Tag: mózgowe porażenie dziecięce

Body composition and spasticity in children with bilateral cerebral palsy

Lawia Szkoda, Andrzej Szopa, Ilona Kwiecień-Czerwieniec, Małgorzata Domagalska-Szopa


Lawia Szkoda, Andrzej Szopa, Ilona Kwiecień-Czerwieniec, Małgorzata Domagalska-Szopa – Body composition and spasticity in children with bilateral cerebral palsy. Fizjoterapia Polska 2022; 22(2); 174-185

Abstract
Objective. The objective of this study was to identify the correlation between body composition of children with cerebral palsy and the degree of spasticity in the muscles of the lower limbs.
Material and methods. The study included a group of 59 independently walking children aged 8 to 16 with spastic diplegia. The control group included 59 children without central movement disorders – students at Primary School No. 25 in Sosnowiec. The research included: 1) assessment of body composition and its components using the TANITA MC-780 S MA scale; 2) assessment of the degree of spasticity according to the modified Ashworth scale; 3) calculations of BMI indices in accordance with the recommendations of the World Health Organization (WHO) and BMI OLAF developed by the Children’s Memorial Health Institute in Warsaw.
Results. The most severe spasticity, both in the right and left lower limbs, was observed in the extensors of the ankle joint. In turn, the mildest spasticity was observed in the group of flexors of the knee joint of the right and left lower limbs. The greater the degree of spasticity in the muscles of the lower limbs, the greater the deficit in fat-free mass and muscle mass in the lower limbs.
Conclusions. Children with CP have deficits in terms of muscle mass. The deficit of muscle tissue depends on the degree of spasticity of the proximal muscle groups of the lower limbs.
Key words:
body composition, spasticity, cerebral palsy
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Online-based versus photos-based home programs on upper extremity functions for children with hemiplegic cerebral palsy following botulinum toxin injection

Eslam E. Hassan, Khaled A. Mamdouh, Samia A. Abdel Rahman, Tarek E.I. Omar

Eslam E. Hassan, Khaled A. Mamdouh, Samia A. Abdel Rahman, Tarek E.I. Omar – Online-based versus photos-based home programs on upper extremity functions for children with hemiplegic cerebral palsy following botulinum toxin injection. Fizjoterapia Polska 2021; 21(5); 112-116

Abstract
Background. Online-based home program allows continuous care at any time controls the economic demand and is considered as a perfect method for infection control. This study was conducted to study the effect of adding online-based versus photos-based home program to the traditional physical therapy program, on hand grasping skills and range of motion of wrist extension and forearm supination of the affected upper extremity for children with hemiplegic cerebral palsy following botulinum toxin A injection. Materials and methods. Thirty children with hemiplegic cerebral palsy were classified into two equal groups (A and B). Both groups received traditional physical therapy program in clinic in addition to online-based home program for group (A) and conventional photos-based home program for group (B). The measured variables were the grasp domains of Quality of Upper Extremity Skills Test and range of motion of wrist extension and forearm supination using electronic digital goniometer for the affected upper extremity before as well as after three successive months of treatment. Results. The study revealed significant improvement of all measured variables in both groups in post treatment compared to pretreatment values. Regarding between groups comparison, there was significant improvement in group (A) post treatment regarding grasp domain score compared to group (B), while there was non-significant difference regarding the range of motion of wrist extension and forearm supination. Conclusion. Adding online-based home program is more effective than adding photos-based home program to the traditional physical therapy program in improving hand grasping skills in children with hemiplegic cerebral palsy.
Key words:
botulinum toxin A, cerebral palsy, online-based home program, upper extremity functions
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Evaluating the motor development of infants using Vojta’s method, with particular attention to risk factors, in clinical material from a Rehabilitation Center for Children with Cerebral Palsy

Aleksandra Deljewska-Starykow, Zbigniew Śliwiński, Wanda Różyło

Aleksandra Deljewska-Starykow, Zbigniew Śliwiński, Wanda Różyło – Evaluating the motor development of infants using Vojta’s method, with particular attention to risk factors, in clinical material from a Rehabilitation Center for Children with Cerebral Palsy. Fizjoterapia Polska 2002; 2(3); 216-228

Abstract
Background. The author described child’s physical and mental development in the first year his live in Theodor Hellbrige’s opinion. They presented new definitions how „high-risk pregnancy, „high-risk birth, „high-risk child” They talked over risk factors and among of them there is of great importence famillie’s relations connected with the Rh factor, main blood groups, famillie’s enzynopathy and chromosome aberration also mather’s ilnneses during the her pregnancy. They payed special attention to the gestosis, diabetes, tyroid’s ilnneses, obesity, anemia, passed infectius and bleeding. The authors rated negative factors among low height of mather, low weigth of mather befor her pregnancy and no hygienic live. The period shorter than 6 months between the pregnancies is health risk also, and like how the inflammatory proceeses of the Central Nervous System, generalized cyanosis, low evaluation in the Apgar Scale, acidosis, hiperbilirubinamy, infantile convulsions, neonatal asphyxia, the children born after different complications related to labour.The aim of examine.• The neurophysiology analysis of the development newborn from the group high-risk pregnancy, high-risk birth, especially children which was born before 37 weeks lasting pregnancy – premature baby- and children which was born in normal labor but the size those newborn was too small to fetal age- dystrophy child• The paying attention to early diagnosis of the neurodeveloping disturbances and starting the treatment quickly.Material and methods. 32 premature baby was examine , it was the children were born between 28-37 weeks of the pregnancy and 13 dystrophy child which weight were 2 500 g. and 1 child was born after 37 weeks pregnancy. The examine was done in the Rehabilitation Center in Zgorzelec. Results and conclusions. On the basis of examine the authors drown following conclusions: 1. The Vojty’s development neurokinesiology diagnostic is good screening for children from risk groups, is simply to do and let to evaluate early child’s disturbances in psychomotorial development. 2. The bigger worth of the Vojtys diagnostic and therapy is possible right development of children from high-risk birth groups. The results which are presented prove to early start to diagnos and treat give children chance to right development. 3. The age of the child is of great importance for results and time of therapy. 4. The low weigth of labor and relative shorter time of live the child during the pregnancy have the influence for efficiency CNS and the level of disturbances central neurvous coordination. The low weigth and shorter pregnancy live the higher level disturbances central neurvous coordination is presented. 5. The risk factor has influence for time therapy to moment reached the normalization. The intermural dystrophy is worst than premature baby. The premature baby quicklier and large number reache the normal psychomotorial development.

Key words:
infantum Cerebral Palsy, Vojta, child physical and mental development

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An evaluation of gait disturbances in children undergoing rehabilitation for cerebral palsy

Janusz Nowotny, Krzysztof Czupryna, Jacek Sołtys

Janusz Nowotny, Krzysztof Czupryna, Jacek Sołtys – An evaluation of gait disturbances in children undergoing rehabilitation for cerebral palsy. Fizjoterapia Polska 2003; 3(2); 189-196

Abstract
Cerebral palsy (CP) belongs to the group of dysfunctions in which impairment of the gait function is a constant element. The goal in rehabilitation is to steer the process of compensation in such a way that the gait pattern produces a minimum of disturbances and limitations in locomotion. Objective evaluation is essential for purposes of planning rehabilitation and monitoring outcome. Since the evaluation of gait can be parameterized, the authors have presenting methods for making such an evaluation, concentrating on two types of tests. The possibility of evaluating gate symmetry is presented, based on the use of the Parotec® system, along with evaluation based on analysis of particular gate markers, using the Zebris system. Certain practical remarks are given in the conclusion, essential for planning and managing the course of rehabilitation for children with cerebral palsy.

Key words:
Cerebral Palsy, evaluation of gait disturbances, rehabilitation

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Some possibilities for alleviating gait disturbances in children undergoing rehabilitation for cerebral palsy, in the light of baropedographic tests: a preliminary report

Janusz Nowotny, Krzysztof Czupryna, Jerzy Pietruszewski, Małgorzata Matyja

Janusz Nowotny, Krzysztof Czupryna, Jerzy Pietruszewski, Małgorzata Matyja – Some possibilities for alleviating gait disturbances in children undergoing rehabilitation for cerebral palsy, in the light of baropedographic tests: a preliminary report. Fizjoterapia Polska 2003; 3(3); 217-223

Abstract

Background. A pathological gait stereotype often occurs in children with cerebral palsy. The effort is made during rehabilitation to alleviate some of the symptoms, but this requires a precise survey of the component factors involved in the abnormal gait pattern that can be remedied. Atypical methods are sometimes used in rehabilitation, and their suitability also needs objective verification. Material and methods. Our study presents the possibilities for objective gait evaluation using baropedographic tests based on the Parotec® system. The possibilities of improving gait symmetry are also presented, using the example of children undergoing rehabilitation for cerebral palsy who have also been receiving botulin injections or the so-called inhibitive plaster casts. Results and Conclusions. These additional therapeutic devices facilitate further treatment and have a positive impact on improving the symmetry of gait in these children. We also found that this testing can be a valuable source of information for the therapist, pointing out which parameters of abnormal gait should be focused on during further rehabilitation.

Key words:
Cerebral Palsy, evaluation of gait disturbances, botulin, inhibitive plaster casts
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Comparison of motoric activity of American and Polish children with cerebral palsy during rehabilitation

Iwona Kasior-Szerszeń, Wanda Stryła

Iwona Kasior-Szerszeń, Wanda Stryła – Comparison of motoric activity of American and Polish children with cerebral palsy during rehabilitation. Fizjoterapia Polska 2006; 6(1); 7-12

Abstract

Background. Common features of cerebral palsy in children are movement and posture disorders. The most disturbed sphere is motorics. Movement disorders include spastic limb paresis, unvoluntary movements, coordination and balance disturbances. The aim of this report was to compare motor efficiency concerning manual and locomotive functions as well as life activities in Polish and American children. Material and methods. Study material involved 100 Polish children and 107 children from USA. Survey method was used. Results. The results were compared with respect to locomotor and manual functions in Polish and American children. Statistically significant differences were obtained. Conclusions. 1. The level of disability was higher in American children than in Polish children. 2. Manual and locomotive functions in American children were more limited. 3. Everyday child care concerning basic life activities leads to chronic fatigue, frustration, depression and in consequence to disturbances in normal family life.

Key words:
cerebral palsy, rehabilitation, motoric activity
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Vertical positioning advantages in children with cerebral palsy

Stanisław Faliszewski, Ewa Kamińska, Marzena Wiernicka, Wanda Stryła

Stanisław Faliszewski, Ewa Kamińska, Marzena Wiernicka, Wanda Stryła – Vertical positioning advantages in children with cerebral palsy. Fizjoterapia Polska 2006; 6(2); 167-171

Abstract

A primary aim of this paper is an introduction of the concrete arguments to physiotherapists, physicians, parents and other pro-fessionals who deal with rehabilitation of children with cerebral palsy, about the importance and the necessity of application into practice vertical positioning method based on the age of a child, not on the achievements of gross motor activity, at any stage of a physical therapy process. Two basic types of vertical positioning method may be distinguished depending on the condition of a patient: the passive and the active vertical positioning method. The difficulty in the active vertical positioning method, that is in the ability of taking up the standing position unaided, opposing the force of gravity, is the major rehabilitation problem of children suffering from cerebral palsy. It is manifested by the inability to take up the standing position unaided at all or the delay in it in the proportion to the vertical positioning standard (about the 16th month of a lifetime) and it results in many disadvantageous changes mentioned in this article. The passive vertical positioning with the help of vertical positioners seems to be the only alternative in this situation. The passive vertical positioning method is above all, the overcoming of incorrect postural-motor patterns in children. The vertical positioning method enables the suppression of intensified spastic tension. The passive vertical positioning facilitates the performance of different ADL, e. g. eating, doing homework, reading, the use of a computer, and has an influence on the course of physiological processes. The Neurodevelopment Treatment method acknowledges it to be a priority while using techniques of the stimulation during the physical therapy process. The only contraindication to the passive vertical positioning can be the prolonged reluctance of a child to such form of taking up the standing position. The advantages connected with vertical positioning by use of vertical positioning table of children with cerebral palsy (passive method) are considered from the sensomotor, psychological, physiological and anatomical points of view and ability to regain particular motor functions. Disadvantageous effects of a short and long-time immobilisation at horizontal position as result of hypokinesis and hypogravity are taken into account as well. The results of the reaserch carried out on people remaining in a recumbent position shortly or prolongedly in consequence of diseases and injuries as well as on healthy people, prove that bed rest cause essential disadvantageous physiological changes.

Key words:
vertical positioning, cerebral palsy, hypogravia, hypodynamia
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Use of quantitative, objective gait analysis for assessment of selection quality of afos in CP children (gait analysis in afos selection in CP)

Małgorzata Syczewska, Anna Święcicka, Małgorzata Kalinowska, Krzysztof Graff

Małgorzata Syczewska, Anna Święcicka, Małgorzata Kalinowska, Krzysztof Graff – Use of quantitative, objective gait analysis for assessment of selection quality of afos in CP children (gait analysis in afos selection in CP). Fizjoterapia Polska 2006; 6(4); 298-303

Abstract
Background. The main aims of clinical gait analysis are to measure and to assess the parameters which characterize the patient’s locomotion in order to identify the primary pathologies and compensatory mechanisms. The aim of this paper is to present 6 patients with CP, in whose case the gait analysis was used to assess the influence of the AFOs on the gait. Material and methods. Six children with cerebral palsy, aged 6 to 14 years old, were recruited into the study. They all were treated in the Dept. Paediatric Rehabilitation CMHI. They underwent the objective gait analysis (using movement analysis system VICON 460) two times: barefoot, and in shoes with AFOs. Results. In four cases AFOs considerably improved the gait pattern, in two patients caused the gait deterioration. Conclusions. The aim of the AFOs is to improve gait (through improved ankle joint stability, and assistance to the weak calf muscles) and to correct pathological deviations, such as knee hyperextension. The improper choice of the AFO type, or bad fitting could result in no improvement, but in more severe cases even in gait deterioration. The results of this paper indicate that the quantitative gait analysis proved to be the efficient tool in assessing the selection quality of AFOs.

Key words:
gait analysis, AFO, CP

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The efficacy of treatment with botulinum toxin type A in children with dynamic contractures of lower limbs in the management of cerebral palsy

Małgorzata Malinowska-Matuszewska, Małgorzata Kulesa, Antoni Czupryna

Małgorzata Malinowska-Matuszewska, Małgorzata Kulesa, Antoni Czupryna – The efficacy of treatment with botulinum toxin type A in children with dynamic contractures of lower limbs in the management of cerebral palsy. Fizjoterapia Polska 2007; 7(1); 38-44

Abstract

Background. The efficacy of botulinum toxin type A (BTX-A) in the management of cerebral palsy was determined in the lower limb. Material and methods. The study was carried out on 51 children with cerebral palsy aged 2-17 years (mean age 8 years and 6 months). The patients were undergoing treatment with BTX-A to reduce spasticity and alleviate dynamic contractures. Between one and four target muscles were selected according to functional goals (improving the gait pattern, increasing the range of motion at joints) and biomechanical assessments and were injected at multiple sites with BTX-A. The patients were evaluated at baseline and at 3 and 12 weeks post-injection. Parameters evaluated comprised Joint Range of Motion (ROM), Modified Ashworth Scale (MAS), Modified Physician Rating Scale (MPRS), Gross Motor Function Measure (GMFM) and Global Clinical Impression (GCI). Patterns of gait were monitored by VHS registration. Results. The statistical tests showed a significant (one degree) improvement over baseline at 3 weeks after the first injection (p<0.05) in MAS, MPRS, and GCI. A deterioration of MPRS and joint range of motion was observed at 12 weeks after the first dose and before the second dose (p<0.01). Two patients started to walk without mobility devices after the BTX-A treatment. The outcomes were worse in the five patients who did not perform the required rehabilitation programme after the BTX-A treatment. Conclusions. The use of BTX-A is indicated in children with diplegia and spastic hemiplegia to improve locomotor ability, and in tetraplegic children to facilitate nursing care and enable the patients to assume a standing position.

Słowa kluczowe:
spasticity, cerebral palsy, botulinum toxin type A (BTX-A), lower limbs
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Assessment of the efficacy of local cryotherapy in children with cerebral palsy

Marek Woszczak, Zbigniew Śliwiński, Marek Kiljański, Wojciech Kiebzak, Marcin Szczepanik, Wiesław Tomaszewski

Marek Woszczak, Zbigniew Śliwiński, Marek Kiljański, Wojciech Kiebzak, Marcin Szczepanik, Wiesław Tomaszewski – Assessment of the efficacy of local cryotherapy in children with cerebral palsy. Fizjoterapia Polska 2007; 7(3); 275-285

Abstract
Background. The author presents the results of a study of 60 children with infantile cerebral palsy carried out at a rehabilitation centre in the town of Zgorzelec. The study aimed to demonstrate that a 4-week programme of customised kinesiotherapy with cryostimulation of the lower limbs with liquid nitrogen vapour could have a beneficial effect on motor status as well as muscle tone and skin surface temperature in children with infantile cerebral palsy. Material and methods. A group of children of both sexes aged 3-14 with infantile cerebral palsy underwent 4 weeks of customised kinesiotherapy combined with cryostimulation of both lower limbs. Muscle tone was determined with a Szirmai myotonometer using special methodology. The level of spasticity was estimated with the Ashworth test, and motor activity assessment was made before and after the treatment according to a score table designed by the authors. Thermovisual recordings of skin surface temperature in the lower limbs were made immediately before and 5 and 15 minutes after cryostimulation procedures at the beginning and end of the 4-week programme. Results and Conclusions. A comparison of the results of the motor activity assessment, Ashworth test and myotonometry before and after the rehabilitation programme shows that the use of cryostimulation in the rehabilitation of children with infantile cerebral palsy results in a reduction of spasticity in the lower limbs and improvement in motor activity. Thermovisual analysis of skin surface temperature demonstrates full adaptation of the children’s vascular system, i.e. excellent safety of topical cryostimulation.
Key words:
infantile cerebral palsy, spastic muscle tone, local cryostimulation, Ashworth test, motor activity assessment, Szirmai myotonometer, thermovision
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