Journal of Pediatric Rehabilitation Medicine - Volume 17, issue 1

Authors: Mahmood, Qamar | Habibullah, Shaista | Aurakzai, Hazrat Ullah

Article Type: Research Article

Abstract: PURPOSE: This study aimed to assess the effectiveness of simple and basic home-based exercise programs (HEPs), including pediatric massage (PM), executed by caregivers at their homes in the management of children with spastic cerebral palsy (CP). METHODS: Sixty-eight children with spastic CP (diplegia) aged 4–12 years were randomly assigned to PM and HEP groups for a randomized controlled trial continuing from November 01, 2021 to June 2022. Parents provided home-based exercises to both groups, five times a week for 12 weeks. However, the PM group was additionally provided with PM. Modified Ashworth Scale (MAS), …Gross Motor Function Measure (GMFM-88) and Gross Motor Function Classification System (GMFCS) were used for evaluation of spasticity and gross motor activity at baseline as well as after six and 12 weeks of intervention. Comparative analysis of data was carried out with SPSS-20. RESULTS: Mean age in HEP and PM groups was 6.65±2.12 and 7.09±2.22 years respectively. Data revealed homogeneity of both groups at the beginning of study. The PM group showed a statistically significant decrease in MAS scores after six and 12 weeks of intervention (p  < 0.05) when compared with the HEP group, but similar changes did not happen in GMFM scores and GMFCS levels. However, comparative analysis revealed statistically significant change in GMFM scores and GMFCS levels (p  < 0.05) when compared from baseline to 12 weeks of intervention in both groups. CONCLUSION: PM along with HEPs can be used effectively to reduce spasticity and to improve gross motor ability if performed for a period of at least six and 12 weeks respectively. In conjunction with HEPs, PM has better outcomes in the management of tone and movement disorders of spastic CP than HEPs alone Show more

Keywords: Children, gross motor function, modified Ashworth scale, pediatric massage, spastic cerebral palsy

DOI: 10.3233/PRM-220135

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 17, no. 1, pp. 97-106, 2024

Authors: Meriggi, Paolo | Mandalà, Martina | Randazzo, Mattia | Brazzoli, Elena | Castagna, Anna | Di Giusto, Valentina | Cavallini, Anna | Marzegan, Alberto | Lencioni, Tiziana | Olivieri, Ivana

Article Type: Research Article

Abstract: PURPOSE: Unilateral cerebral palsy (UCP) represents about 30–40% of overall cerebral palsy diagnoses. Upper limb impairment has a significant negative impact on activities of daily living (ADL), and recent studies have shown that the use of virtual reality (VR) can increase motivation and promote an improvement in ADL. This preliminary study was aimed at exploring the acceptability and usability of a VR rehabilitation treatment, using the VITAMIN Platform, for children with UCP. A secondary goal of the study was to compare the results of usual standardized clinical scales and questionnaires with kinematic results as well as with the quantitative …measures acquired by the VITAMIN platform in each exercise of the rehabilitation sessions. METHODS: Six children with UCP (aged 7–15) were recruited for a preliminary investigation in using a non-immersive VR system. The treatment was composed of 10 weekly sessions of 45 minutes. Each child played five types of exergames, using the impaired upper limb to hit virtual objects projected on a wide screen. Standardized clinical scales, kinematic analysis, and questionnaires were used to extensively assess upper limb function before and at the end of treatment. Five typically-developing children provided a reference for the instrumented kinematic assessment. RESULTS: At the end of the treatment, Melbourne Assessment 2 (MA2) scores increased for all the participants (mean increase in range of movement (ROM) + 19.1%, accuracy + 4.6%, dexterity + 13.1%, fluency + 10.3%). Shoulder flexion-extension ROM also improved (mean increase + 10.5°), and according to the kinematic analysis, shoulder movements became more similar to reference profiles. These results were confirmed by a general improvement in performing ADL, assessed by the ABILHAND-Kids questionnaire. Finally, a general agreement among the different measures and indexes emerged from the acquired data. CONCLUSION: The results show that VR treatment with the VITAMIN platform could be engaging and functional for rehabilitation of children with UCP. The good agreement among the qualitative and quantitative measures and indexes confirms the potential of such novel treatment. However, due to the limited sample size and small number of sessions, further and larger investigations are required to evaluate the effectiveness and to generalize the results. Show more

Keywords: Virtual reality, unilateral cerebral palsy, hemiplegic children, rehabilitation, upper limb function

DOI: 10.3233/PRM-230028

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 17, no. 1, pp. 107-123, 2024

Authors: Roberts, Jeremy | Tenaglia, Amy | Bellissimo, Elisabeth | Kim, Heakyung

Article Type: Case Report

Abstract: This report describes a 15-year-old female with known spastic and dystonic quadriplegic cerebral palsy (CP), Gross Motor Function Classification System IV, and obstructive sleep apnea (OSA). She experienced decreased apneic episodes after receiving onabotulinumtoxin A (BoNT-A) injections for the treatment of oromandibular dystonia (OMD). After her OSA diagnosis, she initially received injections to the bilateral masseter and temporalis muscles with no effect on the frequency of nightly apneic episodes. Subsequently, the bilateral lateral pterygoid muscles were added and she was later noted to have fewer apneic episodes overnight. This case report describes the use of BoNT-A in the muscles of …mastication for management of OMD and the ensuing improvement in OSA in a teenager with CP. Show more

Keywords: Oromandibular dystonia, botulinum toxin, apnea, cerebral palsy, case report

DOI: 10.3233/PRM-220105

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 17, no. 1, pp. 125-129, 2024

Authors: Mirbagheri, Sedigheh Sadat | Bahramizadeh, Mahmood | Aminian, Gholamreza | Dalvand, Hamid | Farahmand, Farzam | Vahedi, Mohsen

Article Type: Case Report

Abstract: PURPOSE: This study examined the effects of a dynamic neoprene orthosis on kinematic variables of gait in children with spastic bilateral cerebral palsy (CP). METHODS: Five children (whose median age was 9.6 years and who ranged in age from six to 12) with spastic bilateral CP and flexed knee at levels I-III of the Gross Motor Function Classification System were examined using kinematic gait analysis in three different conditions: 1) with dynamic neoprene orthosis; 2) without dynamic neoprene orthosis (immediate effect); and 3) without orthosis after six weeks of intervention. RESULTS: The comparison between condition one …(with dynamic neoprene orthosis) and condition two (without dynamic neoprene orthosis) demonstrated the existence of improvements in minimum hip and knee flexion variables. Moreover, the results indicated that the improvements remained constant in several key gait variables after six weeks. CONCLUSION: The results varied from subject to subject, and there were signs of improvement in some of the subjects. Therefore, it was not possible to draw conclusions at a group level. Nonetheless, a number of individuals may benefit from this type of orthosis. Show more

Keywords: Cerebral palsy, dynamic neoprene orthosis, muscle spasticity, walking

DOI: 10.3233/PRM-200806

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 17, no. 1, pp. 131-138, 2024

Authors: MacCarthy, Matthew

Article Type: Other

Keywords: Disability, cerebral palsy, sport, lifespan, lived experience

DOI: 10.3233/PRM-240012

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 17, no. 1, pp. 139-141, 2024

Article Type: Correction

DOI: 10.3233/PRM-249001

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 17, no. 1, pp. 143-143, 2024