Botox and Serial Casting

The Journal of Pediatric Orthopedics reports on a recent pilot study regarding immediate serial casting versus delayed casting by 4 weeks following botox injections in the gastrocs.  The results of this study indicated that greater range of motion was achieved and decreased pain was reported in the delayed casting group of children.  Range of motion measurements were taken at 3 months and 6 months post botox injections.

Reference:  Newman, C MD, Kennedy, A PT, Walsh, M. PT, et al  (2008) A Pilot Study of Delayed Versus Immediate Serial Casting After Botulinum Toxin Injection for Partially Reducible Spastic Equinus. Journal of Pediatric Orthopaedics. 27(8):882-885, December 2007.


Risk Factors and ADHD

The most recent issue of Pediatrics reports on the Etiologic Classification of Attention-Deficit/Hyperactivity Disorder.  The author, Dr.  J. Gordon Millichap, MD, FRCP, provides an overview of risk factors and considerations for ADHD.  He reports on prenatal risk factors such as prematurity, maternal smoking and alcohol use and more.  Some childhood illnesses put a child at risk for ADHD such as virus infections, meningitis, encephalitis, head injury, epilepsy and toxins.  Dr. Millichap recommends early diagnosis to better manage the disorder.

Reference:  Millichap, J. Gordon Etiologic Classification of Attention-Deficit/Hyperactivity Disorder Pediatrics 2008 121: e358-e365


Prematurity Effects at 12 Years of Age

Pediatrics reports on recent research comparing 12 year old children with a birth history of prematurity (without neonatal brain injury) versus full term infants.   The 29 children studied with prematurity had significantly different scores with regards to full scale, verbal and performance IQ and Developmental Visual Motor Integration.  In addition, imaging studies showed decreased fiber tract organization in the 12 year old brains of the preterm group.

Reference:  Constable, R. Todd, Ment, Laura R., Vohr, Betty R., Kesler, Shelli R., Fulbright, Robert K., Lacadie, Cheryl, Delancy, Susan, Katz, Karol H., Schneider, Karen C., Schafer, Robin J., Makuch, Robert W., Reiss, Allan R. Prematurely Born Children Demonstrate White Matter Microstructural Differences at 12 Years of Age, Relative to Term Control Subjects: An Investigation of Group and Gender Effects Pediatrics 2008 121: 306-316.


Conductive Education and Hand Function

Archives of Physical Medicine and Rehabilitation reports that conductive education improved hand functions during activities of daily living in children with cerebral palsy although there was no effect on elementary hand functions.

Reference:  Blank, R. MD, von Kries, R. MD, Heese, S. MD, vonVoss, H. MD. (2008) Conductive Education for Children With Cerebral Palsy: Effects on Hand Motor Functions Relevant to Activities of Daily Living. Archives of Physical Medicine and Rehabilitaiton 89(2): 251-259.


Fine Motor Skills and Amblyopia

Investigative Ophthalmology and and Visual Science reports that children with a diagnosis of amblyopia (“lazy eye”) when compared to control group had significantly decreased fine motor skills especially with regards to manual dexterity tasks that required speed and accuracy.

Reference:  Ann L. Webber, Joanne M. Wood, Glen A. Gole, and Brian Brown The Effect of Amblyopia on Fine Motor Skills in Children Invest. Ophthalmol. Vis. Sci. 49: 594-603.