BACKGROUND AND OBJECTIVE

The Gross Motor Function Classification System – Expanded and Revised (GMFCS-E&R) is a valid tool commonly used by physicians, therapists, and potentially also by other healthcare workers even at the primary care and grassroots levels to facilitate immediate screening, appropriate referral, and management of children with disability needing mobility devices. As Filipinos comprise one of the largest diaspora populations, this study aimed to provide a Filipino version of the GMFCS-E&R and determine its internal consistency and inter- and intra-rater reliability.

METHODS

A multidisciplinary group of rehabilitation professionals at Philippine General Hospital worked with linguists to translate the original English GMFCS-E&R to Filipino/Tagalog, the Philippines’ official language. Several steps were done: authorization from the original tool developers (CanChild™); forward and backward translations; semantic analysis; content analysis; pilot testing; and submission of final version to CanChild™. Internal consistency and inter- and intra-rater reliability were determined.

RESULTS

The Filipino GMFCS-E&R translation was formulated and underwent several modifications. The final version yielded high internal consistency (Cronbach’s alpha: 0.96) and inter- and intra-rater reliability (interclass correlation coefficients: 0.895 and 0.928, respectively).

CONCLUSION

The Filipino GMFCS-E&R is a reliable tool for use among pediatric Filipino patients for communication, clinical decision-making, registries, and research.

Human ; Children With Disabilities ; Disabled Children ; Cerebral Palsy

The economic burden of children with cerebral palsy exceeds far beyond the needs of typical children leading to physical and mental stress to their parents. The study aims to examine the economic burden of parents of children with cerebral palsy in Malaysia. Calculation is made using a cost of illness approach due to cerebral palsy disorders that includes direct healthcare costs, direct non-healthcare costs, developmental costs and indirect costs. Using convenient sampling method, a total of 74 parents completed questionnaires through online or hard copies. Direct healthcare costs represent the highest cost of RM14, 715.49, followed by the developmental costs of RM10, 146.07, RM2, 674.00 for direct non-healthcare costs and RM2,175.20 for indirect costs. So the total cost of financing for the needs of a child with cerebral palsy is RM29, 710.76 per year. This is a huge and burdensome amount for their parents. The findings of this study may assist policy makers in their planning of effective service provision to suit the needs of parents of children with cerebral palsy in Malaysia.
economic burden ; cerebral palsy ; parents ; children with cerebral palsy

Today, more chronically ill and handicapped children are being cared for at home by a family member caregiver. The task of caring for a family member may feel burden that the caregiver has less time and money and more work. Family functioning and their burden have influence on coping and adaptation of families with chronically-ill children. This study attempted to identify the levels of burden and family functioning in families of children with cerebral palsy and to examine their relationships. The instruments were burden scale developed by Suh and Oh(1993), and a modified Feetham Family Functioning Survey based on Roberts and Feetham.(1982). The subjects were 98 parents of children, under 15 years, who have cerebral palsy and being treated and living in Pusan. Data were collected through a self-administered questionaire from April 26 to May 29. The collected data were tested using frequencies, percentiles, means, t-test, ANOVA, and Pearson correlation coefficient with SPSSWIN program. The results of this study were as follows ; 1. The mean rating scores of burden and family functioning were 2.79 +/- .51 and 4.12 +/- .69, respectively. 2. The relationships between general characteristics and burden were statistically significant difference : degree of children's handicap(F=6.333, P <.01). The relationships between general characteristics and family functioning were statistically significant differences : familial relation with the children(F=3.628, P <.05), caregiver's health status(F=4.359, P <.05), age of children (F=4.185, P <.05), and duration of treatment (F=6.802, P <.01). 3. In families of children with cerebral palsy, there was significantly negative correlation between the burden of parents and the performance of family functioning(r=-.230, P <.05). There were significantly negative correlations between the burden of parents and the satisfaction of family functioning (r=-.211, P <.05), and between the perceived importance and the satisfaction of family functioning(r=-.481, P <.01); however, there was a positive correlation between the performance and the perceived importance of family functioning(r=.425, P <.01). In conclusion, this study suggests that families of children with cerebral palsy need family-focused nursing interventions as supportive care for relieving their burden and for improving family functioning.
Busan ; Caregivers ; Cerebral Palsy* ; Child* ; Chronic Disease ; Disabled Children ; Humans ; Nursing ; Parents* ; Child Health

OBJECTIVE: To investigate the disability registration state of children with cerebral palsy (CP) in Korea. METHODS: Based on the National Health Information Database, the disability registration state was examined for brain lesion disability and other possible complicated disabilities accompanying brain disorder in children diagnosed with CP aged up to 5 years old who were born between 2002 and 2008. RESULTS: Of children diagnosed with CP, 73.1% were registered as having brain lesion disability for the first time before they turned 2 years old. The younger the children, the more likely they will have 1st and 2nd degree disability. However, when the age of children is increased, such likelihood is decreased. The percentage of children registered as having overlapping disabilities was 7%–20%. CONCLUSION: It is important to establish a more accurate standard to rate disability and provide national support systems for children with CP with various severities and multiple disabilities. By reorganizing the current disability registration system for pediatric brain lesions, the system could serve as a classification standard to provide medical and social welfare services.
Brain ; Brain Diseases ; Cerebral Palsy* ; Child* ; Classification ; Disabled Children ; Humans ; Korea* ; Registries ; Social Welfare

PURPOSE: The purpose of this study was to develop an empowerment program as a nursing intervention for mothers who care for a child with cerebral palsy at home and to determine the effects of the program on those mothers' self efficacy, coping behavior and burden. METHOD: An non-equivalent control group pretest-posttest design was used in this study. An Empowerment program was developed based on Dunst & Trivette's model. Using the program, the study was carried out from Dec. 13, 2003 to Jan. 17, 2004, mothers whose children, aged 1 to 6, were outpatients of the Dept. of Rehabilitation Medicine, at P University Hospital or registered at educational institutions for early disabled children. The experimental group of subjects were included in the new empowerment program which was held for two and half hours every week for 6 times. RESULTS: After treatment with the Empowerment Program, the experimental group was found to be significantly increased in score for self efficacy(t=4.55, p<.01), coping behavior(t=5.54, p<.001), objective burden(t=-3.96, p<.01) and subjective burden(t=-5.05, p<.01), in comparison to the control group. CONCLUSION: The Empowerment Program is very effective in increasing self efficacy and coping behavior of mothers having a child with cerebral palsy and decreasing their burden. Finally, this study would recommend that an empowerment program should be extended to community facilities such as public health offices and welfare centers.
Self Efficacy ; Power (Psychology) ; Personal Autonomy ; Mothers/*psychology ; Humans ; Female ; *Disabled Children ; *Cost of Illness ; Child ; *Cerebral Palsy ; Adult ; *Adaptation, Psychological

OBJECTIVE: To know the effectiveness of a custom molded fitting chair between pre- and post-chair status through comparison of musculoskeletal indices in severely disabled children. METHODS: We researched 34 severely disabled patients who had used a custom molded fitting chair continuously for more than a year. There were 27 cerebral palsy patients and 7 patients with other kinds of diseases that affect the brain such as chromosomal disease or metabolic disease. By radiographic studies, Cobb's angle, the femoral neck-shaft angle of the femur, and Reimers migration percentage were measured. The indices are analyzed before and after application. RESULTS: The average period of application was 24 months. There was a significant reduction in the angles of femur neck-shaft, 163.4 degree before and 158.2 degree after the use of the chair (p<0.05), and 23 of 34 had demonstrated a reduced angle. Cobb's angle and Reimers migration percentage increased but the difference of pre- and post-chair status was not statistically significant. Seventeen of 33 children showed reduced Cobb's angle. Also, 19 of 37 showed a reduced degree of dislocation of the hip joints. CONCLUSION: In spite of the use of a custom molded fitting chair, a significant improvement did not emerge for musculoskeletal deformity indices in severely disabled children. However, there was no significant aggravation of Cobb's angle or Reimers migration percentage in developing children. Therefore, it is thought be helpful to prevent rapid aggravation of musculoskeletal deformities.
Brain ; Cerebral Palsy ; Child ; Congenital Abnormalities ; Disabled Children ; Dislocations ; Femur ; Fungi ; Hip ; Humans ; Metabolic Diseases ; Musculoskeletal System ; Orthotic Devices

Intractable aspiration may be the most severe life-threatening problem for handicapped children with altered laryngeal function secondary to neurologic disorders or abnormal laryngeal anatomy. If medical therapy fails to prevent intractable aspiration, surgical treatment of the upper airway from the digestive tract is necessary to prevent recurrent aspiration of the respiratory system. Here we describe a patient who underwent a laryngotracheal separation for intractable aspiration following a cerebral palsy. Laryngotracheal separation is relatively easy to perform and potentially reversible. It is known as a good choice of treatment for handicapped child with intractable aspiration.
Cerebral Palsy ; Child ; Disabled Children ; Disabled Persons ; Gastrointestinal Tract ; Humans ; Nervous System Diseases ; Pneumonia ; Respiratory System ; Tracheostomy

Purpose: The purpose of this study is to find out the immediate effect of motor point block using phenol on the degree of spasticity and the gait patterns of children with spastic cerebral palsy and then to ascertain the cases to which these findings are most beneficial. Subjects & Methods: We injected 5% phenol into spastic muscles of 33 cases with spastic cerebral palsy under the electromyographic monitoring. The clinical evaluation for type and severity of cerebral palsy was performed before the block and then, observations on both the degree of spasticity using 'modified Ashworth scale' and the range of motion were made before and after the procedures. Finally, the gait patterns before and after block were analyzed by using locomotion rating scale for gait analysis. Results: The degree of spasticity, which was measured with modified Ashworth scale, was reduced dramatically through our phenol block -i. E. from 2.8 to 1.2-. The limited range of motion in some cases was not increased significantly after block. The constant pes equinus state resulted in the state that heel contact is occasionally possible. There was also much improvement in genu recurvatum and scissoring tendency, while little change was observed in crouch gait and hind foot instability. The speed of gait, deviation to normal gait and instability in walking were improved significantly after block, but their locomotion state was still moderately incomplete. When comparing the different outcomes of motor point block with one another according to the cases in moderately disabled state improved most dramatically. The group with both high degree of spasticity and the full range of motion in their joints improved by far the better after motor point block. Conclusion: The immediate effect of motor point block with phenol solution can be best described as a dramatic relief of spasticity and tip toeing, but other problems such as other abnormal gait patterns and locomotion activity or state improved little, if any. The moderately disabled children with both high degree of spasticity and the full range of motion in their joint could get the best of our findings.
Cerebral Palsy* ; Child ; Disabled Children ; Foot ; Gait ; Heel ; Humans ; Joints ; Locomotion ; Muscle Spasticity* ; Muscles ; Phenol* ; Range of Motion, Articular ; Toes ; Walking

Purpose of this study was to compare nutrient intakes of disabled children and non-disabled children. Subjects consisted of 86 disabled children from a special education school and 127 non-disabled children from an elementary school in Seoul. Nutrient intakes were assessed by modified 24-hr recall method, with the help of children's parents and teachers. Almost all nutrient intakes (energy, protein, fat, carbohydrates, vitamin B1 and niacin) of children with cerebral palsy were significantly lower than those of other groups. But nutrient intakes per body weight of children with cerebral palsy were not significantly different with those of other groups. There was no significant difference between disabled and non-disabled children in almost % RDA (rate of actual intake to RDA) except of energy %RDA in children with cerebral palsy. NARs (nutrient adequacy ratio) for energy and vitamin B1 of children with cerebral palsy were significantly lower than those of children with autism and mental retardation, and non-disabled children. The proportions of energy, carbohydrate and protein intakes from lunch were significantly higher than those from breakfast and dinner in children with mental retardation and autism. The nutrient intakes of disabled children were different between other groups according to the type of handicap. For example, children with cerebral palsy had the risk of undernutrition. On the other hand, autistic children had the tendency of overnutrition. These results suggest that nutrition educational programs and educational materials for disabled children, their teachers and their parents should be developed considering the type of handicap.
Autistic Disorder* ; Body Weight ; Breakfast ; Carbohydrates ; Cerebral Palsy ; Child* ; Disabled Children ; Education, Special ; Hand ; Humans ; Intellectual Disability ; Lunch ; Malnutrition ; Meals ; Overnutrition ; Parents ; Seoul ; Thiamine

OBJECTIVETo study the efficacy of conductive education combined with Frenkel training in the improvement of balance function in children with cerebral palsy.

METHODSOne hundred and fifteen children with cerebral palsy were randomly administered with conductive education and Frenkel training (study group, n=60) or conventional training (control group, n=55). Activities of daily living (ADL) scale and gross motor function measurement (GMFM) of physical performances were used to assess the balance function.

RESULTSThe scores of ADL scale and GMFM of physical performances in both the study and the control groups increased after training. The study group showed higher scores of ADL scale (37.91+/-10.12 vs 34.18+/-6.13; p<0.05)and GMFM (62.93+/-15.00 vs 54.53+/-14.11) than the control group (p<0.05).

CONCLUSIONSConductive education combined with Frenkel training is more effective for the improvement of balance function in children cerebral palsy.

Activities of Daily Living ; Adolescent ; Cerebral Palsy ; physiopathology ; rehabilitation ; Child ; Child, Preschool ; Disabled Children ; rehabilitation ; Education, Special ; methods ; Female ; Humans ; Infant ; Male ; Motor Skills ; Physical Therapy Modalities ; Postural Balance