Cerebral Palsy ; prevention & control ; rehabilitation ; therapy ; Child ; Humans

This study was designed to determine the effectiveness of electrical stimulation over the trunk in improving sitting balance in young children with spastic diplegic cerebral palsy who displayed poor trunk control. The subjects ranged in age from 8 to 16 months and were randomly assigned to two groups. Both group had physical therapy for 6 weeks. Electrical stimulation (ES) group had additional electrical stimulation over the abdomen and posterior back muscles. Radiographic studies were carried out on the whole spine while they were sitting before and after treatment. Kyphotic angle, Cobb's angle and lumbo-sacral angle were measured. Additionally, sitting score-Gross Motor Function Measure (GMFM) was also evaluated. There was no difference of these values at initial evaluation between the two groups. Following 6 weeks of intensive therapy, the changes of kyphotic angle and sitting score-GMFM were significantly higher in ES group statistically when compared with those of the control group. The Cobb's angle following treatment was improved in ES group, but not statistically compared with that of control group. This study suggests that electrical stimulation over the trunk become a beneficial therapeutic technique in improving the sitting posture and trunk control in young children with spastic diplegic cerebral palsy.
Cerebral Palsy/prevention & control/*therapy ; *Electric Stimulation Therapy/methods ; Human ; Infant ; Spine ; Treatment Outcome

OBJECTIVEThis study aimed to evaluate the effectiveness of multi-disciplinary treatment approaches in reducing neurological disabilities in premature infants.

METHODSA total of 117 infants who were born premature in our hospital between March 2008 and February 2010 but had no congenital malformations and no severe neonatal complications, were enrolled in this study. They were randomly allocated to a multi-disciplinary treatment group (n=63) and a control group (n=54). While patients in the control group underwent an early conventional treatment, those in the multi-disciplinary treatment group were subjected to regular development monitoring, neurological examination and screening for brain injury, neuro-nutrition and neurodevelopment therapies, and rehabilitation training.

RESULTSThe incidence rates of abnormalities in posture, reflex, sleep, muscle tone and EEG were significantly lower in the multi-disciplinary treatment group than in the control froup (P<0.05) at corrected postnatal ages of 6-12 months. At corrected postnatal ages of 6, 12, 18 and 24 months, both mental development index (MDI) and psychomotor development index (PDI) scores were significantly higher in the multi-disciplinary treatment group than in the control group (P<0.05). At corrected postnatal age of 3 years, incidence rates of cerebral palsy, language barrier, abnormal muscle tone and hearing impairment were significantly lower in the multi-disciplinary treatment group than in the control group (P<0.05).

CONCLUSIONSEarly multi-disciplinary intervention approaches may significantly improve mental and motor developments and reduce the incidence of cerebral palsy-associated neurological disabilities in premature infants.

Cerebral Palsy ; prevention & control ; Child, Preschool ; Developmental Disabilities ; prevention & control ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; prevention & control ; Male

OBJECTIVETo investigate the clinical effect of mild warming moxibustion (MWM) on acupoints Shenque (RN8) and Guanyuan (RN4) for treatment of recurrent respiratory tract infection (RRTI) in children with cerebral palsy (CP).

METHODSSixty-four CP patients with RRTI were randomly and equally assigned to two groups, all received conventional rehabilitation treatment, but in acute infection stage, MWM was applied on the treated group, and intravenous dripping of immunoglobulin was given to the control group, all for 3 months. The frequency of RRTI attacking (Fre), the mean cough alleviating time (T-CA) and rale disappearing time (T-RA) during infection, as well as the serum levels of immune globulins during the post-treatment 1-year follow-up period were observed.

RESULTSThe effectiveness in the treated group was better than that in the control group, showing in aspects of Fre (2.38 +/- 0.64 times vs. 6.50 +/- 0.84 times), T-CA (3.92 +/- 1.32 days vs. 6.48 +/- 2.18 days) and T-RA (4.66 +/- 1.82 days vs. 7.64 +/- 1.44 days), significant difference was shown between groups (P < 0.01). The serum levels of IgG, IgM and IgA all raised in both two groups (P < 0.05), comparison of immunoglobulin levels between groups showed that they were lower immediately after treatment, but higher at the end of the 1-year follow-up in the treated group than those in the control group.

CONCLUSIONMWM on acupoints Shengue and Guanyuan has a better and long-term clinical effect for treatment of RRTI in children with CP.

Acupuncture Points ; Cerebral Palsy ; complications ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Moxibustion ; methods ; Respiratory Tract Infections ; complications ; drug therapy ; prevention & control ; Secondary Prevention

OBJECTIVETo investigate major risk factors for childhood cerebral palsy (CP) during pregnancy and to provide evidence for the prevention of CP.

METHODSUsing the search terms of "cerebral palsy", "pregnancy", "risk factor", and "case-control", a search was performed to collect case-control studies on the risk factors for childhood CP from 1998 to 2011. The obtained data were subjected to metaanalysis using fixed effects model and DersimonionLaird random effects model to quantitatively evaluate risk factors for childhood CP during pregnancy.

RESULTSEighteen studies involving 11050 cases and 15941 controls were collected. The results of the multivariate analysis for risk factors of childhood CP during pregnancy were as follows: maternal age (≥35 years) (OR = 4.172, 95%CI = 1.670-10.426, P < 0.05), multiple pregnancy (OR = 8.402, 95% CI = 2.386-29.584, P < 0.05), medicine use in early pregnancy (OR = 3.974, 95% CI = 2.217-7.123, P < 0.05), harmful environment (OR = 3.299, 95% CI = 1.058-10.289, P < 0.05), recurrent vaginal bleeding during pregnancy (OR = 4.736, 95% CI = 1.792-12.517, P < 0.05), pregnancy infectious diseases (OR = 1.238, 95%CI: 0.284-5.395, P > 0.05), pregnancy induced hypertension (OR = 4.096, 95%CI: 2.246-7.469, P < 0.05), meat intake (OR = 1.436, 95%CI:0.382-5.393, P > 0.05), father smoking (OR = 2.376, 95%CI: 0.801-7.049, P > 0.05).

CONCLUSIONSThe major risk factors for childhood CP during pregnancy include advanced maternal age (≥35 years), multiple pregnancy, medicine use in early pregnancy, harmful environment, recurrent vaginal bleeding during pregnancy and pregnancy-induced hypertension.

Adult ; Case-Control Studies ; Cerebral Palsy ; etiology ; prevention & control ; Child ; Female ; Fetus ; drug effects ; Humans ; Hypertension, Pregnancy-Induced ; physiopathology ; Maternal Age ; Pregnancy ; Risk Factors ; Uterine Hemorrhage ; complications

OBJECTIVEIn recent years, the survival rate of premature infants is increased, but the incidence of cerebral palsy did not decrease, instead, there was a tendency of increase. The incidence of cerebral palsy of premature infants was 29.13 per thousand in 7 provinces in China in an investigation of over 30,000 children 1 - 6 years of age in 1997, which is 25.16 times higher than that of full term infants. Each year, about 1 million premature infants are born in China, which may include an increase of approximately 29,000 cerebral palsy infants. The rehabilitation expense of cerebral palsy infants is high, older patients cannot be cured; only improved life quality is possible. Therefore, we carried out this research from March 1, 2000 to the end of February 2003 to explore the effects of early intervention in lowering the incidence of cerebral palsy among premature infants.

METHODSA total of 1053 cases of survived premature infants, gestational age under 37 weeks, excluding those with congenital deformity and hereditary metabolic diseases, born or treated in all collaborative units were classified into 2 groups: early intervention group (551 cases) and routine care group (502 cases). Method of classification: all premature infants born within 1 year before beginning of the study and premature infants born after beginning of the study whose parents did not want to receive early intervention were included in the routine care group; all premature infants born after beginning of the study whose family intended to actively participate in early intervention were included in the intervention group. The numbers of infants in the two groups were quite close in each collaborative unit. In the intervention group, the premature infants received early intervention after discharge from hospital, in addition to routine care, once a month before corrected age of 6 months and once every two months after 6 months. The parents were instructed to cultivate the infant's cognition, language, emotion and communication ability, and the infants were given massage, subjected to exercise and received active motor training. All infants with abnormal motor manifestations were given appropriate rehabilitation training. In the routine care group, infants received similar routine care only.

RESULTSIn the 2 groups, no significant differences (P > 0.05) were found in complications of pregnant mothers, average gestational age and birth weight, proportion of small for gestational age (SGA), proportion of single and multiple births, fetal stress, postnatal asphyxia, incidence of neonatal hypoxic inschemic encephalopathy (HIE) and intracranial hemorrhage, Apgar Score and Neonatal Behavioral Neurological Assessment Score at 40 weeks of gestational age. These indicate that the two groups were comparable. At 1 year of age, the incidence of cerebral palsy was 0.91% (5/551) in the intervention group and 3.19% (16/502) in the routine care group (P < 0.01). Of the 5 cases with cerebral palsy in the interventional group, 3 were mild and 2 severe. Of the 16 cases in the routine care group, 7 were moderate and 9 severe.

CONCLUSIONEarly intervention can reduce the incidence of cerebral palsy of premature infants. This conclusion awaits confirmation from studies with larger sample size.

Apgar Score ; Birth Weight ; Cerebral Palsy ; epidemiology ; prevention & control ; China ; epidemiology ; Early Intervention (Education) ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Male ; Pregnancy

OBJECTIVETo explore the effect of acupoint massage dominant early comprehensive intervention on the prognosis of premature infants with brain injury.

METHODSTotally 210 premature infants with brain injury were assigned to the intervention group (112 cases) and the control group (98 cases). All patients received routine therapy (medicinal + routine care instructions). Patients in the intervention group additionally received acupoint massage. Those with abnormal early motion received physical sports treatment. Those with upper limbs dysfunction or with fine movement disorders received occupational therapy. Premature infants' development quotient (DQ) was performed at corrected age of 6 and 12 months by using neuropsychological development examination table for 0 - 6 years old children. The incidence of cerebral palsy was statistically calculated.

RESULTSAt corrected age of 6 months, DQ of gross motor, fine motor, language three functional areas was higher in the intervention group than in the control group with significant difference (P < 0.05). At corrected age of 12 months, DQ of gross motor, fine motor, language, social and adaptive capacities was higher in the intervention group than in the control groupwith significant difference (P < 0.05). The incidence of cerebral palsy was 4.46% (5/112) in the intervention group and 12.24% (12/98) in the control group (P < 0.05).

CONCLUSIONAcupoint massage dominant early comprehensive intervention could obviously improve the intelligence development level and lower the incidence of cerebral palsy in premature infants with brain injury.

Acupuncture Points ; Brain Injuries ; therapy ; Cerebral Palsy ; prevention & control ; Early Medical Intervention ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Male ; Massage ; Prognosis

Although, recently in Korea, it has been apparent that declining total birth rate in face of rapidly aging population and rapid increasing birth rate for high-risk infants such as preterm infants, mortality rate of premature infants is still higher than that of other developed countries and the significant morbidities including cerebral palsy or development delay is high among survived patients. Thus, the substantial socio-economic burden caused by high risk infants became a substantial problem to us. To improve the survival rate and to decrease major morbidities of high risk infants, Korean Neonatal Network (KNN) was established by Korean Society of Neonatology with the support from Korea Centers for Disease Control and Prevention and begins an official operation with a declaration for launching on April 15th, 2013. With base project of national prospective registry of very low birth weight infants, KNN would be an infrastructure for active and productive multi-center research for quality improvement of neonatal intensive care units (NICU) and development of Korean-style guideline or strategy for NICU management. In this review, we describe the background, purpose, progress, expected outcomes and future plans of the KNN.
Aging ; Birth Rate ; Centers for Disease Control and Prevention (U.S.) ; Cerebral Palsy ; Delivery of Health Care ; Developed Countries ; Evidence-Based Medicine ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Critical Care ; Intensive Care Units, Neonatal ; Korea ; Neonatology ; Quality Improvement ; Survival Rate