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

OBJECTIVE: To compare gross motor function outcomes in children with moderate to severe degrees of bilateral spastic cerebral palsy (CP) who received either intensive inpatient rehabilitation or intermittent rehabilitation on an outpatient basis. METHODS: A non-biased retrospective chart review was done for patients diagnosed with bilateral spastic CP who received rehabilitation therapy. The intensive rehabilitation group (inpatient group) agreed to be hospitalized to receive 22 sessions of physical and occupational therapy per week for 1 month. The intermittent rehabilitation group (outpatient group) received four sessions of physical and occupational therapy per week for 3 months in an outpatient setting. Changes in the total score on the Gross Motor Function Measure (GMFM) between baseline and the follow-up period were analyzed. RESULTS: Both groups showed significant improvements in total GMFM scores at the follow-up assessment compared to that at baseline (p=0.000 for inpatient group, p=0.001 for outpatient group). The increase in mean total GMFM score after 1 month was significantly greater in the inpatient group than that in the outpatient group (p=0.020). Higher increase in GMFM score was observed in younger subjects as revealed by the negative correlation between age and the increase in GMFM score after 1 month (p=0.002, r=-0.460). CONCLUSION: Intensive inpatient rehabilitation therapy for patients with bilateral spastic CP of moderate to severe degree was more effective for improving gross motor function than intermittent rehabilitation therapy on an outpatient basis.
Cerebral Palsy* ; Child* ; Follow-Up Studies ; Humans ; Inpatients ; Muscle Spasticity* ; Occupational Therapy ; Outpatients ; Rehabilitation* ; Retrospective Studies

OBJECTIVETo observe the clinical effect of exercise therapy on rehabilitation after selective posterior rhizotomy (SPR) in children with cerebral palsy, so as to provide reliable rehabilitation method for children with cerebral palsy.

METHODSTwo hundred and twenty-six children with cerebral palsy were treated in the study during September 2003 to April 2007. All the patients were randomly divided into the training and control groups. There were 113 patients in the treatment group, including 66 males and 47 females, ranging in age from 3 to 8 years, with an average of (6.5 +/- 1.2) years, and the patients were treated with SPR as well as exercise therapy. Among 113 patients in the control group, 59 patients were male and 54 patients were female, ranging in age from 3 to 10 years, with an average of (6.9 +/- 1.5) years, and the patients were treated with SPR simply. Gross Motor Function Measure (GMFM), passive range of motion and muscle tension were used to evaluate therapeutic effects before and after treatment for both groups.

RESULTSAll the patients were followed up for 6 to 18 months (averaged 8 months). There were significant improvements in training group compared with the control group on GMFM (134.29 +/- 46.43, P < 0.05), passive range of motion (dorsiflexion of the ankle 14.2 +/- 3.1 degree, P < 0.05) and muscle tension (1.27 +/- 0.42, P < 0.05).

CONCLUSIONPhysical therapy has more effective on rehabilitation after SPR for children with cerebral palsy, which can decrease spasticity and muscle tension and improve motor function.

Cerebral Palsy ; surgery ; Child ; Child, Preschool ; Exercise Therapy ; methods ; Female ; Humans ; Male ; Rhizotomy ; rehabilitation ; Treatment Outcome

PURPOSE: To identify the characteristics of static standing balance and its postural control mechanisms during quiet side-by-side standing and the changes in these measures whilst wearing hinged ankle-foot orthoses (AFOs) in children with bilateral spastic cerebral palsy (CP). MATERIALS AND METHODS: Twenty-one children with bilateral spastic CP (6.10 +/- 1.09 year-old) and 22 typically developing (TD) children (5.64 +/- 0.49 year-old) were recruited. Pressure data were recorded while subjects with or without AFOs stood on dual force platforms and net body center of pressure (CoP) coordinates were calculated from this data. Net body CoP was traced for measuring mediolateral (ML) and anteroposterior (AP) displacement and path length per second. Correlation coefficients between parameters representing ankle, hip, and transverse body rotation strategies were also analyzed. RESULTS: ML and AP displacement and path length per second of the CoP trajectory were higher in children with CP compared to TD children (p < 0.05). There were no significant improvements in these parameters whilst wearing hinged AFOs. Compared to TD children, children with CP used less ankle strategy though more hip and transverse rotation strategies for postural control during quiet standing. Whilst wearing hinged AFOs, the contribution of ankle strategy was significantly increased for ML balance control in children with CP (p < 0.05). CONCLUSION: Hinged AFOs for children with CP may be helpful in improving the postural control mechanisms but not the postural stability in quiet side-by-side standing.
Ankle Joint/*pathology ; Cerebral Palsy/rehabilitation/*therapy ; Child ; Child, Preschool ; Humans ; Male ; *Orthotic Devices ; Postural Balance/*physiology

OBJECTIVE: To investigate rehabilitation treatment cost of patients with cerebral palsy (CP) according to age. METHODS: We analyzed the cost of rehabilitation treatment from 2007 to 2013 for patients diagnosed with CP by sourcing data from the National Health Information Database. RESULTS: While the number of recently born children requiring rehabilitation treatment has decreased, the number of patients requiring this treatment in other age groups has gradually increased. In addition, annual physical therapy, occupational therapy, hydrotherapy, and botulinum toxin injection treatment costs per person have increased. On the other hand, the number of orthopedic surgeries and selective dorsal rhizotomy performed has decreased. CONCLUSION: This study investigated trends in the cost of treatment for patients with CP. This study can be used as a basis to provide treatment support for patients with CP.
Botulinum Toxins ; Cerebral Palsy* ; Child ; Hand ; Health Care Costs ; Humans ; Hydrotherapy ; Korea* ; Occupational Therapy ; Orthopedics ; Rehabilitation* ; Rhizotomy

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

OBJECTIVETo observe clinical therapeutic effect of scalp-acupuncture combined with exercise therapy on spastic cerebral palsy.

METHODSEighty children of spastic cerebral palsy were randomly divided into a scalp-acupuncture plus exercise therapy group and a exercise therapy group, 40 cases in each group. The scalp-acupuncture plus exercise therapy group were treated with scalp-acupuncture and exercise therapy, with Yundongqu (the motor area), Pinghengqu (the balance area), Ganjuequ (the sensory area), etc. selected for scalp-acupuncture, and puncture at main points Baihui (GV 20) and Sishencong (EX-HN 1) and exercise therapy. The exercise therapy group were treated by exercise therapy. Changes of GMFM scores and WeeFIM scores before and after treatment were compared.

RESULTSThere were significant differences in GMFM scores and WeeFIM scores before and treatment in the scalp-acupuncture plus exercise therapy group (P < 0.001) and in the exercise therapy group (P < 0.05), the former being better than the later (P < 0.05); the total effective rate was 92.5% in the scalp-acupuncture plus exercise therapy group and 72.5% in the exercise therapy group with a significant difference between the two groups (P < 0.05), the former being significantly higher than the later.

CONCLUSIONThe scalp-acupuncture combined with exercise therapy can improve motor function of limits of children with spastic cerebral palsy, with therapeutic effect better than that of simple exercise therapy.

Acupuncture Therapy ; Cerebral Palsy ; physiopathology ; rehabilitation ; therapy ; Child ; Child, Preschool ; Combined Modality Therapy ; Exercise Therapy ; Female ; Humans ; Male ; Meridians ; Motor Activity

OBJECTIVETo investigate the effect of acupuncture in children with spastic cerebral palsy (SCP).

METHODSOne hundred SCP children, 2 to 7 years old, were randomly assigned to two groups equally. The control group was treated with rehabilitation training using Bobath and Vojta physical training methods and the acupuncture group treated also with the same training but with acupuncture conducted additionally. The therapeutic course was 3-12 months arranged according to the state of illness.

RESULTSThe total effective rate, development quotient (DQ), improvement rate of brain hypogenesis and atrophy showed by skull CT, and recovery rate of cerebral emission computed tomography (ECT) were all higher in the acupuncture group than those in the control group (all P < 0.01).

CONCLUSIONAcupuncture obviously promotes the compensation of cerebral function and shows a favorable effect in improving quality of life of the children with SCP.

Acupuncture Therapy ; Cerebral Palsy ; diagnostic imaging ; rehabilitation ; therapy ; Child ; Child, Preschool ; Combined Modality Therapy ; Humans ; Physical Therapy Modalities ; Quality of Life ; Tomography, Emission-Computed

OBJECTIVETo observe and evaluate a method that is effective and practical for treatment of cerebral palsied (CP) children in China.

METHODThe patient's age and disease type and individual specific conditions were considered in choosing therapy methods accordingly: Chinese herbs, acupuncture, auricular seed pressure, point finger pressing, massage, orthopedic hand manipulation, physiotherapy, occupational therapy, language therapy, etc. Meanwhile we created a new CP treatment model that combines hospitalized treatment with family therapy.

RESULTSThe majority of CP patients improved greatly in motor and social adaptation capacities after treatment. Wilcoxon paired rank sum test analysis showed that there were significant differences between the data before and after treatment (P<0.01).

CONCLUSIONThis combined therapy method, based on traditional Chinese medicine and western medicine plus family supplemental therapy, is an effective and practical treatment strategy for CP children in China.

Adolescent ; Cerebral Palsy ; epidemiology ; rehabilitation ; Child ; Child, Preschool ; China ; epidemiology ; Combined Modality Therapy ; methods ; statistics & numerical data ; Female ; Humans ; Infant ; Male ; Medicine, Chinese Traditional ; methods ; Treatment Outcome

Cerebral palsy (CP), known as "Little's disease" is the most common neurologic disorder in pediatric patients. The core problem of CP is the abnormal movement and posture which manifests very early in the development. The cornerstone to treat the children with CP is the conventional rehabilitation program based on neurodevelopmental approach that has been done for decades. Recently, various translational research has emerged, and focused on the changing therapeutic paradigm using high technologic equipment such as computer- or robotic-approach, botulinum toxin, or stem cell use with potential therapeutic effect. Many other trials using newly developed devices, or combination of old and new therapies are ongoing to demonstrate the evidence, however obstacles still remain. Regarding rehabilitative therapy, the use of exercise-based treatment such as early intervention, gross motor task training, hippotherapy, reactive balance training, treadmill training with/without body weight support, and trunk-targeted training are promising. Virtual reality, robot-assisted and computer-enhanced therapies are very potent therapeutic tools for CP under way of mass commercialization. Regarding medical therapy, botulinum toxin injection showed the most concrete benefit for CP children. Stem cell therapy is just beginning, performing experimental studies in vivo. The author reviewed the current research, expanding therapeutic options to improve the posture and movement control in children with CP.
Body Weight ; Botulinum Toxins ; Cerebral Palsy* ; Child ; Dyskinesias ; Early Intervention (Education) ; Equine-Assisted Therapy ; Humans ; Nervous System Diseases ; Posture ; Rehabilitation ; Stem Cells ; Translational Medical Research