Dissertationen: „Occupational therapy Cerebral palsy“

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Novak, Iona, University of Western Sydney und College of Social and Health Sciences. „The effect of a standardised occupational therapy home program for children with spastic hemiplegic cerebral palsy“. THESIS_CSHS_XXX_Novak_I.xml, 2004. http://handle.uws.edu.au:8081/1959.7/694.

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Despite the popularity of home program interventions there is little evidence to demonstrate effectiveness, particularly when an explicit family centred framework is adopted. This single-group pre-post design study evaluates the impact of a standardised occupational therapy home program implemented with a group of 20 children (2-7 years, mean age 3.8)with spastic hemiplegic cerebral palsy. The study measured the effect of the program using: goal attainment scaling(GAS);pediatric evaluation of disability inventory (PEDI); and quality of upper extremity test(QUEST). In addition, parent participation intensity was measured through a home program log. The use of a standardised occupational therapy home program for children with cerebral palsy is recommended as an effective method to achieve therapy goals. Further research using more rigorous designs is required to fully explore treatment efficacy.
Master of Science (Hons.)

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Thomas, Denise Keiko. „Participation in leisure activities among adolescents with Cerebral Palsy: description, preferences and determinants“. Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114292.

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Cerebral Palsy (CP) is the most common cause of physical disabilities in children. It is a broad term that describes a set of conditions that is associated with major physical impairments and other developmental deficits and arises in the early stages of brain development. Children and youth with CP often experience limitations in everyday activities in different life situations.Participation in leisure activities is an important aspect of health, as described by the International Classification of Functioning, Disability and Health (ICF). Engagement in leisure activities is essential for the development of a series of crucial competencies for a healthy development. Recently, studies have found factors related to participation in children with physical disabilities. However, information is lacking with regards to participation of adolescents, particularly what types of leisure activities are preferred by this population and predictors of participation in different type of leisure activities. Understanding of factors associated with participation in leisure activities may contribute to the development of rehabilitation and community programs and policies.The primary objective of this study is to quantify the level (intensity and diversity) of participation in leisure activities of adolescents (12-19 years of age) with cerebral palsy (CP), and to estimate the potential influence of both intrinsic child characteristics and extrinsic environmental factors as determinants of leisure participation. The secondary objective of this study is to determine factors associated with preferences for specific leisure activities in this population of interest. A cross sectional design was used. A total of 185 adolescents (12-20 years old) completed the study. Participation was measured with the Children's Assessment of Participation and Enjoyment (CAPE) and preferences for activities was measured with the Preferences for Activities of Children (PAC). Results demonstrate that adolescents with CP participated in a variety of out-of-school leisure activities. Adolescents participated more in informal activities than formal activities. Adolescents engaged in a variety of recreational and social activities, but not in many self-improvement activities. Participation in skill-based activities was the least frequent type of activity done, but diversity and frequency of participation in physical activities was also limited.In terms of preferences for activities, social and physical activities were most preferred, and self-improvement activities were least preferred. Family factors, personal factors and functional abilities influenced leisure preferences. High preference for certain activities was not always associated with actual involvement in these activities. Models of determinants of intensity of participation in five leisure activity domains demonstrated that leisure is a multifaceted construct that appears to be associated with a variety of factors related to the adolescents' functional characteristics and attitudes, the family environment and socioeconomic status and other contextual factors such as school type. Aspects of the adolescent's mastery motivation and behavior were also associated with participation in different activity domains. The adolescent's perception of self in relation to competence in different life skills and physical appearance was also associated with participation in certain types of leisure activities. Rehabilitation interventions should consider adolescents' preferences and family dynamics to minimize barriers to leisure participation, such as low motivation or environmental obstacles, so as to promote engagement in leisure activities. Expanding the scope of rehabilitation interventions to support the creation of programs in the community and advocate for policies that may facilitate participation in a variety of activities is needed, to promote a healthy development and well-being for this at-risk population.
La paralysie cérébrale (PC) est un ensemble de conditions associées à des déficiences majeures et à des déficits au niveau du développement qui se forment lors des premiers stades de développement du cerveau et est la cause de handicap physique la plus importante chez les enfants. Souvent, les individus atteinent de la PC peuvent être limité dans ses activités de tous les jours. La participation à des activités de loisir est un aspect important de la santé, selon la Classification Internationale du Fonctionnement, du Handicap et de la Santé (CIF). Participer à des activités de loisir est essentiel pour le développement d'une série de compétences. Récemment, des études ont démontré des facteurs liés à la participation chez des enfants souffrant de handicaps physiques. Par contre, la documentation concernant la participation d'adolescents, particulièrement les types d'activités de loisirs préférés par cette population et les prédicteurs de la participation dans différents types d'activités de loisir, est incomplète. L'objectif principal de cette étude est de quantifier le niveau, l'intensité et la diversité de la participation des adolescents (de 12 à 19 ans) souffrant de paralysie cérébrale (PC) à des activités de loisir et d'estimer l'influence potentielle des caractéristiques intrinsèques de l'enfant et les facteurs environnementaux extrinsèques en tant que déterminants de la participation à l'activité de loisir. Le second objectif de cette étude est de déterminer les facteurs associés aux préférences pour des activités de loisirs spécifiques chez cette population. Notre étude, de type transversale, a été complétée par 185 adolescents entre 12 et 20 ans. La participation a été mesurée avec le "Children's Assessment of Participation and Enjoyment" (CAPE), et les préférences pour les activités ont été mesurées avec le "Preferences for Activities of Children" (PAC). Les résultats démontrent que les adolescents souffrant de PC participent à une variété d'activités récréatives et sociales, mais à très peu d'activités de croissance personnelle. La participation à des activités basées sur les compétences était le type d'activité le moins populaire, mais la diversité et la fréquence de la participation à des activités physiques était également limitée. En ce qui a trait à la préférence pour certaines activités, les activités sociales et physiques étaient les plus populaires, et les activités de croissance personnelle étaient les moins populaires. Des facteurs familiaux et personnels ainsi que les habiletés fonctionnelles influençaient les préférences. Une préférence élevée pour certaines activités n'était pas toujours associée à la participation à ces activités. Des modèles déterminant l'intensité de la participation à cinq domaines d'activités ont démontré que le concept de loisir comporte de nombreuses facettes qui sont associées à une variété de facteurs reliés à l'environnement familial, au statut socio-économique et à divers facteurs contextuels comme le type d'école fréquenté. La motivation et le comportement étaient aussi associés à la participation dans différents domaines d'activité. La perception de soi de l'adolescent en relation avec la maîtrise des différentes compétences de base et l'apparence physique étaient également associées à la participation à certains types d'activités de loisir.Les interventions visant la réhabilitation devraient considérer les préférences des adolescents et les dynamiques familiales afin de minimiser les obstacles à la participation à des activités de loisir. Il est nécessaire de développer la portée des interventions de réhabilitation afin de supporter la création de programmes dans la communauté et de plaider en faveur de politiques qui faciliteront la participation à une variété d'activités. Ceci permettrait de promouvoir le développement sain ainsi que le bien-être de cette population à risque.

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Fuller, Lauren. „Occupational therapy for children with severe cerebral palsy in government healthcare facilities in the Western Cape: an overview of current services“. Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33755.

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Background: There is a high worldwide prevalence of cerebral palsy, a neurological condition which impacts most areas of life of children and their families. Evidence shows that occupational therapy is effective in enhancing the child's function, participation and quality of life, especially when provided at a young age and with high intensity. Literature provides additional recommendations for occupational therapy to follow a holistic and family-centred approach, considering participation in context, rather than an individual medical focus. These notions place pressure on the strained South African healthcare system, where human and physical resources, as well as contextually-relevant evidence for practice, are limited. The aim of this research was, therefore, to obtain a baseline description of the occupational therapy services being provided to children with severe cerebral palsy, across all government healthcare facilities of the Western Cape province. Methods: A quantitative, cross-sectional descriptive study was conducted, using a selfdesigned questionnaire. The questionnaire was developed using recognised survey principles in order to maintain research rigour, reliability and validity of results, and guidelines from previousstudies of a similar nature. The questionnaire was available to participants in duplicate online and hard copy formats. The anonymous, self-report questionnaire obtained profiles of the participating occupational therapists and their departments, descriptions of current service provision (assessments, goal-setting and interventions), perceived factors influencing service selection, and an understanding of services therapists felt they should be providing more of. No sampling took place and responses were invited from all occupational therapists employed by the provincial health department. All recruitment and correspondence took place via email or telephone. Recruitment and data collection took place over a period of 16 weeks, with each participant having a maximum of two weeks to submit their responses, after which a maximum of three reminders were sent. Numerical data were analysed using non-parametric descriptive statistics and categorical data were presented in terms of frequencies and percentages. Ethical principles adhered to included respect, confidentiality, anonymity, beneficence, non-maleficence and justice. Results: There was a response rate of 53%, with all provincial health districts and levels of care represented amongst participants. Assessments frequently involved observations of the child in activities(85%) and interviews with their caregiver (98%). Goals formulated, with some input of caregivers, related to occupational performance components (91%) more often than occupational performance (77%), and largely aimed to maintain the child's condition (68%), rather than improve development or functional participation (47%). A range of interventions were provided, but appointments were infrequent (median: 1 per month), mainly took place in clinical environments (100%), and waiting periods for assistive devices and orthotics were common. Opportunities for direct therapy and interventions in the child's daily context were limited, and home programmes and caregiver education were heavily relied upon indirect intervention methods, frequently implemented by 100% and 91% of participants respectively. Key factors influencing the selection of services included resource availability (62%), therapists' training (62%) and the level of care at which they worked (59%). Therapists felt they were meeting some of the children's needs, and required the support of the multidisciplinary team to meet more of their needs effectively. Conclusion: This study provides insight into occupational therapists' roles in the government healthcare sector in the Western Cape province, and highlights the degree of alignment of services with policy and elements of best practice. Some merits are clear, in terms of the combination of direct and indirect services provided and the involvement of families in therapy processes. However, there remains a shortfall in terms of effective holistic, evidence-based, family-centred, and early and intensive approaches. This study, therefore prompts revision of strategies to implement existing policies promoting quality services for people with disabilities and align occupational therapists' training with evidence-based practice and holistic frameworks and approaches. Further research is recommended, particularly a qualitative consideration of the contextual factors influencing service provision, in order to better understand and address the barriers to meaningful and effective services for this population within the context of Primary Healthcare. With these recommendations, quality service provision, leading to participation and quality of life outcomes for children with severe cerebral palsy and their families, may be enhanced.

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Novak, Iona E. „The effect of a standardised occupational therapy home program for children with spastic hemiplegic cerebral palsy“. View thesis, 2004. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20050615.162942/index.html.

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Novak, Iona. „Effectiveness of occupational therapy home program intervention for children with cerebral palsy a double blind randomised controlled trial /“. View thesis, 2009. http://handle.uws.edu.au:8081/1959.7/38884.

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Thesis (Ph.D.)--University of Western Sydney, 2009.
A thesis presented to the University of Western Sydney, College of Health and Science, School of Biomedical and Health Sciences, in fulfilment of the requirements for the degree of Doctor of Philosophy. Includes bibliographies.

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Unger, Marianne. „The impact of an eight-week progressive resisted exercise program in adolescents with spastic cerebral palsy“. Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/50155.

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Thesis (MScPhysio)--Stellenbosch University, 2004.
ENGLISH ABSTRACT: Muscle weakness is a problem for many young people with spastic cerebral palsy (CP). Many studies have reported that selective strength-training programs can improve muscle strength. However, most of these studies are of single group design and do not adequately control for confounding variables. Objective: To determine the impact of a comprehensive strength training program targeting multiple muscle groups on adolescents with CP, using basic inexpensive free weights and resistance devices. Method: A randomised clinical trial evaluated the effects of an eight-week strength-training program on 31 independently ambulant adolescents with spastic CP, with or without walking aids, from Eros School (19 males, 12 females; mean age 16 years 1 month; range 13 - 18 years). The Kin-Com dynamometer, 3-D gait analysis, the Economy of Movement test and a questionnaire was used to evaluate selected muscle strength, the degree of crouch gait, free walking velocity and stride length, energy consumption during walking and perceptions of body image and functional competence. Twenty one subjects took part in the strength-training program and were compared with 10 control subjects. Results were analysed using repeated measures ANOVA and bootstrap analysis. Results: Compared with the control, significant improvement in the degree of crouch as measured by the sum of the ankle, knee and hip angles at midstance (p=0.05) and perceptions of body image (p=0.01) were noted for the experimental group. Significant trends were also noted for isometric knee extension muscle strength at 30° as well as for hip abduction at 10° and 20°. Walking efficiency, -velocity and stride length remained unchanged as well as perceptions of functional ability. Conclusion: A strength-training program targeting multiple muscle groups including upper and lower limbs as well as the trunk, can lead to changes in muscle strength and improve the degree of crouch gait with improved perception of body image. Successful participation in such a program at school may motivate children with CP to continue with home-based basic strength training. Strength training alone did not decrease oxygen consumption during walking and inclusion of aerobic exercise is recommended.
AFRIKAANSE OPSOMMING: Spierswakheid is 'n probleem vir baie jong mense met serebrale verlamming (SV). Navorsing het getoon dat selektiewe versterkende oefenprogramme selektiewe spiere kan versterk, maar die meeste studies bestaan uit 'n enkel groep met onvoldoende beheer oor verstrengelde veranderlikes. Doel: Om die impak van 'n omvattende versterkende oefenprogram met basiese, goedkoop gewigte en weerstandsaparaat wat vele spiergroepe teiken, op adolesente met spastiese SV te evalueer. Metodologie: Die effekte van 'n agt weke lang versterkende oefenprogram is op 31 onafhanklik mobiel adolesente met spastiese SV, met of sonder loophulpmiddel, van Eros Skool deur middel van 'n ewekansige kliniese proef geevalueer (19 manlike, 12 vroulike deelnemers; gemiddelde ouderdom 16 jaar 1 maand; omvang 13 - 18 jaar). Die Kin-Com dinamometer, "3-D gait analysis", die "Economy of Movement" toets en 'n vraelys is gebruik om geselekteerde spiersterkte, die hoeveelheid knie fleksie gesien in die onderste ledemaat tydens loop, loopspoed en treelengte, energieverbruik tydens loop asook persepsies van liggaamsbeeld en funksionelevermoë te evalueer. Een en twintig het in die versterkende oefenprogram deelgeneem en is met 10 kontrole deelnemers vergelyk. Resultate is met behulp van herhaalde metings "ANOVA" en "bootstrap analysis" geanaliseer. Resultate: In vergelyking met die kontrole groep, het die experimentele groep betekenisvolle verbetering getoon in die hoeveelheid fleksie gesien in die ondersteledemaat (p=0.05) soos bereken deur die som van die enkel-, knie- en heuphoek in midstaan fase tydens loop, asook in liggaamspersepsie (p=0.01). Beduidenisvolle tendense is ook gesien by die experimentele groep vir isometriese knie ekstensie spiersterkte by 30° asook vir heup abduksie by 10° en 20°. Energieverbruik tydens loop asook loopspoed en treelengte was onveranderd asook persepsie van funksionele vermoë. Gevolgtrekking: 'n Versterkende oefenprogram wat verskeie spiergroepe teiken, insluitende die onderste en boonste ledemate asook die romp, kan lei tot In verbetering in spiersterkte, minder fleksie in die onderste ledemate tydens loop asook 'n verbetering in ligaamspersepsie. Suksesvolle deelname aan so 'n program op skool, mag kinders dalk motiveer om In basiese versterkende oefenprogram tuis voort te sit. Versterkende oefening alleen het geen vermindering in suurstofverbruik tydens loop veroorsaak en die insluit van aerobiese oefening word aanbeveel.

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Rassafiani, Mehdi. „Occupational therapists' decisions about the management of upper limb hyertonicity in children and adolescents with cerebral palsy /“. [St. Lucia, Qld.], 2006. http://adt.library.uq.edu.au/public/adt-QU20060619.130832/index.html.

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Andersson, Amanda, und Linnea Kalliomäki. „Arbetsterapeuters erfarenheter av att använda sig av CI-terapi för barn med hemiplegisk cerebral pares“. Thesis, Luleå tekniska universitet, Institutionen för hälsovetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-79042.

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Syfte: Syftet med studien var att beskriva arbetsterapeuters erfarenheter av att använda sig av CI-terapi som intervention för barn med hemiplegisk cerebral pares. Metod: En kvalitativ ansats valdes för att beskriva arbetsterapeuternas subjektiva upplevelser. Åtta semistrukturerade intervjuer genomfördes med arbetsterapeuter som arbetade på barn- och ungdomshabiliteringar i landet och analyserades därefter utifrån kvalitativ innehållsanalys. Resultat: Den insamlade datan resulterade i fyra kategorier: Arbetsterapeutens stöd; Nätverkets betydelse; Anpassning av interventionen samt Organisatoriska strukturer. Resultatet visade att interventionen bör utgå från barnets motivation och lek i samverkan med barnets nätverk samt att interventionen mestadels bidrog till att barnet fick en utökad aktivitetsrepertoar. Vidare beskrevs att interventionen utfördes endast av några arbetsterapeuter runt om i landet då den är tidskrävande, kräver resurser och en tydlig struktur. Det framkom även att kollegialt stöd bland arbetsterapeuterna främjar genomförandet av CI-terapi. Slutsats: I studien framkommer att barnets aktivitetsrepertoar mestadels förbättrades med CI-terapi men kunde inte påvisas med nuvarande bedömningsinstrument.
Purpose: The aim of this study was to describe occupational therapists’ experience of using Constraint Induced Movement Therapy for children with hemiplegic cerebral palsy. Methods: A qualitative method was chosen to describe the subjective experiences of the occupational therapists. Eight semi structured interviews were conducted with occupational therapists that were working at different centres for child and adolescent rehabilitation in this country, thereafter the collected data was analysed using qualitative content analysis. Result: The results were divided into four categories: The occupational therapist’s support, The importance of the network, Adaptation of the intervention and The organisational structures. The result indicate that the intervention should be centred on the child’s motivation and play in collaboration with the child’s social network and the intervention usually leads to an extended activity repertoire for the child. Furthermore, the result indicates the intervention to be time consuming, demanding extensive structure and resources, which led to the intervention was performed by only a few occupational therapists. It also appeared that collegial support among occupational therapists promotes the implementation of Constraint Induced Movement Therapy. Conclusion: The study show that the child’s range of activities often were improved when using Constraint Induced Movement Therapy, but this could not be proven with today’s assessment instrument.

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Pieterse, Gisele Shaline. „Participation in meaningful occupation : how do young adults living with cerebral palsy experience the quality of their participation?“ Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80333.

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Thesis (MOccTher)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: Participation in meaningful occupations is what defines us as human beings and is an important indicator of health and well-being. It is the way we experience the world around us and is closely linked to quality of life. As an occupational therapist at a school for learners with special educational needs, the researcher was interested in how young adults with a diagnosis of Cerebral Palsy (CP) who attended this school, experience their participation or the lack thereof in occupations and if it contributes to meaning and fulfilment in their lives? She established through informal conversation with some of these young adults or their parents, that they experience unemployment, unhappiness and poor integration within the community. The aim of this study was therefore to describe how young adults living with CP in economically disadvantaged communities within the Western Cape, experience the quality of their participation in meaningful occupations. A qualitative phenomenological study design was used, enabling the researcher to explore the value and meaning participants attach to different occupations, the participants perceptions of their experience and the factors impacting on their participation. The study population was young adults between the ages of 18-28 years with a diagnosis of CP, who attended the previously mentioned school and who exited school over the duration of the past nine years. The researcher used purposive maximum variation sampling, to ensure variation in terms of diagnosis, living arrangements, employment and marital status. Data collection took the form of ten face-to-face semi-structured individual interviews and inductive content analysis was utilized to analyse data. The following four themes emerged from the data: overcoming challenges; having equal opportunities; barriers holding me back and the future is mine to shape. These young adults participated in a variety of meaningful occupations and have learned to utilize various strategies to overcome the difficulties they faced in this process. The following factors influenced their participation positively: having meaningful relationships; accepting their disability and nurturing a positive attitude; being proud of their achievements; positive work experiences and involvement in the community. Factors contributing to these young adults not experiencing meaningful participation were the following: their perception of themselves and also how they perceived being treated by others; non-acceptance of their physical circumstances and disability; incompetence and poor self-confidence; termination of previously meaningful occupations; challenges with interpersonal relationships and unsatisfactory work experiences. The need to be as independent as possible was of utmost importance to all these young adults, as it was an indicator of being in control of their own lives. Given the above information, the researcher recommends a transition preparation program for senior phase learners that will include sessions on work habits, social skills, transportation, self-employment and integration into the community to be implemented at the school. Supported employment options should be explored as well to ensure maximum employment among these learners exiting school. A follow-up system should be established to evaluate the effectiveness of the above-mentioned program.
AFRIKAANSE OPSOMMING: Deelname in betekenisvolle aktiwiteite is uniek aan die mens en is ook ‘n belangrike aanduiding van gesondheid en welstand. Ons ervaar die wêreld rondom ons deur betekenisvolle deelname, was nou verbind word kwaliteit van lewe. Tydens haar werk as ‘n arbeidsterpeut by ‘n skool vir leerders met spesiale onderrig behoeftes, het die navorser begin belangstel in hoe jongmense met ‘n diagnose van serebraalgestremdheid (wat oudleerders is) hulle deelname aan aktiwiteite of die gebrek daaraan ervaar en of dit bydra tot betekenisvolheid en vervulling in hulle lewens. Sy het deur informele gesprekke met van hierdie jongmense of hul ouers vasgestel dat hulle ervaring ongelukkig, werkloos and swak geïntegreed in hulle gemeenskap is. Die doel van hierdie studie was dus om te beskryf hoe jongmense met ‘n diagnose van serebraalgestremdheid wat in ekonomies benadeelde gemeenskappe binne the Weskaapse Provinsie woon, die kwaliteit van hul deelname aan betekenisvolle aktiwiteite ervaar. Die navorser het ‘n kwalitatiewe fenomenologiese studie ontwerp gebruik sodat sy die volgende aspekte kon verken: die waarde en betekenis wat die studie deelnemers aan spesifieke aktiwiteite heg; hulle persepsie van hulle ervaringe, asook die faktore wat deelname beïnvloed. Die studiepopulasie was jongmense tussen die ouderdomme van 18-28 jaar oud met ‘n diagnose van serebraalgestremdheid, wat die bogenoemde skool bygewoon en verlaat het in die afgelope nege jaar. Die navorser het ‘n doelgerigte maksimum variasie steekproef gebruik, om sodoende variasie in terme van diagnose, verblyf, werk en getroude status te verseker. Data was ingesamel deur middel van tien semi-gestruktureerde individuele onderhoude. Induktiewe inhoud-analise was gebruik om die data te ontleed en die volgende vier temas het na vore gekom naamlik: om uitdagings te oorkom; om gelyke geleenthede te hê; hindernisse wat my terughou en die toekoms is myne om te vorm. Hierdie jongmense neem deel aan ’n groot verskeidenheid aktiwiteite en het deur ondervinding verskeie strategieë aangeleer om die probleme wat hulle ervaar het te oorkom. Die volgende faktore het hulle deelname positief beïnvloed: betekenisvolle interpersoonlike verhoudings; aanvaarding van hulle gestremdheid en koestering van ‘n positiewe houding; trots op hulle prestasies; positiewe werkservaringe en betrokkenheid in hulle gemeenskap. Die faktore wat bygedrae het tot swak deelname aan aktiwiteite was die volgende: hul self-persepsie, asook hul persepsie van hoe ander hulle behandel; nie-aanvaarding van hulle gestremdheid en fisiese omstandighede; swak selfvertroue en gevoelens van onbevoegdheid; die staking van vorige betekenisvolle aktiwiteite; uitdagings in hulle verhoudings en onbevredigende werkservaringe. Hul onafhanklikheid is vir hierdie jongmense van uiterste belang, want dit is ‘n aanduiding dat hulle in beheer is van hulle eie lewens. Na aanleiding van bogenoemde informasie, maak die narvorser die volgende aanbeveling: Om ‘n voorbereidings program vir senior fase leerders te begin, wat sessies van werksgewoontes, sosiale vaardighede, transport, self-indiensneming en integrasie in die gemeenskap insluit. Die moontlikheid van ondersteunde indiensneming moet ook verken word, om maksimale indiensneming onder hierdie jongmense te verseker. ‘n Opvolg sisteem moet ook in plek gestel word om die doeltreffendheid van bogenoemde program te bepaal.

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Saleh, Maysoun. „Actual versus best practices for young children with cerebral palsy : a survey of pediatric occupational therapists and physical therapists in Quebec, Canada“. Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=103179.

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Background and rationale. Cerebral palsy (CP) is one of the most common disabling disorders of childhood and constitutes a substantial portion of pediatric rehabilitation. This condition demands comprehensive rehabilitation using age-appropriate tasks and activities and encompassing aspects of body function and structure, activity and participation, and personal and environmental factors. Yet little is known regarding actual occupational therapy (OT) and physical therapy (PT) practices.
Objective. The primary objective of this doctoral thesis was to describe OT and PT practices for young children with CP in the Province of Quebec, Canada.
Methods. This was a cross-sectional, multi-centered survey. All eligible and consenting pediatric occupational therapists (OTs) and physical therapists (PTs) were interviewed using a structured telephone interview based on vignettes of two typical children with CP at two age points---18 months and 4 years. Reported practices were grouped according to the International Classification of Functioning, Disability, and Health (ICF). Literature review of pediatric assessments and interventions potentially used for CP was done to determine their level of evidence of effectiveness. In addition, two expert groups provided, for each vignette, a best practice problem identification list and a best practice intervention list.
Results. A total of 62 PTs (83.8% participation rate) and 85 OTs (91.4% participation rate) participated in the study. Overall, 91.9% of PTs and 67.1% of OTs reported using at least one standardized pediatric assessment for at least one vignette. OT and PT interventions focused primarily on impairments and primary function, with less attention to interventions related to play and recreation/leisure. Clinicians reported the need for more training and education specific to CP and to the use of research findings in clinical practice. Wide variations and gaps were identified in therapists' responses suggesting the need for a basic standard of PT and OT management as well as strategies to encourage knowledge dissemination regarding current best practice. Further, implementation of evidence-based practice necessitates more collaboration between researchers, clinicians and administrators.

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SCHMIT, JENNIFER MARIE. „Supra-Postural Task Performance in Children with Cerebral Palsy: The Importance of Functional Context“. University of Cincinnati / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1212085865.

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Myllergård, Elin, und Lina Runnelid. „CI-terapi som arbetsterapeutisk intervention för barn med cerebral pares. : En litteraturöversikt“. Thesis, Luleå tekniska universitet, Hälsa och rehabilitering, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-69216.

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Syftet med studien var att sammanställa arbetsterapeutiska interventioner inom CI-terapi och dess effekter på aktivitetsförmåga för barn med unilateral CP i åldrarna 2-18 år. Åtta artiklar granskades i litteraturöversikten, varav sex var randomiserade kontrollerade studier. De kvantitativa artiklarna analyserades enligt en deduktiv ansats och beskrevs under tre av fyra arbetsterapeutiska interventionsmodeller. I kategorin Modell för kompensation framkom att anpassning av den sociala miljön var av vikt för att främja motivation. I kategorin Modell för aktivitetsträning framkom att aktiviteter bör vara åldersanpassade och att målsättningen ska vara personlig. I kategorin Modell för förbättring av personliga faktorer och kroppsfunktioner framkom att rörelser isolerades genom lek för att ge förbättrad kroppsfunktion. I kategorin Effekter framkom att alla studier beskrev olika ökade positiva effekter med påverkan på aktivitetsförmåga. Resultatet av denna studie visar att motivation och engagemang hos barnet med unilateral cerebral pares vid mottagande av CI-terapi är betydande. Positiv effekt påvisas gällande handfunktion, vilket har en fortsatt märkbar effekt i tre till sex månader. För att få en bild av vilka interventioner som är bäst lämpade för den effekt som önskas finns ett behov av vidare forskning.
The purpose of the study was to compile occupational interventions within Constraint induced movement therapy and their effects on occupational ability for children with unilateral cerebral palsy in the ages 2-18 years. Eight articles were examined in this literature review, of which six of them were Randomised Control Trials. The quantitative articles were analysed according to a deductive approach and described under three out of four occupational intervention models. In the category Compensatory Model results showed that adaptations to the social environment were of importance to enhance motivation. In the category Acquisitional Model results showed that activities should be adapted to age and that the goal should be set individually. In the category Restorative Model results showed that movements could be isolated through play with the purpose of enhancing motor functions. In the category Effects results showed that all articles described different increasing positive effects concerning occupational ability. The result of study shows that motivation and commitment of the child with unilateral cerebral palsy is of great importance when recieving Constraint Induced Movement Therapy. The results concerning hand function show positive effect at the follow-up 3-6 months later. Further research is needed to understand which interventions are most suited to get the desired effect.

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Morress, Claire. „Environmental and family factors affecting the participation of young children with cerebral palsy: An ecocultural perspective“. Diss., NSUWorks, 2015. https://nsuworks.nova.edu/hpd_ot_student_dissertations/46.

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"May 2015" A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Occupational Therapy. Typescript Project Advisor : Max A. Ito Participation in social roles and daily activities is considered a primary outcome for children with cerebral palsy (CP) and thus is an important focus of pediatric therapy. The purpose of this study was to describe the participation patterns of children ages 2 to 6 years with CP, investigate how gross motor impairment affects participation, and identify those family and environmental factors that may influence participation in daily activities and social roles. A convenience sample of 51 children with CP between the ages of 2 and 6 years and their parents completed this study. Parents completed four standardized instruments: the Assessment of Life Habits (LIFE-H), the Impact on Family Scale, The Child and Adolescent Scale of Environment, and the Child Health Conditions Questionnaire, which measured participation, family burden, the environment, and associated conditions respectively. Hierarchical multiple regression analysis was used to determine the extent to which family and environmental factors explained participation in daily activities and social roles while controlling for gross motor impairment (GMFCS), associated conditions and age. The findings of this study suggest that very young children with CP experience substantial restrictions across 10 of 11 domains of participation. Parents report greater environmental barriers, associated health conditions and impact on family as GMFCS levels increase. Gross motor impairment, associated health conditions, and age accounted for 65% of the variance in participation. The environment and family factors did not contribute significantly to the model. For the children in this study, intrinsic factors accounted for most of the variance in participation.

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Cazeiro, Ana Paula Martins. „Formação de conceitos por crianças com paralisia cerebral: um estudo exploratório sobre a influência das brincadeiras“. Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/47/47131/tde-12062008-074728/.

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O desenvolvimento de conceitos básicos ocorre em situações cotidianas e lúdicas, por meio do contato da criança com os objetos e pessoas presentes em seu ambiente. A criança com deficiência, contudo, vê-se muitas vezes privada de tais experiências, seja por conta de sua incapacidade motora, que restringe a exploração ativa, seja em decorrência da falta de oportunidades para participar de atividades lúdicas, familiares e sociais, seja pelo excesso de proteção por parte de seus cuidadores. Visando estimular o desenvolvimento desta criança e fornecer-lhe oportunidades para vivenciar situações comuns a infância, o terapeuta ocupacional utiliza-se, com freqüência, da atividade lúdica. Consoante esta prática, o objetivo desta pesquisa é investigar a influência deste tipo de atividade no processo de formação de conceitos básicos por crianças com seqüelas de paralisia cerebral. Em face das dificuldades de se trabalhar com este tipo de população, optou-se por realizar uma pesquisa do tipo qualitativo com um pequeno número de participantes, os quais foram submetidos a um pré-teste, a fim de avaliar o grau de domínio inicial de alguns conceitos, 16 sessões individuais de brincadeiras que envolviam alguns dos conceitos avaliados e reaplicação do teste inicial a fim de avaliar o grau de aprendizagem final dos conceitos trabalhados. A prova utilizada foi uma adaptação do Teste de Conceitos Básicos de Boehm. A pesquisadora, que participava das brincadeiras junto à criança, nomeava sempre que possível os conceitos pertinentes a cada situação. Todas as crianças participantes aprenderam ao menos um dos conceitos mais trabalhados durante as sessões de brincadeiras, além de terem aprendido outros conceitos não avaliados por meio dos testes. Também se verificou que as crianças apresentaram progressos em outros aspectos do seu desenvolvimento, tais como coordenação motora, atenção, qualidade da participação nas brincadeiras, comportamento e relacionamento interpessoal. Verificou-se, assim, que o fornecimento de oportunidades para participar de brincadeiras mediadas por um adulto influencia positivamente o processo de formação de conceitos básicos, bem como o desenvolvimento global da criança com seqüelas de paralisia cerebral. Estes resultados foram discutidos segundo o referencial teórico da psicologia sócio-histórica de Vygotsky.
The development of basic concepts occurs in everyday situations and play activities, by children\'s contact with objects and persons present in their environment. However, the disabled children are often deprived of such experiences, either on account of their motor disability that restricts the active exploration, or as a result of the lack of opportunities for play and participate in familiar or social tasks, often because of over-protection by their caretakers. To stimulate the development of the child and give him opportunities to experience situations common to all children, the occupational therapist uses often playthings. Consonant with this practice, the objective of this research was to investigate the influence of this type of activity in the process of formation of basic concepts by children with cerebral palsy. In face of the difficulties of working with this kind of population, it was decided to conduct a qualitative research with a small number of participants, which have been submitted to: a pre-test to assess the degree of initial domain of some concepts; 16 individual sessions of play therapy involving some of the evaluated concepts; a second administration of the initial test to assess the degree of learning of the treated concepts. The test administered was an adaptation of the Boehm Test of Basic Concepts. The researcher, who went on to play with child, named whenever possible the concepts relevant to each situation. All children learned at least one of the concepts more treated during the sessions of play therapy. They learned also other concepts not evaluated by tests. It was also found that children showed progress in other aspects of their development, such as motor coordination, attention, play skills, behavior and interpersonal relationships. It is therefore clear that the provision of play opportunities, mediated by an adult, positively influences the process of formation of basic concepts, as well as the overall development of children with cerebral palsy. These results were discussed according to the Vygotskyan perspective.

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Taranto, Stephanie R. „Reliability and Validity of the HASTe in Assessing Bilateral Sensory Function in Children with Hemiplegia“. The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1354594987.

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Lopes, Priscila Bianchi. „Parentalidade, participação e suporte social : dando voz aos adolescentes com paralisia cerebral e às suas mães“. Universidade Federal de São Carlos, 2016. https://repositorio.ufscar.br/handle/ufscar/7485.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Cerebral palsy (CP) describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain. Research has indicated that children and adolescents with disability have difficulties related to their social participation. However, family has been indicated as an important factor that could optimize the social participation of children and youth with CP. Though, it is still being a challenge to understand the factors of the family that collaborates to the social participation of adolescents with CP. Hence, this study aimed to better understand about the social participation and the social support of adolescents with CP and about the parenting of their parents. Further specific objectives were raised: to identify the perspectives of adolescents about the parenting practices that they received; to understand the perspectives and wishes of the adolescents about their future; and to identify the parents expectative about the challenges related to parenting their children with CP. The participants of this research were 7 adolescents with CP aged from 11 to 17 years old and their mothers. For collecting data, two semi-structured interviews scripts were applied, in addition, the GMFCS - Gross Motor Function Classification System the Family Report Questionnaire, and the Social Support Appraisals (SSA) were utilized. The interviews were analyzed qualitatively using the Collective Subject Discourse technique. Results from GMFCS and SSA were analyzed according to instructions of each instrument. As major results, the present research showed that in general, mothers understand that their parenting practices are positive and contribute to the social participation of their children. However, some mothers identified that the social participation of their children was restricted to the school context, whereas other mothers reported that the social participation of their adolescents included the engagement in activities in the community. Furthermore, mothers discussed about their worries on the independence and autonomy of their children with CP, and how to help them to establish relationships in a mature way. However, some difficulties in parenting were also identified such as the differences between the mother’s and father’s parenting style, which may result in conflicts. Mothers also reported difficulties in properly stimulating the participation of their children and expressed difficulties in teaching their values and principles to their children. From the perspective of the adolescents with CP, results indicated that they enjoy and try to engage in various leisure activities, where they seek for their social participation with friends in different contexts, such as restaurants, church, school, in others. Furthermore, results on the perspectives of the adolescents about their future revealed the importance that they attributed to progress in the academic studies, establishing a professional carrier and having a family. It is hoped that this study contributed to the understanding of parenting of families of youth with CP and about the consequences of them practices to the social participation of these youths. It is also wished that this study can provide elements contributing to best understand about how the social participation of youth with CP is established and about what they expect for their future. It is hoped that this study can adds to the positive efforts of appropriately implementing practices of Occupational Therapists and other rehabilitation professions which focuses on the participation of this population.
A Paralisia Cerebral (PC) descreve um grupo de desordens permanentes do desenvolvimento do movimento e da postura, causando limitações nas atividades, que são atribuídas a distúrbios não progressivos ocorridos no desenvolvimento fetal ou no cérebro infantil. Estudos têm indicado que crianças e adolescentes com deficiência têm dificuldades na participação social. Por outro lado, a família tem sido apontada como um importante fator que pode facilitar a participação social de crianças e adolescentes com PC. Entretanto, ainda está colocado o desafio de se compreender sobre os fatores relacionados à família que corroboram para a participação social de adolescentes com PC. Assim, este estudo teve como objetivo compreender sobre a participação social e o suporte social de adolescentes com PC e sobre a parentalidade de seus pais. Como objetivos específicos foram elencados: identificar a visão que os adolescentes têm sobre as práticas parentais que receberam de seus pais; compreender a visão e desejos dos adolescentes em relação ao seu próprio futuro; identificar a expectativa dos pais em relação aos desafios futuros relacionados à criação de seus filhos com PC. Foram participantes desta pesquisa 14 sujeitos, a saber, 7 adolescentes com Paralisia Cerebral, com idade entre 11 e 17 anos e suas mães. Para a coleta de dados foram utilizados dois roteiros de entrevista semiestruturada, um formulário de identificação dos participantes, o GMFCS Sistema de Classificação da Função Motora Grossa – Questionário do Relato Familiar, e o Social Suport Appraisals (SSA). Os dados gerados a partir das entrevistas foram analisados à luz da metodologia do Discurso do Sujeito Coletivo (DSC), os demais dados foram analisados de acordo com as planilhas dos instrumentos (SSA e GMFCS) e apresentados de forma descritiva. Os principais resultados indicaram que as mães, em geral, entendem que as práticas parentais efetivadas com seus filhos são positivas e contribuem para a participação social de seus filhos, entretanto várias mães também identificaram que esta participação pode estar restrita ao contexto escolar, enquanto algumas relataram a participação em atividades na comunidade como importante contexto para a participação. Além disso, as mães fazem reflexões como a preocupação em manter seus filhos com PC independentes, ajuda-los a se desenvolverem e a estabelecerem relacionamentos de forma madura. Por outro lado algumas dificuldades no exercício da parentalidade também são apresentadas como a divergência do estilo parental com o do parceiro resultando em conflitos, dificuldades em encontrar maneiras apropriadas de estimular a participação e ensinar valores morais. Com relação aos adolescentes com PC encontrou-se que eles gostam e procuram engajar-se em várias atividades de lazer, buscando a participação social com amigos em diversos contextos, como lanchonetes, igreja, escola dentre outras, além disso, em relação ao futuro os adolescentes destacam a importância de estudarem, estabelecerem uma carreira e terem uma família. Acredita-se que este trabalho contribui para o entendimento da parentalidade em famílias de adolescentes com PC e sobre os rebatimentos destas práticas na participação social destes adolescentes, além de fornecer elementos para a compreensão de como se dá a participação social destes adolescentes e o que eles esperam para seu futuro. Espera-se que este estudo some esforços positivos na efetivação de práticas da Terapia Ocupacional e demais profissões da reabilitação, cujo foco é promover a participação desta população.

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Oliveira, Alyne Kalyane Câmara de. „Repertório funcional de crianças com paralisia cerebral : a perspectiva de cuidadores e profissionais“. Universidade Federal de São Carlos, 2012. https://repositorio.ufscar.br/handle/ufscar/6854.

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Financiadora de Estudos e Projetos
The cerebral palsy (CP) due to a non-progressive lesion in the immature brain presents neuromotor impairments and disabilities associated who, allied with contextual factors such as task demands, environmental characteristics and attitudes of family members, can lead to impaired functional performance and the independence of children. Regarding to the actions of family members about the stimuli and expectation relating to children with CP, some studies reported differences between the assessment of family caregiver and the professional responsible for the children treatment and little is known about this difference of perception, being the understanding in the literature concerning aspects related to the way of thinking and acting of family members, still limited. This study aims to verify the agreement between the profile of functionality of children with CP reported by caregivers and rehabilitation professionals in the areas of self-care, mobility, social function and to identify variables related to the caregiver, child and environment that were associated with such agreement. We tested two hypotheses: caregivers and rehabilitation professionals disagree about the typical functional repertoire of the child with CP; and there are variables of the caregiver, child and environment, which may affect the assessment of caregivers in relation to the functional repertoire of his children, who are present when there is disagreement on this score between caregivers and professionals. The study included 50 children with CP aged from 3 to 7.5 years, their primary caregivers of 50 children with CP and 25 rehabilitation professionals, physiotherapists and occupational therapists, linked to six health institutions from the inside the State of São Paulo. The instruments Lipp´s Inventory of Stress Symptoms in Adults (ISSL), Social Support Questionnaire (SSQ), Gross Motor Function Classification System for Cerebral Palsy (GMFCS) and Pediatric Evaluation of Disability Inventory (PEDI) were used, beyond a form identifying the participants. The data were analyzed from the spreadsheets of each instrument and descriptive and inferential statistical analysis, and for the correlation 9 analysis was used nonparametric Spearman test and for the remaining analyzes, the Quisquare, Fisher s Exact, Mann-Whitney test, Kruskal-Wallis and Odds-Ratio. General Strong correlations were found, indicating agreement between the profile of functionality reported by caregivers and professionals, mainly in relation to functional abilities of children and caregivers support needed to the children perform the functional activities, with less agreement on changes of the environment that children use routinely. The relevance of correlations was influenced by factors such as: caregiver's marital status, family income, stress symptoms, professional guidance received regarding the activities of daily living of the child, caregiver time spent with the child and the level motor function of the child. Discusses that part of results does not support one of hypothesis of the research by distancing themselves from notes of literature, which indicate a convergence between the assessments of professional and caregivers, in the environment family and therapeutic, respectively, and a similarity of functional repertoire of children with CP in different contexts investigated, at same time as part of the results confirms the other hypothesis of study, when identifying factors that may explain the level of agreement between caregivers and professionals, configured as variables in this process. It is considered that, the present study may contribute by adding to the knowledge produced in the field, highlighting the influence of variables related to the assessment of caregivers regarding to functionality of the child with CP and interventions of occupational therapists and other professionals to be proposed with children and families in their developmental context.
A paralisia cerebral (PC), decorrente de uma lesão não-progressiva no cérebro imaturo, apresenta comprometimentos neuromotores e deficiências associadas que, aliados a fatores contextuais como demanda das tarefas, características do ambiente e atitudes de familiares, podem levar ao comprometimento do desempenho funcional e da independência das crianças. Em relação às atitudes de familiares acerca dos estímulos e expectativas relativas às crianças com PC, alguns estudos verificaram divergências entre a avaliação do cuidador familiar e do profissional responsável pelo tratamento da criança, e pouco se sabe sobre esta diferença de avaliação, sendo o entendimento na literatura sobre os aspectos relacionados ao modo de pensar e agir de familiares, ainda limitado. Este estudo objetivou verificar a concordância entre o perfil de funcionalidade de crianças com PC relatado por cuidadores e profissionais da reabilitação, nas áreas de autocuidado, mobilidade, função social e identificar variáveis relativas ao cuidador, criança e ambiente que estivessem associadas a tal concordância. Foram testadas duas hipóteses: cuidadores e profissionais da reabilitação discordam quanto ao repertório funcional típico da criança com PC; e existem variáveis do cuidador, criança e ambiente, que podem afetar a avaliação de cuidadores em relação ao repertório funcional de sua criança, que estão presentes quando há discordância sobre esta avaliação entre cuidadores e profissionais. Participaram do estudo 50 crianças com PC na faixa etária de 3 a 7,5 anos, os respectivos 50 cuidadores principais das crianças com PC e 25 profissionais da reabilitação, fisioterapeutas e terapeutas ocupacionais, vinculados a 6 instituições de saúde do interior do Estado de São Paulo. Foram utilizados os instrumentos Inventário de Sintomas de Stress para Adultos de Lipp (ISSL), Questionário de Suporte Social (SSQ), Sistema de Classificação da Função Motora Grossa para Paralisia Cerebral (GMFCS) e o Inventário de Avaliação Pediátrica de Incapacidade (PEDI), além de uma ficha de identificação dos participantes. Os 7 dados foram analisados a partir das planilhas de cálculo de cada instrumento e de análise estatística descritiva e inferencial, sendo que para as análises de correlação foi usado o teste não-paramétrico de Spearman e para as demais análises, os testes Qui-quadrado, Exato de Fisher, Mann-Whitney, Kruskal-Wallis e Odds-Ratio. Fortes correlações gerais foram encontradas, indicando concordância entre o perfil de funcionalidade relatado por cuidadores e profissionais, principalmente em relação às habilidades funcionais das crianças e a assistência dos cuidadores necessária para as crianças realizarem as atividades funcionais, com menor concordância sobre as modificações do ambiente que as crianças utilizam rotineiramente. A força das correlações foi influenciada por alguns fatores como, por exemplo: situação conjugal da cuidadora, renda familiar, sintomas de estresse, recebimento de orientação por profissionais quanto às atividades de vida diária da criança, tempo de permanência do cuidador com a criança e o nível de função motora da criança. Discute-se que parte dos resultados encontrados não sustenta uma das hipóteses de pesquisa, distanciando-se de apontamentos da literatura, ao indicar uma aproximação entre as avaliações de cuidadores e profissionais nos ambientes familiar e terapêutico respectivamente, e uma similaridade de repertório funcional das crianças com PC nos diferentes contextos investigados, ao mesmo tempo em que parte dos resultados confirma a outra hipótese do estudo, ao identificar fatores que podem explicar o nível de concordância entre cuidadores e profissionais, configurando-se como variáveis presentes neste processo. Considera-se que o presente estudo poderá contribuir acrescentando ao conhecimento produzido na área, evidenciando a influência de variáveis relacionadas à avaliação de cuidadores sobre a funcionalidade da criança com PC e para intervenções do terapeuta ocupacional e demais profissionais da saúde e educação a serem propostas com as famílias e crianças em seus contextos de desenvolvimento.

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Crawford, Emily Anne. „The relevance of the Goldsmith Index of Body Symmetry to functional seated posture“. University of Western Australia. School of Human Movement and Exercise Science, 2006. http://theses.library.uwa.edu.au/adt-WU2006.0007.

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Whilst literature exists describing prevalence and theories about mechanisms of development of deformity, there is a distinct lack of research that examines how deformity can be measured despite it being an area of identified need. This study established the inter- and intra-rater reliability of the Goldsmith Index of Body Symmetry and examined the relevance of the information it provides within the context of a comprehensive postural assessment for individuals with cerebral palsy in conjunction with a commonly used clinical assessment ... Results demonstrated that high index levels were not exclusively associated with people with windswept deformity. Postural patterns of windsweeping, frog leg (abducting) and scissor (adducting) postures and hip extension were found to occur in all categories, suggesting that asymmetry is not confined to one particular postural pattern. Clinically observable changes were identified through comparison of the supine evaluation and index scores. The flexibility of postural components (or the ability to correct asymmetry) in a supine position for the SD categories demonstrated wide variation. However, subjects in the 3+SD groupings had fixed scoliosis and the majority (83%) also had fixed pelvic obliquity and rotation. All other subjects up to the 3SD category had flexible pelvic obliquity and rotation. No definitive differences in postural components between groups were identified in sitting positions, which was attributed to the influence of gravity on the body in an upright posture. Examination of sitting ability and index level did not demonstrate any relationship, suggesting that greater independence in sitting is not necessarily associated with a lower Goldsmith Index. The study highlighted that assessment of posture is complex, and that no single tool provides the answers required to manage a person’s posture. It demonstrates the need for clinicians to be aware that subjective clinical assessment may not be sufficient to adequately assess and detect changes in posture, and that the Goldsmith Index of Body Symmetry provides objective data that can be used as a powerful adjunct in interpreting clinical assessment and supporting the evaluation of clinical interventions.

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Bodkin, Amy Winter. „Home-based treadmill training in ambulatory children with hemiplegic cerebral palsy /“. Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2006.

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Thesis (Ph.D. in Clinical Science) -- University of Colorado at Denver and Health Sciences Center, 2006.
Typescript. Includes bibliographical references (leaves 58-61). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

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Van, Colle Susan Judith. „Music therapy process with young people who have severe and multiple disabilities“. Thesis, University of Reading, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.288927.

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Fox, Cynthia Marie. „Intensive voice treatment for children with spastic cerebral palsy“. Diss., The University of Arizona, 2002. http://hdl.handle.net/10150/280175.

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Purpose. The purpose of this study was to examine the effects of an intensive speech treatment for children with spastic cerebral palsy (CP). Background. Children with spastic CP have speech and voice disorders, which may limit functional communication and negatively impact quality of life. There are limited published outcome data on speech treatment approaches for these children. Recent advances in theories of motor development and behavioral gait and limb treatment provide a solid framework (consistent with theories of motor learning) from which to test different speech treatment concepts (e.g., intensive treatment, high effort exercises, repeated practice trials, and sensory augmentation/sensory awareness training) in children with spastic CP. Method. A multiple baseline single-subject design with replication across participants (five children with spastic CP) was used. Acoustic measures related to voice functioning, auditory-perceptual analysis of speech samples, and perceptual ratings by parents of participants in this study were obtained from baseline, post-treatment, and 6 week follow-up data recording sessions. Results. The four participants who received treatment demonstrated a marked change in performance on one or more of the acoustic measures and there were strong listener preferences for the treated speech samples (post-treatment or follow-up sessions) over baseline samples for most perceptual characteristics rated. In addition, parents of these four participants reported improved perceptions on two or more voice, speech, or communication characteristics following treatment, and all had an overall favorable impression of their child's treatment outcome and of the treatment approach used. No changes were observed in the one participant with CP who did not receive treatment. Conclusions. These findings suggest that in these four participants with CP, intensive speech treatment changed the output of the speech motor system in a manner that listeners preferred over baseline speech samples. In addition, this positive effect was maintained in nearly all cases 6 weeks after the conclusion of treatment. These findings are consistent with those in limb and gait treatment literature, thus highlighting potential key treatment concepts to consider in behavioral treatment for children with spastic CP.

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Irochu-Omare, Margaret Helen. „Parent/caregiver satisfaction with physiotherapy services for children with cerebral palsy: an explorative qualitative study at the cerebral palsy clinic in Mulago Hospital, Kampala, Uganda“. Thesis, University of the Western Cape, 2004. http://hdl.handle.net/11394/1527.

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Magister Scientiae (Physiotherapy) - MSc(Physio)
The extent to which customers are satified with the care they receive from the health professionals has been an important area of interest for researchers, managers and health care workers. The physiotherapy cerebral palsy clinic at Mulago Hospital in Kampala Uganda provides physiotherapy services for parents caregivers of children with cerebral palsy. The parents caregivers visit the clinic seeking physiotherapy services that will address their problems and those of the child. The purpose of this study was to explore the satisfaction that the parents caregivers of children with cerebral palsy get from utilising the physiotherapy services at the clinic and to identify the barriers problems that they encounter that might affect their attendance.
South Africa

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Nixon, Mason Earl. „Utilization of auditory cues to enhance therapy for children with cerebral palsy“. Thesis, Georgia Institute of Technology, 2013. http://hdl.handle.net/1853/51736.

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The objective of the research is to examine the impact of auditory stimulus on improving reaching performance in children with cerebral palsy. A form of auditory stimulus, called rhythmic auditory stimulation (RAS), is well-established in neurological fields as well as in music-based rehabilitation and therapy. RAS is a method in which the rhythm functions as a sensory cue to induce temporal stability and enhancement of movement patterns by what is believed to be a temporal constraint of the patient’s internal optimized path of motion. In current neurological studies, it is suggested that activity in the premotor cortex may represent the integration of auditory information with temporally organized motor action during rhythmic cuing. Based on this theory, researchers have shown that rhythmic auditory stimulation can produce significant improvement in mean gait velocity, cadence, and stride length in patients with Parkinson’s disease. Evidence validating this observation was also seen in a study on hemiparetic stroke wherein patients displayed improvements in spatio-temporal arm control, reduction in variability of timing and reaching trajectories, and kinematic smoothing of the wrist joint during rhythmic entrainment. Lastly, studies have suggested an accompaniment of sound feedback in addition to visual feedback can result in a positive influence and higher confidence in patients who have had a stroke or spinal cord injury. Although an effect of rhythmic cuing on upper extremity therapy has been explored in areas where brain injury has occurred (such as patients who have incurred stroke, spinal injury, traumatic brain injury, etc.), what has not been explored is the effect of rhythmic cuing on upper extremity therapy for individuals with neurological movement disorders, such as cerebral palsy. Thus, in this research, we set out to explore the effect of RAS in therapeutic interventions for children with cerebral palsy. Through this investigation, we examine its effect on reaching performance as measured through range of motion, peak angular velocity, movement time, path length, spatio-temporal variability, and movement units. For this assessment, we created a virtual system to test the aforementioned principles. We established clinically based angular measurements that include elbow flexion, shoulder flexion, and shoulder abduction using a 3D depth sensor to evaluate relevant metrics in upper extremity rehabilitation. We validated the output of our measurements through a comparison with a Vicon Motion Capture System. We then confirmed the trends of the metrics between groups of adults, children, and children with cerebral palsy. Through testing our system with adults, children, and children with cerebral palsy, we believe we have constructed a system that may induce engagement, which is critical to physical therapy, and may also have a positive impact on the metrics. Although we see trends indicative of an effect through use of the system on children with cerebral palsy, we believe further testing is needed in order to establish or refute the effect and also to definitively establish or refute the effect of rhythmic auditory stimulation. The system, the angular measurements, and the metrics we employ could provide an excellent foundation for future research in this space.

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Psychouli, Pavlina. „Modified constraint-induced movement therapy in children with congenital hemiplegic cerebral palsy“. Thesis, University of Southampton, 2008. https://eprints.soton.ac.uk/71895/.

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One new treatment strategy for children with hemiplegic cerebral palsy (CP) is constraint-induced movement therapy (CIMT). CIMT combines restraint of the less affected upper extremity and intensive exercise with the affected limb. CIMT has been shown to be effective in adults following stroke but it is not clear whether or not CIMT can readily be incorporated into clinical practice either with adults or children. An intervention that may be more practical involves the restraint element of CIMT without additional exercise (Forced use therapy-FUT). FUT has been only sparsely investigated, especially in children with CP. Different versions of CIMT protocols have been suggested as being „child-friendly‟ but identifying a practical and effective protocol remains challenging. Part of a child-friendly protocol includes identification of the most appropriate type of constraint, as different splints have been used for different populations without justification of their selection. In this project, the aim was to identify the most appropriate splint from children‟s and parents‟ perspective as reflected by effectiveness and adherence to home-based FUT (feasibility study) and to investigate the functional effects of a modified version of CIMT (mCIMT) (effectiveness study) that was designed based on the findings of the feasibility study. A further aim of the study was to compare the effect of additional functional activities and feedback with constraint alone. Two questions emerged as being important during the course of the project; the first addressed poor recruitment to the effectiveness study and explored parents and therapist‟ views on the practicality and effectiveness of both the classic paediatric protocol and the one suggested by the present study. The second was to provide insight into the physiological effects of CIMT or other treatments that might explain variations in response. In this study a test using the lateralised readiness potential (LRP) component of the EEG that was appropriate for young children was developed and evaluated with a small sample of unimpaired children and children with CP.

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Cooper, Jasmine. „The determination of sensory deficits in children with hemiplegic cerebral palsy /“. Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61229.

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Cerebral palsy is a non-progressive disorder associated with brain injury, defect, or disease, of early onset. Emphasis is placed on the more easily observable motor deficits, with any underlying sensory deficits often being overlooked. Existing sensory assessments have either been standardized on an adult population or for a paediatric population without significant neuromotor impairment. Thus, there is a need to formulate a standardized sensory assessment battery that may be used to evaluate physically handicapped children. A review of the literature highlights the necessity to evaluate the presence and extent or sensory dysfunction in school-age hemiplegic children, using a standardized clinical sensory assessment battery, as well as somatosensory evoked potentials.
A reliable sensory battery, which assesses 5 sensory modalities, was formulated and normative data for school-age children was derived. Sensory function was evaluated in 9 hemiplegic children (4-19 years) and 18 healthy age-matched controls. Significant bilateral sensory deficits were documented in hemiplegic children. Thus a sensory assessment should be an integral part of the evaluation of a child with hemiplegia.

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Yap, Rita. „Determinants of responsiveness to botulinum A toxin in children with cerebral palsy“. Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=98524.

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Botulinum A toxin (BTX) has become increasingly recognized as a treatment option in the management of spasticity in children with cerebral palsy (CP). Preliminary evidence suggests that certain baseline characteristics of the child may affect responsiveness to BTX. However, the contribution of these factors has not been fully elucidated.
The primary objective of the study was to examine whether specific intrinsic and extrinsic characteristics of the child were associated with responsiveness to BTX. The results indicate that age, number of treatments, parenting stress and child's motivation were associated with the degree of change in gait pattern, level of ambulation, gross motor function and functional independence. The findings suggest that the contribution of contextual factors (personal and environmental) on responsiveness to BTX is underappreciated in children with mild CP. Identification of potential factors contributing to responsiveness to BTX will assist clinicians in identifying children who would benefit most from this procedure.

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Schneiberg, Dias Sheila. „Rehabilitation strategies to improve upper limb movement quality in children with cerebral palsy“. Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=66702.

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Children with CP are extremely heterogeneous in terms of etiology and clinical features. The diversity of symptoms among CP syndromes is a challenge for different branches of health research. Despite the efforts of many studies in examining rehabilitation strategies to improve upper limb (UL) function in children with CP, the confidence in the validity of these studies' evidence is still moderate to low. One limitation suggested is related to the type of outcomes used to measure improvement. Many are not sensitive enough to detect change (lack of responsiveness), are not age-related, and do not describe the movement quality. Movement quality concerns about movement performance or how well an activity is performed taking into reference normative data from typical populations. The assessment of movement quality in UL activities refers to the measurement of range of motion, hand trajectories, interjoint and intersegment coordination, muscle contraction patterns, and postural adjustments. The objective assessment of movement quality can be made by kinematic and kinetic analyses. The description of movement quality is important, because early brain injuries are more susceptible to 'maladaptative' plasticity, which might result in abnormal movement behaviors. The primary objective of this prospective single subject research design study was to determine the effect of two rehabilitation strategies in UL movement quality: arm constraint and trunk restraint, in the context of a modified constraint induced therapy (mCIT) and a task-oriented intervention, respectively. The UL movement quality was measured by kinematic analysis of a functional reaching task: a self-feeding simulation. Overall, the kinematic variables investigated are related to hand trajectories, arm angles and trunk forward displacement. Two clinical outcomes measuring UL movement quality were also used, the QUEST for the mCIT study, and the Melbou
Les enfants avec paralysie cérébrale (PC) constituent un groupe clinique fortement hétérogène, tant au point de vue de l'étiologie que des caractéristiques cliniques. Malgré les efforts de recherche qui ont été déployés dans plusieurs études pour examiner les stratégies de réadaptation visant l'amélioration de la fonction du membre supérieur chez les enfants avec PC, il demeure que la confiance démontrée envers la validité de ces résultats est encore de modérée à faible. Une des limites notées dans la littérature est reliée au type de variables qui sont mesurées : ces variables ne seraient pas assez sensibles pour détecter des changements ou ces études ne décriraient pas la qualité du mouvement. Cette évaluation objective de la qualité de mouvement peut être réalisée par l'intermédiaire d'analyses cinématiques ou cinétiques. La description de la qualité du mouvement est considérée primordiale, puisque des lésions cérébrales en bas âge sont plus susceptibles d'amener une plasticité « maladaptative » et donc d'engendrer des mouvements anormaux.Le premier objectif de cette recherche prospective à protocoles individuels est de déterminer les effets de 2 stratégies de réadaptation visant la qualité du mouvement du membre supérieur: la contrainte du bras et la restriction du tronc, réalisées respectivement dans le contexte d'une intervention par contrainte modifiée (mCIT) et d'une intervention orientée vers la tâche. Globalement, les variables cinématiques mesurées dans ces protocoles comprennent les trajectoires de la main, les angles articulaires du bras et le déplacement du tronc vers l'avant. Deux échelles de mesure cliniques reliées à la qualité du mouvement du bras ont aussi été utilisées : le QUEST (étude mCIT) et le Melboune assessment (intervention orientée vers la tâche). Étant donné l'observation d'une grande variabilité au

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Andersson, Johanna, und Caroline Gärd. „Handfunktion hos barn med cerebral pares : - en beskrivande litteraturstudie“. Thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-29567.

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Seniorou, Maria. „Rehabilitation in cerebral palsy evaluation of physiotherapy intervention after multi-level orthopaedic surgery“. Thesis, University of Oxford, 2006. http://ora.ox.ac.uk/objects/uuid:6a184f1a-f708-4cd4-bc4f-9fa7bfcf2f11.

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Complex orthopaedic surgery is often indicated in the management of deformity in children with spastic diplegic cerebral palsy (CP) and a long rehabilitation programme is important for a successful outcome. However, the frequency and content of physiotherapy treatment following surgery varies between centres. This thesis aimed at providing a scientific basis for post-operative rehabilitation following multi-level surgery in children with CP. The effect of muscle weakness on function in patients with CP is recognised. However, the short and long-term impact of multi-level orthopaedic surgery on muscle strength is unclear. Strength changes would have implications for both surgical and conservative treatment planning. The objectives of this study were to establish a better understanding of the impact of surgery on muscle strength, gait and function, as well as the natural history of weakness in CP. Furthermore, the study aimed to clarify whether physiotherapy, focused on resistance strengthening techniques, was more effective than routine physiotherapy. The reliability of a protocol for measuring muscle strength in lower limb muscle groups in this population was firstly established. A pilot study of 10 children with a diagnosis of spastic diplegic CP and healthy counterparts demonstrated a reliable strength testing protocol. The main study of 20 diplegic children who underwent multi-level surgery showed that despite improvements in gait parameters, significant loss of strength in lower limb muscle groups and gross motor function persisted at six months. The value of intensive physiotherapy was assessed in a randomised controlled trial six months after surgery. Advantages of resistance training over active exercise were demonstrated. Assessment at one year showed that surgical patients preserved the post-physiotherapy strength and function gains but these did not reach the pre-operative values. Another group of 10 diplegic children who received routine physiotherapy but no surgical treatment for 12 months showed significant deterioration of their gait. The rate of deterioration demonstrated in conservatively treated diplegic patients and the degree of weakness caused by surgery, should inform parents and clinicians during decisions regarding surgery. Future research in multi-level surgery should include specific strength assessment protocols. The results from the randomised clinical trial showed that overall intensive strengthening regimes after multi-level surgery are beneficial. This finding would have significant implications on managing resources and designing appropriate rehabilitation programmes after multi-level orthopaedic surgery.

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Liebich, Ingrid. „Hyperbaric oxygen therapy for children with cerebral palsy : Jebsen-Taylor test of hand function“. Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31117.

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Despite lack of scientific evidence, hyperbaric oxygen therapy (HBO2) has been used as a treatment for children with cerebral palsy (CP). Recently, a multi-centre randomised, double-blind, placebo-controlled trial assessed the efficacy of HBO2 therapy for children with CP. Using the same cohort, the purpose of this study was to examine the effectiveness of HBO2 therapy on hand function using the Jebsen-Taylor test. All children received 40 treatments over a 2-month period. HBO2 treatments were 60 minutes with 100% O2 at 1.75 atmospheres absolute (ATA). Placebo treatments were also 60 minutes with air (21% O2) at 1.3 ATA. Seventy-eight children with CP, aged 3--12 years completed pre and post hand function assessments. Hand function was evaluated using one quantitative measure (time) and three qualitative measures. There were no significant changes between baseline and follow-up tests for any of the measures, although both experimental and control groups improved ( p = 0.08) their total times for the Jebsen test. The HBO2 group improved by 54.5 seconds (8.8%) while the placebo group improved by 47.8 seconds (7.7%). The results indicate that HBO2 therapy did not enhance the hand function of children with CP.

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Mäenpää, Helena. „Electrostimulation therapy and selective posterior rhizotomy in the treatment of children with cerebral palsy“. Helsinki : University of Helsinki, 2005. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/maenpaa/.

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Hoving, Marjanke Aaltje. „Intrathecal baclofen therapy in children with intractable spastic cerebral palsy a Dutch national study /“. [Maastricht] : Maastricht : Universitaire Pers Maastricht ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=10712.

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Fitzpatrick, Louise. „The efficacy of the neurodevelopmental therapy treatment approach in 4-7 year old children with cerebral palsy“. Thesis, Stellenbosch : Stellenbosch University, 2001. http://hdl.handle.net/10019.1/52523.

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Thesis (MSc)--Stellenbosch University, 2001.
ENGLISH ABSTRACT: Although the neurodevelopmental therapy (NDT) treatment approach is used extensively in the management of children with cerebral palsy, there is currently very little documented research to support its efficacy. The purpose of this study was to evaluate the efficacy of NDT in terms of its effect on motor function in a group of 10 cerebral palsy children. A multiple simple single-subject design was used in which the children each acted as their own controls. A 5 week baseline period, during which no intervention was received by the children, was followed by a 5 week intervention phase during which the children received twice weekly NDT treatment. The children were assessed at the beginning and end of each phase using the Gross Motor Function Measure (GMFM), and an assessment tool, which allowed the establishment of individualised outcome measures, called TELER. The group of children demonstrated no statistically significant gains in motor function on either of the outcome measures during the baseline phase of the study. However during the intervention phase the overall improvements demonstrated by the group on both the GMFM and TELER were statistically significant. Nine out of the ten children achieved greater improvements in their goal total GMFM scores during the intervention phase than during the baseline phase. Similarly all of the children achieved a greater number of clinically significant improvements on the TELER outcome measures. NDT was beneficial and useful in promoting motor function in this group of cerebral palsy children.
AFRIKAANSE OPSOMMING: Alhoewel die Neuro-ontwikkelingsterapie (NOT) behandelingsbenadering wydeverspreid gebraik word in die behandeling van kinders met serebrale verlamming, is daar huidiglik baie min gedokumenteerde navorsing om die effektiwiteit daarvan te staaf. Die doel van hierdie studie was om die effektitiwiteit van NOT te evalueer met betrekking tot die impak daarvan op die motoriese funksie van ‘n groep van 10 kinders met serebrale verlamming. ‘n Veelvuldige eenvoudige enkeling -subjek raamwerk is gebruik waarvolgens die kinders elk as hul eie kontrolegoep ageer het. ‘n 5-weke basislyn fase, waartydens die kinders aan geen intervensies onderwerp is nie, is gevolg deur ‘n 5-weke intervensie fase waartydens die kinders twee keer per week NOT behandeling ontvang het. Die kinders is geevalueer aan die begin en einde van elke fase met die Oorhoofse Motoriese Funksie Maatstaf (OMFM)/Gross Motor Function Measure (GMFM), asook ‘n evalueringsmaatstaf genaamd TELER, wat die bepaling van geindivualiseerde resultate moontlik gemaak het. Die groep kinders het geen statistics bewese vordering in motoriese fiinksies getoon volgens beide die evalueringsmaatstawwe tydens die basislyn fase van die studie nie. Daarteenoor het die groep tydens die intervensie fase oorhoofs gesproke statistics bewese vordering getoon met betrekking tot beide die OMFM en die TELER. Nege uit die 10 kinders het groter vordering getoon met hul totale OMFM resultate tydens die intervensie fase as gedurende die basislyn fase. A1 die kinders het tegelykertyd ‘n groter hoeveelheid substantiewe kliniese verbeterings getoon met betrekking tot hul TELER uitkomste. NOT was voordelig en nuttig in terme van die verbetering van motoriese funksie in die groep van serebraal verlamde kinders.

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Ödman, Pia. „Intensive training in group for children with cerebral palsy : evaluation from different perspectives /“. Linköping : Univ, 2007. http://www.bibl.liu.se/liupubl/disp/disp2007/med1008s.pdf.

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Collins, Michael J. „The Use of Hyperbaric Oxygenation Therapy to Change Cerebral Metabolism Rates in Patients with Chronic Brain Damage“. NSUWorks, 2009. http://nsuworks.nova.edu/cps_stuetd/20.

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Hyperbaric Oxygenation Therapy (HBOT) has a successive history for treating very specific groups of physical conditions. Research by Neubauer and colleagues states that HBOT's ability to increase cerebral metabolism in the brain regenerates dormant neural tissue (Neubauer, Gottlieb, & Pevsner 1994). According to this research, the increase of cerebral metabolism levels restores mental capacity from the neurological insult. Despite promise, uncertainty exists as to whether this is a viable treatment option for people suffering from neural damage. The research results for this experiment will examine the effect of HBOT on cerebral metabolism levels in adults and pediatrics with chronic neurological problems. Fifty individuals diagnosed as having a neurological impairment whom met criteria for the study were analyzed from an archival data set. Criterion required chronic impairment, baseline SPECT, followed by HBOT exposures, and a post SPECT scan. Statistical analyses consisted of a Pearson correlation that examined pre-metabolism rates with total change, a Pearson correlation that examined total change and number of treatments, and a one way ANOVA analysis that examined cerebral metabolism change in patients under 18 and over 18. Results indicated change

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Ödman, Pia. „Intensive training in group for children with Cerebral Palsy : Evaluation from different perspectives“. Doctoral thesis, Linköpings universitet, Sjukgymnastik, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-11046.

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There is a need of more evidence‐based knowledge of different treatment/training‐approaches for children with Cerebral Palsy (CP) to better describe the objectives of interventions, effects on functioning and fulfilment of health care needs. The general aim of this thesis was to evaluate the effectiveness of intensive training in groups (ITGs) with a habilitation approach and a conductive education approach. In addition, this thesis explored different meanings of participation in ITGs to parents from a parent perspective. This thesis consists of two parts, a quantitative evaluation of the effectiveness of two ITGs (paper I‐III) and a qualitative study exploring parents’ different ways of experiencing ITGs (paper IV). Fifty‐four children, 3‐16 years old, with different types of CP, intellectual capacity and level of gross motor function, participated with their parents in a four weeks ITG with a short‐term and a one‐year follow‐up (paper I‐III). The second sample was strategically composed of parents to 15 children with CP with experiences of ITGs in different settings. The results showed that the proportion of clinically significant change in gross motor capability, functional skills or self‐reported individualized goal measure didn’t show any major differences between the two ITGs. One period of ITG facilitated small clinical and parent reported improvements in functioning for the short‐term. Nine children out of 54 made a clinically significant improvement in gross motor capability (GMFM‐88 total score); 36 children improved if an improvement in any dimension A‐E was counted for. Twenty‐two children out of 52 improved in one of the domains self‐care, mobility and social function (PEDI Functional Skills). Twenty‐eight parents out of 54 perceived a clinically significant improvement on the self‐reported individualized goal measure. Most individualized goals dealt with motor activities and movement‐related body functions in both ITGs. The self‐reported individualized goal measure was not found to be more sensitive to change than the clinical measures. The one‐year follow‐up showed that children had a stable level of functioning. No child deteriorated on the clinical measures short‐term and at the one‐year follow‐up. A higher proportion of change was seen in the social function domain at the one‐year follow‐up, indicating a better potential to change in social function than in gross motor function. The majority of children had a high consumption of training delivered by the Child and Youth Habilitation and merely half of the group continued with repeated ITGs. The differences in functional outcome between children continuing with repeated ITGs compared with only customary Child and Youth Habilitation were limited to a higher proportion of improvements in social functioning. Parents perceived a high service quality in both ITGs. To parents, fulfilment of health care needs was as important as functional outcome. The probability for high service quality was associated with previous experience of the ITG, high expectations of improvements, if expectations and improvements in gross motor capability were achieved and if the child participated in the ITG with the habilitation approach. Therapists in the habilitation approach were more involved in discussions with parents about expectations for the ITG and knowledge exchange than conductors were, indicating more familycenteredness. The qualitative study points to a variety of parental needs that may be met at ITGs but also indicates some problems that should be addressed. Five overarching meaning categories of ITGs were described: ITGs as knowledge promotion, as a complementary training resource, as a bracket to ordinary life, as building up relations with therapists, and as a leisure‐activity. An additional category – “ITGs as risk for ill‐being” – subsumed different kinds of problems that may arise. Conceptions suggest that ITGs contribute to parents’ improved knowledge, support and well‐being, but ITGs could also negatively influence family‐functioning. Professionals and parents need to discuss parents’ previous experiences of ITGs, expectations of functional improvements, the functioning of the child and health care needs in order to individualize goals for ITGs and make the objectives for participation clear. There were no major differences in effectiveness between the two ITGs, a habilitation approach and conductive education approach. Various training approaches should be chosen depending on the child’s and family’s needs. In the choice between different training approaches it is of equal importance to acknowledge functional needs of the child as well as health care needs of the child and parent.

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Godwin, Ellen M. „Long-term effect of single event multiple level orthopedic surgery on the functional classification of children with cerebral palsy“. NSUWorks, 2005. http://nsuworks.nova.edu/hpd_pt_stuetd/29.

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Galen, Sujay Saphire. „A combination of Botulinum toxin A therapy and functional electrical stimulation in children with cerebral palsy“. Thesis, University of Strathclyde, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435110.

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Mayo, Nancy Elizabeth. „Evaluating intensity of physical therapy for children with cerebral palsy : problems and solutions in a clinical trial“. Thesis, McGill University, 1986. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=70353.

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Physical therapists recommend neurodevelopmental therapy (NDT) for cerebral palsy, but its effectiveness is unknown. A randomized controlled trial was undertaken to compare the effects, over six months, of intensive (weekly) NDT therapy and basic (monthly) NDT, on the motor development of young children with suspected cerebral palsy.
The trial soon strayed from its plans, but it was continued in order to identify all problem areas, to allow refinement of the measurement system and to plan a "trial proper" with good internal validity. In this, statistical power had to be sacrificed; nevertheless, the average outcome for the 17 infants on the intensive regimen was substantially better than that for the 12 on the basic regimen, after adjusting for the child's age, term birth or not, and mother's education (the equivalent of a t-statistic with 24 df was 3.49; p =.0019).
Inter-rater agreement, one aspect of external validity, was also tested and proved excellent.

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Smith, Brennan L. „MUSCLE SYNERGY DURING A SINGLE LEG STANDING TEST IN AMBULATORY CHILDREN WITH CEREBRAL PALSY“. UKnowledge, 2018. https://uknowledge.uky.edu/khp_etds/51.

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INTRODUCTION: Cerebral Palsy (CP) is a sensorimotor disorder characterized by dysfunctional motor coordination, balance problems, and loss of selective motor control. Motor coordination exhibited as co-contraction, has been subjectively quantified using gait analysis, but recent studies have begun to objectively analyze the amount of co-contraction by collecting electromyography (EMG) data. Center of pressure excursion (COPE) measurements collected during a single leg standing test (SLST) have shown to be more valid measurements of balance in populations with motor disabilities than a SLST alone. A recent study has correlated increased COPE velocity with a lower fall risk as determined by reported fall frequency, suggesting a more objective measure of fall risk. The current study aimed to determine if the fall risk calculated by COPE velocity in children with CP is correlated with co-contraction index value in various muscle synergy groups. It was hypothesized that i) co-contraction index values will differ between high and low fall risk groups, ii) there will be preferential activation of different synergy groups within the high and low fall risk groups, and iii) there will be a negative and direct correlation between COPE velocity and co-contraction index values for all synergy groups. METHODS: Fall risk grouping was determined by average COPE velocity values calculated from previously reported fall frequency groups. Balance ability was determined by COPE measurements during a SLST on a force plate. Muscle synergy groups were determined by common muscle pairings at the hip, knee and ankle. Co-contraction indices were determined from linear envelopes plotted from muscle group EMG data. An independent t-test was run on muscle synergy groups between high and low fall risk groups. Nonparametric Analysis of Variance (ANOVA) and Tukey post-hoc tests were run on the high and low fall risk groups separately to determine differences in co-contraction index value within high and low fall risk groups. A Pearson correlation analyzed COPE velocity and co-contraction index value. RESULTS: No significant differences in muscle synergy between the high and low fall risk groups were found (p = 0.476, 0.076, 0.064, 0.364). The ANOVA and Tukey post-hoc tests for high fall risk group found significant differences in co-activation index value between the sagittal hip and frontal hip groups (p = 0.022) and sagittal hip and ankle groups (p = 0.016). Low fall risk group was found to have significant differences between the sagittal hip and frontal hip groups (p = 0.038) and frontal hip and knee groups (p = 0.012). Weak and negative correlations were found between COPE velocity and both knee and ankle groups (r = -0.309, -0.323, p = 0.059, 0.050). Negligible and insignificant correlations were found between frontal hip and sagittal hip synergies and COPE velocity ((r = 0.013, -0.068, p = 0.475, 0.367). CONCLUSION: There is insufficient evidence to claim that muscle group activations are different depending on fall risk grouped by COPE velocity. It is not currently possible to correlate COPE velocity to a specific synergy group recruitment. However, data do suggest that sagittal hip and knee strategies are recruited more than ankle and frontal hip strategies during SLST.

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Prosser, Laura Anne. „Trunk and hip muscle activity patterns in early walkers with and without cerebral palsy“. Diss., Temple University Libraries, 2009. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/32354.

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Physical Therapy
Ph.D.
Poor control of postural muscles is a primary impairment in cerebral palsy (CP), however little is known about the activity of postural muscles during walking in individuals with CP. The objective of this study was to investigate differences in trunk and hip muscle activation patterns during the early stages of walking in children with CP compared to children with typical development (TD). Thirty-one children (16 TD, 15 CP) with an average of 28.5 months of walking experience participated. Electromyographic (EMG) data were collected from 16 trunk and hip muscles as participants walked at a self-selected pace over an instrumented walkway. Custom-written computer programs were used to identify the onset of muscle activity, and to generate instantaneous mean frequency (IMNF) curves. A functional principal component analysis was performed to determine differences in IMNF curves between groups. Linear regression analyses were performed to investigate relationships between gait parameters, muscle activation, and musculoskeletal measures. Group means were significantly lower in the CP group than the TD group for all spatiotemporal gait parameters measured. The CP group had greater percent activation and coactivation for all muscles except the external oblique. Greater hip adductor spasticity was related to increased abdominal muscle activity in the CP group. The CP group also had higher mean frequency throughout the gait cycle for all muscles. Higher IMNF can result from increased rates of motor unit activation, increased number of recruited motor units, or decreased synchrony of motor units, and may contribute to muscle fatigue in children with CP. Within the CP group, children classified as Gross Motor Function Classification System (GMFCS) level II demonstrated no differences in spatiotemporal parameters or percent muscle activation, but had greater gait symmetry and lower INMF for the trunk muscles, compared to the children classified as GMFCS level III. The potential influence of recording activity from adjacent trunk muscles is discussed, as well as the influence of the use of an assistive device by some children with CP. Postural muscle training during the early stages of walking in CP should be investigated to encourage the development of more functional and efficient movement strategies in these children.
Temple University--Theses

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Bolduc, Marie-Eve. „The impact of cerebellar malformations on cerebral development and child functioning“. Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=96674.

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The overall objective of this study was to delineate the impact of cerebellar malformations on cerebral development and child functioning in children aged one to six years.This study describes a high prevalence of developmental disabilities in children with cerebellar malformations and provides evidence for an important relationship between regional cerebellar volumetric growth and domain specific developmental and functional deficits. Additionally, our data suggests that cerebellar malformations significantly alter region specific cerebral development including, the subgenual white matter, midtemporal white matter, subcortical grey matter and inferior occipital grey matter when compared to healthy age-matched controls. Finally, decreased cerebellar volume significantly predicts total and regional cerebral growth impairments The results of this study may improve our ability to prognosticate the developmental outcome in young children with cerebellar malformations, and assist in developing targeted early intervention strategies, aimed at minimizing developmental disabilities and optimizing life quality in children with cerebellar malformations.
L'objectif général de cette étude était de définir l'effet des malformations cérébellaires sur la croissance cérébrale et sur les capacités fonctionnelles des enfants âgés de un à six ans.Cette étude décrit une forte prévalence de déficits développementaux chez les enfants ayant une malformation cérébellaire et démontre une importante association entre les volumes cérébellaires régionaux et des déficits développementaux et fonctionnels spécifiques. En outre, nos données suggèrent que les malformations cérébellaires affectent significativement le développement de régions cérébrales spécifiques, incluant les régions sous-genual, mi-temporal, et occipitale inférieure lorsque comparées aux témoins jumelés selon l'âge. De plus, une réduction du volume cérébellaire prédit significativement des réductions volumétriques cérébrales tant au niveau global que régional.Ces résultats peuvent améliorer notre habileté à pronostiquer la trajectoire développementale des jeunes enfants ayant une malformation cérébellaire, et contribuer à développer des stratégies ciblées d'intervention précoce visant à minimiser les limitations fonctionnelles et optimiser la qualité de vie chez les enfants ayant une malformation cérébellaire.

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Naylor, Catharine Elisabeth. „Modified constraint induced movement therapy for young children with congenital hemiplegic cerebral palsy : a randomised controlled trial“. Thesis, Queen Mary, University of London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.498025.

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Barka, Anna. „Effective Physical Therapy Methods For Improving Postural Control In Children Diagnosed With Cerebral Palsy: A Systematic Review“. Thesis, Högskolan i Jönköping, Högskolan för lärande och kommunikation, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-46505.

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AIM: The aim of this study was to investigate which physical therapy methods are most effective for improving the postural control in children and adolescents diagnosed with CP, in order to provide to physical therapists with new evidence on the topic for integrating them in theirs intervention plans. METHOD: A systematic literature review was conducted in order to collect all the relevant information according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Five databases (PubMed, ProQuest, CINAHL, Web of science and Scopus) were used to identify relevant studies to include in this review. Keywords included “physical therapy”, “postural control”, “cerebral palsy” and their synonyms. Inclusion and exclusion criteria were settled according to the research question. RESULTS: Following the exclusion and inclusion criteria and after the quality assessment of the yielded data 11 articles were included in this review out of 97 of the initial search. PT interventions that were identified in the review included aquatic physical therapy, electrical stimulation therapy, intensive upper- and lower-extremity training (HABIT-ILE), virtual reality therapy and reactive balance exercise and standard PT combined with other methods such as backward walking training, Whole Body Vibration (WBV) training and antigravity treadmill training. CONCLUSION: In order to achieve improvements in postural control that are maintained over a period of time, children with cerebral palsy need to have PT included in their everyday routine and to have consistency in their sessions. All the PT interventions showed some positive effects on PC but, as Cerebral Palsy has many classifications and the effects of it varies for each child the PT method needs to be adjusted to meet each child´s individual characteristics and disability and also to their environmental needs.

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Pinho, Iryna. „Eficácia dos protocolos modificados de constraint induced movement therapy na função motora e desempenho de atividades diárias“. Bachelor's thesis, [s.n.], 2016. http://hdl.handle.net/10284/5732.

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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia
Introdução: A Constraint Induced Movement Therapy (CIMT) é um programa de reabilitação intensivo muito utilizado em crianças com paralisia cerebral (PC) que promove a funcionalidade do membro superior. Nos últimos anos surgiram vários protocolos de CIMT modificados. Objetivo: Verificar qual o protocolo mais eficaz de CIMT na função motora e desempenho de atividades diárias em crianças com paralisia cerebral. Metodologia: Pesquisa realizada entre Maio e Julho de 2016 com expressões chave na base de dados PubMed, PEDro e ScienceDirect para identificar estudos publicados randomizados controlados realizados em humanos, publicados em inglês nos últimos 5 anos em que se utiliza um programa de CIMT em crianças com paralisia cerebral e que avaliem função motora e/ou Atividades da vida diária (AVD’s). Resultados: Nesta revisão foram incluídos 11 artigos randomizados controlados com uma média de classificação metodológica de 5,5/10 na escala de PEDro, incluíram no total 373 participantes.􀀁Conclusão: Apesar de existirem vários fatores a ser incluídos na realização de um programa de CIMT em crianças, ainda não é consensual o protocolo que promova mais benefícios sendo necessária mais investigação em torno deste tema.
Objective: Find what is the most effective protocol of constraint induced movement therapy on motor function and performance of daily activities in children with cerebral palsy. Methodology: Computerized search conducted between May and July 2016 with keywords on PubMed, PEDro and ScienceDirect databases to identify randomized controlled trials carried out on humans, published in the last 5 years that use constraint induced movement therapy in children with cerebral palsy. Results: In this review were included 11 randomized controlled items with a mean methodological score of 5,5/10 in PEDro scale, involving 373 individuals. Conclusion: Although there are several factors to be included in the realization of a CIMT program in children, it is still no consensus about the protocol that promotes more benefits, more research is needed around this theme.
N/A

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Ekström, Lena. „Hälsa och funktion i kvalitetsregistret för uppföljning av cererbral pares - CPUP : En genomlysning utifrån den internationella klassifikationen av funktion, funktionshinder och hälsa för barn och ungdom“. Thesis, Uppsala universitet, Sjukgymnastik, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-153527.

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Abstract: Objective: This study aimed at describing the health concept in the Swedish follow up programme for cerebral palsy (CPUP), with main focus on how aspects of participation is expressed in the agenda of the programme. Design: Document analysis: The home-page of CPUP was searched for three types of written material; references to the nature and aim of the programme, protocols used for data collection and abstracts from articles and reports on the list of publications. Within these all expressions of health, with bio-psycho-social understanding of the concept, were extracted and condensed with manifest content analysis. The meaning units obtained were linked to the International Classification of Function, Disability and Health – Child/Youth (ICF-CY). All resulting codes of participation were further compaired to an alternative model for describing the activity/participation component where the notion of "social participation" requires an aspect of role taking. The involvement of children/ youths and parents by the follow up routines were estimated and related to the results of the coding process. Results: 1276 meaning units were identified.The health focus of the CPUP involving data collected from children was on body and movement functions. The aspects in which parents were involved included more health aspects, especially if an optional assessment protocol aiming performance was used. Defined as peformance participation accounted for 19% of the meaning units (7% whitout the optional instrument). Defined as "societal participation" the rate of participation was under 3%. Conclusion: CPUP focuses on body-related aspects of health. The participation perspective needs strengthening to ensure the information needed to plan and implement interventions that have an impact on the self image of involved children. Thereby CPUP would gain an even stronger relation with the overall goal of Swedish habilitation services.
Abstract: Syfte: Studiens syfte var att beskriva hälsobegreppet i det svenska kvalitets-registret för uppföljning av cerebral pares (CPUP). Ett speciellt intresse riktades mot hur aspekter av delaktighet återspeglades i registrets arbete. Design: Text-analys. CPUP’s hemsida genomsöktes och tre texttyper avgränsades; uttryck för vad registret "var" eller hade till syfte, rapportformulär för datainsamling och abstracts från arbeten på publikationslistan. Alla uttryck för hälsa i bio-psyko-social mening avgränsades ur texterna med manifest innehållsanalys och kondenserades. De betydelseenheter som erhölls kodades till den internationella klassifikationen av funktion, funktionshinder och hälsa för barn och ungdomar (ICF-CY). De koder för delaktighet som erhölls analyserades vidare utifrån en alternativ modell för beskrivning av aktivitet/delaktighetskomponenten, där begreppet "social delaktighet" (definierat utifrån rolltagande) tillämpades. Barn/ungdomars och föräldrars involvering i datainsamlingen uppskattades och relaterades till resultaten av kodningen. Resultat: 1276 betydelseenheter identifierades. Hälsofokus för de data i CPUP vars insamling involverade barn gällde kropp och rörelse. Hälsoaspekter som involverade föräldrar uppvisade ett något bredare spektrum, speciellt om ett valbart instrument med inriktning på performance användes. Definierat som performance utgjorde delaktighet 19% av betydelseenheterna (7% utan det valbara instrumentet). Definierat som "social delaktighet utgjorde delaktighet under 3%. Konklusion: CPUP fokuserar kroppsrelaterade hälsoaspekter. Delaktighetsperspektivet behöver stärkas för att säkra den information som behövs för att planera och implementera åtgärder med inverkan på självbilden hos deltagande barn. Därigenom skulle starkare överensstämmelse mellan CPUP och övergripande mål för svensk habilitering kunna uppnås.

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Rousseau, Aletta Helena. „The use of play activities in eliciting specific components of movement in the development of handfunction of the spastic cerebral palsied child“. Master's thesis, University of Cape Town, 1985. http://hdl.handle.net/11427/26356.

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Salib, Sherif. „Psychometric properties of the gross motor function classification system for children with cerebral palsy : validity, reliability and prognostic value“. Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=80871.

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The objective of this thesis was to evaluate the construct validity, the inter-rater reliability and the prognostic potential of the Gross Motor Function Classification System (GMFCS). The analysis was carried out in a cohort of 111 children with cerebral palsy who participated in the HBO Study for children with cerebral palsy; a randomized multicentre clinical trial. Construct validity was examined by correlating the results from the GMFCS with that of the Gross Motor Function Measure (GMFM), the Pediatric Evaluation of Disability Inventory (PEDI) and the JEBSEN test of hand function. The inter-rater reliability of the GMFCS was explored by comparing the GMFCS values calculated by one therapist, using the HBO Study pre-trial patient charts, with those of another physical therapist who was blinded to the initial scores done earlier on the same records, and who was well-versed in the GMFCS. The prognostic properties of the GMFCS were examined by comparing, within each of the GMFCS levels, the mean change over time, for the GMFM, the PEDI, and the JEBSEN.

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Morina, Élido José 1980. „A inclusão do aluno com paralisia cerebral : demanda do professor para apoio técnico em fisioterapia“. [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311686.

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Orientador: Regina Yu Shon Chun
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-24T11:52:14Z (GMT). No. of bitstreams: 1 Morina_ElidoJose_M.pdf: 1043701 bytes, checksum: 646c468913680f5857d31856d3357f07 (MD5) Previous issue date: 2013
Resumo: Introdução: A inclusão escolar envolve tanto a questão de aceitação dos alunos com necessidades educacionais especiais na escola, como a quebra de estigmas, barreiras atitudinais e físicas acerca destas pessoas. As atuais políticas de educação inclusiva implicam mudanças e adequações no ambiente escolar, abrangendo a parceria entre profissionais da Educação e da Saúde. Para que se possa atender esses alunos de forma integral é necessária a atuação multidisciplinar e/ou interdisciplinar além dos educadores, incluindo fisioterapeutas, terapeutas ocupacionais, fonoaudiólogos, médicos, assistentes sociais, psicólogos, dentre outros profissionais. Em particular, a Fisioterapia assume importância na assistência aos alunos com deficiência física ou motora, como no caso da Paralisia Cerebral. População foco deste estudo em função de demandas como adaptações de materiais, mobiliário, postura e manuseio para permanência e acesso desses alunos na escola. Interessa conhecer a percepção dos professores em relação a esses aspectos. Objetivo: Analisar as demandas do professor em relação aos aspectos físicos e motores de crianças com paralisia cerebral da rede regular de ensino. Sujeitos e Método: Trata-se de estudo transversal, que segue os preceitos éticos do CONEP, aprovado pelo CEP sob n° 1214/2011. Foram entrevistados 30 sujeitos, dezoito professores e doze professores mediadores de alunos com paralisia cerebral inseridos na rede regular de ensino de um município de médio porte do interior de São Paulo. As entrevistas foram gravadas e transcritas para a análise segundo critérios de relevância e repetição. Resultados: Os sujeitos indicaram demandas em relação aos aspectos de manuseio, locomoção e posicionamento dos alunos, além do espaço físico e mobiliário, que podem gerar situações adversas ao processo de inclusão. Grande parte dos professores referiu realizar adequação de atividades e de materiais, visando melhor integrar o aluno. Em relação aos recursos humanos os relatos destacam de maneira positiva a atuação do AEE e do CAADE, além de indicar a necessidade de outros profissionais como o fisioterapeuta. Conclusão: De modo geral, os resultados mostram as demandas físicas e motoras, as dificuldades, os desafios e os avanços em relação à inclusão dos alunos com paralisia cerebral na percepção dos educadores, evidenciando que a parceria entre educadores e profissionais de saúde, dentre os quais o fisioterapeuta, pode favorecer mudanças em relação a barreiras físicas e atitudinais de modo a se colocar em prática uma escola verdadeiramente inclusiva. Este estudo aponta que a atuação da fisioterapia pode auxiliar nas práticas inclusivas, em conjunto com os educadores, os alunos com necessidades educacionais especiais e suas famílias, de maneira a facilitar o acesso e a permanência dos alunos com Paralisia Cerebral no ambiente escolar
Abstract: Introduction: The school inclusion involves both the issue of acceptance of students with special educational needs in the school, such as the breaking of stigmas, attitudinal barriers and physical about these people. The current policies of inclusive education imply changes and adaptations in the school environment, covering the partnership between professionals of Education and Health. For that you can meet these students in an integral way are required multidisciplinary approach and /or interdisciplinary addition of educators, including physical therapists, occupational therapists, speech language pathologists, physicians, social workers, psychologists, among other professionals. In particular, the Physiotherapy assumes importance in assistance to students with physical disabilities or motor, as in the case of Cerebral Palsy. Population focus of this study on the basis of demands as adaptations of materials, furniture, posture and handling for permanence and access for these students in the school. Interested to know the perception of teachers in relation to these aspects. Objective: to Analyze the demands of the teacher in relation to the physical aspects and engines of children with cerebral palsy of regular schools. Subjects and Methods: This cross-sectional study, which follows the ethical precepts of CONEP, approved by CEP under no. 1214/2011. Thirty subjects were interviewed, eighteen teachers and twelve teachers mediators for students with cerebral palsy inserted in regular schools of a medium-sized city in the interior of São Paulo. The interviews were recorded and transcribed for analysis according to the criteria of relevance and repetition. Results: The subjects indicated demands in relation to the aspects of handling, locomotion and placement of students, in addition to the physical space and furniture, which can generate adverse situations in the process of inclusion. Most teachers mentioned perform suitability of activities and materials, aiming to better integrate the student. In relation to human resources reports stand out in a positive way the actuation of the AEE and the CAADE, besides indicating the need of other professionals such as the physiotherapist. Conclusion: overall, the results show the demands physical and motor, the difficulties, the challenges and advances in relation to the inclusion of students with cerebral palsy in the perception of educators, evidencing that the partnership between educators and health professionals, among which the physiotherapist, can encourage changes in relation to the physical and attitudinal barriers in order to put into practice a truly inclusive school. This study shows that the performance of physiotherapy can assist in inclusive school. This study shows that the performance of physiotherapy can assist in inclusive practices, in conjunction with the teachers, the students with special educational needs and their families, so as to facilitate access and permanence of students with Cerebral Palsy in the school environment
Mestrado
Interdisciplinaridade e Reabilitação
Mestre em Saúde, Interdisciplinaridade e Reabilitação

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Necus, Emma Faye. „sEMG biofeedback as a tool to improve oral motor control and functional swallowing in school age children with cerebral palsy: a case series“. Thesis, University of Canterbury. Communication Disorders, 2011. http://hdl.handle.net/10092/5477.

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The number of children with complex medical needs has risen in recent years, due to the increase in medical technology and subsequent increased survival rate of premature infants. This has led to an increasing number of children with complex neurological conditions, such as Cerebral Palsy, being seen by speech-language therapists to address their complex feeding and communication needs in schools (Arvedson 2008). Surface electromyography (sEMG) has been successfully used as a tool to facilitate therapy in adult dysphagia rehabilitation (Huckabee & Cannito 1999), and has been used in studies of dysarthric speech in children with Cerebral Palsy (Marchant, Mc Auliffe & Huckabee 2007). This case series report examines the effect of oral motor control therapy with sEMG biofeedback to increase motor control and inhibit increased muscle tone. Three participants aged 6, 16, and 18 were selected from the population of Kimi Ora Special School. Each of the three participants were offered sixty, twice daily treatment sessions of 30 minutes each focusing on active relaxation, and reducing duration of return to reset after recruitment of the masseter and submental muscles using sEMG biofeedback. After each session each participant was fed a prescribed amount of thin fluid and a range of food textures to encourage generalization of increased control of the submental and masseter muscles during eating and drinking. One participant was withdrawn after 42 sessions, and two participants completed all 60 sessions. Results showed variable improvement in feeding skills, with a notable improvement in anterior food loss. All participants were able to participate fully in the treatment and made significant gains in their ability to control their muscles during treatment sessions which was reflected in the reduction of sEMG amplitudes. This study demonstrated that oral motor control therapy with sEMG is a viable treatment tool, which warrants further larger scale research into its effectiveness.

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Dissertationen zum Thema „Occupational therapy Cerebral palsy“

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