Evidence-Based, Implementable Motor Rehabilitation Guidelines for Individuals With Cerebral Palsy

Neurology, Journal Year: 2022, Volume and Issue: 99(7), P. 283 - 297

Published: June 24, 2022

Cerebral palsy is a life-long condition that causes heterogeneous motor disorders. Motor rehabilitation interventions must be adapted to the topography of symptoms, ambulatory capacity, and age individual. Current guidelines do not differentiate between different profiles individuals with cerebral palsy, which limits their implementation.To develop evidence-based, implementable for according age, capacity individual determine level priority each intervention.We used mixed methods design combined systematic review literature on available expert opinions. Based French National Authority Health methodology, recommendations were graded as strong, conditional, or weak. Interventions then prioritized by experts both evidence own opinions relevance implementability provide guide clinicians. All approved who independent from working group.Strong first-line treatments made gait training, physical activities, hand-arm bimanual intensive therapy all children adolescents palsy. Moderate against passive joint mobilizations, muscle stretching, prolonged stretching limb fixed, neurodevelopmental therapies Strong training adults moderate importance strengthening exercises ankle-foot orthoses impairment feet ankles.These guidelines, combine research opinions, could help families codetermine goals health professionals, preferences.

Language: Английский

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Three-Dimensional Instrumented Gait Analysis for Children With Cerebral Palsy: An Evidence-Based Clinical Practice Guideline

Pediatric Physical Therapy, Journal Year: 2024, Volume and Issue: 36(2), P. 182 - 206

Published: March 29, 2024

Background: Children with cerebral palsy (CP) who walk have complex gait patterns and deviations often requiring physical therapy (PT)/medical/surgical interventions. Walking in children CP can be assessed 3-dimensional instrumented analysis (3D-IGA) providing kinematics (joint angles), kinetics moments/powers), muscle activity. Purpose: This clinical practice guideline provides PTs, physicians, associated clinicians involved the care of CP, 7 action statements on when how 3D-IGA inform assessments potential It links statement grades specific levels evidence based a critical appraisal literature. Conclusions: addresses 3D-IGA’s utility to surgical non-surgical interventions, identify among segments/joints planes evaluate effectiveness Best provide guidance for about preferred characteristics laboratories including instrumentation, staffing, reporting practices. Video Abstract: Supplemental digital content available at http://links.lww.com/PPT/A524.

Language: Английский

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Prescribing Physical, Occupational, and Speech Therapy Services for Children With Disabilities

PEDIATRICS, Journal Year: 2019, Volume and Issue: 143(4)

Published: March 25, 2019

Pediatric health care providers are frequently responsible for prescribing physical, occupational, and speech therapies monitoring therapeutic progress children with temporary or permanent disabilities in their practices. This clinical report will provide pediatricians other pediatric information about how best to manage the needs of patients medical home by reviewing International Classification Functioning, Disability Health; describing general goals habilitative rehabilitative therapies; delineating types, locations, benefits therapy services; detailing write a prescription include therapists neighborhood.

Language: Английский

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Automating General Movements Assessment with quantitative deep learning to facilitate early screening of cerebral palsy

Nature Communications, Journal Year: 2023, Volume and Issue: 14(1)

Published: Dec. 14, 2023

The Prechtl General Movements Assessment (GMA) is increasingly recognized for its role in evaluating the integrity of developing nervous system and predicting motor dysfunctions, particularly conditions such as cerebral palsy (CP). However, necessity highly trained professionals has hindered adoption GMA an early screening tool some countries. In this study, we propose a deep learning-based assessment model (MAM) that combines infant videos basic characteristics, with aim automating at fidgety movements (FMs) stage. MAM demonstrates strong performance, achieving Area Under Curve (AUC) 0.967 during external validation. Importantly, it adheres closely to principles exhibits robust interpretability, can accurately identify FMs within videos, showing substantial agreement expert assessments. Leveraging predicted frequency, quantitative method introduced, which achieves AUC 0.956 enhances diagnostic accuracy beginners by 11.0%. development holds potential significantly streamline CP revolutionize field video-based medical diagnostics.

Language: Английский

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“A Different Ride”: A Qualitative Interview Study of Parents’ Experience with Early Diagnosis and Goals, Activity, Motor Enrichment (GAME) Intervention for Infants with Cerebral Palsy

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(2), P. 583 - 583

Published: Jan. 11, 2023

Cerebral palsy is the most common physical disability of childhood, and early diagnosis followed by best practice intervention important for optimizing child family outcomes. We investigated parents' views an cerebral (CP), Goals, Activity, Motor Enrichment (GAME) intervention. Semi-structured interviews were conducted within a pilot randomised clinical trial. Transcriptions analyzed using grounded theory. Participants nine mothers whose infants had received GAME because they identified as being at high risk in infancy. The parenting experience was described "different ride". devastating with many time-consuming challenges, but acceptance ensued. Parents wanted diagnosis, prognosis, intervention, despite anxiety workload, it meant could help. perceived that beneficial taught how to help; goal-based home-based. They believed collaboration communication skills therapist shaped success. Future research should focus on broader range participants understand parent's experiences key aspects more fully.

Language: Английский

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The evolution of nutrition management in children with severe neurological impairment with a focus on cerebral palsy

Journal of Human Nutrition and Dietetics, Journal Year: 2024, Volume and Issue: 38(1)

Published: Jan. 9, 2024

Abstract Nutritional management of children with severe neurological impairment (SNI) is highly complex, and the profile this population changing. The aim narrative review was to give reader a broad description evolution nutritional SNI in high resource setting. In last decade, there has been an emphasis on using multiple anthropometric measures monitor status SNI, several attempts at standardising approach have made. Tools such as Feeding Nutrition Screening Tool, Subjective Global Assessment, Eating Drinking Ability Classification System Focus Early Swallowing (FEEDS) toolkit become available. There increased understanding how gut microbiome influences gastrointestinal symptoms common use fibre these received attention. A new diagnosis, ‘gastrointestinal dystonia’, defined. acceptance blended food tube feeds major development reported benefits managing symptoms. New interventions support eating drinking skill show promise. conclusion, life expectancy people increases due advances medical nutrition care, our necessitates view long‐term health quality life. This involves balancing adequate growth, well‐being while avoiding overnutrition its associated detrimental effects.

Language: Английский

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Treating Pediatric Feeding Disorders and Dysphagia: Evidence-Based Interventions for School-Based Clinicians

Language Speech and Hearing Services in Schools, Journal Year: 2024, Volume and Issue: 55(2), P. 444 - 457

Published: Jan. 10, 2024

Children with pediatric feeding disorder (PFD) and dysphagia are increasingly prevalent in school-based caseloads. This tutorial discusses the current best practices for treating children PFD as well considerations service delivery educational settings.

Language: Английский

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The Knowledge Translation of Early Cerebral Palsy (KiTE CP) Study: Implementing Screening Among a High-Risk Prospective Cohort of Australian Infants

The Journal of Pediatrics, Journal Year: 2024, Volume and Issue: 268, P. 113949 - 113949

Published: Feb. 8, 2024

ObjectiveTo describe the implementation of international guidelines for early diagnosis cerebral palsy (CP) and engagement in screening process an Australian cohort infants with neonatal risk factors CP.Study designProspective study recruited at <6 months CA from 11 sites states Victoria, New South Wales, Queensland, Australia. First, we implemented a multi-modal knowledge translation strategy including barrier identification, technology integration special interest groups. Screening was as follows: clinical indications neuroimaging underwent magnetic resonance imaging and/or cranial ultrasound. The General Movements Assessment (GMA) recorded clinically or using app (Baby Moves). Infants absent abnormal fidgety movements on GMA videos were offered further assessment Hammersmith Infant Neurological Examination (HINE). atypical findings 2/3 assessments met criteria high CP.ResultsOf 597 (56% male) recruited, 95% (n=565) received neuroimaging, 90% (n=537) had scorable (2% unscorable/8% no video), 25% (n=149) HINE. Overall, 19% (n=114/597) CP, 57% (340/597) least two normal (of HINE), 24% (n=143/597) insufficient assessments.ConclusionsEarly CP across participating strategy. Although COVID-19 pandemic affected recruitment rates, there process. Reasons parents clinicians warrant contextualization investigation.

Language: Английский

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Uncertainties Regarding Cerebral Palsy Diagnosis

Neurology Clinical Practice, Journal Year: 2024, Volume and Issue: 14(6)

Published: Aug. 16, 2024

We have established that physicians, including neurologists, variably diagnose cerebral palsy (CP) when using the most recent CP definition from 2006. also know child neurologists and neurodevelopmentalists view themselves to be optimally suited based on their training backgrounds. Therefore, reduce variability in diagnosis, our objective was elucidate uncertainties may regarding practical application of 2006 definition.

Language: Английский

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Outcomes of a Parent-Delivered Baby-mCIMT Model for Infants at High Risk of Unilateral Cerebral Palsy Using Remote Coaching in Telerehabilitation

Children, Journal Year: 2024, Volume and Issue: 11(1), P. 101 - 101

Published: Jan. 15, 2024

There is growing evidence of the positive effects constraint-induced movement therapy (CIMT) for infants at high risk unilateral cerebral palsy (UCP) when provided by parents with in-person coaching/supervision from occupational therapists during home visits. The aim this study to investigate whether Baby-mCIMT (modifiedCIMT) can be as effective if are coached/supervised remotely. In case-control study, we recruited 20 and re-used 18 controls, 4-8-month-old in both groups UCP. same protocol regarding inclusion criteria, data collection, training volume was used groups. conducted two 6-week periods, separated a break, consisting daily 30 min sessions parents, supported therapist coaching once week. primary outcome measured using Hand Assessment Infants (HAI). no difference change HAI units (

Language: Английский

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