Hip Dislocation Indicators and CP
Recently published in the BMC Musculoskeletal Disorders 2007 Volume 8, was research hip dislocation and cerebral palsy. This study revealed that range of motion was not a good indicator of hip dislocation. Early x-rays or other indicators were more benficial to determine hip dislocation. Type of cerebral palsy influenced the risk of hip dislocation – i.e. 0% with ataxia and 79% in children with spastic tetraplegia. A direct relationship was found regarding GMFCS measure and hip dislocation with 0% of children from GMFCS Level I to 64% of children from GMFCS Level V. This group of researchers recommend early detection of hip dislocation by monitoring x-rays, GMFCS level from age 2 years old and type of cerebral palsy at age 4 years old.
Reference: Hagglund, G., Lauge-Pedersen, H., and Wagner, P. (2007) Characteristics of children with hip displacement in cerebral palsy. BMC Musculoskeletal Disorders 8: 101.
Medulloblastomas and Cognitive Impact
A review of the research in The Journal of Pediatric Psychology indicates that children who are treated for medulloblastomas (the most common central nervous system tumor in childhood) may experience decling IQ and academic struggles. Prior to this decline, children may experience problems with memory, attention and processing speed.
As therapists who may be treating children who have or have had medulloblastomas it is important for us to be aware of these potential deficits. Pre diagnosis symptoms are also important for therapists to be aware of. These symptoms include unsteadiness, headaches and vomiting due to hydrocephalus. Medulloblastomas are diagnosed quickly and progress rapidly. Improvements are being made in treatment options and survival rate is improving. Treatment may include surgery, radiation and chemotherapy. This recent reports reveals that post treatment children may suffer academically.
References:
Shawna L. Palmer , Wilburn E. Reddick , and Amar Gajjar. Understanding the Cognitive Impact on Children Who are Treated for Medulloblastoma . Journal of Pediatric Psychology Advance Access published on October 1, 2007, DOI 10.1093/jpepsy/jsl056. J. Pediatr. Psychol. 32: 1040-1049.
Packer, R. MD. Medulloblastoma. Retreived from web on 10/25/07 at http://www.childhoodbraintumor.org/02revisionMedullo.htm
Exercise Obesity and Thinking Skills
In a recent study lead by Dr. Catherine Davis, clinical health psychologist at the Medical College of Georgia, it was revealed that daily vigorous exercise can improve thinking and reduce diabetes risk in overweight children ages 7-11. Through MRI it was discovered that the children who exercised exhibited different brain activity than the children who did not exercise during an executive function task.
Reference: Baker, T. Exercise improves thinking, reduces diabetes risk in overweight children. Retreived from web at https://my.mcg.edu/portal/page/portal/News/archive/2007/3D1600D219D147BAE0440003BAD149FF on October 24, 2007.
Body Weight Support on Treadmill for Cerebellar Ataxia
To be published in the upcoming Physical Therapy journal is a case study that reports that locomotor training using body weight support on the treadmill and regular gait training resulted in improved ambulation in a client with severe cerebellar ataxia.
Reference: Cernak, K., Stevens V., Price, R., Sumway-Cook, A. Locomotor Training Using Body-Weight Support on a Treadmill in Conjunction With Ongoing Physical Therapy in a Child With Severe Cerebellar Ataxia. To be published November 2007 Physical Therapy.
Infant Swaddling
Pediatrics journal published a systemic review of reasearch on swaddling. The review discusses the advantages and disadvantages of swaddling. The authors state the advantages of swaddling a baby are longer sleep patterns, arising less and decreases pain. For preterm babies the advantages also include increase neuromusclular development, less distress, better motor organization and increased ability to self regulate.
The disadvantages to swaddling are the risk of hyperthermia, increased risk of hip dysplasia (hips are adducted and extended when swaddled) and if swaddled immediately after birth is could cause a delay of weight gain.
Reference: van Sleuwen, Bregje E., Engelberts, Adele C., Boere-Boonekamp, Magda M., Kuis, Wietse, Schulpen, Tom W.J., L’Hoir, Monique P. Swaddling: A Systematic Review Pediatrics 2007 120: e1097-e1106
Smaller Class size benefits
Medical benefits can be added to the list of benefits of smaller class sizes. A study done by researchers at the Columbia University School of Public Health demonstrated that that smaller class sizes would result in more quality-adjusted life-year gains per dollar invested than the majority of medical interventions.
Reference: Columbia University’s Mailman School of Public Health (2007) Study Shows Reducing Class Size May Be More Cost-Effective than Most Medical Interventions. Article retreived on Oct 17, 2007 from http://www.mailmanschool.org/news/display.asp?id=575
Block Play
Recent research indicated that playing with blocks can improve language development in low to middle income children.
Reference: Dimitri A. Christakis; Frederick J. Zimmerman; Michelle M. Garrison. Effect of Block Play on Language Acquisition and Attention in Toddlers: A Pilot Randomized Controlled Trial Arch Pediatr Adolesc Med 2007 161: 967-971
Premature Infants and Motor Function
Recent research reports that children who were born at less than 25 weeks gestation (without cerebral palsy) exhibited motor impairments, visual impairments and sensoriomotor impairments at 6 years of age which contibutes to school failure.
Reference: Marlow, Neil, Hennessy, Enid M., Bracewell, Melanie A., Wolke, Dieter, for the EPICure Study Group, Motor and Executive Function at 6 Years of Age After Extremely Preterm Birth Pediatrics 2007 120: 793-804
TBI and GMFM
Recent study validated the use of the Gross Motor Function Measure for evaluative measure in children and adolescents with traumatic brain injury.
Reference: Linder-Lucht, Michaela, Othmer, Verena, Walther, Michael, Vry, Julia, Michaelis, Ulla, Stein, Sabine, Weissenmayer, Heike, Korinthenberg, Rudolf, Mall, Volker, and the Gross Motor Function Measure-Traumatic Brain Injury Study Group, Validation of the Gross Motor Function Measure for Use in Children and Adolescents With Traumatic Brain Injuries Pediatrics 2007 120: e880-e886
Motor Skills and Complex Congenital Heart Disease
Recent research study indicated that children with congenital heart disease, ages 7-12 years old who were treated with surgical intervention within the first year of life, exhibit a significant difference in manual dexterity, ball skills, grip strength, quadriceps muscle strength, and static and dynamic balance than their peers without congenital heart disease.
Reference: Inger Holm; Per Morten Fredriksen; Merete Aarsland Fosdahl; Marte Olstad; Nina Vollestad Impaired Motor Competence in School-aged Children With Complex Congenital Heart Disease Arch Pediatr Adolesc Med 2007 161: 945-950.
NOVEMBER 2007 – LINKS
The American Academy of Pediatrics has released two new clinical reports that will assist doctors to recognize early signs of autism and for families to manage autism. The two reports, Identification and Evaluation of Children with Autism Spectrum Disorders and Management of Children with Autism Disorders, are detailed and informative. To view the current copies of the reports go to http://www.aap.org/advocacy/releases/oct07autism.htm