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Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Occasionally, evidence of a spastic paraparesis will be found in asymptomatic subjects and, unless serial neurologic examinations have been performed, it is not possible to know whether these signs are static (e.g. representing mild spastic cerebral palsy) or represent a progressive disorder. If HSP is suspected, such subjects should be classified as probably affected and examined serially.
Neurological disorders
Published in Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize, Developmental and Adapted Physical Education, 2019
Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize
In order to avoid contraindicated activities, consultation with physicians and physical therapists is required. Children with spastic cerebral palsy should avoid activities that increase tension in already-tight muscles. For example, leg extensions might cause adduction in the lower extremities and would be contraindicated in some children. Likewise, children who experience grasping and releasing problems should not be evaluated for muscular strength using a hand-grip dynamometer.
Signs and Symptoms in Psychiatry
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Spastic dysarthria is caused by bilateral damage of corticobulbar tracts. It is commonly caused by spastic cerebral palsy, multiple sclerosis, amyotrophic lateral sclerosis, multiple strokes, and closed head injuries. Speech in spastic dysarthria is slow, labored, and has a harsh vocal quality and excessive nasal resonance. Articulation is imprecise with slurred sound productions and periods of speech unintelligibility. Other neurological manifestations of UMN damage are usually evident in individuals with spastic dysarthria.
Do physical activity interventions influence subsequent attendance and involvement in physical activities for children with cerebral palsy: a systematic review
Published in Disability and Rehabilitation, 2022
Gaela Kilgour, Brooke Adair, Ngaire Susan Stott, Michael Steele, Amy Hogan, Christine Imms
The 13 identified studies included six RCTs of physical activity interventions compared to usual care [36–41], five RCTs of physical activity interventions compared to other interventions [42–46], and two physical activity interventions investigated as case series [47,48] (Table 1). The level of evidence was II for all 11 RCTs and IV for the two case-series using the Australian Government National Health and Medical Research Council criteria [49]. Across the 13 studies, there were a total of 478 participants with cerebral palsy, with 6–34 participants included in the intervention groups (mean age 10.2 years, range 4–16.7 years). Participants were predominantly described as having spastic cerebral palsy, with unilateral or bilateral limb involvement. All GMFCS levels were represented, but there was a predominance of children functioning at GMFCS I or II. In total, 13 children classified at GMFCS IV were included in treatment and comparison groups [44,50] and one classified at GMFCS V [50].
Longitudinal Changes in the Sensorimotor Pathways of Very Preterm Infants During the First Year of Life With and Without Intervention: A Pilot Study
Published in Developmental Neurorehabilitation, 2021
Sonia Khurana, Megan E Evans, Claire E Kelly, Deanne K Thompson, Jennifer C. Burnsed, Amy D. Harper, Karen D. Hendricks-Muñoz, Mary S Shall, Richard D Stevenson, Ketaki Inamdar, Gregory Vorona, Stacey C Dusing
Quantifying changes in the CNS in response to intervention would aid in the development and subsequent efficacy assessment of evidence-based interventions for infants at high-risk of motor impairments. At present, only a handful of studies have evaluated changes in the CNS in response to intervention in children. For instance, DTI done on children receiving constraint induced movement therapy12 and Hand and Arm Bimanual Intensive Therapy Including Lower Extremities13 reported corticospinal tract reorganization post-intervention. However, this work was completed in older children with longstanding brain injuries and a diagnosis of unilateral spastic cerebral palsy. While this evidence indicates the neuroplastic benefits of rehabilitation interventions, additional research looking at intra and inter-subject variability, and changes in neural connectivity over time in response to rehabilitation, are required to evaluate the associations, understand the mechanisms, and identify the causal pathways.
Economic evaluations of physiotherapy interventions for neurological disorders: a systematic review
Published in Disability and Rehabilitation, 2020
Stanley Winser, Sing Hong Lee, Hung Sing Law, Hei Yuen Leung, Umar Muhammad Bello, Priya Kannan
Weindling et al. [18] and Adie et al. [12] drew a negative conclusion for cost-effectiveness of interventions tested. However, it is worth noting that Weindling et al. [18] concluded additional intervention by family or physiotherapy assistant in children with spastic cerebral palsy to be cost ineffective. Likewise, Adie et al. [12] compared novel physiotherapy to conventional physiotherapy (Wii against traditional arm exercise) for rehabilitation of stroke patients. Considering the cost-ineffectiveness of providing additional therapy to conventional intervention, future studies testing the benefits of additional therapies such as the Wii or extra therapy need to consider conducting a cost-effectiveness estimation extension to RCT to provide evidence for the cost-effectiveness of the proposed modification to conventional physiotherapy treatment.