China
Africa
Explore chapters and articles related to this topic
Examination of a Child with Cerebral Palsy
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
The child’s upper limb involvement must also be noted and documented in detail.15,16 The spasticity needs to be quantified and the joint position/attitude/active and passive range of motion and presence of any contracture are noted. For example, the shoulder might have an adduction or internal rotation contracture, the elbow might be flexed and pronated, and the wrist might be flexed and deviated. All these are to be documented in detail and it is essential to do a functional assessment. There are many scoring methods for functional assessment but a description of all of them is beyond the scope of this book. The clinician must be aware of the Manual Ability Classification System (MACS) (Table 13.10) to categorize upper limb involvement and functional ability.
Neurorehabilitation
Published in Walter J. Hendelman, Peter Humphreys, Christopher R. Skinner, The Integrated Nervous System, 2017
Walter J. Hendelman, Peter Humphreys, Christopher R. Skinner
Over the last few decades, researchers have established a motor classification for CP that allows prediction of whether a child will eventually walk independently or will require the support of a walker or a wheelchair for independent mobility. This tool, the Gross Motor Function Classification System ER (expanded and revised; see Palisano et al., 2007), can allow motor prediction soon after diagnosis and the classification appears to be fairly stable into the second decade of life. Any clinician working with individuals with this diagnosis should be aware of this scale, as this knowledge will help in the setting of reasonable motor goals. Classification systems are also evolving for upper extremity function (Manual Ability Classification System; Eliasson et al., 2006) and communication (Communication Function Classification System; Cooley Hidecker et al., 2011). These systems of classification promote focused assessment, efficient and clear communication among clinicians and allow grouping of patients for treatment/monitoring protocols and multi-centre research.
Anodal Contralesional tDCS Enhances CST Excitability Bilaterally in an Adolescent with Hemiparetic Cerebral Palsy: A Brief Report
Published in Developmental Neurorehabilitation, 2023
Rodrigo G. Delatorre, Ellen N. Sutter, Samuel T. Nemanich, Linda E. Krach, Gregg Meekins, Timothy Feyma, Bernadette T. Gillick
The participant was a 14-year-old male with a history of perinatal stroke who subsequently developed spastic hemiparesis affecting the right side. His Manual Ability Classification System (MACS) level was III (“handles objects with difficulty; needs help to prepare and/or modify activities”). The participant’s structural MRI revealed cystic degeneration and significant volume loss of the left frontoparietal lobes and subcortical parenchyma, as well as dilation of the left lateral ventricle and midline shift to the left due to volume loss, consistent with an in-utero infarct of the left middle cerebral artery (Figure 1). He had no history of seizure, or of cardiac, pulmonary, GI, or renal impairment. Medications included 10 mg Lisdexamfetamine Dimesylate (Vyvanse) taken once per day in the morning.
Selecting assessment tools to characterize upper limb function of children with cerebral palsy: A mega-review of systematic reviews
Published in Developmental Neurorehabilitation, 2022
Leonardo Vinícius Thomé Teixeira da Silva, Milena Vegas, Natalia Aquaroni Ricci, Cristina S. Cardoso de Sá, Sandra Regina Alouche
Classification systems that use a common language to describe functionality are commonly used in the assessment and treatment of children with CP and in intervention research.7,8 Such classification systems include the Manual Ability Classification System (MACS)9 and the International Classification of Functioning, Disability and Health (IFC).10 However, these systems do not describe potential improvements or assess underlying etiologies.11 Classification systems are proposed as a process of grouping data with common features into classes, reducing the quantity of variables within these data,9 that is, children classified in one level are little likely to change it over time.12 The ICF has contributed to an expanded assessment of participation in activities of daily living.13 Increased use of the ICF has resulted in research that emphasized what children actually do instead of what they are thought to be able to do and significantly altered perspectives in relation to the UL function of children.14
A Preliminary Evaluation of Energy Efficiency for Children with Cerebral Palsy for Driving A Manual Wheelchair and Walking: Use of the Total Heart Beat Index
Published in Developmental Neurorehabilitation, 2020
Hirokazu Abe, Kazuhiro Inoue, Naoki Kozuka
This study provides that the energy efficiency of using a manual wheelchair depends on the participant’s gross motor function abilities. Previous studies found that the energy efficiency of walking also depends upon gross motor function.7 The significant differences we found in the THBI values between participants at GMFCS levels III and IV may be related to the severity of upper limb paralysis. This notion is supported by prior studies of patients with spinal cord injuries, which found that the energy efficiency of using a manual wheelchair was lower in tetraplegia than in lower limb paraplegia, suggesting that upper limb paralysis caused a decrease in energy efficiency.28 This study compared the THBI score using a manual wheelchair versus walking at different GMFCS levels, but it did not examine the THBI score at different levels of upper extremities function. The Manual Ability Classification System (MACS) is widely used to measure the operational ability of the upper extremities, which describes how children with CP use their hands to handle objects in daily activities.29 Previous studies have suggested that GMFCS is related to MACS.30 Further studies are required to extrapolate the difference of energy efficiency in the operational ability of upper extremities using MACS.