Percutaneous Subtrochanteric Osteotomy for Painful Dislocated Hips in Patients With Cerebral Palsy

Background: Treatment of a painful, chronically dislocated hip in nonambulatory children with cerebral palsy (CP) is challenging and controversial. Although many surgical options have been described, there is limited information, including patient-centered outcomes, following treatment. The purpose of our study was to evaluate the effect of a percutaneous subtrochanteric valgus osteotomy (SVO) using external fixation (EF) on hip abduction, radiographic parameters, and quality of life (QOL) measures in such patients. Methods: Fifteen nonambulatory patients (8 male, 7 female) with CP with 19 chronically dislocated hips underwent SVO using EF and adductor tenotomy at an average age of 14.3 years (range, 10.7 to 26.8 y). Changes in hip abduction and radiographic angular correction following surgery were assessed. Caregivers completed 2 surveys detailing differences in the patient’s QOL measures, including severity and duration of pain and ease of nursing care, and the modified Child Health Index of Life with Disabilities (CPCHILD). Results: Caregivers of 11 patients completed both surveys at an average follow-up of 50 months (range, 17 to 119 mo) after fixator removal. There was improvement in pain, sitting tolerance, ease of transfers, and perineal care in the majority (9/11) of patients. The modified CPCHILD (possible score, 10 to 50) improved from 27.2 to 16.23 (P=0.05). Hip abduction improved from −7 degrees (range, −32 to 5 degrees) to 24 degrees (range, ...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Cerebral Palsy Source Type: research

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Conclusions Stabilization exercises could improve the voluntary activity of transverse abdominal muscle of mothers of children with cerebral palsy.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research
ConclusionAdults with spastic diplegic CP who received their first orthopaedic intervention more than 15  years ago (based on ISA) showed similar incidence of spinal deformities as reported in the younger CP population, suggesting stability of spinal curvature into adulthood.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Conclusions and implicationsBehavioral difficulties were reported in one in four children with CP and were associated with sleep problems and nighttime pain. Identifying and treating behavioral difficulties, sleep problems or nighttime pain is important in the care of children with CP.
Source: Research in Developmental Disabilities - Category: Disability Source Type: research
Conclusions: Half of this group of young children with CP were reported to have pain. Pain restricted the children's everyday lives and seemed to be under-treated. If pain can be addressed early, the children's everyday lives are likely to be improved. Implications for rehabilitation There is a need to early identify and treat pain in young children. Important to discuss pain with parents irrespectively of the child's age and severity level. Pain interference assessment gives valuable information. Early treatment of pain might improve children's everyday life. PMID: 31526138 [PubMed - as supplied by publisher]
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
 Schizophrenia does not just affect the person with schizophrenia, but their families, also. This episode of Inside Schizophrenia explores the family relationships impacted by schizophrenia, both immediate and extended.  Two guests join us. The first is Chrisa Hickey, who is the mother of an adult son with schizophrenia and started an online site for parents of children who have a severe mental illness. The other guest, interviewed by co-host Gabe Howard, is Janel Star Withers, mother of host Rachel Star Withers. Janel shares her experiences with raising a schizophrenic daughter.  Host Rachel Star Withers, a d...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Children and Teens Family Inside Schizophrenia Parenting Bipolar disorder and schizophrenia Family Mental Health family mental illness Helping Families in Mental Health Crisis life with schizophrenia Mental Disorder Mental illness and Source Type: blogs
  Schizophrenia does not just affect the person with schizophrenia, but their families, also. This episode of Inside Schizophrenia explores the family relationships impacted by schizophrenia, both immediate and extended.  Two guests join us. The first is Chrisa Hickey, who is the mother of an adult son with schizophrenia and started an online site for parents of children who have a severe mental illness. The other guest, interviewed by co-host Gabe Howard, is Janel Star Withers, mother of host Rachel Star Withers. Janel shares her experiences with raising a schizophrenic daughter.  Host Rachel Star Withers, ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Children and Teens Family General Inside Schizophrenia Mental Health and Wellness Parenting Bipolar disorder and schizophrenia Family Mental Health family mental illness Helping Families in Mental Health Crisis life with schizophrenia Source Type: blogs
Conclusions: In vivo exposure to remifentanil exerts a beneficial effect against excitotoxicity on the developing mouse brain, which is associated with a reduction in the size of ibotenate-induced brain lesion as well as prevention of some behavioral deficits in young mice. The long-term effect of neonatal exposure to remifentanil should be investigated. Introduction The potential neurotoxicity of anesthetics in the perinatal period prompted the US Food and Drug Administration (FDA) to release a drug safety communication warning in 2016 that stated, “repeated or lengthy use of general anesthetics or sedation ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Christophe Duret1,2*, Anne-Gaëlle Grosmaire1 and Hermano Igo Krebs3,4,5,6,7,8 1Centre de Rééducation Fonctionnelle Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Neurorééducation, Boissise-Le-Roi, France 2Centre Hospitalier Sud Francilien, Neurologie, Corbeil-Essonnes, France 3Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States 4Department of Neurology, University of Maryland, Baltimore, MD, United States 5Department of Physical Medicine and Rehabilitation, Fujita Health University, Nago...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Silvia Pregnolato1*, Elavazhagan Chakkarapani1, Anthony R. Isles2 and Karen Luyt1 1Department of Neonatal Neurology, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom 2Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom Preterm birth complications are the leading cause of child death worldwide and a top global health priority. Among the survivors, the risk of life-long disabilities is high, including cerebral palsy and impairment of movement, cognition, and behavior. U...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Assessing pain among individuals with communicative impairments and developmental disabilities is a clinical challenge. In this preliminary study, we addressed, in part, the issue of the association between chronic pain and spasticity in cerebral palsy (CP). Specifically, we evaluated the measurement performance of a proxy-reported spasticity rating scale (Multiple Sclerosis Spasticity Scale –MSSS) and the feasibility of a range of motion examination procedure (Pain Examination Procedure–PEP) using direct-observation to code behavioral reactivity during the exam (Pain and Discomfort Scale – PADS).
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
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