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Bower, Eva. "Physiotherapy for children with cerebral palsy." Thesis, University of Southampton, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242574.
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Rezgui, Taysir. "Musculoskeletal modeling of cerebral palsy children." Compiègne, 2012. http://www.theses.fr/2012COMP1991.
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La modélisation musculosquelettique est aujourd’hui utilisée dans de nombreux domaines tels que l’analyse de la marche pathologique et la simulation des traitements thérapeutiques et chirurgicaux. Dans le cadre de la paralysie cérébrale (PC), la prise en considération des spécificités des patients, des troubles neurologiques et des déformations osseuses est nécessaire. Etant donné que les techniques d’imagerie médicale sont encore marginales en routine clinique, le recours aux modèles génériques reste donc indispensable. Notre étude rétrospective vise le développement d’un modèle musculosquelettique (MMS) générique adapté aux enfants PC. Une première étude détermine les limites d’un tel modèle pour la marche normale, les marches pathologiques des enfants paralysés cérébraux, et les postures pathologiques imitées par une population saine. Une seconde étude propose une technique de calibration pour raffiner les paramètres du MMS à partir des données recueillies de l’analyse quantifiée de la marche (AQM). Ainsi, on a pu déduire que, même si les résultats estimés sont représentatifs pour les adultes sains, le MMS standard présente des limites concernant la cinématique et les forces musculaires prédites pour les enfants sains et les enfants PC. D’autre part, la procédure de calibration influe de façon positive sur les données prédites comme les activations musculaires et les forces musculaires. Ce travail montre que le MMS générique peut être calibré à partir des données de l’AQM afin d’améliorer les résultats du modèle. Cette technique pourrait représenter une nouvelle perspective dans les applications cliniques de la modélisation musculosquelettiqueThe analysis of pathological gait using musculoskeletal modeling is a promising approach to qualify and quantify the pathology as well as to monitor the potential recovery after therapy. When dealing with cerebral palsy, its specific neurological disorders and consequently bones deformities, specific-subject musculoskeletal models has been developed. The imaging techniques are still unaffordable in clinical practises. So, using the LifeMod software, we aimed to develop musculoskeletal model in a retrospective study to evaluate the accuracy of surgical treatments on cerebral palsy. Two principles studies are performed. First, relying on the accuracy of a rescaled generic adult skeleton, the musculoskeletal modeling limitation have been determined when applying normal gait and pathological crouch and jump postures, imitated by healthy adults and children. Second, calibration technique had been developed to refine the model’s parameters based on data collectid from the subject. Results from musculoskeletal modeling are compared to gait analysis date. As results, even if the model outputs gave correct results with healthy adults, the standard rescaled musculoskeletal modeling showed limits on predicted kinematics and muscle forces for healthy and CP children. The refinement of subject-specific joint parameters and driving the model with the experimental GRF data have a huge influence in model outputs and improve quantitatively the predicted muscle activations and forces. This work pointed out that the parameters of a rescaled generic musculoskeletal moded can be refined and personalized to improve model’s outcomes. It may represent a new perspective in clinical applications
3
Critten, Valerie. "Literacy development in children with cerebral palsy." Thesis, Open University, 2013. http://oro.open.ac.uk/49059/.
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This thesis concerns the literacy difficulties of fifteen children with cerebral palsy (CP). The children were an opportunistic sample from two schools, and were initially selected on the basis that they had typical abilities in other school subjects. A review of the literature pertaining to the development of literacy and related aspects of cognitive development in typically-developing children and children with CP informed the development of the research strategy. The children's literacy, their general non-verbal and communication abilities, as well as a set of cognitive abilities that could be related to literacy impairments, were assessed. The findings revealed that most, but not all, of the children with CP had literacy difficulties with low scores in reading and spelling, and all the children had problems with handwriting. Standardised assessments showed that while the children had good verbal abilities, they had very low scores on a non-verbal test. The children with the most severe literacy difficulties also had the most problems with phonological processing. Almost all of the children had difficulties with visual and spatial perception; however the better readers had typical results in an assessment of visual sequential memory. Tests of working memory (WM) revealed a clear division between typical levels of performance on verbal recall measures, and very poor performance on the visual components of working memory tests. There were mixed results for the assessment of the central executive, but generally those children who were the more able in literacy had higher scores. Correlations suggested that visual sequential memory; phonological segmentation; verbal recall; and aspects of the central executive of working memory were most closely associated with the children's literacy abilities. Thus, the findings indicate that children with CP ha,ve specific cognitive impairments, including a new suggestion that poor visual sequential memory abilities could delay the development of reading and spelling skills.
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Campbell, Craig. "Bone health in children with cerebral palsy." Thesis, University of Ottawa (Canada), 2006. http://hdl.handle.net/10393/27231.
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Background. Children with cerebral palsy (CP) encounter a number of orthopedic complications as a result of abnormalities in motor function. One of the most significant complications is fragility fractures, occurring in up to 23% of children in prior reports. Despite a growing literature on how to best interpret bone densitometry in children, little research has determined optimal utilization of dual x-ray absorptiometry (DXA) in children with CP in order to characterize the patients' bone health status. This study outlines the use of the mechanostat theory of bone physiology to classify osteopenia and interpret bone complications in this population. The mechanostat theory posits that muscle forces have the greatest impact on bone strength and that low bone mass will result from one of two pathologic circumstances: a primary disorder of abnormally low bone mass despite normal muscle forces, and a secondary disorder of bone mass due to abnormally low muscle forces on bone. The later category, secondary osteopenia, is hypothesized to be the bone health state of most children with CP, due to the motor dysfunction resulting from brain injury in these children. Bone morbidity is expected to be greater in those with osteopenia.
Methods. Single, community-based, rehabilitation centre, cross sectional study of 53 subjects with CP age 2-15 years of age. Subjects underwent a baseline interview, examination, x-ray, laboratory and DXA bone densitometry. Calculations of z-score values for total body bone mineral content and muscle mass were made based on published normal children. The z-scores determined the classification of osteopenia with -2 defined as abnormally low bone mineral content or muscle mass.
Results. The subjects (51% females) had a mean age of 9 years (s.d.=3.8, range=2.5-15.8). All types and severity of CP were represented in the sample. Normal DXA bone parameters were seen in 24 children, with 11 children classified as having primary osteopenia, five having secondary osteopenia and three with both primary and secondary (mixed). Three children had fragility fractures. Using the classification proposed herein, the fractures occurred only in children defined as having osteopenia. Having at least one bone complication and joint subluxation were more prevalent in the osteopenic subjects compared to non-osteopenic subjects (Chi square, p<0.05). Using z-scores for bone mineral content as an outcome variable, only one CP specific factor, the Gross Motor Function Classification System, was an important independent variable (beta=-0.48, R2=0.18, p<0.05). The final model also included age (beta=0.52, R2=0.34, p<0.05) and gender (beta=-0.36, R2=0.12, p<0.05), showing lower z-scores in males and those of younger age. Use of anti-convulsants, type of CP, family history, calcium and vitamin D intake did not contribute to the model. Measures of pain or quality of life, although worse in osteopenic subjects, were not significantly related to reductions in bone mineral content, when severity of CP was controlled.
Conclusions. Using the mechanostat theory to interpret bone density DXA measurements is a more physiologic way to interpret bone health in children and appears foundationally sound in this sample of children with CP. In the reported subjects orthopedic complications were more common in those with osteopenia, and fragility fractures were accurately classified in functional terms according to whether the osteopenia resulted from a primary or secondary bone defects.
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Aytolun, Nilay. "Psychological Adjustment Of Children With Spastic Cerebral Palsy." Master's thesis, METU, 2009. http://etd.lib.metu.edu.tr/upload/2/12611295/index.pdf.
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The aim of the present study was to examine the predictive values of sociodemographic variables, parental variables (parental stress, family functioning, parental adjustment, coping methods), and child variables (coping methods, self
concept) for the adjustment of children with spastic cerebral palsy. Transactional stress and coping model was used as the conceptual framework for the study. The sample of the study was composed of 80 children with spastic cerebral palsy and
one of their parents. Hierarchical regression analysis was conducted to test the child adjustment by using child gender, parent education, parental stress, family functioning, parental adjustment, parental coping methods, child coping methods,
and child self concept as independent variables. Results revealed that parentalstress, parents&rsquoproblem solving/optimistic coping and fatalistic coping predicted the adjustment of children with spastic CP. However, parental adjustment, family functioning, child coping and child self concept were not significantly predicting of child adjustment. The findings, strengths, limitations as well as the implications of the findings were discussed.
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Sandberg, Annika Dahlgren. "Literacy abilities in nonvocal children with cerebral palsy." Göteborg : Dept. of Psychology, Göteborg University, 1996. http://catalog.hathitrust.org/api/volumes/oclc/38956224.html.
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Humphreys, Ginny. "Posture and sleep in children with cerebral palsy." Thesis, University of Brighton, 2010. https://research.brighton.ac.uk/en/studentTheses/3522a298-94d0-4eb7-b383-ce4bb7d54d3c.
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This case study explored the factors that influence the experience of night-time postural management equipment by children with cerebral palsy in the South-West of England. The aims were to explore the views of children on using a sleep system, the role of their parents and therapist in its use and the quality of sleep experienced before and during use of a sleep system. Further objectives were the identification of factors that affect the use of sleep systems and the production of findings to guide therapists' clinical practice. Seven subunits made up the whole case, with each one consisting of a child, aged 18 months to nine years who had just been prescribed a sleep system, the child's therapist and parents. All participants, excepting children under three years old, were interviewed. Talking Mats, an innovative communication tool, was used to enable children with little or no verbal communication to give their views. Children as young as three years old were able to express their views on sleeping in a sleep system and to provide reasons for waking in the night. The findings included sleep difficulties in six out of seven children, two of whom improved with the use of a sleep system. Six children were thought to experience regular pain or discomfort, two of whom were more comfortable when sleeping in their sleep system. Factors were identified that influenced whether a child and family were able to continue using a sleep system at night including the finding that some of the therapists who were prescribing sleep systems did not have the necessary knowledge and experience. It was concluded that when children are given the appropriate tools they can have a voice and be able to practice making decisions about their healthcare. It is suggested that when considering prescription of a sleep system, use of the ICF framework model would assist clinicians in focussing on those factors that predict the child and family are most likely to continue to use it. Therapy services should consider the role of a specialist clinician to lead local postural management services and to put in place training and competency measures for generalist therapists to ensure that they have the necessary knowledge and experience.
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Gulliksen, Anette. "Upper Extremity Muscle Endurance in Children with Cerebral Palsy." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for bevegelsesvitenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-13141.
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Aim: The aim of this study was to evaluate whether submaximal muscle endurance at 20% of maximal voluntary isometric contraction (MVIC) is as reduced as muscle strength in elbow flexion in children with cerebral palsy (CP), and whether motor unit recruitment to compensate muscle fatigue is hampered in this group. Methods: Twelve subjects with cerebral palsy and seventeen control subjects performed three MVICs of elbow extension and flexion, and an endurance task holding a load of approximately 20% of MVIC until exhaustion. Both tasks involved either the affected or the non-dominant arm. During the MVICs, elbow extension and flexion torque and surface electromyography (EMG) from biceps brachii, triceps longus and triceps lateralis were collected. During the endurance task EMG from the same three muscles, in addition to accelerometer and inclinometer data were collected. Results: The CP group produced some lower torque and significant lower agonist EMG amplitudes during MVIC compared to the control group. The holding time to exhaustion was similar in the two groups. The CP group did not increase EMG amplitudes during this task, while the control group did. This difference between the two groups was significant. The median frequency (MDF) from start to end of the endurance task decreased on average 50% less in the CP group, but this difference between the two groups was not significant. Standard deviation (SD) of angle increased from start to end in both groups, increasing significantly more in the control group. SD of acceleration increased significantly in both groups, increasing more in the control group. Conclusion: The CP and the control group carried out the endurance task to exhaustion. The CP and the control group had similar holding time at the same relative load during the endurance task indicating muscle endurance was similar affected as muscle strength in children with CP. Agonist muscle activity during the endurance task did not increase in the CP group. Consequently, the CP subjects were not able to recruit additional motor units and had relatively lower levels of muscle fatigue. Key words: Cerebral palsy, MVIC, endurance, 20% of MVIC, holding time, EMG, biceps brachii, motor unit recruitment, muscle fatigue.
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Johnson, David L. "Midthigh adipose tissue infiltration in children with cerebral palsy." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 56 p, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:1440591.
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Berg-Emons, Hendrika Johanna Gerarda van den. "Physical training of school children with spastic cerebral palsy." Maastricht : Maastricht : Rijksuniversiteit Limburg ; University Library, Maastricht University [Host], 1996. http://arno.unimaas.nl/show.cgi?fid=6649.
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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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Price, Katherine. "Early social communication skills of children with cerebral palsy." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/10025176/.
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The clinical motivation for this study arose from repeated observations that some children with cerebral palsy (CP), despite provision of equipment and support, were still failing to reach their expected communication potential. In the clinical field, this failure has been commonly viewed to be the result of physical dependence on adult partners, or linked directly to the children’s physical or learning disabilities, arising from the neurological and developmental deficits associated with CP. Social responsiveness and shared attention underpin language and communication development. Children with cerebral palsy (CP) may be vulnerable to disruption in the development of these foundation skills (Nordin & Gillberg, 1996). However, there are few guidelines for assessment of these skills in this group of children (Watson & Pennington, 2015). This current study aimed to: 1. develop an assessment protocol to support the identification of autism spectrum disorder (ASD) in children with CP at GMFCS levels IV and V; 2. compare the assessment tool (Gaze-NoTe) profiles of performance of children with CP with those seen in children with ASD and with children with Down syndrome (DS); 3. investigate any links, for the children with CP, between social communication deficits skills/deficits and performance on other measures of motor, language, visual and cognitive skills. The study included 57 children in these three groups, matched for age, language and non-verbal abilities. The children with CP (n=32) were screened for their ability to use looking behaviours to give responses (Clarke et al., 2016). A measure of social responsiveness/joint attention, (Gaze-NoTe), accessible by all three groups was derived from established assessments. Children with CP gave reliable responses to the tasks offered, and a range of skills was seen. Many children showed social responsiveness/joint attention skills at a level of development significantly below their language age/performance age, and the performance on the target measure Gaze-NoTe was significantly different across the three groups.
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Du, Yanlin Rennan. "Oral health of preschool children with and without cerebral palsy." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B44173520.
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Harvey, Adrienne Ruth. "The functional mobility scale for children with cerebral palsy : reliability and validity /." Connect to thesis, 2008. http://repository.unimelb.edu.au/10187/2310.
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Falkmer, Torbjörn. "Transport mobility for children and adolescents with cerebral palsy (CP) /." Linköping : Univ, 2001. http://www.bibl.liu.se/liupubl/disp/disp2001/med672s.pdf.
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Barks, Lee. "Wheelchair positioning and pulmonary function in children with cerebral palsy." [Tampa, Fla.] : University of South Florida, 2007. http://purl.fcla.edu/usf/dc/et/SFE0002107.
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McConnell, Karen Lisa. "Management of the upper limb in children with cerebral palsy." Thesis, Queen's University Belfast, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.602599.
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Background Impairment of the upper limb (UL) is a common consequence of cerebral palsy (CP), and results in difficulties completing daily activities. Methods Literature reviews evaluated UL classification systems and measures of impairment for children with CP. Cross-sectional surveys were mailed to paediatric therapists and families of children with CP to describe the perceived severity of UL problems and current therapy management of such problems. Seven children aged 8-15 years with hemiplegic CP were recruited to a mixed methods study (single subject research design and semi-structured interviews) evaluating the efficacy and feasibility of constraint induced movement therapy (CIMT). Results Five classification systems were recommended for clinical use; two classified function, and three, deformities. Continued use of the Modified Ashworth Scale, manual muscle testing and goniometry when measuring UL impairments in clinical practice was supported. Families and therapists perceived muscle weakness, decreased grip strength, reduced coordination and impaired fine motor function as having a moderate or great impact on the UL in children with the condition. Therapists commonly assessed joint range of motion and muscle strength, however standardised measurement of activity was rare. Current therapy management reflected training received by therapists with neurodevelopmental therapy and positioning being most often reported in managing the UL of children with CP. CIMT resulted in significant improvements in unimanual capacity in four participants, two of whom also significantly improved on UL active range of motion, although UL strength, tone and participation remained largely unchanged. Conclusions This programme of work identified issues regarding assessment and treatment of UL dysfunction in the paediatric CP population. Recommendations regarding UL assessment methods and CIMT, pertinent to clinical practice and research, have stemmed from the completed studies. This thesis has increased understanding of the complexity of UL problems and provides a basis for further research in the area.
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Du, Yanlin Rennan, and 杜妍霖. "Oral health of preschool children with and without cerebral palsy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B44173520.
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Parkes, Jacqueline Louise. "Children with cerebral palsy in Northern Ireland : needs and services." Thesis, Queen's University Belfast, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268292.
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McClelland, Julie F. "Accommodative dysfunction and refractive anomalies in children with cerebral palsy." Thesis, University of Ulster, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413287.
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Honeycombe, Cheryl Anne. "Head position and head movement in children with cerebral palsy." Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.402425.
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Casady, Renee Lynn. "The Effect of Hippotherapy on Ten Children with Cerebral Palsy." The Ohio State University, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=osu1363620240.
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McQuiston, Jessie Elizabeth. "The Dental Home for Children with Cerebral Palsy: Caregiver Priorities." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1337829927.
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Dixon, Philippe Courtney. "The biomechanics of turning gait in children with cerebral palsy." Thesis, University of Oxford, 2015. http://ora.ox.ac.uk/objects/uuid:369e3d4a-ea07-456f-a05d-6d3f6205eac4.
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Turning while walking is a crucial component of locomotion; yet, little is known about how the biomechanics of turning gait differ from those of straight walking. Moreover, it is unclear how populations with restricted gait ability, such as children with cerebral palsy (CP) adapt to turning, compared to their typically developing (TD) peers. Thus, the aims of this thesis were to quantify the biomechanical differences between turning gait and straight walking in TD children and to explore if further, pathology specific, changes present during turning in children with CP. Biomechanical data, including three-dimensional body motion, ground reaction forces, and muscle activity from both groups were collected during straight walking and 90 degree turning gait using motion capture technology. Experimental data were used to compute joint kinematics (angles) and joint kinetics (moments and power) as well as more novel measures to quantify turning fluency and dynamic stability. These data were also used to derive walking simulations using a musculo-skeletal model of the human body in order to quantify muscle contributions to medio-lateral center of mass (COM) acceleration. The results show that both groups preferred to redirect their body during turning about the inside, rather than the outside, limb (with respect to the turn center). For TD children, substantial biomechanical adaptations occurred during turning, compared to straight walking. Furthermore, turning gait simulations reveal that proximal (hip abductors) and distal (ankle plantarflexors) leg muscles were mainly responsible for the redirection of the COM towards the new walking direction during turning. For children with CP, the results suggest that turning gait may be better able to reveal gait abnormalities than straight walking for a number of kinematic and kinetic gait variables. Potentially, analysis of turning gait could improve the identification and management of gait abnormalities in children with CP.
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Lai, Cheng-hsiu. "An exploration of temperament among Taiwanese children with mild cerebral palsy /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.
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Morris, Christopher. "The effect of disability on children with cerebral palsy and their families." Thesis, University of Oxford, 2005. http://ora.ox.ac.uk/objects/uuid:299406e6-9b6b-4ffe-9969-d9a84c8b8f66.
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Objectives: To describe the 'activities and participation' of children with cerebral palsy, as defined by the International Classification of Functioning, Disability and Health (ICF), using family-assessed instruments. Methods: A structured review of family assessed instruments appropriate for measuring children's activities and participation was undertaken to identify questionnaires for use in a postal survey. The survey involved a geographically-defined population of children with cerebral palsy between 6 and 12 years old, identified from the 4Child database in Oxford. Indices of children's 'activities and participation' were families' assessment of the Gross Motor Function (GMFCS) and Manual Ability (MACS) Classification Systems, the Activities Scale for Kids (ASK) and Lifestyle Assessment Questionnaire (LAQ-CP). To determine the reliability of families' assessments their classifications of the GMFCS and MACS were compared to ratings made professionals; the response frequencies and internal consistency of the ASK and LAQ-CP scales were also examined. Details of children's impairments and abilities were then used as explanatory variables in multiple regression analyses to identify the effect of disability on children's activities and participation. Results: Families of 129/314 (41%) of the children fully participated in the survey and 175/314 (56%) provided a classification using the GMFCS. These children did not differ from children who did not take part by age, gender or characteristics of their cerebral palsy and associated impairments. Although there was not always perfect agreement the families' classifications of children's movement and manual abilities using the GMFCS and MACS were highly reliable compared to those of health professionals (ICC>0.9). Analysis of the ASK and LAQ-CP showed these also to be reliable. Scores for the ASK and LAQ-CP were generally best predicted by children movement, manual and intellectual disability. Conclusions: Family assessment of children's movement and manual abilities using the GMFCS and MACS was highly reliable compared to health professionals. In concordance with similar studies that used professionally-assessed measures, children's activities and participation were most adversely affected by movement, manual and intellectual disabilities. Family assessment offers a highly reliable method for measuring activities and participation; however currently available instruments do not fully represent all the domains in the ICF.
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Tait, Kathleen J. "Analysis and enhancement of communication behaviour in children with cerebral palsy /." St. Lucia, Qld, 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17769.pdf.
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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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Clayton, Kellie. "The behavioural responses of children with cerebral palsy to tactile stimuli /." [St. Lucia, Qld], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18260.pdf.
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DeLacy, Michael. "Postural muscle activation timing in children with and without cerebral palsy /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19973.pdf.
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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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Lai, Chau-kun May, and 賴秋勤. "The help-seeking behaviour of parents of children with cerebral palsy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1992. http://hub.hku.hk/bib/B31249255.
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Lai, Chau-kun May. "The help-seeking behaviour of parents of children with cerebral palsy /." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13417514.
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DiFazio, Rachel Lee. "Patient-Centered Outcomes of Orthopaedic Surgeries in Children with Cerebral Palsy." Thesis, Boston College, 2013. http://hdl.handle.net/2345/3296.
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Thesis advisor: Judith A. VesseyPurpose: The purpose of this study was to elucidate changes in parents' perceptions of health related quality of life (HRQOL), functional status, and caregiver burden in children with severe cerebral palsy (CP) following extensive orthopedic surgery and to determine the amount of nonmedical out-of-pocket expenses (NOOPEs) incurred during hospitalization. Background: CP is the most common cause of childhood physical disability. Children with severe non-ambulatory CP have multiple complex medical problems and frequently develop hip dislocations and neuromuscular scoliosis; these require extensive orthopaedic surgical interventions to prevent progression. The surgical trajectory is costly, resource intensive, and complications are common. Decision-making needs to extend beyond anticipated physical and radiographic improvements to include patient-centered outcomes including HRQOL, functional status, caregiver impact, and financial burden. Currently, research on this second group of outcomes does not exist. Methods: A single group prospective cohort study (N=48) design was used to measure changes pre- and post- surgery. NOOPEs were collected on a daily basis from parents during their child's hospitalization. A linear mixed-model regression analysis for longitudinal data, incorporating serial patient measurements over one year, was used to assess changes in HRQOL, functional status, and caregiver impact using measures normed for this population (i.e., CPCHILD, ACEND). NOOPEs were calculated using descriptive statistics. Results: Significant declines in HRQOL and functional status were noted at six weeks post-operative with return to baseline at three months. Long-term significant (p = .005) improvements, however, were noted beginning at six months. Caregiver impact did not change significantly over time. The total NOOPEs for the inpatient ranged from $59.00-$6977.50 (Median = $479.30) with 1971.5 missed hours from work. Conclusion: Children with severe CP who undergo extensive orthopaedic surgery and their families experience improvements across a variety of patient-centered outcomes in the long-term following surgery. Nursing has a critical role in assisting families in decision-making around surgery and providing anticipatory guidance and support
Thesis (PhD) — Boston College, 2013
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Amir, Nili S. "Frequency of Complications Following Spinal Fusion in Children with Cerebral Palsy." eScholarship@UMMS, 2020. https://escholarship.umassmed.edu/gsbs_diss/1070.
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Background:
Neuromuscular Scoliosis is a frequent complication of Cerebral Palsy that requires surgical management including spinal fusion. The objective of this observational study was to describe differences in the frequency of postoperative complications in children with Cerebral Palsy following spinal fusion surgery compared to children with Idiopathic Scoliosis.
Methods:
The 2016 Kids’ Inpatient Database was queried to identify pediatric patients (old) with concurrent diagnoses of Cerebral Palsy and Neuromuscular Scoliosis undergoing spinal fusion surgery. Cases were compared to children without Cerebral Palsy and with a diagnosis of Idiopathic Scoliosis undergoing the same procedure. Fitted Poisson regression analysis with robust variance was performed to estimate relative risks in the frequency of various clinical complications while adjusting for several potentially confounding variables of importance.
Results:
A total of 660 cases and 5,244 comparators were identified. Compared to children with Idiopathic Scoliosis, children with Cerebral Palsy were younger (13.6 vs. 14.3 years), more likely to be male (54% vs. 23%), and more likely to have had governmental insurance (52% vs. 32%). They also had longer hospital lengths of stay (8 days vs. 4 days). After adjusting for a number of potentially confounding sociodemographic and clinical variables, children with Cerebral Palsy were more likely to have postoperative pulmonary, gastrointestinal, and surgical complications, receive blood transfusions, and be admitted to the ICU.
Conclusions:
Children with Cerebral Palsy have an increased risk of complications following spinal fusion surgery leading to longer hospital stays. These results further inform surgical decision-making and anticipatory guidance for these children and their caregivers.
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Carriero, Alessandra. "Modelling gait abnormalities and bone deformities in children with cerebral palsy." Thesis, Imperial College London, 2009. http://hdl.handle.net/10044/1/4649.
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Cerebral palsy (CP) is a neuromuscular disorder that affects the motor control of muscles. CP children exhibit abnormal walking patterns and frequently develop lower limb, long bone deformities. To improve functionality and guide orthopaedic treatments effectively, it is critical to elucidate the relationship existing between bone morphology and movement of the lower limbs CP children. The hypothesis of this study is that gait abnormalities result in bone deformities. The investigation of this complex relationship represents the core of this thesis. The examination of magnetic resonance images and gait analysis of healthy and CP children showed different development in femoral and tibial morphology and varied gait characteristics between them. Similarly, different correlations between bone morphology and gait characteristics resulted in healthy and CP children. Gait characteristics also varied between CP children. An objective and quantitative graphical classification method of CP gait patterns was developed. This classified the CP children in overlapping clusters according to their gait patterns, confirming the presence of multiple gait abnormalities on the same lower limb for CP children. With the intention to define the effect of the walking characteristics on the bone structure, femoral muscle and hip contact forces in healthy and CP children with different walking strategies were estimated by using inverse dynamic analysis. The different gait styles resulted in different loadings on the developing femur bone. These constituted the loading conditions for bone growth analysis. A three-dimensional finite element model for femoral growth was developed and mechanobiological theories applied in order to predict femur changes over time in healthy and CP children. The models predicted higher femoral anteversion and neck3 shaft angle formation in children with CP, emphasizing how different gait characteristics can influence bone morphology. This information has potential to explain and eventually prevent or treat the development of bone deformities in CP children.
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Yude, Carole. "Peer relations of children with hemiplegia in mainstream primary schools." Thesis, University College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.362205.
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Novak, Iona, University of Western Sydney, and 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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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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Russell, Siabhainn C. "From coherence to fragmentation : 'transition policy' affecting young people with cerebral palsy in Scotland." Thesis, University of Aberdeen, 2018. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=238593.
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Young people with disabilities face a time of great stress as they move from child to adult care, which profoundly impacts them and their families. They 'transition' from very high and cohering levels of care, until they reach a point, determined by age, when they are receiving low levels of far less cohesive care. Further, the propensity shown by the Scottish Government to devolve down the responsibility for service and local policy delivery, can lead to unforeseen consequences resulting in variation in experiences. Does this devolution of responsibility, to local bodies and service users, produce a valuable personalisation of delivery or a worrying 'postcode lottery'? I draw on policy concepts to examine these two expectations:- 'street level bureaucracy' and the 'personalisation' agenda highlight the potential for discretion, learning and transfer, and accountability theory, highlight the potential to cooperate or conform to the same basic standards. I examine the case of young disabled people in Scotland moving from child orientated to adult care to show, through semi-structured interviews and documentary analysis, that there is some cooperation between various professions, but they make sense of policy from different perspectives. I found that, while broad parameters set by the Scottish Government were adhered to, council and health board protocols often varied, meaning that, in some cases, a house address number dictates the level of service delivered. The research is particularly important and timely in that it focuses on Scotland, is cross-professional in focus, has profound social implications and contributes to knowledge in placing 'transition' in the context of public policy theory. It confirms the importance of street level bureaucracy in a new context but, unexpectedly, I found that professionals would welcome increased accountability and outcome measurement.
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Reilly, Sheena. "The objective assessment of oral motor function during feeding : development and validation of the Schedule for Oral Motor Assessment (SOMA)." Thesis, University College London (University of London), 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.283439.
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Bell, Kristie L. "Energy expenditure, physical activity and body composition of children with cerebral palsy /." [St. Lucia, Qld.], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18505.pdf.
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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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Attard, Jesmond. "Physiological and biomechanical effects of pressure garments on children with cerebral palsy." Thesis, University of Salford, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.491046.
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Introduction: Lycra® pressure garments are being used in the management of cerebral palsy (CP) to enhance proprioceptive feedback and improve function as well as mobility. This study investigates the changes in interface pressure (IP), temperature, humidity and skin blood flow (SBF) at the patient-garment interface. Conclusion: Generally, IP increased with the number of Lycra® layers built in garments. It also increased with increased movement and activity, perhaps implying the dynamic nature of these garments. The overall decrease in SBF was in keeping with the increased IP; in some cases this was highly dependent on the position of the body in relation to gravity as blood flow increased when the position of the upper limb improved from an elevated to a more natural position down by the side of the body. The changes in temperature and humidity were lower than expected for such a tight-fitting garment, but the breathable nature of the material used allowed for the evaporation of perspiration as the level of activity and/or the ambient temperature increased.
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Al-Amri, Mohammad. "A virtual reality based gait rehabilitation system for children with cerebral palsy." Thesis, University of Surrey, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.580341.
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Cerebral Palsy (CP) refers to a motor disorder that affects approximately one in every 400 live births in the UK. Living with CP can be challenging for both patients and their families. There are a range of established approaches used by physiotherapists to improve motor capacity in children with CP. Staffing and space allocation, however, can limit the number of rehabilitation sessions that can be offered. Treadmill training has been suggested as one approach to address some of these limitations. Walking using a treadmill can maintain or improve movement function, yet questions remain over the effectiveness of the programme and how to maintain motivation on the part of the child. The inclusion of a virtual reality (VR) environment into training is a possible approach to engage children who might otherwise lack the motivation needed to undertake rehabilitation. VR based lower extremity rehabilitation to improve standing (balance) and walking (gait) skills has been shown to be relevant for patients post stroke. VR has also been noted to help children with CP increase their self- confidence and motivation, resulting in improvements of upper extremity function. The potential for VR based lower extremity rehabilitation for CP has also been reported. It has been suggested, however, that most VR systems are not designed with rehabilitation in mind. Some have been designed specifically for use in rehabilitation, but these can be expensive which has limited their use. Consequently, VR based rehabilitation, particularly for gait assist, has not been reported or investigated in detail. The overall aim of the present work was to develop, design, and investigate the practicality of a virtual rehabilitation system (the Surrey Virtual Reality System - SVRS) suitable for routine clinical use in gait re-education for children with CP. For this work, the practicality evaluation was directed at: satisfaction (how enjoyable is it to use the SVRS); comfort (how easy is it for users to complete tasks, once they have learned the system); safety (how safe is it to use the equipment and what are side effects of using the system); and to some extent utility (to what extent the selected scenarios will benefit the rehabilitation of children with CP effectively). Therefore, pilot game scenarios were developed for training in balance and treadmill based walking. A Real-time Treadmill Speed Control Algorithm was developed as part of the SVRS, which may provide a more immersed and realistic treadmill training. The performance and the 3D presentation quality of the SVRS were first evaluated in 13 young able-bodied using questionnaires. The overall results were positive and showed that the SVRS provided safe and visually acceptable virtual training environments. The statistical results suggest that self selected 'slow' and 'normal' speeds were significantly higher when using the RTSCA. This may suggest that they walked more naturally or confidently on the treadmill when using the RTSCA as compared to the use of conventional treadmill speed control buttons. To investigate the 'practicality' of the SVRS in a clinical situation; three clinicians and two children with CP used it, the latter observed by their parent/guardian and a treating physiotherapist. Feedback was collected using both questionnaires and an open-discussion. The overall results show that the SVRS appears practical for rehabilitation purposes and the children with CP and the other able-bodied participants used the RTSCA safely. Further modification is required in the future research that should focus on formally examining the clinical effectiveness of the SVRS in children with CP. For example, providing a mechanism for clinicians to alter the virtual environment should be considered in order to meet the specific rehabilitation aims for patients.
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Adams, M. S. "The management of feeding difficulties in children with cerebral palsy in Bangladesh." Thesis, University College London (University of London), 2009. http://discovery.ucl.ac.uk/18980/.
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The majority of children with Cerebral Palsy (CP) have feeding difficulties, which result in chronic malnutrition and respiratory disease, reducing quality of life for caregiver and child, and causing early child mortality. In well-resourced countries, high and low-tech medical interventions, ranging from gastrostomy tube-feeding to parent training, are available. In Bangladesh the former is not viable and the latter is both scarce and its effectiveness not evaluated. The study aimed to evaluate the effectiveness of a training programme to improve the feeding practices of carers of children with CP, observing the impact on level of nutritional intake, risk of aspiration and distress caused to both during feeding. Thirty-seven caregivers and their children aged 1-11 with moderate-severe CP and feeding difficulties were invited to a six-session training programme. Pre and post measures (quantitative and qualitative) were taken during home visits in addition to giving brief advice. A control phase was evaluated for 12 of the participant pairs whilst awaiting training. A minimum of four training sessions was successful in significantly improving children’s nutritional intake and chest health, maximising independence in feeding, improving the experience of mealtimes for both child and caregiver, decreasing caregiver stress regarding their child’s feeding difficulties and improving child levels of cooperation. Catch-up growth was observed in 26% of the children. A significant difference in the outcomes between advice only and groups was observed. In conclusion, carers in Bangladesh, who have minimal formal education and live in abject poverty are able to change care-giving practices significantly after four training sessions, with positive consequences for both child and caregiver. Methods of providing affordable food supplementation need to be investigated and further steps must to be taken to lobby policy-makers in order to ensure that services have the motivation and capacity to address this area of need.
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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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McDonald, Rachael Leigh. "Seating systems for children with cerebral palsy : study of acceptability and effectiveness." Thesis, University College London (University of London), 2004. http://discovery.ucl.ac.uk/1383524/.
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Background. Adaptive seating systems are used with children with cerebral palsy to promote function and independence and to prevent the development of deformity. A seating system that uses a sacral pad and kneeblock to control the pelvis was investigated. Methods A mixed methodology design was employed. Acceptability was addressed through the development and administration of matching questionnaires to the parents and therapists of the children participating in the project. Effectiveness was investigated by measuring pressure at the sacral pad, force exerted through a kneeblock, seated postural alignment and seated function; during a case controlled trial, where children were seen 6 times over a period of 6 months. Children removed their kneeblocks for a period of one month between visits 3 and 4. The force, pressure and postural alignment data were statistically analysed. Theoretical biomechanical analyses were also performed. Results Questionnaire results showed important differences between parents and therapists views of the seating systems. Therapists concentrated on postural management, whilst parents were concerned with day-to-day management of the child. There were few statistically significant differences over the 6-visit trial for force, pressure or postural alignment. There were no statistically significant correlations between force measured at the kneeblocks and pressure exerted through a sacral pad, nor between force and postural alignment. Statistically significant effects on hip abduction and hip rotation were found on removal of kneeblocks. Finally, individual biornechanical analysis illustrated positive effects for hip abduction for some children, but a tendency to increase deformity in half of the children. Conclusions Adaptive seating systems that use a kneeblock and sacral pad may achieve hip rotation and abduction for children with cerebral palsy. However, no other improvements in posture were seen, and biomechanical analysis showed an increase in tendency of the children to develop secondary deformity.
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Fowler, J. R. "A microcomputer-based education and communication system for children with cerebral palsy." Thesis, Teesside University, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.382801.
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Huang, Yijun. "The usability of assistive devices for children with cerebral palsy in Taiwan." Thesis, University of Leeds, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.446508.
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