What scales exist to distinguishing between choreoathetosis and dyskinetic movement impairments in pediatric Cerebral Palsy (CP)? Choreoathetos is characterized by irregular involuntary movements that may involve the fa e, neck, trunk, extremities, or respiratory muscles, giving an appearance of restlessness. Onbaliu E et al from Department of Rehabilitation Sciences, Belgium discuss the use of the Dyskinesia Impairment Scale (DIS) by Physical therapists (PT) in the European Paediatric Neurology Society Journal 04/25/2013.
Posts Tagged ‘Cerebral palsy’
8 Apr
Balance, mobility and falls in adult CP population
The Physiotherapy Department, School of Primary Health Care, Monash University , Frankston , Australia are working on establishing a falls risk predictor for the adult CP population between 30-65 years. Dr. Morgan and team look at a predictive relationship of standardised measures of functional mobility, gait decline, falls history and risk scores, and Gross Motor Function Classification System (GMFCS) level.
3 Apr
Improving walking ability in CP patients
A comparison of Treadmill training and overground walking exercise practice in Cerebral Palsy CP patients presented in Clinical Rehabilitation, 04/03/2013 by Grecco LAC et al shows greater improvements in functional mobility, functional performance, gross motor function and functional balance in children for the treadmill training group. The research was conducted in the center for Rehabilitation Sciences, Universyt Nine July, São Paulo, SP, Brazil.
7 Mar
Reducing the risk of impairment of body structure and function in CP patients
Published in Clinical Rehabilitation, 03/06/2013 Rodby-Bousquet E and team from Department of Orthopaedics, Lund University, Skåne University Hospital, Lund, Sweden show that the Posture and Postural Ability Scale could reliably detect postural asymmetries in adults with cerebral palsy. The adults were cerebral palsy patients aged 19-22 years with levels I-V of the Gross Motor Function Classification System. Postural asymmetries are thought to lead to impairment of body structure and function such as muscle imbalance, gait asymmetry and possible chronic conditions therefore clinicians should include postural assessment as part of their routine evaluations in an effort to achieve postural symmetry and reduce the risk of chronic conditions associated with impairment of body structure and function in CP patients.
28 Feb
Group-based constraint-induced movement therapy (CIMT) effective and feasible
Published in the American Journal of Occupational therapy (AJOT) Wen-Chi Wu OTR/L and her team from Department of Rehabilitation, Kaohsiung Chang Gung Memorial Hospital look at the feasibility and effectiveness of group-based constraint-induced movement therapy (CIMT) for children with hemiplegic cerebral palsy in a clinical setting.
The group of 7 children underwent CIMT at a dose of 2.5 hr/day at 5 days/wk for 4 weeks
Outcome measures used were Grasping and Visual–Motor Integration subtests of the Peabody Developmental Motor Scales and Functional Skills and Caregiver Assistance Scales of the Pediatric Evaluation Disability Inventory.
The group showed that the children demonstrated significant improvement on all outcome measures after intervention and that group-based CIMT for children with hemiplegic cerebral palsy may be a feasible and effective alternative to individual CIMT in clinical practice.
11 Feb
Plasticity targets for physical and occupational therapy after brain injury
Dr. Kirton from the Calgary Pediatric Stroke Program at Alberta Children’s Hospita, Department of Pediatrics and neurology looks at a model of plastic motor development after perinatal stroke that causes motor disability and hemiparetic cerebral palsy. The research aims at finding therapeutic targets that can be used to direct evidence based physical and occupational therapy rehabilitation techniques and improve rehabilitation outcomes after brain injury.
5 Feb
Young adults with unilateral CP maintain their hand function into early adolescent
Dr Ann-Christin Eliasson from the Neuropediatric Research Unit in the Children’s Hospital Stockholm Sweden did a six years follow up assessment on children undergoing Modified Constraint Induced Movement Therapy (CIMT) Program. The group aimed at looking at what happened to the childrens hand function when these children are now young adults.
The group describe the development of hand function in young adults with unilateral cerebral palsy (CP), who participated in a 2-week Constraint Induced Movement Therapy (CIMT) camp 6 years earlier. The outcome measure looked at was the Hand Assessment and the Jebsen-Taylor Hand Function test as well as grip strength.
27 Jan
Employment outcomes of adults with cerebral palsy
CP employment outcomes
Writing in the January edition of Disability Rehabilitation, Dr. Huang and colleagues from the Graduate Institute of Rehabilitation Counseling, National Changhua University of Education , Changhua , Taiwan look at Employment outcomes of adults with cerebral palsy in Taiwan. The group found that the employment rate for adults with CP is 22.9% with 67% of these individuals working in an integrated setting, 14% in supported employment, and 19% in sheltered employment.
The group consider that age, CP diagnosis, educational attainment, and functional performance all contribute to employment outcomes and suggest more research to determine which effective medical and vocational rehabilitation interventions improve employ ability of people with CP.
18 Dec
Multiple Sclerosis Symptom Guidelines
Blurred or double vision
Weakness in one or more limbs
Cognitive difficulties
Sudden onset of paralysis
Slurred speech
Lack of coordination
Early symptoms of MS include:
Tingling
Loss of balance
Numbness
Later, as the disease progresses, other symptoms may appear such as fatigue, muscle spasms, sensitivity to heat, sexual disturbances and changes in thinking or perception.
Fatigue is typically present in the afternoon and may include increased muscle weakness, mental fatigue, or sleepiness. Many patients with MS complain of fatigue even after a good night’s sleep.
Heat sensitivity which can worsen symptoms occurs in most people with MS.
Spasticity. Muscle spasms are a common symptom of MS. Spasticity affects the muscles of the legs and arms, and may interfere with being able to move those muscles freely.
Dizziness. A feeling of “off balance” or lightheadedness or that the surroundings are spinning is common; this is called vertigo. These symptoms are due to damage in the complex nerve pathways that coordinate vision and are needed to maintain balance.
Impaired thinking occurs in about half of the people with MS. This can manifest itself by slowed thinking, decreased concentration, or decreased memory. 10% of people with the disease have it so severe that they cannot carry out tasks of daily living.
Vision problems can include blurring or graying of vision or blindness in one eye.
Abnormal sensations. Many MS patients experience sensations such as numbness, “pins and needles,” burning, itching, stabbing, or tearing pains. Even though these symptoms are aggravating, they are not life-threatening and can be treated.
Speech and swallowing problems in people with MS are caused by damaged nerves that normally would aid in performing these tasks.
Tremors are fairly common in people with MS and can be debilitating and difficult to treat.
Difficulty walking is among the most common symptoms of MS. This is related to muscle weakness and/or spasticity. Balance problems or numbness in the feet can also make walking difficult.
There are other rare symptoms which include breathing problems and seizures.
The symptoms can be divided into three categories: primary, secondary, and tertiary.
Primary symptoms are a result of the impairment of the transmission of electrical signals to muscles and the organs of the body. These symptoms include: tremors, weakness, tingling, paralysis, loss of balance, numbness, vision impairment and bladder or bowel problems. These can be kept under control through the use of medication and rehabilitation.
Secondary symptoms are a result of primary symptoms. For example, paralysis can lead to bedsores and bladder or urinary incontinence can cause frequent urinary tract infections. Although these symptoms can be treated, the ideal goal is to treat the primary symptoms.
Tertiary symptoms include psychological, social, and vocational complications that are associated with the primary and secondary symptoms. Depression can be a common problem for those with MS.
Deterioration of the protective sheath (known as Demyelination) that surrounds nerve fibers, can occur anywhere in the brain or spinal cord. Demyelination in the nerves that communicate with the muscles causes problems with movement (called motor symptoms) and demyelination along the nerves that carry messages to the brain causes disturbances in sensation.
Multiple sclerosis is a varied and unpredictable disease. For many people, it starts with a single symptom, followed by months or longer without any progression of symptoms. In others, the symptoms can become worse within weeks or months.
There are many symptoms, as stated above, but it is important to know that a given individual may only experience some of the symptoms and not others. With some the symptom may occur and then disappear. It is not wise to compare one MS patient with another.
When the symptoms reach a level where physical rehabilitation can be helpful the most effective solutions should be incorporated into the patient rehabilitation treatment program. Such solutions would include the TUTORs. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are ergonomic wearable devices together with powerful dedicated rehabilitation software. The system is indicated for patients in rehabilitation centers,, private clinics and the home supported by telerehabilitation. The TUTORs have been used to create an intensive exercise program for patients who have had MS or stroke, Parkinson’s disease, head or brain injuries, CP and other upper and lower limb disabilities.
Currently in use in leading U..S. and European rehab facilities the TUTORs are fully certified by the FDA and CE.
See WWW.MEDITOUCH.CO.IL for further information.
13 Dec
Music/ Dance Therapy for CP Patients
She has developed some studies on the effect of music on movement and how it can be used to train movement in children that have cerebral palsy. It makes intuitive sense that people move much better with music. She has analyzed how music can change, for example, the length of the motor segments in an arm task. She has found evidence that certain types of music can also assist with relaxation. There are different musical genres or rhythms that are more likely to produce a slow movement, which would not necessarily elicit a quick stretch, vis a vis those that would be more excitatory and therefore result in more spasticity. Dr. Gaebler-Spira says that this is only preliminary research, and is very interesting. She also says that it probably has applicability to other disorders.
Aside from the values and advantages of music or dance therapy as a tool for Cerebral Palsy for children and adults other physical therapy products such as the TUTOR system are available for rehabilitation use as well for CP, MS, brain or spinal cord injuries, stroke, Parkinson’s disease, Radial and Ulnar nerve injuries and several other upper or lower limb disabilities.
The Meditouch rehabilitation system consists of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR which are ergonomic wearable devices together with powerful dedicated rehabilitation software. The TUTORs are indicated for children from the age of 5 and up as well as adults at home through telerehabilitation.
The TUTOR system consists of motivating and challenging games that allow the patient to practice isolated and/or interjoint coordination exercises. This exercise practice helps to prevent the development of compensatory movement patterns. The therapists monitor the exercise and customize a specific program for that patient. The TUTOR system optimizes the patient’s sensory, cognitive and motor performance in order to better perform everyday functional tasks.
