Cerebral palsy
Peter Lindsay in Care of the Adult with Intellectual Disability in Primary Care, 2011
Cerebral palsy is a persistent but not unchanging disorder of movement and posture due to a defect or lesion of the developing brain. The prevalence is about 2.0 to 2.5 per 1000 live births. The majority of children with cerebral palsy live to adulthood and so cerebral palsy must be regarded as a condition with which people live rather than a condition from which they die’. Individuals may begin to experience the effects of ageing in their early thirties. Clinical management of adults with cerebral palsy may be complicated by the persons inability to communicate with the doctor, resulting in an inaccurate or incomplete health history. Consequently, it is impor tant to evaluate each person as an individual and to encourage patients and their support persons to maintain accurate health records.
Cerebral palsy
James Law, Alison Parkinson, Rashmin Tamhne, David Hall in Communication Difficulties in Childhood, 2017
Cerebral palsy has no single cause or consistent set of symptoms. Increasingly, research is pointing to problems during intrauterine development and prematurity as being the most common aetiologies, rather than perinatal causes as had been assumed hitherto. Cerebral palsy is often classified according to the predominant pattern of motor impairment. Differences in classification between studies have made it difficult to establish the relative proportions of the types of cerebral palsy, and to link these to speech and language difficulties. It can be a difficult task to identify which children will not develop speech, but children with early feeding problems and abnormal bulbar signs, such as excessive drooling or opening of the mouth, are likely to be at risk. However, for many children with cerebral palsy where there is no clear aetiology, the neonatal periods and early months of life may be uneventful.
Paralytic dislocation of the hip – cerebral palsy
Benjamin Joseph, Selvadurai Nayagam, Randall Loder, Ian Torode in Paediatric Orthopaedics, 2016
Hip subluxation and dislocation are common in children with cerebral palsy. The frequency of hip dysplasia varies with the topographic pattern of involvement. Dislocation of the hip is most frequent in children with total body involvement; it is significantly less frequent in diplegics and rare in hemiplegics. The implications of hip dislocation vary profoundly. In diplegic children, hip dislocation can lead to loss of walking ability while in children with total body involvement it may result in development of painful arthritis, problems in sitting and personal hygiene. There also seems to be an association between hip dislocation and the development of scoliosis, although a causative relationship has not been proven. The primary cause for hip dislocation in all types of cerebral palsy is spasticity of the hip flexors and adductors. In a bedridden child with quadriplegic cerebral palsy, the decision to operate on a painless hip dislocation will depend on the general condition of the child.
Prevalence of Muscle Trigger Points in Children with Cerebral Palsy
Published in Physical & Occupational Therapy In Pediatrics, 1998
Marie McKenzie, Leslie Taylor, Gordon S. Cummings, Paul D. Andrew
In this study, incidence of trigger points was compared between 75 children with cerebral palsy and 25 children without neuromuscular impairment. The children with cerebral palsy were recruited to form three groups of 25 children each according to impairment of gross mobility: mild, moderate, and severe. Sixteen muscles of the upper quarter were examined manually for the presence of trigger points. Children with cerebral palsy had 3.42 times more trigger points than those without neuromuscular impairment. Fifty-four percent of all trigger points were located in the upper trapezius and teres major. No significant difference in incidence of trigger points was detected among the three groups of children with cerebral palsy. Post hoc analysis failed to reveal a relation between incidence of trigger points and type of cerebral palsy. Further research should focus on muscle trigger points in other muscles of children with cerebral palsy as well as on the functional importance of trigger points in cerebral palsy.
When I do, I become someone: experiences of occupational performance in young adults with cerebral palsy
Published in Disability and Rehabilitation, 2019
Lena Bergqvist, Ann-Marie Öhrvall, Kate Himmelmann, Marie Peny-Dahlstrand
Purpose: Persons with cerebral palsy, even if they have relatively good motor functions, have a lower level of independence and participation in everyday activities than persons of the same age without disabilities. However, there are few descriptions of how persons with cerebral palsy themselves perceive their performance of activities in everyday life. The aim of this study was to describe the perceptions that young adults with cerebral palsy have of occupational performance in everyday life. Methods: This qualitative interview study includes 10 participants with cerebral palsy classified with Manual Ability Classification System level I–II, aged 19–30 years. The data were analyzed using a phenomenographic approach. Results: The interviews resulted in five categories: “Important to do”; “Demanding but can be facilitated”; “Excludes or includes”; “Diminishes me or makes me grow”; and “Comes at a price”. Conclusions: The young adults with cerebral palsy consider that, despite life being so demanding, it is extremely important to perform activities themselves and to feel included, as this enables personal growth. Hence, it is necessary to advance intervention methods based on personally important activities to enable individuals with cerebral palsy to find their own way to perform activities. Further research is needed to increase opportunities for individuals with cerebral palsy to perform everyday activities without too much fatigue and struggle.Implications for RehabilitationFor young adults with cerebral palsy it is extremely important to perform everyday activities independently; by DOING activities they form their identity.Intervention models aimed to enable persons with cerebral palsy to be involved and find their own way to perform everyday activities should be emphasized.Attention must be paid to how mental fatigue is manifested in persons with cerebral palsy.To build self-awareness and self-efficacy, individuals with cerebral palsy need information, early in life, about cerebral palsy and the multifaceted difficulties the disability might lead to.
What makes children with cerebral palsy vulnerable to malnutrition? Findings from the Bangladesh cerebral palsy register (BCPR)
Published in Disability and Rehabilitation, 2019
Israt Jahan, Mohammad Muhit, Tasneem Karim, Hayley Smithers-Sheedy, Iona Novak, Cheryl Jones, Nadia Badawi, Gulam Khandaker
Purpose: To assess the nutritional status and underlying risk factors for malnutrition among children with cerebral palsy in rural Bangladesh. Materials and methods: We used data from the Bangladesh Cerebral Palsy Register; a prospective population based surveillance of children with cerebral palsy aged 0–18 years in a rural subdistrict of Bangladesh (i.e., Shahjadpur). Socio-demographic, clinical and anthropometric measurements were collected using Bangladesh Cerebral Palsy Register record form. Z scores were calculated using World Health Organization Anthro and World Health Organization AnthroPlus software. Results: A total of 726 children with cerebral palsy were registered into the Bangladesh Cerebral Palsy Register (mean age 7.6 years, standard deviation 4.5, 38.1% female) between January 2015 and December 2016. More than two-third of children were underweight (70.0%) and stunted (73.1%). Mean z score for weight for age, height for age and weight for height were −2.8 (standard deviation 1.8), −3.1 (standard deviation 2.2) and −1.2 (standard deviation 2.3) respectively. Moderate to severe undernutrition (i.e., both underweight and stunting) were significantly associated with age, monthly family income, gross motor functional classification system and neurological type of cerebral palsy. Conclusions: The burden of undernutrition is high among children with cerebral palsy in rural Bangladesh which is augmented by both poverty and clinical severity. Enhancing clinical nutritional services for children with cerebral palsy should be a public health priority in Bangladesh.Implications for RehabilitationPopulation-based surveillance data on nutritional status of children with cerebral palsy in Bangladesh indicates substantially high burden of malnutrition among children with CP in rural Bangladesh.Children with severe form of cerebral palsy, for example, higher Gross Motor Function Classification System (GMFCS) level, tri/quadriplegic cerebral palsy presents the highest proportion of severe malnutrition; hence, these vulnerable groups should be focused in designing nutrition intervention and rehabilitation programs.Disability inclusive and focused nutrition intervention programme need to be kept as priority in national nutrition policies and nutrition action plans specially in low- and middle-income countries.Community-based management of malnutrition has the potential to overcome this poor nutritional scenario of children with disability (i.e., cerebral palsy). The global leaders such as World Health Organization, national and international organizations should take this in account and conduct further research to develop nutritional guidelines for this vulnerable group of population.
Related Knowledge Centers
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