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The Spastic Hip – Hip Flexion in Spastic Cerebral Palsy
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
An 8-year-old boy with a history of spastic triplegia presented with progressive gait disturbance and loss of endurance. He had previously been treated with physical therapy, serial casting, and BOTOX injections. He used a hinged ankle-foot orthosis and required a posterior walker for support, and at night he wore dynamic knee extension orthoses. Despite all of this, he developed progressive knee flexion and walked on his toes. He had occasional anterior knee pain, and got tired very quickly. While he had functioned at the GMFCS 3 level previously, his function had deteriorated to GMFCS 4.
Pediatric Imaging in General Radiography
Published in Christopher M. Hayre, William A. S. Cox, General Radiography, 2020
Allen Corrall, Joanna Fairhurst
Cerebral palsy describes a range of disabilities resulting from an insult during brain development. Depending on when in it occurs during neuronal development and the extent of the insult, the child can be hemiplegic with normal intelligence but often suffers with visual deficits and epilepsy; diplegic, which predominantly affects the lower limbs with normal levels of intelligence, or quadriplegic with varying levels of developmental, visual and occasionally oromotor impairments, and poor trunk control requiring supportive wheelchairs. The Gross Motor Function Classification System (GMFCS) is used to show the mobilizing abilities of the child. This ranges from mild motor control problems causing clumsiness but otherwise fully mobile through to spastic quadriplegia with little or no muscular control requiring splints and orthoses.
Orthopaedics and Fractures
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Children are often classified according to the GMFCS (Gross Motor Function Classification System), which allows the treating team to predict, with some accuracy, the likelihood that the child will be able to function independently as a young adult. It must be remembered that a child does not have to be able to walk to function independently and treatment should not be directed at ‘getting the child to walk’ at any cost. There may be considerable differences in treatment aims for the GMFCS I–III children compared to their non-walking GMFCS IV/V counterparts.
Can items on the TIMP aide in determining the motor performance of children with severe cerebral palsy? A pilot study
Published in Physiotherapy Theory and Practice, 2023
Sébastien Vanderlinden, Delphine Dispa, Fanny Gustin, Clémence Arets, Gay L. Girolami, Hélène M. Larin
Building on recommendations from Russell et al. (2000) and based on the successful use of the TIMP for populations other than preterm infants and infants at high risk for motor delays, Vermeire (2012) conducted a study to determine if the TIMP might be a reliable tool to quantify motor performance in children with severe quadriplegic cerebral palsy. Vermeire’s rationale was based on two premises. First, before 6 months, infants and severely involved children do not possess sufficient postural control to organize a variety of positions against gravity, and present with a predominance of extension, poor motor organization and poor coordination. Second, the global motor development, based on test scores on the GMFM-88, has shown children classified as GMFCS Level V plateau in their motor skill acquisition at about 3 years of age (Rosenbaum et al., 2002). Therefore, having another standardized assessment tool with the sensitivity to capture changes in motor performance in severely involved children would be beneficial for clinicians working with this population. In addition, it would be important to determine if that tool might be able to demonstrate changes in the performance of severely involved children after the age of three years.
Translation, reliability and validity of the Greek functional mobility scale (FMS) for children with cerebral palsy
Published in Disability and Rehabilitation, 2022
Vasileios C. Skoutelis, Zacharias Dimitriadis, Efstratia Kalamvoki, Stamatis Vrettos, Vasileios Kontogeorgakos, Argirios Dinopoulos, Panayiotis Papagelopoulos, Anastasios Kanellopoulos
In the present study, the Greek translation of the GMFCS was used for concurrent validity testing, which has been found to have good reliability (κ = 0.80, 95% CI = 0.67–0.94) [26]. The GMFCS is a valid five-level, age categorized system, which is globally used in clinical practice and research to describe the gross motor function performance and the severity of motor disability in children with CP. Differences between GMFCS levels are based on functional abilities and limitations (I = independent ambulation; II = independent ambulation with limitations; III = ambulation with walking aids; IV = self-locomotion using wheeled mobility; V = dependent locomotion and transportation by others). The GMFCS has different descriptors for five different age bands (under 2 years, 2 to < 4 years, 4 to <6 years, 6 to <12 years and 12 to <18 years). It has been found to be valid in many countries [6].
Investigation of the validity and reliability of the L test in children with cerebral palsy
Published in Physiotherapy Theory and Practice, 2022
Sebahat Yaprak Cetin, Suat Erel
Cerebral palsy (CP) is a motor disorder in which the brain is damaged before or shortly after birth. Individuals with CP may experience problems with muscle coordination and the organization and processing of sensory information. In these individuals, functional mobility is impaired by spasticity and musculoskeletal problems. Although approximately 60% of individuals with CP are able to walk, they experience problems in balance and functional mobility (Morgan and McGinley, 2018). There are individualized exercise programs that improve the functional balance and mobility of individuals with CP who are able to walk (Morgan and McGinley, 2018). Improving functional mobility in physical therapy is one of the most important goals (Zaino, Marchese and Westcott, 2004). The components of functional mobility are gait, dynamic postural control, and the skill of climbing stairs (Nicolini-Panisson and Donadio, 2013). Good functional mobility enables children with cerebral palsy to be independent in their physical activities and helps them to adapt to daily life (Lawrence et al., 2016). Therefore, determination of functional mobility levels of children with CP is very important in terms of both the creation of rehabilitation programs and the assessment of treatment results. The Gross Motor Functional Classification System (GMFCS) is a 5-level motor function classification system designed to reflect gross motor functional problems that are significant in the daily lives of children with CP (Russman, 2007). The levels in this system differ according to the functional mobility of the child (Russman, 2007).