy and selective posterior rhizotomy in the treatment of children with cerebral palsy". Helsinki : University of Helsinki, 2005. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/maenpaa/.
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Polak, Frances. "Comparison of two doses of botulinum toxin in the treatment of children with cerebral palsy". Thesis, University of Nottingham, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.289068.
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Johnson, Barbara A. "Evaluation of the Optimum Duration and Effectiveness of a Plyometric Training Program for Improving the Motor Abilities of Youth with Cerebral Palsy". DigitalCommons@USU, 2012. https://digitalcommons.usu.edu/etd/1374.
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Current research examining the effects of resistive exercise programs in children with cerebral palsy (CP) has not met national guidelines for the duration of training. The lack of improvement in gross motor abilities after resistive training may be attributed to insufficient duration. Additionally, plyometric training has not been used as a treatment, despite evidence suggesting that it can improve running, throwing, and jumping skills. The current study evaluated the optimum duration and effects on gross motor abilities of a plyometric training treatment for three participants with spastic, unilateral CP using a multiple baseline, multiple probe design. Treatment was designed using the National Strength and Conditioning Association’s guidelines for intensity, volume, frequency, and variety of training. Treatment resulted in improvements in GMFM 66 scores, agility, and broad jump distance for all three participants. Consistency preceded improvements in distance or height. The optimum duration was dependent on the individual child and the outcome measure. Ongoing training is necessary to maintain running speed. However,slight declines or maintenance of performance in the GMFM, agility, and power tests at follow-up may be attributed to inconsistency in performance rather than decline.
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Hösl, Matthias. "Spastic equinus deformity in children with Cerebral Palsy – Treatment effects in terms of muscular morphology and function". Doctoral thesis, Humboldt-Universität zu Berlin, 2018. http://dx.doi.org/10.18452/18861.
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Die meisten Kinder mit infantiler Zerebralparese (IZP) entwickeln eine spastische Parese, was zu Schwäche, erhöhtem Muskel-Dehnungswiderstand und Kontrakturen führt. Der Spitzfuß ist eines ihrer häufigsten Defizite. Das übergeordnete Ziel dieser Arbeit war es, nicht-invasive Behandlungsstrategien für diese Pathologie näher zu untersuchen. In der ersten Studie wurden die Effekte einer Unterschenkel-Lagerungsorthese auf die Muskelmorphometrie des Gastrocnemius unter zu Hilfenahme von Ultraschall und 3D Bewegungsanalyse untersucht. Lagerungsorthesen konnten das Gangbild verbessern, führten gleichzeitig aber zu Atrophie. Um eine alternative Therapieform zu finden, wurde in der zweiten Studie die kontraktile Aktivität des Gastrocnemius mittels Ultraschall, Bewegungsanalyse und EMG während des Gehens, Vorwärts-Bergauf, bzw. Rückwärts-Bergab, sowie in der Ebene untersucht. Das Bergaufgehen steigerte die konzentrische Exkursion der Faszikel, wohingegen das Rückwärts-Bergabgehen zu vermehrter Exzentrik führte. Da sich exzentrisches Training positiv auf Faszikellängenwachstum auswirken kann, wurde in der dritten Studie das Rückwärts-Bergabgehen mit statischem Dehnen als traditionelle Therapieform verglichen. Ultraschall, Bewegungsanalyse und handgesteuerte Dynamometrie wurden verwendet, um die Plantarflexorenkraft, die passive Sprunggelenksbeweglichkeit, die Gastrocnemius Morphometrie sowie die Steifigkeit und Dehnbarkeit auf Muskel-Sehnen und Gelenkebene zu untersuchen. Dehnen zeigte keinerlei Benefits gegenüber dem Laufbandtraining. Rückwärts-Bergabgehen war dagegen ein effektives Gangtraining und setzt vermutlich neuronale und koordinative Reize. In der Zusammenschau scheinen positive Änderungen im Gangbild bei IZP Kindern sowohl durch Unterschenkelorthesen, als auch durch Rückwärts-Bergabgehen erreichbar zu sein. Beides führte aber nicht zu Muskelwachstum. Funktionelle Verbesserungen scheinen daher auch stark von neuronal, koordinativen Aspekten abhängig zu sein.Most children with Cerebral Palsy (CP) develop spastic paresis, which leads to muscle weakness, increased stretch-resistance and joint contractures. The gastrocnemius muscle is frequently targeted to alleviate a common deficiency known as equinus. The overall objective of this thesis was to investigate several non-invasive treatment strategies for this pathology. The first study investigated the effects of ankle foot orthotics on spastic gastrocnemius morphometrics as well as on gait by using ultrasound and motion capturing. We concluded that braces improved walking function but also lead to atrophy. During the second study, we searched for a readily available, substituting stimulus and compared the contractile activity of the gastrocnemius on treadmills, namely during flat-forward, forward-uphill and backward-downhill gait using ultrasound, motion capturing and EMG. Uphill gait promoted concentric fascicle action, while backward-downhill gait increased eccentric fascicle action. Since eccentric training had been previously shown to increase fascicle length in controls, during the third study, we compared backward-downhill walking versus static, manual stretching. Ultrasound, motion analysis and handheld dynamometry were used to test plantarflexor strength, passive ankle joint flexibility, as well as gastrocnemius morphometrics, stiffness and strain on muscle-tendon and joint level. Backward-downhill walking led to larger single stance dorsiflexion and faster achievable walking velocities while stretching aggravated knee flexion in swing. Strength, joint flexibility, as well as stiffness on muscle-tendon and joint level were not altered. Backward-downhill walking can be an effective gait treatment, probably improving coordination. Nevertheless, more intense training might be necessary to alter muscle-tendon properties. In sum, backward-downhill walking and bracing increased function without promoting or even by harming muscle growth.
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Redman, Toni Annette. "Upper limb Botulinum Toxin-A in children with hemiplegic cerebral palsy : physiological corticomotor pathways and effect on health related quality of life". University of Western Australia. Faculty of Medicine and Dentistry and Health Sciences, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0123.
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[Truncared abstract] Introduction: The assessment of any therapy requires not only an understanding of how that therapy works but also how it affects health related quality of life (HRQOL). Botulinum Toxin A(BoNT-A) therapy for upper limb spasticity management in children with hemiplegic cerebral palsy(CP) is currently under trial. Despite its use for over a decade for lower limb spasticity, little is known about the mechanisms involved in improving motor function and the effect on the child and their familys HRQOL. Both central and peripheral mechanisms are hypothesised[1]. Whilst evidence of improved quality of movement and ability to perform tasks is emerging[2-4], this cannot be directly correlated with an improvement in HRQOL. In addition, the traditional method of assessing child HRQOL by parent proxy reports has come under question[5, 6]. The World Health Organisation now recommends the collection of both parent proxy and child self-reports[7]. Aims: 1. Investigate the corticomotor projections to the upper limb in school aged children with hemiplegic CP and the changes that occur with BoNT-A therapy by transcranial magnetic stimulation (TMS). 2. Investigate the effect of upper limb BoNT-A therapy on HRQOL of school aged children with hemiplegic CP by completion of the PedsQL 4.0 Generic Core Scales and 3.0 CP Module. 3. Determine the concordance between Child Self-Report and Parent Proxy Report scores for the PedsQL 4.0 Generic Core Scales and 3.0 CP Module. 4. Determine the concordance between PedsQL scores and function as assessed by the Melbourne Assessment of Unilateral Upper Limb Function (MUUL). Methods: Design: Prospective randomised pilot study. Setting: Department of Paediatric Rehabilitation, Princess Margaret Hospital, and Centre for Neurological and Neuromuscular Disorders, Perth. Participants: 22 school aged children with hemiplegic CP aged 7yr 0mth-13yr 11mth (12 treatment, 10 control). 3 Treatment: One episode BoNT-A injections (dose 1-2U/kg/muscle) into the upper limb for treatment group. The control group received usual care. ... Conclusion: This pilot study provides preliminary evidence of the effects of upper limb BoNT-A therapy at both a central physiological and a broader quality of life level in school aged children with hemiplegic CP. At a central level, corticomotor pathway reorganisation occurs in the setting of BoNT-A. However the reorganisation is not limited to the affected side pathways suggesting a systemic BoNT-A effect or developmental changes. Similarly, in this pilot study, there was no statistically significant effect of upper limb BoNT-A on the childs HRQOL as assessed by the PedsQL although positive trends were observed 4 for a number of physical and psychosocial domains. The collection of both child self-report and parent proxy reports when assessing HRQOL is recommended, and function needs to be assessed independently. Larger studies across the broader CP population, the design of CP specific HRQOL tools appropriate for use in the higher functioning CP cohort, and alternative better tolerated methods of investigating the motor system in children with movement disorders are recommended.
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Camargo, Marcela Aparecida Ferreira de. ""Estudo da prevalência de cárie em pacientes portadores de paralisia cerebral"". Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/23/23148/tde-12012006-094913/.
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O objetivo deste estudo foi é avaliar a prevalência de cárie em pacientes portadores de paralisia cerebral, bem como avaliar o envolvimento de fatores socioeconômicos com a manifestação da doença. Uma única dentista efetuou o exame bucal em 207 pacientes portadores de paralisia cerebral que aguardavam por triagem no setor de odontologia, da AACD-SP, segundo os critérios da Organização Mundial da Saúde para levantamento epidemiológico de cáries (condição de coroa dentária e necessidade de tratamento). Os cuidadores dos pacientes informaram através de questionário semi-estruturado suas características socioeconômicas (grau de parentesco, nível de escolaridade, renda familiar mensal, tipo e condição de moradia) e aspectos comportamentais (antecedentes de consulta odontológica, idade da 1ª consulta, dieta, condição de higiene bucal). Para indicar a condição de cárie dentária foram utilizados os índices ceo-d e CPO-D. Na elaboração das análises comparativas, optou-se pela divisão em dois grupos etários relativos aos indicadores da dentição decídua (132 crianças de 3 a 8 anos de idade) e permanentes (86 pacientes de 7 a 17 anos). De acordo com a análise dos índices utilizados, observou-se elevada prevalência de cárie na dentição decídua com baixa incorporação de tratamento odontológico. Na dentição permanente, o índice CPO-D demonstrou-se positivamente associado com a idade, o índice de cuidado foi mais elevado que para as crianças com dentição decídua. Fatores socioeconômicos e comportamentais associaram com a prevalência de cárie e a necessidade de tratamento nos pacientes portadores de paralisia cerebral que fizeram parte deste estudo.The aim of this study is to evaluate dental caries prevalence in patients with cerebral palsy, and to assess socioeconomic and behavioral conditions associated with the disease. One single dentist performed the examination of 207 patients with cerebral palsy, which were enrolled for treatment in the dental department of AACD-SP, following international criteria standardized by the World Health Organization for surveys on oral health (dentition status and treatment needs). Caretakers informed socioeconomic (kinship, schooling attainment, familial income, household characteristics) and behavioral characteristics (age at the first dental visit, previous treatments, dietary habits and oral hygiene). The appraisal of caries experience used the dmft and DMFT indices. For the comparative analyses, the assessment of two groups differentiated children with primary dentition (132 children from 3 to 8 years old) from those presenting permanent teeth (86 children from 7 to 17 years old). Children with primary dentition presented elevated indices of caries, with low incorporation of dental treatment. For children presenting permanent teeth, the DMFT index was positively associated with age, and the dental care index was higher than the corresponding figure for the primary dentition. Socioeconomic and behavioral factors associated with caries experience and dental needs for the patients with cerebral palsy gathered in the current study.
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Seifart, Anja. "The impact of functional electrical stimulation to the lower leg after a single botulinum toxin injection in children with a spastic equinus gait due to cerebral palsy". Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/2860.
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Thesis (MScPhysio (Physiotherapy))--Stellenbosch University, 2008.Cerebral palsy (CP) is a common neurological condition seen in children which results in childhood disability. Damage to the developing brain results in abnormal muscle tone and decreased force generation, which leads to loss of independent function. Previous studies investigating interventions targeting the typical equinus gait pattern seen in spastic CP have reported inconclusive and widespread outcomes. Objectives The objectives of the study were to determine (1) the effect of functional electrical stimulation (FES) after a single botulinum toxin injection into the triceps surae muscle as a functional orthosis on various gait parameters and economy of movement; (2) caregivers’ perceptions of the impact of the intervention on their child’s function and participation, and (3) optimal timing intervals for introducing FES after a botulinum toxin injection. Method Single-subject research with a multiple baseline approach was conducted on five ambulant subjects (average age 5.1 years, SD=1.4) in the Cape Metropole with a dynamic equinus gait due to hemiplegic CP. Two-dimensional gait analysis, isometric dynamometry, Energy Expenditure Index (EEI), and a caregiver questionnaire were used to gather data on walking speed, ankle angles at initial contact of gait, isometric plantarand dorsiflexior muscle strength, energy expenditure during gait, as well as caregiver perception on participation changes. Statistical analysis was conducted by means of ANOVA tests and graphic data illustrations. Results A statistically significant pre- to post intervention (FES after botulinum toxin) change was found for plantarflexor muscle strength. This effect was partially maintained over the withdrawal phase. Caregivers felt the intervention to have a positive influence on their children’s walking speeds, as well as on age-appropriate function and participation. Selfselected walking speed, dorsiflexor muscle strength, and ankle angles at initial contact did not change significantly. A 32-day interval between between botulinum toxin and the FES programme resulted in the most pronounced improvements in terms of walking speed, EEI scores, and plantarflexor muscle strength. Conclusion FES to the lower limb, 32 days after botulinum toxin into the triceps surae, applied for 30 minutes per day, five times a week over a total of four weeks, seemed to improve selected gait parameters as well as caregiver perception of impact on function and activities of daily living. However, further research is needed.
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King, Carolyn Ann. "The effect of neurodevelopmental treatment on gross motor function and ambulation in children with cerebral palsy, a series of single-subject studies". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22331.pdf.
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Hösl, Matthias [Verfasser], Diamantis [Gutachter] Arampatzis i Thomas [Gutachter] Dreher. "Spastic equinus deformity in children with Cerebral Palsy – Treatment effects in terms of muscular morphology and function / Matthias Hösl ; Gutachter: Diamantis Arampatzis, Thomas Dreher". Berlin : Humboldt-Universität zu Berlin, 2018. http://d-nb.info/1185668047/34.
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Elliott, Catherine. "Efficacy of lycra arm splints : an international classification of functioning disability and health approach". University of Western Australia. School of Human Movement and Exercise Science, 2005. http://theses.library.uwa.edu.au/adt-WU2006.0017.
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[Truncated abstract] This thesis consists of five experimental studies from seven data collection periods. The first two studies quantitatively analyse children with and without cerebral palsy using upper limb three dimensional (3D) motion analysis. Upper limb angular kinematics and sub-structures were measured and analysed, both of which were utilised during subsequent studies. The final three studies assess the efficacy of lycra® arm splints using clinical assessments, 3D dimensional upper limb kinematics and 3D sub-structures. Study 1 analysed 3D movement sub-structures in children with and without cerebral palsy ... The aim of the study was to quantitatively analyse movement sub-structures in children with and without cerebral palsy during four functional tasks taken from the Melbourne Assessment of Unilateral Upper Limb Function (Melbourne Assessment - Randall, Johnson & Reddihough, 1999) ... Results demonstrated significant differences in angular kinematics in children with and without cerebral palsy, while the methodology developed in this study provided improved insight into the movement of the upper limb and trunk during functional tasks. Study 3 reported a randomised controlled trial of lycra® arm splints in children with cerebral palsy across all levels of the International Classification of Functioning Disability and Health (ICF) ... Lycra® arm splints were shown to have a statistically significant impact at the level of participation, whereas no significant difference was seen at the level of impairment and activity. Study 4 reported a randomised controlled trial of the effects of lycra® arm splints on 3D movement sub-structures during functional tasks in children with cerebral palsy ... This research demonstrated that movement sub-structures (including movement time) can be quantified and are amenable to change with intervention. Study 5 reported a randomised controlled trial of the effects of lycra® arm splints on angular kinematics (thorax, shoulder and elbow) during functional tasks in children with cerebral palsy ... The benefits of the splint on angular kinematics were only apparent when worn for the 3 month period, as minimum evidence was established for the short-term (1hour) and long term (3 month post splint wear) carry-over effects.
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Peltoniemi, O. M. (Outi-Maria). "Corticosteroid treatment in the perinatal period:efficacy and safety of antenatal and neonatal corticosteroids in the prevention of acute and long-term morbidity and mortality in preterm infants". Doctoral thesis, University of Oulu, 2007. http://urn.fi/urn:isbn:9789514284601.
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Abstract
The aim of the study was to evaluate the efficacy and safety of antenatal and postnatal corticosteroids in the prevention for mortality and acute and long-term morbidity in preterm infants.
Altogether 109 eligible preterm infants participated in a randomized, multi-center, double-blinded controlled trial studying the efficacy of early dexamethasone (DX) treatment. The infants received either four doses of DX or placebo. DX treatment did not have a detectable influence on survival without bronchopulmonary dysplasia (BPD), severe intracranial hemorrhage, or periventricular leukomalacia.
In a meta-analysis of 15 trials, we found that early prolonged DX treatment (> 96 h, n = 1594 infants) decreased the risk of BPD (RR 0.72 95% CI 0.61–0.87), whereas early short DX course did not (n = 1069 infants). However, prolonged DX increased the risk of gastrointestinal (GI) complications (RR 1.59 95% CI 1.02–2.46).
Fifty-one very preterm infants participated in a randomized placebo-controlled trial studying early hydrocortisone (HC) started before 36 hours of age and continued for 10 days. The basal and stimulated serum cortisol levels were measured before the intervention. The study was interrupted because of GI perforations in the HC group. HC decreased the risk of patent ductus arteriosus. HC-treated infants with serum cortisol concentrations above the median had a high risk of GI perforation. HC increased survival without BPD among infants with low endogenous cortisol levels.
Altogether 45 surviving infants were enrolled in the follow-up of the early HC trial at 2 years of age. None of the study patients had died after discharge. There was no difference in the recorded rehospitalization rate, growth characteristics, or neurological development between HC and placebo-treated children.
Altogether 249 women pregnant at less than 34.0 gestational weeks participated in a randomized trial studying the efficacy of a single additional dose of betamethasone (BM). All of the 159 infants in the BM group and 167 in the placebo group were born before 36 weeks of gestation. Intact survival was comparable between the BM and placebo groups, whereas the need for surfactant therapy in RDS was increased in the BM group. According to a post hoc analysis of 206 infants delivered within 1–24 hours, the BM booster tended to increase the risk of RDS and to decrease intact survival.
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Crawford, Emily Anne. "The relevance of the Goldsmith Index of Body Symmetry to functional seated posture". University of Western Australia. School of Human Movement and Exercise Science, 2006. http://theses.library.uwa.edu.au/adt-WU2006.0007.
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Whilst literature exists describing prevalence and theories about mechanisms of development of deformity, there is a distinct lack of research that examines how deformity can be measured despite it being an area of identified need. This study established the inter- and intra-rater reliability of the Goldsmith Index of Body Symmetry and examined the relevance of the information it provides within the context of a comprehensive postural assessment for individuals with cerebral palsy in conjunction with a commonly used clinical assessment ... Results demonstrated that high index levels were not exclusively associated with people with windswept deformity. Postural patterns of windsweeping, frog leg (abducting) and scissor (adducting) postures and hip extension were found to occur in all categories, suggesting that asymmetry is not confined to one particular postural pattern. Clinically observable changes were identified through comparison of the supine evaluation and index scores. The flexibility of postural components (or the ability to correct asymmetry) in a supine position for the SD categories demonstrated wide variation. However, subjects in the 3+SD groupings had fixed scoliosis and the majority (83%) also had fixed pelvic obliquity and rotation. All other subjects up to the 3SD category had flexible pelvic obliquity and rotation. No definitive differences in postural components between groups were identified in sitting positions, which was attributed to the influence of gravity on the body in an upright posture. Examination of sitting ability and index level did not demonstrate any relationship, suggesting that greater independence in sitting is not necessarily associated with a lower Goldsmith Index. The study highlighted that assessment of posture is complex, and that no single tool provides the answers required to manage a person’s posture. It demonstrates the need for clinicians to be aware that subjective clinical assessment may not be sufficient to adequately assess and detect changes in posture, and that the Goldsmith Index of Body Symmetry provides objective data that can be used as a powerful adjunct in interpreting clinical assessment and supporting the evaluation of clinical interventions.
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Welch, Joanna. "Cerebal Palsy an analysis of hip pathology and possible treatments /". [Denver, Colo.] : Regis University, 2007. http://165.236.235.140/lib/JWelchPartI2007.pdf.
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Silva, Bruna Maria da. "Desenvolvimento de protocolo biomédico de avaliação de tratamento de crianças com paralisia cerebral por meio do baropodômetro eletrônico computadorizado". Universidade Tecnológica Federal do Paraná, 2016. http://repositorio.utfpr.edu.br/jspui/handle/1/1868.
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A encefalopatia crônica da infância não progressiva, comumente conhecida como paralisia cerebral (PC), trata-se de uma doença que afeta o sistema nervoso central e esta diretamente relacionada à prematuridade e a asfixia perinatal. As disfunções motoras causadas por essa afecção limitam as crianças a realizaram atividades e tarefas diárias, a partir dessa incapacidade tratamentos veem sido desenvolvidos e aplicados para melhorar a qualidade de vida desses indivíduos, como tratamentos cirúrgicos, medicamentosos, de adaptação e fisioterapêutico. No entanto, na prática, a avaliação desses pacientes, ainda é realizada através de escalas de pontuação, sendo subjetivas em sua maioria. Nesse sentido, foi realizado um estudo do tipo descritivo que teve como objetivo, desenvolver e sistematizar um protocolo biomédico de avaliação baropodométrica de tratamento para crianças com PC, como contribuição quantitativa ao repertório de métodos de avaliações já existentes. Foram incluídas na pesquisa, crianças com PC, ambos os sexos, na faixa etária dos dois aos 12 anos de idade, independente da topografia e do tônus muscular e que estavam em tratamento fisioterapêutico com o método PediaSuit e/ou fisioterapia convencional. Foram excluídos da pesquisa indivíduos com diagnóstico de mielomeningocele, doenças progressivas e/ou degenerativas e indivíduos que associaram outras terapias de tratamento, além da fisioterapia convencional e/ou PediaSuit. Compuseram a amostra do estudo 21 crianças, que foram avaliadas antes e durante os tratamentos fisioterapêuticos. No entanto, essas crianças foram avaliadas com a finalidade de determinar as possíveis fragilidades e vantagens no desenvolvimento do protocolo, no total foram realizados 91 testes. Algumas crianças precisaram do auxílio de um andador para se manter na postura em pé. Relativamente ao objetivo proposto, este foi alcançado e considerou-se que o Protocolo Biomédico de Avaliação de Tratamento de Crianças com PC por meio do Barapodômetro Eletrônico Computadorizado (PROBIOBEC) poderá ser utilizado para avaliar crianças em tratamento fisioterapêutico. Assim, concluiu-se que a sistematização alcançada no formato de um protocolo de aquisição de dados por meio do baropodômetro eletrônico computadorizado (BEC) pode ser um exame complementar quantitativo viável e útil para o acompanhamento do impacto de intervenções terapêuticas nessa classe clínica de população. Além disso, foram desenvolvidos quatro artigos, sendo um publicado na Revista Uniandrade e outro publicado no Congresso de Engenharia Biomédica – CBEB, ambos no ano de 2014, e outros dois em processo para publicação.Chronic encephalopathy nonprogressive childhood, commonly known as cerebral palsy (CP), it is a disease that affects the central nervous system and is directly related to prematurity and perinatal asphyxia. The motor dysfunction caused by this condition limit children performed daily activities and tasks, from that failure treatments see been developed and applied to improve the quality of life of individuals, such as surgical treatments, medications, physical therapy and adaptation. However, in practice, the evaluation of these patients is still performed using rating scales, being largely subjective. In this sense, was performed a descriptive study that had as objective develop and systematize a biomedical protocol baropodometric evaluation of treatment for children with CP as quantitative contribution to the repertoire of existing ratings methods. Were included in the study, children with CP, both sexes, aged from two to 12 years of age, regardless of topography and muscle tone, and that were in physical therapy with PediaSuit method and / or conventional physical therapy. Were excluded from the research individuals diagnosed with myelomeningocele, progressive disease and / or degenerative and individuals associated with other therapies treatment in addition to conventional therapy and / or PediaSuit. Comprised the sample of the study 21 children who were evaluated before and during physical therapy treatments.However, these children were evaluated in order to determine possible fragility and advantages in the development of the protocol, in total were carried out 91 tests. Some children needed the aid of a walker to stay in the standing posture. Regarding the proposed objective, this was achieved and it was considered that the Protocol Biomedical Treatment Assessment of Children with PC by means of Barapodômetro Electronic Computerized (PROBIOBEC) can be used to assess children in physical therapy. Thus, it was concluded that the systematization achieved in the format of a data acquisition protocol by means of computerized electronic baropodômetro (BEC) can be a viable quantitative further examination and useful for monitoring the impact of therapeutic interventions in this clinical class population. In addition, four articles were developed, one published in the Journal Uniandrade and another published in Congress of Biomedical Engineering - CBEB, both in 2014, and two more in the process of publication. Thus, it was concluded that the systematization achieved in the format a data acquisition protocol by means of computerized electronic baropodômetro (BEC) can be a viable quantitative complementary examination and useful for monitoring the impact of therapeutic interventions in this clinical class population. In addition, four articles were developed, one published in the Journal Uniandrade and another published in Congress of Biomedical Engineering - CBEB, both in 2014, and two more in the process of publication.
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Carneiro, Ângela Patrícia Pacheco. "Intervenção da fisioterapia em crianças com paralisia cerebral: revisão bibliográfica". Bachelor's thesis, [s.n.], 2018. http://hdl.handle.net/10284/6746.
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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaIntrodução: A paralisia cerebral (PC) é um grupo de afeções do sistema nervoso central da infância que não tem carácter progressivo e que apresenta clinicamente distúrbios da motricidade. Assim, a intervenção da fisioterapia terá uma enorme importância para o desenvolvimento da criança. Objectivo: Este estudo serve para perceber qual a melhor forma de intervenção fisioterapêutica para o tratamento de uma criança com PC. Metodologia: Foi realizada uma pesquisa bibliográfica recorrendo às bases de dados, B-on, Pubmed e PEDro , incluindo, artigos de livre acesso, estudos randomizados controlados, estudos realizados em humanos, idioma português ou inglês, com classificação igual ou superior a 5 na classificação de PEDro. Resultados: 104 617 encontrados, dos quais 7 foram incluídos nesta análise de acordo com os critérios de inclusão. Conclusão: Foi possível concluir, segundo diferentes autores, que existem várias técnicas de intervenção que trazem melhoria para as crianças com PC.
Introduction: Cerebral Palsy (CP) is a group of children central nervous system disorder that is not progressive and represents clinically motor disorders. The intervention of physiotherapy will be very importante for the development of the child. Objective: This study serves to understand the best form of physiotherapeutic intervention for the treatment of a PC child. Methodology: A bibliographic search was carried out using B-on, Pubmed and PEDro, including articles of free access, randomized controlled trials, from human subjects, namely, portuguese or english children, with a rating of 5 or higher in classification from PEDro. Results: 104617 were found, of wich 7 were included in this analysis according to the inclusion criteria. Conclusion: It was possible to conclude that according to different authors, there are several intervention techniques that bring improvement for children with CP.
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Wilkinson, Dominic James Clifford. "Ethical issues in the use of magnetic resonance imaging of the brain in newborn infants with hypoxic-ischaemic encephalopathy : neuroimaging and decision-making for brain injured newborns". Thesis, University of Oxford, 2010. http://ora.ox.ac.uk/objects/uuid:d61e4318-3568-4310-bf92-c7d70f2cb3da.
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Infants with hypoxic-ischaemic encephalopathy (birth asphyxia) have a high risk of death or disability. Those with poor prognosis are sometimes allowed to die after withdrawal of intensive care. In recent years, doctors have used new types of brain scan, magnetic resonance imaging (MRI), to predict the type and severity of impairment if the infant survives and to help with such decisions. In this thesis, I analyse the issues arising from the use of MRI for prognostication and decision-making in newborn infants. I argue that previous prognostic research has been hampered by a failure to identify and focus on the most important practical question and that this contributes to uncertainty in practice. I outline recommendations for improving research. I then look at existing guidelines about withdrawal of life-sustaining treatment. I identify several problems with these guidelines; they are vague and fail to provide practical guidance, they provide little or no genuine scope for parental involvement in decisions, and they give no weight to the interests of others. I argue that parental interests should be given some weight in decisions for newborn infants. I develop a new model of decision-making that, using the concept of a Restricted Life, attempts to set out clearly the boundaries of parental discretion in decision-making. I argue that where infants are predicted to have severe cognitive or very severe physical impairment parents should be permitted to request either withdrawal or continuation of treatment. I justify this model on the basis of overlapping interests, (prognostic, experiential and moral) uncertainty, asymmetrical harms, and the burden of care. In the conclusion, I set out a guideline for the use of MRI in newborn infants with hypoxic-ischaemic encephalopathy. I suggest that this guideline would provide a more robust, coherent and practical basis for decision-making in newborn intensive care.
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Mheni, Syrine. "Physical activity in the treatment of cardiorespiratory disorders for children with cerebral palsy". Master's thesis, 2021. http://www.nusl.cz/ntk/nusl-448594.
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Children with cerebral palsy have lesser cardiorespiratory endurance (or aerobic capacity) and less physical activity than children who are developing normally. Cardiorespiratory problems are linked to a higher risk of noncommunicable diseases and premature aging. The goal of this research is to discover aspects that can be added in physiotherapy practice to ensure a long-term improvement in aerobic capacity in children with cerebral palsy while engaging in physical activity. Also investigated is the effect of aerobic capacity on functional abilities. A systematic review of the literature was undertaken utilizing the PubMed, Cochrane Library, ScienceDirect, and PEDro databases. The child's cardiorespiratory fitness appears to improve when they engage in high- intensity, goal-directed physical activity. The child's adherence appears to be aided by a motivating intervention and the removal of environmental barriers to the activity's practice. This allows for a long-term increase in aerobic capacity. It was impossible to draw a direct link between this improvement and functional capacity. Few studies have incorporated cerebral palsy and low global motor skills in recent years. Despite the importance of the findings, their heterogeneity prevents generalizable suggestions for all children with cerebral...
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Conway, Mikayla Diane. "Neurodevelopmental treatment for children with hemiplegic cerebral palsy: clinical guidelines for occupational therapists". Thesis, 2020. https://hdl.handle.net/2144/41534.
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Clinical data supporting the benefit of neurodevelopmental treatment (NDT) for children with hemiplegic cerebral palsy (CP) is limited due to inconsistencies in methodology across studies, including variations in: NDT definitions, intervention protocols, and outcome measures (Butler & Darrah, 2001; Graham et al., 2009; Tsorlakis et al., 2004). This has led to disagreement in the literature regarding the benefit of NDT in children with CP. Several contemporary studies indicate that the NDT approach can be effective as a motor and functional intervention for this patient population (Acar et al., 2016; Tsorlakis et al., 2004; Türker et al., 2015). In contrast, others (Novak et al., 2020) have concluded that NDT is not an effective motor intervention for children with CP and should be discontinued. In order to support consistency of evidence-based NDT service delivery, a clinical guideline project was conducted at Children’s Specialized Hospital in the Toms River, NJ outpatient pediatric center. This project was guided by the Knowledge to Action Framework (Graham et al., 2006) and involved the creation of NDT guidelines, including appraisal of current evidence on NDT for children with hemiplegic CP, the proposal of eight essential components of NDT, and recommendations for evidence-based assessments to track patient progress over the course of NDT intervention. Post-Capstone project feedback indicated that key stakeholders of the project identified the clinical guidelines as useful and practical. Recommendations included the implementation of these guidelines into practice, as well as a continual review process to incorporate future research and clinical experience in NDT effectiveness.
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陳翕琪. "A study of the main trainer participate children of cerebral palsy about home treatment". Thesis, 2009. http://ndltd.ncl.edu.tw/handle/13396076188150782054.
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Naidoo, Pravani. "An analysis of the experiences of children with cerebral palsy in therapeutic horse riding". Thesis, 2009. http://hdl.handle.net/10413/488.
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Chen, Yuh Chuan, i 陳郁全. "Effects of EEG Biofeedback in the treatment of attention deficit in children with Cerebral Palsy". Thesis, 2013. http://ndltd.ncl.edu.tw/handle/56057768665147836496.
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碩士長庚大學
早期療育研究所
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Purpose: Cerebral Palsy (CP) often accompanies with other problems, such as behavioral, cognitive, learning, language and attention deficits. EEG biofeedback has been used as a treatment to improve attention and impulsivity for children with attention deficits. This research project investigated the effects of EEG biofeedback in the treatment of attention deficits in in children with CP. We hypothesize the EEG biofeedback can improve the EEG patterns, attentional index, visual perception, sensory profile, which further enhance the behavior, quality of life, and enjoyment. Material &; Methods: Nineteen children (4-12 years) with CP associated with attention deficits were assigned to experiment (EEG-biofeedback training, n=8) and to the control (n=11) group. The EEG biofeedback program was carried out on the basis of 1 hour/day, two days/week, for 10weeks (a total of 20 sessions). Outcome measures were QEEG(θ/β), Continuous Performance Test (CPT)（Confidence index, Omission, Commission, Hit RT, Variability, Detectability）, Test of Visual-percrptual skills (TVPS)（Visual discrimination , Visual memory, Visual spatial-relationship, Visual form-constancy, Visual sequential-memory, Visual figure-ground, Visual closure）, and subjective questionaires, including Sensory Profile, Conners’ Rating Scale (CRS), Cerebral Palsy Quality of Life Questionnaire for Children (CPQOL) and Physical activity enjoyment scale (PACES). Outcome measures were administrated before and after the intervention except CPQOL and PACES. The CPQOL and PACES were measured at post-treatment. Statistical analysis was used by ANCOVA and Repeated measure ANOVA. Results:The ANCOVA revealed that EEG-biofeedback training induced greater gains in the QEEG (θ/β) （F=2.41, η2=.13, P=.07）and CPT subscores (Omission)（F=2.19, η2=.13, P=.08）than control intervention. EEG-biofeedback group showed significant in the TVPS subscores -visual sequential-memory（F=5.20, η2=.25, P=.02）, visual closure（F=8.88, η2=.36, P=.01）than did the control group. However, there were no significant differences in the CRS or Sensory Profile between the EEG-biofeedback and control groups. Both groups showed higher scores in careless in Sensory Profile. CPQOL and PACES showed significant higher scores after EEG-biofeedback training compared to control group. EEG-biofeedback group showed significant in the QEEG(θ/β)（F=4.07, η2=.37, P=.02）after 20 sessions. Conclusions: These findings suggest the EEG-biofeedback training had positive effects on QEEG(θ/β), continuous attention, and some visual-perceptual skills for children with CP. However, there were no significant differences in the sensory profile and attention behaviors. This results may indicate the intervention is too short to detect the behavioral differences between groups. We did not make the difinite conclusion due to small sample size. Further study will include more cases and longitudinal follow-up to validate the efficacy of EEG-biofeedback training in children with CP.
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Peng, Chien Wei, i 彭健瑋. "Treatment Efficacy of Somatosensory Level Mesh-Glove Electrical Stimulation for Upper Extremity Function in Patients with Cerebral Palsy". Thesis, 2017. http://ndltd.ncl.edu.tw/handle/55kxbw.
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Smetana, Christer. "Comparing Neurophysiological Methods to Functional Therapy in Treatment of Cerebral Palsy from Newborns To Adolescents- A literary review". Master's thesis, 2012. http://www.nusl.cz/ntk/nusl-305884.
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Title: Comparing Neurophysiological Methods to Functional Therapy in Treatment of Cerebral Palsy from Newborn to Adolescents Investigative questions: What are the scientifically proven advantages of Neurophysiological Methods and Functional therapy, respectively? In what situations would one treatment approach be more beneficial than the others? Background: Cerebral palsy is the most prevalent of the chronic childhood motor disability disorders, with a prevalence of approximately 2 in every 1000 live born. Definitions and classifications have been varying for the last 150 years, leading to a great deal of confusion and controversy in this field of paediatric medicine, resulting in varying recommendations in terms of therapy. In complex cooperative therapy team is necessary in each individual, and in terms of physiotherapeutic treatment, two big and very distinct blocks of treatment philosophies are found, namely the Neurophysiologic Method and the Functional Therapy. Previously, no definite recommendations towards therapy has been provided, and many studies simply conclude that the field of cerebral palsy, despite centuries of attention, still lacks substantial parts of information to conclude with anything in particular. The purpose of this thesis is to evaluate and compare the Neurophysiological...
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Novak, Iona, University of Western Sydney, College of Health and Science i School of Biomedical and Health Sciences. "Effectiveness of occupational therapy home program intervention for children with cerebral palsy : a double blind randomised controlled trial". 2009. http://handle.uws.edu.au:8081/1959.7/38884.
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Home programs are widely used by occupational therapists as a strategy to address health and development needs of children with cerebral palsy. Experts believe they are essential. Despite wide-spread clinical use there is no high quality research evidence proving home program effectiveness. Further there is no information that provides a parent perspective on home programs. The aim of this research was to evaluate the effectiveness of occupational therapy home program intervention for school-aged children with cerebral palsy and identify factors perceived to be important in home program practice from a parent perspective. A double blind randomised controlled trial design was used to evaluate effectiveness, where parents and evaluators were blinded to intervention. Children were randomised to three groups, home program intervention for eight weeks (“8WEEKS”), home program intervention for four weeks (“4WEEKS”), and a control group, that did not receive home program intervention (“NoHP”). The primary end-point was change in performance of functional activities and satisfaction with function as measured by the Canadian Occupational Performance Measure (COPM), after eight weeks. Secondary endpoints were change in COPM scores after four weeks, goal achievement at four and eight weeks as measured by Goal Attainment Scale (GAS), quality of arm movement at four and eight weeks measured on the Quality of Upper Extremity Skills Test (QUEST) and participation levels at four and eight weeks measured on the Children’s Assessment of Participation and Enjoyment (CAPE). Parent experience was explored through semistructured interviews of parents who participated in the home program trial. Content analysis of interview data was conducted to the level of “open coding” to identify factors. Results for the primary outcome measure at the primary end point (eight weeks) - Effect of an 8WEEK or 4WEEK home program on COPM scores: comparison between the three groups was conducted using a linear regression model with baseline COPM performance/satisfaction scores, participant age and severity of cerebral palsy as measured by the GMFCS entered into the model as covariates. Overall, there were statistically significant and clinically important differences in performance of activities and satisfaction with function on COPM when comparing either home program group to the NoHP group at eight weeks. There was no difference between 4WEEKS versus 8WEEKS on COPM performance or satisfaction scores at eight weeks. Results on secondary outcome measures: compared to NoHP, receiving a home program for either 4WEEKs or 8WEEKs increased COPM performance scores and GAS measures at four weeks, and increased COPM performance and satisfaction scores, GAS measures, and QUEST scores at eight weeks. There were no differences within or between groups on the CAPE at either four week or eight weeks. There were no statistically significant between-group differences between the 4WEEK and 8WEEK home program groups on any secondary outcome measures. This was most likely the result of a protocol implementation flaw that occurred in the study where 4WEEK group participants continued program activity for the final four weeks when they should have suspended it. Parents perceived their experience of implementing home programs as characterised by five features: ����guidance for the journey”, practice makes perfect, they were a necessary “way of life”, they maximised progress and something that made it easier to juggle competing demands. Positive home program experiences were characterised by: support, realistic expectations, flexibility, motivation from goals, activities that translated to real-life, reminders to practice, progress updates and role clarity. Parents advised other parents to: accept the disability, never refuse help, be honest, consider home programs essential, develop routines and view programs as a way of improving the child and parents’ life. No negative experiences were reported. Parents advised professionals that they wanted: support, interdisciplinary co-ordination of programs, advice without pressure and prognostic guidance for future planning. This dissertation presents new information about occupational therapy home programs. Until this study, there was little research evidence to inform therapist or parent decision-making regarding the therapeutic value of home programs or the parent perspective on home programs. Findings from this dissertation can inform clinical practice and parent decisions regarding the use of home program interventions for children with cerebral palsy.Doctor of Philosophy (PhD)
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ŠLECHTOVÁ, Dana. "Potřeba zavedení holistického přístupu v péči o dítě s diagnózou dětská mozková obrna". Doctoral thesis, 2011. http://www.nusl.cz/ntk/nusl-80036.
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