Based on the community-based and family-centered concepts, the Chain Rehabilitation Services for children with cerebral palsy (CP) integrates all kinds of social resources to build the early screening network and community rehabilitation centers, and to enhance the integration of rehabilitation and educational services. This chain model makes it possible to coordinate the related institutes to provide better services for children with CP. Better services and better systematic management of children with CP in Shanghai and surrounding areas has also been achieved through this project.

Objective To compare the effect of motor development massage and neural development approach on the children with cerebral palsy. Methods The children with cerebral palsy were selected with layered matching as they accepted motor development massage or neural development approach, and reviewed with their score of Gross Motor Function Measure (GMFM-66). Results There were 24 children in each group. The GMFM-66 score increased after treatment in both groups, but there was no statistical difference between these groups. Conclusion The gross motor function can be improved in the children with cerebral palsy with motor-development massage and neural development approach similarly.

Objective To investigate the effect of acupuncture combined with rehabilitation on Joubert syndrome. Methods 2 infants with Joubert syndrome were reviewed. Results After the treatment of acupuncture combined with rehabilitation for 4~6 months, the clinical symptoms of these 2 cases improved, and the scores of Gross Motor Function Measure increased. Conclusion Acupuncture combined with rehabilitation is effective on Joubert syndrome.

Objective To observe the effect of rehabilitation training on fine motor in children with Down syndrome. Methods 30 children with Down syndrome accepted rehabilitation training for 3.1~4.6 months. They were assessed with fine motor function in Peabody Developmental Motor Scales (PDMS-FM) before and after treatment. Results The scores of fine motor quotients, grasping and visual-motor integration improved after treatment(P<0.05). Conclusion Rehabilitation can improve the fine motor in children with Down syndrome.

It is very important to have a clear and widely accepted definition and classification for clinical diagnosis, rehabilitation, research and social support of children with cerebral palsy, as well as in establishing a regional, national and global monitoring database. There are some new changes about the definition, clinical types and function classification of cerebral palsy recently domestic and abroad, which pay more attention to assessments on function and participation in daily life.

Objective To analyze the correlation between gross motor function and activities of daily living(ADL)in children with cerebral palsy.Methods 42 children with CP(26 males,16 females,average age 49.5±21.5 months,11 children with spastic quadriplegia,22 with spastic diplegia,5 with spastic hemiplegia,2 with athetosis and 2 with dystonia)were assessed with Gross Motor Function Classification System(GMFCS)and Gross Motor Function Measure(GMFM)for the assessment and classification of gross motor function.Pediatric Evaluation of Disability Inventory(PEDI)was used to assess the ADL.The ADL of children with different levels of GMFCS and the correlation between gross motor function and ADL were analyzed.Results The more severe of GMFCS,the less standard score of PEDI.There was the highest correlation between the GMFM66 scores and scaled scores of PEDI in mobility and social function(r=0.84),whereas a weaker correlation appeared between GMFM66 scores and scaled scores of PEDI in social function(r=0.72).Conclusion Since the gross motor function of children with CP greatly affects the ADL,the gross motor function training should be the main item for CP children,the training goal of ADL should be made according to the levels of GMFCS.

Objective To study the application value of electroencephalogram and CT in children with cerebral palsy.Methods Electroencephalogram and CT examinations were carried out in 224 children with cerebral palsy.Results Abnormal prevalence of electroencephalogram was 47.77%, 58.88% of which were found as epileptic discharge. Abnormal prevalence of CT was 79.46%. The abnormal rate of CT was significantly higher than that of electroencephalogram ( P<0.001). The abnormal rates of electroencephalogram and CT among different types of cerebral palsy were not significantly different ( P>0.05).Conclusion Combination of CT and electroencephalogram will be helpful for the diagnosis and treatment in children with cerebral palsy.

Objective: To study the therapeutic effects of combined treatment with Chinese and western medicine in children with cerebral palsy (CP). Methods: 104 CP children were treated mainly with physiotherapy and acupuncture, together with occupational therapy, sensory integration and electrical stimulation. Gross Motor Function Measure (GMFM) was used to assess the effects of treatment. Results: After treatment for 3.29±0.80 months, the majority of CP children improved their IQ and limb symptoms, with decreased abnormal posture, increased muscle strength and improved motor developmental function. GMFM88 and GMFM66 scores had significantly increased after treatment. Conclusions: Combined treatment with Chinese and Western Medicine has confirmed effects on CP children.

Objective: To quantify the effect of motor-developmental Tuina therapy on 61children with cerebral palsy. Methods: All the children received the motor-developmental Tuina therapy for 20 min each time, 3 to 6 times per week. The gross motor functions of the children were evaluated by GMFM 66. The baseline period evaluations in 15 children and follow-up period evaluations in 26 children were performed. Results: GMFM 66 score significantly increased at the end of treatment period (P<0.001). The GMFM 66 score changes per month in treatment period was significantly greater than those of both baseline period and follow-up period (P<0.001). Conclusion: The effect of motor-developmental Tuina therapy was notable on children with cerebral palsy. Continuous progress of the gross motor functions in these children may be obtained by continuous therapy.

BACKGROUND: Fine motor function impairment is the most common complication in various eneephalopathy in children and is the key factor to hinder the normal development. Acupuncture injection brings not only the stimulation of needling but also the pharmaceutical action into play. In combination with occupational therapy,it improves probably the therapeutic effects.DESIGN: Retrospective analysis based on the patients.SETTING: Rehabilitation center of a university-affiliated hospital.OBJECTIVE: To probe into the effective method for the treatment of fine motor function impairment of children with encephalopathy.PARTICIPANTS: Totally 31 children with encephalopathy were admitted in clinic of the hospital from November 2001 to October 2002. Inclusion criteria: ① To conform to the diagnostic criteria on cerebral palsy and metal retardation. ② Age<5 years old. ③ Having be assessed with peabody developmental motor scale-fine motor(PDMS-FM) before and after treatment.Exclusion criteria: ① To be less than one session treatment. ② To suffer from progressive disorders and palsy caused by various encephalitis and encephalopathy. ③ Transient delayed motor development . Of those patients,19 cases were male,12 cases female,aged varied from 4 months to 5years. 94% of patients were younger than 3 years old. Twenty cases were in full-term delivery. Eleven cases were born prematurely.METHODS: Thirty-one patients were treated primarily with acupunc ture injection in combination with occupational therapy. Assessment was carried on with PDMS-FM.MAIN OUTCOME MEASURES: Primary results: To observe the motor improvement in children with encephalopathy. Secondary results: To observe the changes in fine motor quotient (FMQ) before and after treatment.RESULTS: FMQ was increased in 21 cases(68%),grasp capacity index was elevated in 27 cases(87%) and capacity index of visual perception was improved in 31 cases.CONCLUSION: Acupuncture has firmly achieved remarkable therapeutic effects on fine motor function impairment in children with encephalopatby in combination with occupational therapy.