Intervention and CP
Pediatric Neurology published research on a study comparing 40 children under six years old with cerebral palsy and the intensity of rehabilitation services. One group underwent one year of rehab services 2 times per week. The other group, received one month of twice daily, rehab services followed by 2x/week services for five months and then the cycle was repeated to complete the year. Results indicated a 37% improvement in gross motor function overall. The group that received the intensive services showed the largest improvements in gross motor function. The authors recommend increasing services at younger ages.
Reference: Chiara Gagliardi MD, Cristina Maghini MD, Chiara Germiniasi MD, Giuseppe Stefanoni PT, Francesca Molteni PT, D. Michael Burt PhD and Anna C. Turconi MD. The Effect of Frequency of Cerebral Palsy Treatment: A Matched-Pair Pilot Study Pediatric Neurology Volume 39, Issue 5, November 2008, Pages 335-340
Predicting DCD in Premature Children
The most recent issue of Archives of Disease in Childhood published a research study on 8 year old children born at less than 29 weeks or less than 1000 g at birth and the prevalence of developmental coordination disorder (DCD). Forty two percent of the children scored less than one standard deviation below the norm on the Movement Assessment Battery for Children. Thirty percent scored more than 1.5 SD below the norm. The best predictor of DCD was a motor score of less than 27th percentile on the Peabody Motor Scales at 3 years of age. DCD was also associated with prolonged rupture of membranes and retinopathy of prematurity.
Reference: Goyen, Traci-Anne, Lui, Kei Developmental coordination disorder in ‘apparently normal’ school children born extremely preterm Arch Dis Child 2008 0: adc.2007.134692
ASD and Sensory Processing
The American Journal of Occupational Therapy published a study comparing children with autism spectrum disorder (ASD) to their typically developing peers with regards to sensory processing and educational results. Children with ASD exhibited scores on the Short Sensory Profile for Underresponsive/Seeks Sensation and Auditory filtering which effected academic performance. The researchers found negative correlations between:
- auditory filtering and inattention
- tactile hypersensitivity and hyperactivity and inattention
- movement sensitivity and oppositional behavior.
Reference: Jill Ashburner-BOccThy, PhD, Jenny Ziviani-BAppSc(OT), BA, Med, PhD, Sylvia Rodger BOccThy, MEdST, PhD (2008) Sensory Processing and Classroom Emotional, Behavioral, and Educational Outcomes in Children With Autism Spectrum Disorder AJOT 65:5 abstract.
Nerve Palsy and Hamstring Lengthenings
The Journal of Pediatric Orthoepdics published a review of medical records to determine the rate of nerve palsy in children following hamstring lengthening surgery. According to the review of the records, 9.6% of children had nerve palsy following the surgery. Treatment for the nerve palsy was immediate knee flexion with 82.1% having relief of symptoms.
Reference: Karol, Lori A. MD ; Chambers, Carol PT ; Popejoy, Debra MD ; Birch, John G. MD Nerve Palsy After Hamstring Lengthening in Patients With Cerebral Palsy.Journal of Pediatric Orthopaedics. 28(7):773-776, October/November 2008.
Remote Effects of Botox Injections
Pediatric Neurology published recent research that injections of Botox A in the lower extremities in children with cerebral palsy did not effect upper extremity muscle strength.
Reference: Beth E. Crowner PT, DPT, MPPA and Brad A. Racette MD (2008) Prospective Study Examining Remote Effects of Botulinum Toxin A in Children With Cerebral Palsy Pediatric Neurology Volume 39, Issue 4, October 2008, Pages 253-258
Muscle Strength and Walking in CP
Gait and Posture reports on a recent study that indicates decreased muscle strength in children with bilateral spastic cerebral palsy effects walking ability. The researchers recorded a high correlation between muscle strength and the Gross Motor Function Measure. Muscle weakness was noted the most in the ankles followed by the hips.
Reference: Meta Nyström Eek and Eva Beckung (2008) Walking ability is related to muscle strength in children with cerebral palsy Gait & Posture Volume 28, Issue 3, October 2008, Pages 366-371
Tilt In Space Wheelchair Use
The Archives of Physical Medicine and Rehabilitation recently published research on the use of a new, manual wheelchair equipped with rear anti tip device as compared to a traditional “tilt in space” wheelchair. Caregivers tested the two chairs. It was reported that the manual wheelchair with the rear anti tip device had better wheelchair handling, wheelchair satisfaction and less exertion.
Reference: R. Lee Kirby MD, Blair MacDonald BS, Cher Smith BSc, OT, Donald A. MacLeod MSc and Adam Webber MSc (2008) Comparison Between A Tilt-in-Space Wheelchair and a Manual Wheelchair Equipped With a New Rear Anti-Tip Device From the Perspective of the Caregiver Archives of Physical Medicine and Rehabilitation Volume 89, Issue 9, September 2008, Pages 1811-1815
Childhood Obesity and Hypertension
The current issue of Pediatrics reports that children (ages 4-17 years old) who live in rural Canada exhibited a strong relationship between being overweight and obese and high blood pressure. The authors recommended further studies on whether improved diet, physical activity and environment would decrease the higher rates of blood pressure.
Reference: Salvadori, Marina, Sontrop, Jessica M., Garg, Amit X., Truong, Jennifer, Suri, Rita S., Mahmud, Farid H., Macnab, Jennifer J., Clark, William F. Elevated Blood Pressure in Relation to Overweight and Obesity Among Children in a Rural Canadian Community Pediatrics 2008 122: e821-e827
Assessment after Botox
Pediatric Physical Therapy published a research article on assessments following botox injections and casting to treat equinus gait in 10 children with cerebral palsy (ages 26-75 months) . Pre- assessments and post assessments (one week following cast removal) were performed. Improvements were seen on the Modified Ashworth Scale, Modified Tardieu Scale and PEDI (in mobility, self care and social function). Gait analysis revealed slower cadence and speed. The researchers recommend raising the minimum age and to delay gait analysis.
Reference: Kelly, Barbara PT, BSc; MacKay-Lyons, Marilyn J. PT, PhD; Berryman, Susan PT, BSc; Hyndman, Joe MD; Wood, Ellen MD Assessment Protocol for Serial Casting After Botulinum Toxin A Injections to Treat Equinus Gait. Research Report Pediatric Physical Therapy. 20(3):233-241, Fall 2008
Stretch Break for Kids: This is a free download to put on computers to remind children to take a break
from computer time and stretch. There are a few great things about this program:
- It’s free!
- You can program the order and how often the stretches are performed.
- There are a few stretches that are great proprioceptive warm-ups for children.
- It can be done with no adult assistance.
- Did I mention it is free!
Here is the link to get it: http://www.paratec.com/sbform/kidsform.htm